Fernandez, A; Osrin, D
This article describes the critical first steps taken to revitalize the vast public health system of Mumbai City through the active participation of personnel from within the system. It focuses on one of two components of an ambitious action-research project aimed at improving the survival and health of newborn infants and mothers living in slum communities in Mumbai.
Bhakoo, O N; Kumar, R
More than 50% of infant deaths in India occur during the neonatal period. High priority therefore needs to be given to improving the survival of newborns. A large number of neonatal deaths have their origin in the perinatal period and are mainly determined by the health and nutritional status of the mother, the quality of care during pregnancy and delivery, and the immediate care of the newborn at birth. Main causes of neonatal mortality are birth asphyxia, respiratory problems, and infections, especially tetanus. Most such deaths occur among low birthweight babies. Hypothermia, undernutrition, and mismanaged breast feeding may also indirectly contribute to neonatal mortality. Community-based studies have, however, demonstrated that most neonatal mortality can be affordably prevented through primary health care. Efforts are underway to expand the health care infrastructure, but the outreach of maternal and child health care remains unsatisfactory especially in rural areas. PMID:12319228
... Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health Stories Screening Newborns for Critical ... Quality Assurance Program Newborn Screening Translation Research Initiative Newborn ... Stay Connected Twitter Facebook ...
Andersen, Zorana J; Sram, Radim J; Ščasný, Milan;
BACKGROUND: The EU strategy for the Danube Region addresses numerous challenges including environment, health and socioeconomic disparities. Many old environmental burdens and heavily polluted areas in Europe are located in the Danube Region, consisting of 14 countries, with over 100 million people...... in collaboration with clinicians propose to establish a new large multi-center birth cohort of mother-child pairs from Danube countries, measure biomarkers of exposure and health in biological samples at birth, collect centrally measured climate, air and water pollution data, conduct pre- and postnatal surveys...... on lifestyle, indoor exposures, noise, occupation, socio-economic status, risk-averting behavior, and preferences; and undertake clinical examinations of children at and after birth. Birth cohort will include at least 2000 newborns per site, and a subset of at least 200 mother-child pairs per site...
de Carvalho, T Marini; dos Santos, H Pimentel; dos Santos, I C G P; Vargas, P R; Pedrosa, J
The newborn screening programme started in Brazil (1976) through isolated initiatives, without governmental directions and/or policies. According to Health Ministry (2000) data the coverage was 55% and unevenly distributed. Only 17 out of 27 Brazilian states had more than 30% coverage. Public budgets covered only diagnostic examinations. There were no official data about assistance, patient follow-up or detected disorders. The creation of the National Programme (2001) has provided new perspective for newborn screening (NBS) in the public health system. It has provided important official data and established management and care units for each state: Reference Services in Newborn Screening. The programme screened about 13 million newborns from October 2001 to December 2005. The coverage increased to 80.2% (2005) and 74% of the states presented coverage of over 70%. Within 34 accredited Reference Services in 27 Brazilian states, all provide screening for PKU and CH. Ten of them provide screening for haemoglobinopathies as well, and three of them provide also for CF. The Reference Services altogether count on at least 170 health professionals, such as paediatricians, endocrinologists, nutritionists, psychologists and social workers. They are qualified to assist positive cases, within the policies established by the National Programme. There has been significant increase in NBS coverage and follow-up assuredness, including detected cases before the National Programme (10,935 positive cases) mostly in those regions where the programme did not exist. There has been significant evolution in the Newborn Screening as a Public Health Program in Brazil due to the government's commitment (federal and each component state). PMID:17694357
Full Text Available Maternal smoking has been associated with elevated risk of type 2 diabetes among the offspring in adulthood. The mechanisms underlying this fetal "programming" effect remain unclear. The present study sought to explore whether maternal smoking affects metabolic health biomarkers in fetuses/newborns.In a prospective singleton pregnancy cohort (n = 248, we compared metabolic health biomarkers in the newborns of smoking and non-smoking mothers. Outcomes included cord plasma insulin, proinsulin, insulin-like growth factor I (IGF-I, IGF-II, leptin and adiponectin concentrations, glucose-to-insulin ratio (an indicator of insulin sensitivity and proinsulin-to-insulin ratio (an indicator of β-cell function.Independent of maternal (glucose tolerance, age, ethnicity, parity, education, body mass index, alcohol use and infant (sex, gestational age, birth weight z score, mode of delivery, cord blood glucose concentration characteristics, the newborns of smoking mothers had lower IGF-I concentrations (mean: 6.7 vs. 8.4 nmol/L, adjusted p = 0.006, and marginally higher proinsulin-to-insulin ratios (0.94 vs. 0.72, adjusted p = 0.06 than the newborns of non-smoking mothers. Cord plasma insulin, proinsulin, IGF-II, leptin and adiponectin concentrations and glucose-to-insulin ratios were similar in the newborns of smoking and non-smoking mothers.Maternal smoking was associated with decreased fetal IGF-I levels, and borderline lower fetal β-cell function. Larger cohort studies are required to confirm the latter finding. The preliminary findings prompt the hypothesis that these early life metabolic changes may be involved in the impact of maternal smoking on future risk of metabolic syndrome related disorders in the offspring.
Mancuso, Leslie; Johnson, Peter; Hart, Leah; Austin, Kate
Globally, each year 289,000 mothers die in childbirth and three million infants die in the first four weeks of life. The shortcomings in maternal and newborn health are particularly devastating in low-resource countries. This qualitative study describes the experience of an international nongovernmental organization, Jhpiego, which has been implementing public health programs to address maternal and newborn health outcomes for more than 40 years. Themes emerged from interviews with leaders of offices in a variety of countries with unique challenges related to health systems, human resources and infrastructure. Results emphasized the importance of partnerships with governments and international agencies for long-term program impact, as well as the recruitment of local talent for improving health systems to address problems that are best understood by the people who live and work in these countries. The discussion of program successes and challenges may inform best practices for promoting the health and wellness of women and families around the world. PMID:26860758
Daysal, N. Meltem; Trandafir, Mircea; van Ewijk, Reyn
We investigate the impact of early-life medical interventions on low-risk newborn health. A policy rule in The Netherlands creates large discontinuities in medical treatments at gestational week 37. Using a regression discontinuity design, we find no health benefits from additional treatments for average newborns. However, there is substantial heterogeneity in returns to treatments with significant health benefits for newborns in the lowest income quartile and no benefits in higher income qua...
Ebener, Steeve; Guerra-Arias, Maria; Campbell, James; Tatem, Andrew J; Moran, Allisyn C; Amoako Johnson, Fiifi; Fogstad, Helga; Stenberg, Karin; Neal, Sarah; Bailey, Patricia; Porter, Reid; Matthews, Zoe
As the deadline for the millennium development goals approaches, it has become clear that the goals linked to maternal and newborn health are the least likely to be achieved by 2015. It is therefore critical to ensure that all possible data, tools and methods are fully exploited to help address this gap. Among the methods that are under-used, mapping has always represented a powerful way to 'tell the story' of a health problem in an easily understood way. In addition to this, the advanced analytical methods and models now being embedded into Geographic Information Systems allow a more in-depth analysis of the causes behind adverse maternal and newborn health (MNH) outcomes. This paper examines the current state of the art in mapping the geography of MNH as a starting point to unleashing the potential of these under-used approaches. Using a rapid literature review and the description of the work currently in progress, this paper allows the identification of methods in use and describes a framework for methodological approaches to inform improved decision-making. The paper is aimed at health metrics and geography of health specialists, the MNH community, as well as policy-makers in developing countries and international donor agencies. PMID:26014352
... Story" 5 Things to Know About Zika & Pregnancy Sleep and Newborns KidsHealth > For Parents > Sleep and Newborns ... night it is. How Long Will My Newborn Sleep? A newborn may sleep up to 18 hours ...
Two percent of women in the United States suffer from intimate partner violence annually, with poor and minority women disproportionately affected. I provide evidence of an important negative externality associated with domestic violence by estimating a negative and causal relationship between violence during pregnancy and newborn health,…
Khatri, Resham Bahadur; Mishra, Shiva Raj; Khanal, Vishnu; Gelal, Khageshwor; Neupane, Subas
Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implemented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services. PMID:26904534
Full Text Available In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013–2025.
Atkinson, K.; Zuckerman, B.; Sharfstein, J. M.; Levin, D.; Blatt, R. J.; Koh, H. K.
The development of a new technology, called tandem mass spectrometry (tandem MS), has challenged governments worldwide to consider expanding universal newborn screening for rare metabolic disorders. In 1997 the Massachusetts Department of Public Health developed a public process to meet this challenge. After addressing significant medical, legal, ethical, and logistical issues raised by tandem MS, Massachusetts incorporated one new disorder into the mandatory newborn screen and developed an o...
Bancalari, Eduardo; Claure, Nelson
Background A significant proportion of premature infants present with respiratory failure early in life and require supplemental oxygen and some form of mechanical respiratory support. Findings Many technical advances in the devices for neonatal respiratory support have occurred in recent years and new management strategies have been developed and evaluated in this population. This article describes some of these novel methods and discusses their application and possible advantages and limita...
Dabiri, Tajudeen; Marroquin, Guillermo A; Bendek, Boleslaw; Agamasu, Enyonam; Mikhail, Magdy
Abdominal pregnancy is a very rare form of ectopic pregnancy, associated with high morbidity and mortality for both fetus and mother. It is, and often, seen in poor resource nations, where early diagnosis is often a major challenge due to poor prenatal care and lack of medical resources. An advanced abdominal pregnancy with a good fetal and maternal outcome is therefore a more extraordinary occurrence in the modern developed world. We present a case of an abdominal pregnancy at 33.4 weeks in an individual with no documented prenatal care, who arrived in a hospital in the Bronx, in June 25th 2014, with symptoms of generalized, severe lower abdominal pain. Upon examination it was found that due to category III fetal tracing an emergent cesarean section was performed. At the time of laparotomy the fetus was located in the pelvis covered by the uterine serosa, with distortion of the entire right adnexa and invasion to the right parametrium. The placenta invaded the pouch of Douglas and the lower part of the sigmoid colon. A massive hemorrhage followed, followed by a supracervical hysterectomy. A viable infant was delivered and mother discharged on postoperative day 4. PMID:25544940
Full Text Available Abstract Background Well-trained and highly motivated community health workers (CHWs are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh. Methods Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation, and informal discussion with key project personnel. Results Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay. Conclusions The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.
Smith, Stephanie L; Shiffman, Jeremy
This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years. PMID:27543685
Rylander, Charlotta; Odland, Jon Ø; Sandanger, Torkjel M.
Background: In 2007, the Intergovernmental Panel on Climate Change (IPCC) presented a report on global warming and the impact of human activities on global warming. Later the Lancet commission identified six ways human health could be affected. Among these were not environmental factors which are also believed to be important for human health. In this paper we therefore focus on environmental factors, climate change and the predicted effects on maternal and newborn health. Arctic issues are d...
Rylander, Charlotta; Odland, Jon Øyvind; Sandanger, Torkjel Manning
In 2007, the Intergovernmental Panel on Climate Change (IPCC) presented a report on global warming and the impact of human activities on global warming. Later the Lancet commission identified six ways human health could be affected. Among these were not environmental factors which are also believed to be important for human health. In this paper we therefore focus on environmental factors, climate change and the predicted effects on maternal and newborn health. Arctic issues are discussed ...
Namazzi, Gertrude; N, Kiwanuka Suzanne; Peter, Waiswa; John, Bua; Olico, Okui; A, Allen Katharine; A, Hyder Adnan; Elizabeth, Ekirapa Kiracho
Background Based on the realization that Uganda is not on track to achieving Millennium Development Goals 4 and 5, Makerere University School of Public Health in collaboration with other partners proposed to conduct two community based maternal/newborn care interventions aimed at increasing access to health facility care through transport vouchers and use of community health workers to promote ideal family care practices. Prior to the implementation, a stakeholder analysis was undertaken to a...
Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was
Kapranov, S V; Sapel'nikov, A Ia; Sapel'nikova, L Ia
The aim of the work was to evaluate the health of new-borns born to mothers who lived constantly influenced of the technogenic environmentat on health infant children in Luhansk region. We exameded evaluation of the influence of the technogenic environmental factors on the health of 1119 children in Alchevsk city, Perevalsk town with mining towns and rural villages of Perevalsky area of Lugansk region and Zhovtnev district of Lugansk region. The children were measured in anthropometric studies conducted body length, body weight, chest circumference and the head. Evaluation of the physical development of the children carried tsentilnym method. Prior to discharge from the hospital new-borns divided into three main groups--healthy, risk group, pathology. Also we have done the analysis of the statistical information on the health status of all newborns administrative units Lugansk region. Found that the percentage of new-borns with normal anthropometric variables (from 3 to 97 centile), body length and head circumference was significantly higher in rural areas Perevalsky area with more favorable environmental conditions compared to the industrial city of Alchevsk. New-borns with abnormal significantly higher in women who are domiciled in the city of Alchevsk (19.01% ± 1.44%) under the impact of emissions components ferrous metallurgy and coke-chemical, compared with Perevalskiy and mining towns (13.82% ± 2.20%), as well as rural villages Perevalsky area (11.90% ± 2.89%). Over the period 2004-2011, the incidence of congenital anomalies of new-borns weighing 1000 g or more (per 1000 live births and stillbirths) were significantly higher in the industrial cities of Luhansk region--19.70 ± 0.61 compared with rural areas--15.51 ± 0.73. The incidence of this pathology is one of the highest in Alchevsk--31.88 ± 2.48, which was significantly higher than.in urban areas, as well as in the whole of Luhansk region--19.13 ± 0.55. Therefore, the health of new-born babies is
Marchant, T; Hill, Z; Mangham-Jefferies, L; Schellenberg, JA
IDEAS aims to improve the health and survival of mothers and babies through generating evidence to inform policy and practice. IDEAS uses measurement, learning and evaluation to find out what works, why and how in maternal and newborn health. IDEAS is funded between 2010 and 2015 by a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene & Tropical Medicine. One research question is"Do enhanced interactions lead to increased coverage of interventions?"
Hill, Z; Van Allen, E; Avan, BI; Berhanu, D; Gautham, M; Mangham-Jefferies, L; Makowiecka, K; Marchant, T; Rechel, B.; Schellenberg, JA; Spicer, N.; Kumar, N
The IDEAS project aims to improve the health and survival of mothers and babies through generating evidence to inform policy and practice. IDEAS uses measurement, learning and evaluation to find out what works, why and how in maternal and newborn health. IDEAS is funded between 2010 and 2015 by a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene & Tropical Medicine. This poster outlines the reseach objectives and how research questions will be addressed.
Smith, Stephanie L; Neupane, Shailes
What shapes the level of political priority for alleviation of significant health problems in low-income countries? We investigate this question in the context of the significantly increasing political priority for newborn survival in Nepal since 2000. We use a process-tracing methodology to investigate causes of this shift, drawing on twenty-nine interviews with individuals close to newborn health policymaking in Nepal and extensive document analysis. Shifts in the political context (commitments to the child health MDG), the strength of concerned actors (emergence of collective action, leadership, resources) and the power of ideas (problem status, existence of contextually relevant solutions, agreement on these points) surrounding the issue have been instrumental in elevating priority for newborn survival, if not institutionalizing that priority to ensure long-term support. The findings highlight the significance of political fragmentation in war-torn areas for impeding priority generation. Additionally, theories of social construction provide important insights to the roles of ideas in shaping health initiative success. PMID:21195521
Grisso, Benjamin Luke
The focus of this dissertation is aimed at advancing autonomous structural health monitoring. All the research is based on developing the impedance method for monitoring structural health. The impedance technique utilizes piezoelectric patches to interrogate structures of interested with high frequency excitations. These patches are bonded directly to the structure, so information about the health of the structure can be seen in the electrical impedance of the piezoelectric patch. However, tr...
Full Text Available Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST, aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with
Full Text Available Background: Community health workers (CHWs have been employed in a number of low- and middle-income countries as part of primary health care strategies, but the packages vary across and even within countries. The experiences and motivations of a multipurpose CHW in providing maternal and newborn health have not been well described. Objective: This study examined the perceptions of community members and experiences of CHWs around promoting maternal and newborn care practices, and the self-identified factors that influence the performance of CHWs so as to inform future study design and programme implementation. Design: Data were collected using in-depth interviews with six local council leaders, ten health workers/CHW supervisors, and eight mothers. We conducted four focus group discussions with CHWs. Respondents included 14 urban and 18 rural CHWs. Key themes explored included the experience of CHWs according to their various roles, and the facilitators and barriers they encounter in their work particular to provision of maternal and newborn care. Qualitative data were analysed using manifest content analysis methods. Results: CHWs were highly appreciated in the community and seen as important contributors to maternal and newborn health at grassroots level. Factors that positively influence CHWs included being selected by and trained in the community; being trained in problem-solving skills; being deployed immediately after training with participation of local leaders; frequent supervision; and having a strengthened and responsive supply of services to which families can be referred. CHWs made use of social networks to identify pregnant and newly delivered women, and were able to target men and the wider family during health education activities. Intrinsic motivators (e.g. community appreciation and the prestige of being ‘a doctor’, monetary (such as a small transport allowance, and material incentives (e.g. bicycles, bags were also important
Bari Sanwarul; Al-Mahmud Arif; Shah Rasheduzzaman; Mannan Ishtiaq; Seraji M Habibur R; Jennings Larissa; Ali Nabeel; Rahman Syed; Hossain Daniel; Das Milan; Baqui Abdullah H; El Arifeen Shams; Winch Peter J
Abstract Background Well-trained and highly motivated community health workers (CHWs) are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh. Methods Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as t...
Olusanya Bolajoko O
importance of these priority conditions extends beyond mortality thus suggesting the need for a broader conceptualisation of newborn health to reflect the current realities, paediatricians should be actively engaged in advancing the attainment of global priorities for child survival and health in this population.
Ameh, Charles A; van den Broek, Nynke
An estimated 289,000 maternal deaths, 2.6 million stillbirths and 2.4 million newborn deaths occur globally each year, with the majority occurring around the time of childbirth. The medical and surgical interventions to prevent this loss of life are known, and most maternal and newborn deaths are in principle preventable. There is a need to build the capacity of health-care providers to recognize and manage complications during pregnancy, childbirth and the post-partum period. Skills-and-drills competency-based training in skilled birth attendance, emergency obstetric care and early newborn care (EmONC) is an approach that is successful in improving knowledge and skills. There is emerging evidence of this resulting in improved availability and quality of care. To evaluate the effectiveness of EmONC training, operational research using an adapted Kirkpatrick framework and a theory of change approach is needed. The Making It Happen programme is an example of this. PMID:25911056
Adams, Alayne; Sedalia, Saroj; McNab, Shanon; Sarker, Malabika
Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the three MNH programmes under consideration employed different implementation models to deliver similar services and meet similar MNH goals. Programme targets included adoption of recommended antenatal, post-natal and essential newborn care practices; health systems strengthening through improved referral, accountability and administrative systems, and increased community knowledge. Drawing on focused examples from this research, seven steps for operationalizing the realist evaluation approach are offered, while emphasizing the need to iterate and innovate in terms of methods and analysis strategies. The paper concludes by reflecting on lessons learned in applying realist evaluation, and the unique insights it yields regarding implementation strategies for successful MNH programming. PMID:26104820
Torkjel M. Sandanger
Full Text Available In 2007, the Intergovernmental Panel on Climate Change (IPCC presented a report on global warming and the impact of human activities on global warming. Later the Lancet commission identified six ways human health could be affected. Among these were not environmental factors which are also believed to be important for human health. In this paper we therefore focus on environmental factors, climate change and the predicted effects on maternal and newborn health. Arctic issues are discussed specifically considering their exposure and sensitivity to long range transported contaminants.Considering that the different parts of pregnancy are particularly sensitive time periods for the effects of environmental exposure, this review focuses on the impacts on maternal and newborn health. Environmental stressors known to affects human health and how these will change with the predicted climate change are addressed. Air pollution and food security are crucial issues for the pregnant population in a changing climate, especially indoor climate and food security in Arctic areas.The total number of environmental factors is today responsible for a large number of the global deaths, especially in young children. Climate change will most likely lead to an increase in this number. Exposure to the different environmental stressors especially air pollution will in most parts of the world increase with climate change, even though some areas might face lower exposure. Populations at risk today are believed to be most heavily affected. As for the persistent organic pollutants a warming climate leads to a remobilisation and a possible increase in food chain exposure in the Arctic and thus increased risk for Arctic populations. This is especially the case for mercury. The perspective for the next generations will be closely connected to the expected temperature changes; changes in housing conditions; changes in exposure patterns; predicted increased exposure to Mercury
Savas Basar Kartal; Aziz Gurhan Birler; Demet Ozkul; Selma Unluer; Selime Gurleyuk; Aysun Yamak; Yeliz Ozturk; Asya Banu Topuzoglu
Full Text Available AIM: Keeping health records regularly is important for determining the health status of the population and planning health services. It is observed that the existing health record systems in Istanbul are insufficient in determining the number of pregnant women, puerperants, newborns and preschool children. METHODS: Therefore, an intervention study was planned by Istanbul Directorate of Health in order to provide systematic monitoring of pregnant women, puerperants, newborns and preschool children, and ensure that equity in the distribution of qualified prenatal and postnatal health care is maintained. This project called GEBLIZ has been started to be used since September 2008. RESULTS: According to this project all public and private health centers in which pregnant and child care are given have the responsibility to transfer necessary information about the patients to an electronic database. Through this computerized system, a connection between primary, secondary and tertiary health care settings has been maintained, and deficiencies of paper records have been completed. Health records have become more consistent. CONLUSION: Compared to one year before the start of the intervention, there have been important increases in the number of pregnant women, puerperants, newborns and infants detected by primary health care units. Besides, “home visits” which have been neglected were started actively by primary health care personnel, and preventive health service who stayed in the shadow of therapeutic health services came to life again. [TAF Prev Med Bull 2010; 9(4.000: 289-296
... advance science and clinical care for newborns, children and their families through the use of residual..., health care providers and families to work together to protect this valuable resource for the public good... residual specimens use to advance science and clinical care for newborns, children and their families....
Holland, Amanda; Watkins, Dianne
Investment in early intervention by health visitors to support positive parent-infant relationships is a Welsh Government target. An initiative called 'Flying Start' (FS) employs health visitors to undertake intensive home visiting with families who have a new baby to promote positive family interactions. As part of this role FS health visitors utilise the Newborn Behavioural Observation (NBO) system to observe, assess, support and enhance relationships between parent(s) and child. A project was undertaken to evaluate implementation and make recommendations for future service improvement. This paper describes stage one of the project which set out to evaluate FS health visitors' views of NBO implementation by means of a questionnaire and identifies barriers and facilitating factors to its use. Stage 2 of the project was to identify how NBO use could be improved in health visiting practice, discussed in a further paper. Results revealed a majority of practitioners felt NBO implementation benefited parents and enhanced the parent-infant relationship. It was viewed as an important part of the FS health visitors' role. Barriers included lack of time coupled with chaotic home environments. Variations in practice were identified, contrary to local guidelines. Recommendations are made to enhance NBO implementation that include the development of an NBO champion to support practitioners and provide further training. PMID:26373004
Mangwi Ayiasi, Richard; Kolsteren, Patrick; Batwala, Vincent; Criel, Bart; Orach, Christopher Garimoi
Introduction The World Health Organisation recommends home visits conducted by Community Health Workers (in Uganda known as Village Health Teams—VHTs) in order to improve maternal and newborn health. This study measured the effect of home visits combined with mobile phone consultations on maternal and newborn care practices. Method In a community intervention trial design 16 health centres in Masindi and Kiryandongo districts, Uganda were randomly and equally allocated to one of two arms: con...
Full Text Available Background: Addressing inequitable coverage of maternal and child health care services among different socioeconomic strata of population and across states is an important part of India's contemporary health program. This has wide implications for the achievement of the Millennium Development Goal targets. Objective: This paper assesses the inequity in coverage of maternal, newborn, and child health (MNCH care services across household wealth quintiles in India and its states. Design: Utilizing the District Level Household and Facility Survey conducted during 2007–08, this paper has constructed a Composite Coverage Index (CCI in MNCH care. Results: The mean overall coverage of 45% was estimated at the national level, ranging from 31% for the poorest to 60% for the wealthiest quintile. Moreover, a massive state-wise difference across wealth quintiles was observed in the mean overall CCI. Almost half of the Indian states and union territories recorded a =50% coverage in MNCH care services, which demands special attention. Conclusion: India needs focused efforts to address the inequity in coverage of health care services by recognising or defining underserved people and pursuing well-planned time-oriented health programs committed to ameliorate the present state of MNCH care.
Elazan, Sara J; Higgins-Steele, Ariel E; Jean Christophe Fotso; Rosenthal, Mila H; Dharitri Rout
Background: Male community health workers (CHWs) have rarely been studied as an addition to the female community health workforce to improve access and care for reproductive, maternal, newborn, and child health (RMNCH). Objective: To examine how male health activists (MHAs) coordinated RMNCH responsibilities with existing female health workers in an Indian context. Materials and Methods: Interviews from male and female CHWs were coded around community-based engagement, outreach services, and ...
Minear, Susan; Pedulla, Mary Jo; Philipp, Barbara L.
Multidisciplinary support for families of newborns is critical for their health and safety. This article describes three programs at one urban hospital which were implemented to (a) improve breastfeeding support, (b) enhance practitioners' observation and communication skills, and (c) provide a comprehensive social response to the urgent…
Bazzano, Alessandra N; Oberhelman, Richard A; Potts, Kaitlin Storck; Gordon, Anastasia; Var, Chivorn
Infection contributes to a significant proportion of neonatal death and disability worldwide, with the major burden occurring in the first week of life. Environmental conditions and gaps in water, sanitation and hygiene (WASH) practices may contribute to the risk of infection, particularly in settings where health centers are expanding to meet the growing demand for skilled care at birth and homes do not have adequate access to water and sanitation. A qualitative approach was used to understand the environmental context for infection prevention and control (IPC) and WASH associated behaviors in health centers where women give birth, and in homes of newborns, in a rural Cambodian province. Structured observations and focus group discussions revealed important gaps in optimal practices, and both structural and social barriers to maintaining IPC during delivery and post-partum. Solutions are available to address the issues identified, and tackling these could result in marked environmental improvement for quality of care and neonatal outcomes. Water, sanitation and hygiene in home and health center environments are likely to be important contributors to health and should be addressed in strategies to improve neonatal survival. PMID:25711360
Alessandra N. Bazzano
Full Text Available Infection contributes to a significant proportion of neonatal death and disability worldwide, with the major burden occurring in the first week of life. Environmental conditions and gaps in water, sanitation and hygiene (WASH practices may contribute to the risk of infection, particularly in settings where health centers are expanding to meet the growing demand for skilled care at birth and homes do not have adequate access to water and sanitation. A qualitative approach was used to understand the environmental context for infection prevention and control (IPC and WASH associated behaviors in health centers where women give birth, and in homes of newborns, in a rural Cambodian province. Structured observations and focus group discussions revealed important gaps in optimal practices, and both structural and social barriers to maintaining IPC during delivery and post-partum. Solutions are available to address the issues identified, and tackling these could result in marked environmental improvement for quality of care and neonatal outcomes. Water, sanitation and hygiene in home and health center environments are likely to be important contributors to health and should be addressed in strategies to improve neonatal survival.
Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Bhutta, Zulfiqar A
District level healthcare serves as a nexus between community and district level facilities. Inputs at the district level can be broadly divided into governance and accountability mechanisms; leadership and supervision; financial platforms; and information systems. This paper aims to evaluate the effectivness of district level inputs for imporving maternal and newborn health. We considered all available systematic reviews published before May 2013 on the pre-defined district level interventions and included 47 systematic reviews. Evidence suggests that supervision positively influenced provider's practice, knowledge and client/provider satisfaction. Involving local opinion leaders to promote evidence-based practice improved compliance to the desired practice. Audit and feedback mechanisms and tele-medicine were found to be associated with improved immunization rates and mammogram uptake. User-directed financial schemes including maternal vouchers, user fee exemption and community based health insurance showed significant impact on maternal health service utilization with voucher schemes showing the most significant positive impact across all range of outcomes including antenatal care, skilled birth attendant, institutional delivery, complicated delivery and postnatal care. We found insufficient evidence to support or refute the use of electronic health record systems and telemedicine technology to improve maternal and newborn health specific outcomes. There is dearth of evidence on the effectiveness of district level inputs to improve maternal newborn health outcomes. Future studies should evaluate the impact of supervision and monitoring; electronic health record and tele-communication interventions in low-middle-income countries. PMID:25208460
Bell, Jacqueline S; Marais, Debbi
In the context of slow progress towards Millennium Development Goals for child and maternal health, an innovative participatory training programme in the monitoring and evaluation (M&E) of Maternal and Newborn Health programmes was developed and delivered in six developing countries. The training, for health professionals and programme managers, aimed: (i) to strengthen participants' skills in M&E to enable more effective targeting of resources, and (ii) to build the capacity of partner institutions hosting the training to run similar courses. This review aims to assess the extent to which these goals were met and elicit views on ways to improve the training. An online survey of training participants and structured interviews with stakeholders were undertaken. Data from course reports were also incorporated. There was clearly a benefit to participants in terms of improved knowledge and skills. There is also some evidence that this translated into action through M&E implementation and tool development. Evidence of capacity-building at an institutional level was limited. Lessons for professional development training can be drawn from several aspects of the training programme that were found to facilitate learning, engagement and application. These include structuring courses around participant material, focussing on the development of practical action plans and involving multi-disciplinary teams. The need for strengthening follow-up and embedding it throughout the training was highlighted to overcome the challenges to applying learning in the 'real world'. PMID:25716377
Owili, Patrick Opiyo; Muga, Miriam Adoyo; Chou, Yiing-Jenq; Hsu, Yi-Hsin Elsa; Huang, Nicole; Chien, Li-Yin
Background Despite the progress in the Millennium Development Goals (MDGs) 4 and 5, inequity in the utilization of maternal, newborn and child health (MNCH) care services still remain high in sub-Saharan Africa (SSA). The continuum of care for MNCH that recognizes a tight inter-relationship between maternal, newborn and child health at different time periods and location is key towards reducing inequity in health. In this study, we explored the distributions in the utilization MNCH services i...
Ali Mehryar Karim
Full Text Available BACKGROUND: Improving newborn survival is essential if Ethiopia is to achieve Millennium Development Goal 4. The national Health Extension Program (HEP includes community-based newborn survival interventions. We report the effect of these interventions on changes in maternal and newborn health care practices between 2008 and 2010 in 101 districts, comprising 11.6 million people, or 16% of Ethiopia's population. METHODS AND FINDINGS: Using data from cross-sectional surveys in December 2008 and December 2010 from a representative sample of 117 communities (kebeles, we estimated the prevalence of maternal and newborn care practices, and a program intensity score in each community. Women with children aged 0 to 11 months reported care practices for their most recent pregnancy and childbirth. The program intensity score ranged between zero and ten and was derived from four outreach activities of the HEP front-line health workers. Dose-response relationships between changes in program intensity and the changes in maternal and newborn health were investigated using regression methods, controlling for secular trend, respondents' background characteristics, and community-level factors. Between 2008 and 2010, median program intensity score increased 2.4-fold. For every unit increase in the score, the odds of receiving antenatal care increased by 1.13 times (95% CI 1.03-1.23; the odds of birth preparedness increased by 1.31 times (1.19-1.44; the odds of receiving postnatal care increased by 1.60 times (1.34-1.91; and the odds of initiating breastfeeding immediately after birth increased by 1.10 times (1.02-1.20. Program intensity score was not associated with skilled deliveries, nor with some of the other newborn health care indicators. CONCLUSIONS: The results of our analysis suggest that Ethiopia's HEP platform has improved maternal and newborn health care practices at scale. However, implementation research will be required to address the maternal and
Lee, Siew Hwa; Nurmatov, Ulugbek B; Nwaru, Bright I; Mukherjee, Mome; Grant, Liz; Pagliari, Claudia
OBJECTIVE: To assess the effectiveness of mHealth interventions for maternal, newborn and child health (MNCH) in low- and middle-income countries (LMIC).METHODS: 16 online international databases were searched to identify studies evaluating the impact of mHealth interventions on MNCH outcomes in LMIC, between January 1990 and May 2014. Comparable studies were included in a random-effects meta-analysis.FINDINGS: Of 8593 unique references screened after de-duplication, 15 research articles and ...
Salam, Rehana A; Lassi, Zohra S; Das, Jai K.; Bhutta, Zulfiqar A
District level healthcare serves as a nexus between community and district level facilities. Inputs at the district level can be broadly divided into governance and accountability mechanisms; leadership and supervision; financial platforms; and information systems. This paper aims to evaluate the effectivness of district level inputs for imporving maternal and newborn health. We considered all available systematic reviews published before May 2013 on the pre-defined district level interventio...
Magnus Per; Kise Marit S; Tambs Kristian; Aas Kaja K; Rønningen Kjersti S
Abstract Background Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA) study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about their children. Methods The study was based on questi...
Dele Abegunde; Nosa Orobaton; Kamil Shoretire; Mohammed Ibrahim; Zainab Mohammed; Jumare Abdulazeez; Ringpon Gwamzhi; Akeem Ganiyu
Background: Maternal mortality ratio and infant mortality rate are as high as 1,576 per 100,000 live births and 78 per 1,000 live births, respectively, in Nigeria's northwestern region, where Sokoto State is located. Using applicable monitoring indicators for tracking progress in the UN/WHO framework on continuum of maternal, newborn, and child health care, this study evaluated the progress of Sokoto toward achieving the Millennium Development Goals (MDGs) 4 and 5 by December 2015. The change...
Tannous Elias, Luciana Sabatini Doto; dos Santos, Amélia Miyashiro Nunes; Guinsburg, Ruth
Background An understanding of perceptions of parents and health caregivers who assist critically ill neonates is necessary to comprehend their actions and demands. Therefore this study aim to analyze the agreement among parents, nurse technicians and pediatricians regarding the presence and intensity of pain and distress in mechanically ventilated and intubated newborn infants. Methods Cross-sectional study comprising 52 infants and 52 trios of adults composed of one parent, one nurse techni...
Full Text Available Abstract Background Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about their children. Methods The study was based on questionnaire data from the Norwegian Mother and Child Cohort (MoBa study conducted by the Norwegian Institute of Public Health. Many of the mothers in the MoBa study also took part in the MIDIA study, in which their newborn children were tested for HLA-conferred genetic susceptibility for type 1 diabetes. We used MoBa questionnaire data from the 30th week of pregnancy (baseline and 6 months post-partum (3-3.5 months after disclosure of test results. We measured maternal symptoms of anxiety and depression (SCL-8, maternal self-esteem (RSES, and satisfaction with life (SWLS. The mothers also reported whether they were seriously worried about their child 6 months post-partum. We compared questionnaire data from mothers who had received information about having a newborn with high genetic risk for type 1 diabetes (N = 166 with data from mothers who were informed that their baby did not have a high-risk genotype (N = 7224. The association between genetic risk information and maternal mental health was analysed using multiple linear regression analysis, controlling for baseline mental health scores. Results Information on genetic risk in newborns was found to have no significant impact on maternal symptoms of anxiety and depression (p = 0.9, self-esteem (p = 0.2, satisfaction with life (p = 0.2, or serious worry about their child (OR = 0.98, 95% CI 0.64-1.48. Mental health before birth was strongly associated with mental health after birth. In addition, an increased
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Juliana Santos de Oliveira
Full Text Available OBJECTIVE: To determine the prevalence of hearing loss and to analyze the results of newborn hearing screening and audiological diagnosis in private health care systems. METHODS Cross-sectional and retrospective study in a database of newborn hearing screening performed by a private clinic in neonates born in private hospitals of Porto Velho, Rondônia, Northern Brazil. The screening results, the risk for hearing loss, the risk indicators for hearing loss and the diagnosis were descriptively analyzed. Newborns cared in rooming in with their mothers were compared to those admitted to the Intensive Care Unit regarding risk factors for hearing loss. RESULTS: Among 1,146 (100% enrolled newborns, 1,064 (92.8% passed and 82 (7.2% failed the hearing screening. Among all screened neonates, 1,063 (92.8% were cared in rooming and 83 (7.2% needed intensive care; 986 (86.0% were considered at low risk and 160 (14.0% at high risk for hearing problems. Of the 160 patients identified as having high risk for hearing loss, 83 (37.7% were admitted to an hospitalized in the Intensive Care Unit, 76 (34.5% used ototoxic drugs and 38 (17.2% had a family history of hearing loss in childhood. Hearing loss was diagnosed in two patients (0.2% of the screened sample. CONCLUSIONS: The prevalence of hearing loss in newborns from private hospitals was two cases per 1,000 evaluated patients. The use of ototoxic drugs, admission to Intensive Care Unit and family history of hearing loss were the most common risk factors for hearing loss in the studied population.
An adverse influence of various radiation doses upon human organs and systems is well known. One of the scientific spheres of Mother and child research institute at the end of 80th and beginning of the 90th was the study of population effect of low dose radiation on certain persons both in the frame of works dedicated to medical aftereffects of Chernobyl accident, and in the process of constant monitoring of pregnant women and newborns health condition. Permanent evaluation of indices, characterizing morbidity of pregnant women and newborn infants is being held in Brest-, Mogilov-, Gomel areas in dependence of the level of radionuclide contamination of the residence territory . As a result it was found that: The fact of radionuclide contamination of residence territory did not effect on the reproductive behavior of the population. Over the post-Chernobyl period almost a half of million of new inhabitants was born, whose health status may depend on residence on the contaminated territory both the mother during her pregnancy, and the child itself after its birth. Both in the clean, and in the contaminated regions an increase in morbidity rate of pregnant women in the major groups of diseases was revealed over the whole period of the study. The rate of anemias, urogenital system diseases, late gestosis was higher on the radionuclide contaminated territories. On the base of the study of peculiarities of conformation state of hemoglobin the method of prophylaxis and treatment of anemias of pregnant women by antioxidant complex was developed and put in practice in the suffered regions. As a result, the rate of increase in the number of pregnant women with anemias became considerably slower on the contaminated territories (by factor 1.5). This stage of investigations permitted to state the following: In the first, under the common evidence of disorders in the health status of mothers and infants, residing in ecologically dangerous zones it was not found the confident
Gupta, Mira L; Aborigo, Raymond Akawire; Adongo, Philip Baba; Rominski, Sarah; Hodgson, Abraham; Engmann, Cyril M; Moyer, Cheryl A
Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members. PMID:25635475
Full Text Available Establishment of special care new-born units (SCNU in hospitals not only serves to provide the intensive care to sick neonates, but presents with opportunities to enhance knowledge and modify attitude and practices of their parents through behavior change communication (BCC. A cross-sectional study was conducted in Dibrugarh District, Assam from January to June, 2011 to assess differences in health-care seeking behavior of these mothers from mothers of newborns who were born at home and mothers who had normal uneventful institutional deliveries. Mothers of 29 SCNU discharged, 34 institutions delivered and 26 home delivered children were interviewed using a semi-structured interview schedule and a knowledge, attitude and practice (KAP survey tool. Mothers of children admitted to SCNU scored better in questions related to vaccination, contraception, protection of child from infections and cold and perceptions about traditional healers, but overall KAP scores in the three groups were not found significantly different.
Full Text Available OBJECTIVES: To explore the "how" and "why" of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes. METHODS: A cross sectional and descriptive mixed method study involving a desk review of maternal and newborn care protocols and guidelines availability, focus group discussions and administration of a structured questionnaire and observational checklist to frontline providers of maternal and newborn care. RESULTS: Tacit knowledge or 'mind lines' was an important primary approach to care decision making. When available, protocols and guidelines were used as decision making aids, especially when they were simple handy tools and in situations where providers were not sure what their next step in management had to be. Expert opinion and peer consultation were also used through face to face discussions, phone calls, text messages, and occasional emails depending on the urgency and communication medium access. Health system constraints such as availability of staff, essential medicines, supplies and equipment; management issues (including leadership and interpersonal relations among staff, and barriers to referral were important influences in decision making. Frontline health providers welcomed the idea of interventions to support clinical decision making and made several proposals towards the development of such an intervention. They felt such an intervention ought to be multi-faceted to impact the multiple influences simultaneously. Effective interventions would also need to address immediate challenges as well as more long-term challenges influencing decision-making. CONCLUSION: Supporting frontline worker clinical decision making for maternal and newborn services is an important but neglected aspect of improved quality of care towards attainment of MDG 4 & 5. A multi
Full Text Available Introduction Infants having a birth weight of 2500g or less are known as low birth weight infants. There are multiple factors which affect the nutritional status of newborn children: genetic potential, maternal age, parity, maternal health and maternal nutrition, drugs, alcohol, smoking, geographical situation and socioeconomic living conditions. Material and methods Developmental parameters were analyzed in 15.455 live newborn infants in Subotica, from 1991 to 2002. The following parameters were registered: body mass in the first hour of life, body length, head and thorax circumference. These parameters were examined and correlated with other indicators of maturity and vitality, such as gestational age and Apgar score values. Results and discussion Parameter mean values are presented for each year from 1991 to 2002. Mean body mass values ranged from 3335.74 g in 1991 to 3418.01 gin 1998. Compared with the estimates provided by World Health Organization, the percentage of newborn infants with birht weight under 2500 g has increased (5.64% in 1991, which was the first year of war and sanctions in our country. From 1994 to 1997, there was a war in neighbouring republics and a huge number of refugees from war regions arrived. The percentage of newborn infants with low birth weight has increased (the gratest percentage 5.08% has been found in 1996. During 1999, our country was bombed and since then, we have an increased number of newborn infants with low birht weight (4.46% were registered in 1999 to 5.22% in 2002. The number of children born before 37th week of gestation is greatest in 2000 (3.17%. Average Apgar score in 1992 was (9.20, showing graduate decrease since 1999, with lowest value during 2001 (8.85. Conclusion Harmful environmental factors can strongly affect fetal growth. Continual follow-up of developmental parameters and vitality of infants on population level is an index of interactions between genetic potential and environmental
Ghaffar, Abdul; Qazi, Shamim; Shah, Iqbal
Factors contributing to Pakistan's poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan's GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence base, in some cases leading to the formulation of WHO guidelines, for which they should feel proud. Nevertheless, in order to improve the health of its own women and children, greater investments in human and health resources are required to facilitate the generation and use of policy-relevant knowledge. To accomplish this, fair incentives for research production need to be introduced, policy and decision-makers' capacity to demand and use evidence needs to be increased, and strong support from development partners and the global health community must be secured. PMID:26791944
Kirton, John; Kulik, Julia; Bracht, Caroline
Why do informal, plurilateral summit institutions such as the Group of Eight (G8) major market democracies succeed in advancing costly public health priorities such as maternal, newborn, and child health (MNCH), even when the formal, multilateral United Nations (UN) system fails to meet such goals, when G8 governments afflicted by recession, deficit, and debt seek to cut expenditures, and when the private sector is largely uninvolved, despite the growing popularity of public-private partnerships to meet global health and related nutrition, food, and agriculture needs? Guided by the concert-equality model of G8 governance, this case study of the G8's 2010 Muskoka Initiative on MNCH traces the process through which that initiative was planned within Canada, internationally prepared through negotiations with Canada's G8 partners, produced at Muskoka by the leaders in June, multiplied in its results by the UN summit in September, and reinforced by the new accountability mechanism put in place. It finds that the Muskoka summit succeeded in mobilizing major money and momentum for MNCH. This was due to the initiative and influence of children-focused nongovernmental organizations (NGOs), working with committed individuals and agencies within the host Canadian government, as well as supportive public opinion and the help of those in the UN responsible for realizing its Millennium Development Goals. Also relevant were the democratic like-mindedness of G8 leaders and their African partners, the deference of G8 members to the host's priority, and the need of the G8 to demonstrate its relevance through a division of labor between it and the new Group of Twenty summit. This study shows that G8 summits can succeed in advancing key global health issues without a global shock on the same subject to galvanize agreement and action. It suggests that, when committed, focused NGOs and government officials will lead and the private sector will follow, but that there will be a lag in the
Hirose, Atsumi; Hall, Sarah; Memon, Zahid; Hussein, Julia
Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. Advocacy and research groups (i.e. those who would like to see research evidence used by policymakers) may use different approaches and tools to stimulate the diffusion of research findings. The use of mass- and social media, communication with study participants, and the involvement of stakeholders at the early stages of research development are examples of the approaches that can be employed to stimulate diffusion of evidence and increase evidence uptake. The Research and Advocacy Fund (RAF) for Maternal and Newborn Health (MNH) worked within the health system context in Pakistan with the aim of espousing the principles of evidence, advocacy, and dissemination to improve MNH outcomes. The articles included in this special issue are outputs of RAF and highlight where RAF's approaches contributed to MNH policy reforms. The papers discuss critical health system issues facing Pakistan, including service delivery components, demand creation, equitable access, transportation interventions for improved referrals, availability of medicines and equipment, and health workforce needs. In addition to these tangible elements, the health system 'software', i.e. the power and the political and social contexts, is also represented in the collection. These articles highlight three considerations for the future: the growing
Department of Education, Washington, DC.
This booklet offers guidance to parents in caring for their newborn babies. Advice is given on the following topics: (1) newborn health screening; (2) what a healthy newborn looks like; (3) newborn reflexes; (4) baby checkups; (5) fathers' role; (6) the baby blues; (7) sleeping position; (8) breast milk; (9) breast feeding; (10) bottle feeding;…
Leonardo Arregoces, MSc; Felicity Daly, DrPH; Catherine Pitt, MSc; Justine Hsu, MSc; Melisa Martinez-Alvarez, PhD; Giulia Greco, PhD; Prof. Anne Mills, PhD; Prof. Peter Berman, PhD; Dr. Josephine Borghi, PhD
Background: Tracking of aid resources to reproductive, maternal, newborn, and child health (RMNCH) provides timely and crucial information to hold donors accountable. For the first time, we examine flows in official development assistance (ODA) and grants from the Bill & Melinda Gates Foundation (collectively termed ODA+) in relation to the continuum of care for RMNCH and assess progress since 2003. Methods: We coded and analysed financial disbursements for maternal, newborn, and child hea...
Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan
BACKGROUND Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of he...
Gadd, Cynthia S; Williamson, Jeffrey J; Steen, Elaine B; Andriole, Katherine P; Delaney, Connie; Gumpper, Karl; LaVenture, Martin; Rosendale, Doug; Sittig, Dean F; Thyvalikakath, Thankam; Turner, Peggy; Fridsma, Douglas B
AMIA is leading the effort to strengthen the health informatics profession by creating an advanced health informatics certification (AHIC) for individuals whose informatics work directly impacts the practice of health care, public health, or personal health. The AMIA Board of Directors has endorsed a set of proposed AHIC eligibility requirements that will be presented to the future AHIC certifying entity for adoption. These requirements specifically establish who will be eligible to sit for the AHIC examination and more generally signal the depth and breadth of knowledge and experience expected from certified individuals. They also inform the development of the accreditation process and provide guidance to graduate health informatics programs as well as individuals interested in pursuing AHIC. AHIC eligibility will be determined by practice focus, education in primary field and health informatics, and significant health informatics experience. PMID:27358328
Gauld, Robin; Ikegami, Naoki; Barr, Michael D; Chiang, Tung-Liang; Gould, Derek; Kwon, Soonman
There is growing interest in comparing patterns of social and health service development in advanced Asian economies. Most publications concentrate broadly on a range of core social services such as education, housing, social security and health care. In terms of those solely focused on health, most discuss arrangements in specific countries and territories. Some take a comparative approach, but are focused on presentation and discussion of expenditure, resourcing and service utilization data. This article extends the comparative analysis of advanced Asian health systems, considering the cases of Japan, South Korea, Taiwan, Hong Kong and Singapore. The article provides basic background information, and delves into common concerns among the world's health systems today including primary care organization, rationing and cost containment, service quality, and system integration. Conclusions include that problems exist in 'classifying' the five diverse systems; that the systems face common pressures; and that there are considerable opportunities to enhance primary care, service quality and system integration. PMID:16517000
Michaud, Josh; Kates, Jennifer
Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals.
Yoshida, Sachiyo; Martines, José; Lawn, Joy E;
BACKGROUND: In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadlin...
Speck, W.T.; Rosenkranz, H.S.
Phototherapy has been shown to be an effective therapy for severe neonatal jaundice. The present report summarizes results which indicate that phototherapy is endowed with DNA-modifying properties and has therefore the potential for inducing genetic and carcinogenic effects. These disconcerting findings concerning the long-term hazardous consequences of an accepted therapeutic procedure require that the unique physiologic and pharmacologic characteristics of the newborn populations be recognized when assessing the risks and benefits of phototherapy.
Phototherapy has been shown to be an effective therapy for severe neonatal jaundice. The present report summarizes results which indicate that phototherapy is endowed with DNA-modifying properties and has therefore the potential for inducing genetic and carcinogenic effects. These disconcerting findings concerning the long-term hazardous consequences of an accepted therapeutic procedure require that the unique physiologic and pharmacologic characteristics of the newborn populations be recognized when assessing the risks and benefits of phototherapy
Cox, Shanna; Whiteman, Maura; Jamieson, Denise J.; Macaluso, Maurizio; Bansil, Pooja; Kuklina, Elena; Kourtis, Athena P.; Posner, Samuel; Barfield, Wanda D.
Objectives. We explored how changes in insurance coverage contributed to recent nationwide decreases in newborn circumcision. Methods. Hospital discharge data from the 2000–2010 Nationwide Inpatient Sample were analyzed to assess trends in circumcision incidence among male newborn birth hospitalizations covered by private insurance or Medicaid. We examined the impact of insurance coverage on circumcision incidence. Results. Overall, circumcision incidence decreased significantly from 61.3% in 2000 to 56.9% in 2010 in unadjusted analyses (P for trend = .008), but not in analyses adjusted for insurance status (P for trend = .46) and other predictors (P for trend = .55). Significant decreases were observed only in the South, where adjusted analyses revealed decreases in circumcision overall (P for trend = .007) and among hospitalizations with Medicaid (P for trend = .005) but not those with private insurance (P for trend = .13). Newborn male birth hospitalizations covered by Medicaid increased from 36.0% (2000) to 50.1% (2010; P for trend families who desire but have less financial access to the procedure. PMID:26180994
Sipsma Heather L
Full Text Available Abstract Background Although rates of maternal and neonatal mortality have decreased in many countries over the last two decades, they remain unacceptably high, particularly in sub-Saharan Africa. Nevertheless, we know little about the quality of facility-based maternal and newborn care in low-income countries and little about the association between quality of care and health worker training, supervision, and incentives in these settings. We therefore sought to examine the quality of facility-based maternal and newborn health care by describing the implementation of recommended practices for maternal and newborn care among health care facilities. We also aimed to determine whether increased training, supervision, and incentives for health workers were associated with implementing these recommended practices. We chose to study these aims in the Republic of Rwanda, where rates of maternal and newborn mortality are high and where substantial attention is currently focused on strengthening health workforce capacity and quality. Methods We used data from the 2007 Rwanda Service Provision Assessment. Using observations from 455 facilities and interviews from 1357 providers, we generated descriptive statistics to describe the use of recommended practices and frequencies of provider training, supervision, and incentives in the areas of antenatal, delivery, and newborn care. We then constructed multivariable regression models to examine the associations between using recommended practices and health provider training, supervision, and incentives. Results Use of recommended practices varied widely, and very few facilities performed all recommended practices. Furthermore, in most areas of care, less than 25% of providers reported having had any pre-service or in-service training in the last 3 years. Contrary to our hypotheses, we found no evidence that training, supervision, or incentives were consistently associated with using recommended practices
Béhague, Dominique P
A decade ago, the Partnership for Maternal, Newborn and Child Health (PMNCH) was established to combat the growing fragmentation of global health action into uncoordinated, issue-specific efforts. Inspired by dominant global public-private partnerships for health, the PMNCH brought together previously competing advocacy coalitions for safe motherhood and child survival and attracted support from major donors, foundations and professional bodies. Today, its founders highlight its achievements in generating priority for ‘MNCH’, encouraging integrated health systems thinking and demonstrating the value of collaboration in global health endeavours. Against this dominant discourse on the success of the PMNCH, this article shows that rhetoric in support of partnership and integration often masks continued structural drivers and political dynamics that bias the global health field towards vertical goals. Drawing on ethnographic research, this article examines the Safe Motherhood Initiative’s evolution into the PMNCH as a response to the competitive forces shaping the current global health field. Despite many successes, the PMNCH has struggled to resolve historically entrenched programmatic and ideological divisions between the maternal and child health advocacy coalitions. For the Safe Motherhood Initiative, the cost of operating within an extremely competitive policy arena has involved a partial renouncement of ambitions to broader social transformations in favour of narrower, but feasible and ‘sellable’ interventions. A widespread perception that maternal health remains subordinated to child health even within the Partnership has elicited self-protective responses from the safe motherhood contingent. Ironically, however, such responses may accentuate the kind of fragmentation to global health governance, financing and policy solutions that the Partnership was intended to challenge. The article contributes to the emerging critical ethnographic literature on
Background An understanding of perceptions of parents and health caregivers who assist critically ill neonates is necessary to comprehend their actions and demands. Therefore this study aim to analyze the agreement among parents, nurse technicians and pediatricians regarding the presence and intensity of pain and distress in mechanically ventilated and intubated newborn infants. Methods Cross-sectional study comprising 52 infants and 52 trios of adults composed of one parent, one nurse technician, and one pediatrician who all observed the same infant. All infants were intubated and under mechanical ventilation and were not handled during the observations. Each newborn was simultaneously observed by the trio of adults for 1 minute to evaluate the presence of pain and distress. The intensity of pain and distress that the adults believed was felt by the infants was marked in a visual analogical scale. Adults’ agreement about the simultaneous presence of pain and distress in each infant was analyzed by marginal homogeneity and Cochran tests. The agreement about the intensity of pain and distress in each infant was studied by Bland-Altman plot and intraclass correlation coefficient (ICC). Results The assessments of pain and distress were heterogeneous in all three investigated groups of adults as determined by the results of a Bland-Altman plot. The presence of distress was more frequently reported compared with pain (marginal heterogeneity, p < 0.01). The pain and distress scores in each adult group were not correlated as shown by ICC [parents, 0.36 (95% CI: 0.01-0.63); nurses 0.47 (0.23-0.66); pediatricians, 0.46 (0.22-0.65)]. Conclusions Adults systematically underscore pain in comparison to distress in mechanically ventilated newborns, without recognizing the association between them. PMID:24528475
Green, Nancy S.; Mathur, Sanyukta; Kiguli, Sarah; Makani, Julie; Fashakin, Victoria; LaRussa, Philip; Lyimo, Magdalena; Abrams, Elaine J.; Mulumba, Lukia; Mupere, Ezekiel
Sickle cell disease (SCD) is associated with high mortality for children under 5 years of age in sub-Saharan Africa. Newborn sickle screening program and enhanced capacity for SCD treatment are under development to reduce disease burden in Uganda and elsewhere in the region. Based on an international stakeholder meeting and a family-directed conference on SCD in Kampala in 2015, and interviews with parents, multinational experts, and other key informants, we describe health care, community, and family perspectives in support of these initiatives. Key stakeholder meetings, discussions, and interviews were held to understand perspectives of public health and multinational leadership, patients and families, as well as national progress, resource needs, medical and social barriers to program success, and resources leveraged from HIV/AIDS. Partnering with program leadership, professionals, patients and families, multinational stakeholders, and leveraging resources from existing programs are needed for building successful programs in Uganda and elsewhere in sub-Saharan Africa. PMID:27336011
Nguyen Toan Tran
Full Text Available BACKGROUND: Given country demands for support in the training of community health workers (CHWs to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH, the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs. METHODS: A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. RESULTS: We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages and depth (focused packages, including family planning, antenatal and childbirth care (mainly postpartum haemorrhage, newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems. CONCLUSIONS: There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of
Kyozuka, Hyo; Yasuda, Shun; Kawamura, Makoto; Nomura, Yasuhisa; Fujimori, Keiya; Goto, Aya; Yasumura, Seiji; Abe, Masafumi
This study examined the effects of three disasters (the Great East Japan Earthquake of March 11, 2011, followed by a tsunami and the Fukushima Daiichi Nuclear Power Plant accident) on feeding methods and growth in infants born after the disasters. Using results from the Fukushima Health Management Survey, Soso District (the affected area where the damaged nuclear power plant is located) and Aizu District (a less-affected area located farthest from the plant) were compared. In this study, newborn and maternal background characteristics were examined, as well as feeding methods, and other factors for newborn growth at the first postpartum examination for 1706 newborns born after the disaster in the affected (n = 836) and less-affected (n = 870) areas. Postpartum examinations took place 1 month after birth. Feeding method trends were examined, and multivariate regression analyses were used to investigate effects on newborn mass gain. There were no significant differences in background characteristics among newborns in these areas. When birth dates were divided into four periods to assess trends, no significant change in the exclusive breastfeeding rate was found, while the exclusive formula-feeding rate was significantly different across time periods in the affected area (p = 0.02). Multivariate analyses revealed no significant independent associations of maternal depression and change in medical facilities (possible disaster effects) with other newborn growth factors in either area. No area differences in newborn growth at the first postpartum examination or in exclusive breastfeeding rates were found during any period. Exclusive formula-feeding rates varied across time periods in the affected, but not in the less-affected area. It is concluded that effective guidance to promote breast-feeding and prevent exclusive use of formula is important for women in post-disaster circumstances. PMID:26875100
To determine the extent the World Health Organization (WHO) guidelines on the care of Low Birth Weight (LBW) newborns are followed in Pakistani hospitals and analyze any difference in policy compliance between different hospitals. Study Design: Descriptive analytical study. Place and Duration of Study: Data was collected from five tertiary care hospitals, one each from Peshawar, Lahore, Quetta, Karachi and Islamabad, from January to June 2012. Methodology: LBW newborns data derived from medical records was used. It was collected using a questionnaire, which encompassed the recent WHO recommendations for feeding of LBW. Twenty questionnaires were collected from each hospital. STATA 11.0 was used to analyze the data. Results: Fifty seven LBW newborns (57%) were fed with mother's own milk, and 9 (9%) were fed on donor human milk. Forty four newborns (44%) were initiated breast feeding within the first hour after birth. Most of the babies not able to be breast fed were fed with intra gastric tube. Feeding practices varied markedly across hospitals, ranging from one hospital where all newborns were fed formula milk to one where all were fed breast milk. Conclusion: The WHO guidelines were only partially implemented, with significant differences between hospitals in level of implementation of recommended practices. Given the benefits expected from the application of the guidelines, efforts should be made for the establishment and promotion of a single national policy for LBW feeding that follows the WHO new guidelines and streamlines the LBW feeding practices across the country. (author)
Sara J Elazan
Full Text Available Background: Male community health workers (CHWs have rarely been studied as an addition to the female community health workforce to improve access and care for reproductive, maternal, newborn, and child health (RMNCH. Objective: To examine how male health activists (MHAs coordinated RMNCH responsibilities with existing female health workers in an Indian context. Materials and Methods: Interviews from male and female CHWs were coded around community-based engagement, outreach services, and links to facility-based care. Results: Community-based engagement: MHAs completed tasks both dependent and independent of their gender, such as informing couples on safe RMNCH care in the antenatal and postnatal periods. MHAs motivated males on appropriate family planning methods, demonstrating clear gendered responsibility. Outreach services: MHAs were most valuable traveling to remote areas to inform about and bring mothers and children to community health events, with this division of labor appreciated by female health workers. Link to facility-based services: MHAs were recognized as a welcome addition accompanying women to health facilities for delivery, particularly in nighttime. Conclusion: This study demonstrates the importance of gendered CHW roles and male-female task-sharing to improve access to community health events, outreach services, and facility-based RMNCH care.
Emerging sensor-based structural health monitoring (SHM) technology can play an important role in inspecting and securing the safety of aging civil infrastructure, a worldwide problem. However, implementation of SHM in civil infrastructure faces a significant challenge due to the lack of suitable sensors and reliable methods for interpreting sensor data. This paper reviews recent efforts and advances made in addressing this challenge, with example sensor hardware and software developed in the author's research center. It is proposed to integrate real-time continuous monitoring using on structure sensors for global structural integrity evaluation with targeted NDE inspection for local damage assessment
Ghaffar, Abdul; Qazi, Shamim; Shah, Iqbal
Factors contributing to Pakistan’s poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan’s GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence ...
... 42 Public Health 4 2010-10-01 2010-10-01 false Newborn children. 435.117 Section 435.117 Public..., Children Under 8, and Newborn Children § 435.117 Newborn children. (a) The agency must provide Medicaid eligibility to a child born to a woman who has applied for, has been determined eligible and is...
Lee, Hyun Jung; Ryu, Dojin
Aflatoxins, ochratoxins, fumonisins, deoxynivalenol, and zearalenone are of significant public health concern as they can cause serious adverse effects in different organs including the liver, kidney, and immune system in humans. These toxic secondary metabolites are produced by filamentous fungi mainly in the genus Aspergillus, Penicillium, and Fusarium. It is challenging to control the formation of mycotoxins due to the worldwide occurrence of these fungi in food and the environment. In addition to raw agricultural commodities, mycotoxins tend to remain in finished food products as they may not be destroyed by conventional processing techniques. Hence, much of our concern is directed to chronic health effects through long-term exposure to one or multiple mycotoxins from contaminated foods. Ideally risk assessment requires a comprehensive data, including toxicological and epidemiological studies as well as surveillance and exposure assessment. Setting of regulatory limits for mycotoxins is considered necessary to protect human health from mycotoxin exposure. Although advances in analytical techniques provide basic yet critical tool in regulation as well as all aspects of scientific research, it has been acknowledged that different forms of mycotoxins such as analogs and conjugated mycotoxins may constitute a significant source of dietary exposure. Further studies should be warranted to correlate mycotoxin exposure and human health possibly via identification and validation of suitable biomarkers. PMID:26565730
Murray, C F; Windeyer, M C; Duffield, T F; Haley, D B; Pearl, D L; Waalderbos, K M; Leslie, K E
The objective of this research was to investigate factors associated with serum haptoglobin (Hp) levels in newborn calves. In addition, the associations between serum Hp levels in newborn calves with growth, morbidity, and mortality in calves heifer calves from 15 dairy farms were enrolled in this study from January to December, 2008. Following calving, a birth record was completed, including information on the calving event, colostrum administration, and other details. During weekly farm visits, each calf was assessed at 1 to 8 d, 15 to 21 d, 36 to 42 d, and 90 to 120 d of age. At these sampling times, each calf was assessed using a standardized clinical score for general health, and height and weight were measured. At 1 to 8 d of age, a blood sample was collected to measure serum total protein and Hp concentrations. Treatment events and death loss were recorded throughout the study by the farm staff. Serum Hp concentration in the first week of life was not significantly associated with the degree of calving difficulty. However, serum Hp was higher in calves with a higher rectal temperature and depressed attitude at the first sampling time. Furthermore, the association between serum Hp and the severity of nasal discharge varied by age at first sampling time. Calves with higher Hp in their first week of life had significantly higher total health scores throughout the entire sampling period. Haptoglobin was not significantly associated with average daily gain or treatment for bovine respiratory disease. Yet, for every 1 g/L increase in serum Hp in the first week of life, the odds of being treated for any other disease during the study period increased by 7.6 times. Treatment for bovine respiratory disease, diarrhea, or any other disease resulted in increased odds of calf mortality. In addition, Hp concentration in the first week of life was associated with mortality in calves <4 mo of age. The optimal cut point for Hp was determined to be 0.13 g/L for the prediction
... Video) Meconium Aspiration Syndrome Additional Content Medical News Anemia in the Newborn By Arthur E. Kopelman, MD ... Prematurity (ROP) Necrotizing Enterocolitis (NEC) Jaundice in Newborns Anemia in the Newborn Polycythemia in the Newborn Thyroid ...
Candidiasis - oral - newborn; Oral thrush - newborn; Fungal infection - mouth - newborn; Candida - oral - newborn ... chap 56. Lee GE, Kaufman DA, Zaoutis TE. Candidiasis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach ...
Abegunde, Dele; Orobaton, Nosa; Shoretire, Kamil; Ibrahim, Mohammed; Mohammed, Zainab; Abdulazeez, Jumare; Gwamzhi, Ringpon; Ganiyu, Akeem
Background Maternal mortality ratio and infant mortality rate are as high as 1,576 per 100,000 live births and 78 per 1,000 live births, respectively, in Nigeria's northwestern region, where Sokoto State is located. Using applicable monitoring indicators for tracking progress in the UN/WHO framework on continuum of maternal, newborn, and child health care, this study evaluated the progress of Sokoto toward achieving the Millennium Development Goals (MDGs) 4 and 5 by December 2015. The changes in outcomes in 2012–2013 associated with maternal and child health interventions were assessed. Design We used baseline and follow-up lot quality assurance sampling (LQAS) data obtained in 2012 and 2013, respectively. In each of the surveys, data were obtained from 437 households sampled from 19 LQAS locations in each of the 23 local government areas (LGAs). The composite state-level coverage estimates of the respective indicators were aggregated from estimated LGA coverage estimates. Results None of the nine indicators associated with the continuum of maternal, neonatal, and child care satisfied the recommended 90% coverage target for achieving MDGs 4 and 5. Similarly, the average state coverage estimates were lower than national coverage estimates. Marginal improvements in coverage were obtained in the demand for family planning satisfied, antenatal care visits, postnatal care for mothers, and exclusive breast-feeding. Antibiotic treatment for acute pneumonia increased significantly by 12.8 percentage points. The majority of the LGAs were classifiable as low-performing, high-priority areas for intensified program intervention. Conclusions Despite the limited time left in the countdown to December 2015, Sokoto State, Nigeria, is not on track to achieving the MDG 90% coverage of indicators tied to the continuum of maternal and child care, to reduce maternal and childhood mortality by a third by 2015. Targeted health system investments at the primary care level remain a
Kim, Jim Yong
Jim Yong Kim, President of the World Bank Group, notes that we stand at a critical threshold for global health and development. Too many women and children are still dying because they lack access to quality health care, especially in the least developed countries. He talks about shifting focus from inputs to paying for results, an approach that has been proven to be extremely effective in getting high qua...
Hounton, Sennen; Newlands, David
Background Coverage of maternal and newborn health (MNH) interventions is often influenced by important determinants and decision makers are often concerned with equity issues. The net-benefit framework developed and applied alongside clinical trials and in pharmacoeconomics offers the potential for exploring how cost-effectiveness of MNH interventions varies at the margin by important covariates as well as for handling uncertainties around the ICER estimate. Aim We applied the net-benefit fr...
Miller-Petrie, Molly K; Mazia, Goldy; Serpa, Magdalena; Pooley, Bertha; Marshall, Margaret; Meléndez, Carlos; Vicuña, Marisol
The regional Latin American and Caribbean (LAC) Neonatal Alliance and national neonatal alliances in Bolivia, El Salvador, and Peru were studied through in-depth interviews and a review of publications. Findings were analyzed to distill successful strategies, structures, and tools for improving neonatal health by working through alliances that can be replicated at the regional or national level. The studies found the following factors were the most critical for successful outcomes from alliance work: inclusion of the Ministry of Health as a leader or primary stakeholder; a committed, diverse, technically expert, and horizontal membership; the presence of champions for neonatal health at the national level; development of a shared work plan based on feasible objectives; the use of shared financing mechanisms; the use of informal and dynamic organizational structures; and a commitment to scientific evidence-based programming. The relationship between the regional and national alliances was found to be mutually beneficial. PMID:25211677
Oduro-Mensah, Ebenezer; Kwamie, Aku; Antwi, Edward; Amissah Bamfo, Sarah; Bainson, Helen Mary; Marfo, Benjamin; Coleman, Mary Amoakoh; Grobbee, Diederick E.; Agyepong, Irene Akua
Objectives To explore the “how” and “why” of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes. Methods A cross sectional and descriptive mixed method study involving a desk review of maternal and newborn care protocols and guidelines availability, focus group discussions and administration of a structured questionnair...
Chernenkov Yu.V.; Nechaev V.N.; Lisitsyna A.S.
Objective: to reveal and estimate dependence between a long waterless interval, infectious process at mother and pathology of newborn children. Material and Methods: Supervision and research have been carried out in Perinatal Center of Saratov region for the last 2 years. 167 women and 173 newborns were included in the research. The big group was composed by prematurely born children. Women were divided into 2 groups depending on infectious process of patrimonial ways and on duration of a wat...
Voller, S; Becker, AJ
This study aimed to document the key messages, dissemination activities and impacts of selected projects within the Bill & Melinda Gates Foundation Maternal, Neonatal and Child Health strategy portfolio, and consider how these might contribute toward the learning agenda for the strategy.
Brenøe, Anne Ardila; Molitor, Ramona
We ask whether birth order differences in health are present at birth using matched administrative data for more than 1 million children born in Denmark between 1981 and 2010. Using family fixed effects models, we find a positive and robust birth order effect; lower parity children are less healthy...... at birth. Looking at the potential mechanisms, we find that during earlier pregnancies women have higher labor market attachment, are more likely to smoke, receive more prenatal care, and are diagnosed with more medical pregnancy complications. Yet, none of these factors explain the birth order...... differences at birth. Data on hospital admissions reveal that the health advantage of higher parity children persists in the first years of life and disappears by age 7....
Bazzano, Alessandra N.; Oberhelman, Richard A; Kaitlin Storck Potts; Anastasia Gordon; Chivorn Var
Infection contributes to a significant proportion of neonatal death and disability worldwide, with the major burden occurring in the first week of life. Environmental conditions and gaps in water, sanitation and hygiene (WASH) practices may contribute to the risk of infection, particularly in settings where health centers are expanding to meet the growing demand for skilled care at birth and homes do not have adequate access to water and sanitation. A qualitative approach was used to understa...
Tuthill, R W; Giusti, R A; Moore, G S; Calabrese, E. J.
Because chlorination of potable surface waters may be associated with increased risk of carcinogenicity, substitute methods for the routine disinfection of public water supplies are being explored. As part of this search, it is especially important that the potential health effects of each alternative method should be considered. Chemical treatment of drinking water by chlorine dioxide (ClO2) is a likely alternative mode of disinfection. Two common by-products of the ClO2 disinfection of surf...
Brenøe, Anne Ardila; Molitor, Ramona
We ask whether birth order differences in health are present at birth using matched administrative data for more than 1 million children born in Denmark between 1981 and 2010. Using family fixed effects models, we find a positive and robust birth order effect; lower parity children are less healthy at birth. Looking at the potential mechanisms, we find that during earlier pregnancies women have higher labor market attachment, are more likely to smoke, receive more prenatal care, and are diagn...
Brenøe, Anne Ardila; Molitor, Ramona
Research has shown a strong negative correlation between birth order and cognitive test scores, IQ, and educational outcomes. We ask whether birth order differences in health are present at birth using matched administrative data for more than 1,000,000 children born in Denmark between 1981 and 2010. Using family fixed effects models, we find a positive and robust birth order effect; earlier born children are less healthy at birth. Looking at the potential mechanisms, we find that during earl...
Atkinson, J.M.; Garner, H.C.; Gilmour, W H
Objective: The aim of this study was to examine perceptions of the place of advance directives in mental health care. Methods: Postal survey of stakeholders was carried out to assess their views on different models of advance directives in mental health care. A total of 473 responded. Results: In all, 28% of psychiatrists thought advance directives were needed compared to 89% of voluntary organisations and above two–thirds of the other stakeholder groups. There were clear tensions be...
Mauss, Fredrick J.
Pacific Northwest National Laboratory (PNNL) has developed the Captive Carry Health Monitor Unit (HMU) and the Humidity Indicator HMU. Each of these devices provides end users information that can be used to ensure the proper maintenance and performance of the missile. These two efforts have led to the ongoing development and evolution of the next generation Captive Carry HMU and the next generation Humidity Indicator HMU. These next generation efforts are in turn, leading to the future of HMUs. This evolutionary development process inherently allows for direct and indirect impact toward new HMU functionality, operability and performance characteristics by influencing their requirements, testing, communications, data archival, and user interaction. Current designs allow systems to operate in environments outside the limits of typical consumer electronics for up to or exceeding 10 years. These designs are battery powered and typically provided in custom mechanical packages that employ sensors for temperature, shock/vibration, and humidity measurements. The data taken from these sensors is then analyzed onboard using unique algorithms. The algorithms are developed from test data and fielded prototypes. Onboard data analysis provides field users with a simple indication of missile exposure. The HMU provides missile readiness information to the user based on storage and use conditions observed. To continually advance current designs PNNL evaluates the potential for enhancing sensor capabilities by improving performance or power saving features, increasing algorithm and processing abilities, and adding new features. Future work at PNNL includes the utilization of power harvesting, using a defined wireless protocol, and defining a data/information structure. These efforts will lead to improved performance allowing the HMUs to benefit users with direct access to HMUs in the field as well as benefiting those with the ability to make strategic and high-level supply and
Do, Mai; Micah, Angela; Brondi, Luciana; Campbell, Harry; Marchant, Tanya; Eisele, Thomas; Munos, Melinda
Background Currently many measures of intervention coverage obtained from household surveys do not measure actual health intervention/service delivery, resulting in a need for linking reports of care–seeking with assessments of the service environment in order to improve measurements. This systematic review aims to identify evidence of different methods used to link household surveys and service provision assessments, with a focus on reproductive, maternal, newborn and child health care, in low– and middle–income countries. Methods Using pre–defined search terms, articles published in peer–reviewed journals and the grey literature after 1990 were identified, their reference lists scanned and linking methods synthesized. Findings A total of 59 articles and conference presentations were carefully reviewed and categorized into two groups based on the linking method used: 1) indirect/ecological linking that included studies in which health care–seeking behavior was linked to all or the nearest facilities or providers of certain types within a geographical area, and 2) direct linking/exact matching where individuals were linked with the exact provider or facility where they sought care. The former approach was employed in 51 of 59 included studies, and was particularly common among studies that were based on independent sources of household and facility data that were nationally representative. Only eight of the 59 reviewed studies employed direct linking methods, which were typically done at the sub–national level (eg, district level) and often in rural areas, where the number of providers was more limited compared to urban areas. Conclusions Different linking methods have been reported in the literature, each category has its own set of advantages and limitations, in terms of both methodology and practicality for scale–up. Future studies that link household and provider/facility data should also take into account factors such as sources of data, the
Pagoto, Sherry; Bennett, Gary G
The field of behavioral science has produced myriad data on health behavior change strategies and leveraged such data into effective human-delivered interventions to improve health. Unfortunately, the impact of traditional health behavior change interventions has been heavily constrained by patient and provider burden, limited ability to measure and intervene upon behavior in real time, variable adherence, low rates of implementation, and poor third-party coverage. Digital health technologies, including mobile phones, sensors, and online social networks, by being available in real time, are being explored as tools to increase our understanding of health behavior and to enhance the impact of behavioral interventions. The recent explosion of industry attention to the development of novel health technologies is exciting but has far outpaced research. This Special Section of Translational Behavioral Medicine, Smartphones, Sensors, and Social Networks: A New Age of Health Behavior Change features a collection of studies that leverage health technologies to measure, change, and/or understand health behavior. We propose five key areas in which behavioral science can improve the impact of digital health technologies on public health. First, research is needed to identify which health technologies actually impact behavior and health outcomes. Second, we need to understand how online social networks can be leveraged to impact health behavior on a large scale. Third, a team science approach is needed in the developmental process of health technologies. Fourth, behavioral scientists should identify how a balance can be struck between the fast pace of innovation and the much slower pace of research. Fifth, behavioral scientists have an integral role in informing the development of health technologies and facilitating the movement of health technologies into the healthcare system. PMID:24073178
Full Text Available Adriana Kaplan,1–3 Mary Forbes,4 Isabelle Bonhoure,2 Mireia Utzet,5 Miguel Martín,5 Malick Manneh,4 Haruna Ceesay41Chair of Social Knowledge Transfer/ Parc de Recerca UAB - Santander, Department of Social and Cultural Anthropology, Universitat Autònoma de Barcelona, Barcelona, Spain; 2Interdisciplinary Group for the Study and Prevention of Harmful Traditional Practices, Department of Social and Cultural Anthropology, Universitat Autónoma de Barcelona, Barcelona Spain; 3Wassu Gambia Kafo, Fajara F Section, Banjul, The Gambia; 4School of Enrolled Community Health Nurses and Midwives, Ministry of Health, Mansakonko, Lower River Region, The Gambia; 5Africa and Latin America Research Group, Unit of Biostatistics, Faculty of Medicine, Autonomus University of Barcelona, Barcelona, SpainBackground: Female genital mutilation/cutting (FGM/C is a harmful traditional practice deeply rooted in 28 Sub-Saharan African countries. Its prevalence in The Gambia is 76.3%. The objective of this study was to gain precise information on the long-term health consequences of FGM/C in The Gambia as well as on its impact on delivery and on the health of the newborns.Methods: Data were collected from 588 female patients examined for antenatal care or delivery in hospitals and health centers of the Western Health Region, The Gambia. The information collected, both through a questionnaire and medical examination, included sociodemographic factors, the presence or not of FGM/C, the types of FGM/C practiced, the long-term health consequences of FGM/C, complications during delivery and for the newborn. Odds ratios, their 95% confidence intervals, and P values were calculated.Results: The prevalence of patients who had undergone FGM/C was 75.6% (type I: 75.6%; type II: 24.4%. Women with type I and II FGM/C had a significantly higher prevalence of long-term health problems (eg, dysmenorrhea, vulvar or vaginal pain, problems related to anomalous healing (eg, fibrosis, keloid
Penman-Aguilar, Ana; Talih, Makram; Huang, David; Moonesinghe, Ramal; Bouye, Karen; Beckles, Gloria
Reduction of health disparities and advancement of health equity in the United States require high-quality data indicative of where the nation stands vis-à-vis health equity, as well as proper analytic tools to facilitate accurate interpretation of these data. This article opens with an overview of health equity and social determinants of health. It then proposes a set of recommended practices in measurement of health disparities, health inequities, and social determinants of health at the national level to support the advancement of health equity, highlighting that (1) differences in health and its determinants that are associated with social position are important to assess; (2) social and structural determinants of health should be assessed and multiple levels of measurement should be considered; (3) the rationale for methodological choices made and measures chosen should be made explicit; (4) groups to be compared should be simultaneously classified by multiple social statuses; and (5) stakeholders and their communication needs can often be considered in the selection of analytic methods. Although much is understood about the role of social determinants of health in shaping the health of populations, researchers should continue to advance understanding of the pathways through which they operate on particular health outcomes. There is still much to learn and implement about how to measure health disparities, health inequities, and social determinants of health at the national level, and the challenges of health equity persist. We anticipate that the present discussion will contribute to the laying of a foundation for standard practice in the monitoring of national progress toward achievement of health equity. PMID:26599027
... https://medlineplus.gov/news/fullstory_159719.html Pregnancy Flu Shot Protects Newborn for 8 Weeks: Study Effectiveness ... 2016 TUESDAY, July 5, 2016 (HealthDay News) -- A flu shot during pregnancy protects newborns against the flu ...
Baldacchino, Marilyn; Bezzina, Glorianne; Scerri, Anne Marie; Sammut, Mario R.
A strong primary health care system is the keystone of health care and helps patients manage their health conditions in the community, whilst also providing disease prevention services. Primary care is a continuously evolving specialty, with recent exciting innovations, aiming to improve all aspects of care and to meet people’s needs and expectations. A search for articles focusing on the specific aspects of recent advances in primary health care was done using interne...
Liechty Edward A
Full Text Available Abstract Background Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis and 28-day neonatal mortality. Discussion In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant
Velasco Román Pérez
Full Text Available Abstract Background Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these—such as diabetes, cancer, and inherited inborn metabolic diseases—have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Methods Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Results Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D, and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E. The establishment of a specialised institution to fill the gaps in this area is warranted. Conclusion The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended.
Lewis, Megan A.; Paquin, Ryan S.; Roche, Myra I.; Furberg, Robert D.; Rini, Christine; Berg, Jonathan S.; Powell, Cynthia M.; Bailey, Donald B.
Advances in genomic sequencing technology have raised fundamental challenges to the traditional ways genomic information is communicated. These challenges will become increasingly complex and will affect a much larger population in the future if genomics is incorporated into standard newborn screening practice. Clinicians, public health officials, and other stakeholders will need to agree on the types of information that they should seek and communicate to parents. Currently, few evidence-based and validated tools are available to support parental informed decision-making. These tools will be necessary as genomics is integrated into clinical practice and public health systems. In this article we describe how the North Carolina Newborn Exome Sequencing for Universal Screening study is addressing the need to support parents in making informed decisions about the use of genomic testing in newborn screening. We outline the context for newborn screening and justify the need for parental decision support. We also describe the process of decision aid development and the data sources, processes, and best practices being used in development. By the end of the study, we will have an evidenced-based process and validated tools to support parental informed decision-making about the use of genomic sequencing in newborn screening. Data from the study will help answer important questions about which genomic information ought to be sought and communicated when testing newborns. PMID:26729698
Lewis, Megan A; Paquin, Ryan S; Roche, Myra I; Furberg, Robert D; Rini, Christine; Berg, Jonathan S; Powell, Cynthia M; Bailey, Donald B
Advances in genomic sequencing technology have raised fundamental challenges to the traditional ways genomic information is communicated. These challenges will become increasingly complex and will affect a much larger population in the future if genomics is incorporated into standard newborn screening practice. Clinicians, public health officials, and other stakeholders will need to agree on the types of information that they should seek and communicate to parents. Currently, few evidence-based and validated tools are available to support parental informed decision-making. These tools will be necessary as genomics is integrated into clinical practice and public health systems. In this article we describe how the North Carolina Newborn Exome Sequencing for Universal Screening study is addressing the need to support parents in making informed decisions about the use of genomic testing in newborn screening. We outline the context for newborn screening and justify the need for parental decision support. We also describe the process of decision aid development and the data sources, processes, and best practices being used in development. By the end of the study, we will have an evidenced-based process and validated tools to support parental informed decision-making about the use of genomic sequencing in newborn screening. Data from the study will help answer important questions about which genomic information ought to be sought and communicated when testing newborns. PMID:26729698
... and Trails Are Cost-Effective Ways to Promote Exercise December 8, 2014 Military Culture Enables Tobacco Use December 4, 2014 Physician Behaviors May Contribute to Disparities in Mental Health Care December 3, 2014 Depression and Dementia in ...
Das, Jai K; Kumar, Rohail; Salam, Rehana A; Lassi, Zohra S; Zulfiqar A Bhutta
Most of the maternal and newborn deaths occur at birth or within 24 hours of birth. Therefore, essential lifesaving interventions need to be delivered at basic or comprehensive emergency obstetric care facilities. Facilities provide complex interventions including advice on referrals, post discharge care, long-term management of chronic conditions along with staff training, managerial and administrative support to other facilities. This paper reviews the effectiveness of facility level inputs...
Tripathi, A; Kabra, S K; Sachdev, H P S; Lodha, R
The objectives of this review were to evaluate the effect of home visits by trained community health workers (CHWs) to successfully identify newborns and young infants (up to 59 days of age) with serious illness and improve care seeking from a health facility. The authors searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. Abstracts of all articles were read by two authors independently and relevant articles selected. Data were extracted in a pretested questionnaire by two authors independently. Statistical analysis was performed using Review Manager software. A meta-analysis of included randomized controlled trials (RCTs) was carried out. Pooled estimates (risk ratios (RRs) with 95% confidence intervals (CIs)) of the evaluated outcome measures were calculated by the generic inverse variance method. Seven articles were identified for inclusion in the review. None of them compared the diagnosis of serious illness in young infants by health workers to a 'gold standard' diagnosis. Three studies were available for evaluating the ability of CHWs to identify seriously ill young infants/signs of serious illness. These studies suggest that sensitivity to identify serious illness ranged from 33.3 to 90.5% and specificity from 75.61 to 98.4%. For the outcome of improved care seeking from a health facility, after pooling the data from six RCTs with 4760 subjects in the intervention and 4398 subjects in the control arm, there was a significant improvement in care seeking in the home visit arm (RR=1.35; 95% CI=1.15 to 1.58). Moderate quality evidence indicated that home visits by trained CHWs were associated with improved care-seeking for sick young infants from health facilities by appropriate health care providers in resource-limited settings. However, there is a lack of data regarding successful identification of serious illness. Evidence from validation studies supports the implementation of home visits by trained CHWs for improving outcomes in
Tripathi, A; Kabra, S K; Sachdev, H P S; Lodha, R
The objectives of this review were to evaluate the effect of home visits by trained community health workers (CHWs) to successfully identify newborns and young infants (up to 59 days of age) with serious illness and improve care seeking from a health facility. The authors searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. Abstracts of all articles were read by two authors independently and relevant articles selected. Data were extracted in a pretested questionnaire by two authors independently. Statistical analysis was performed using Review Manager software. A meta-analysis of included randomized controlled trials (RCTs) was carried out. Pooled estimates (risk ratios (RRs) with 95% confidence intervals (CIs)) of the evaluated outcome measures were calculated by the generic inverse variance method. Seven articles were identified for inclusion in the review. None of them compared the diagnosis of serious illness in young infants by health workers to a ‘gold standard' diagnosis. Three studies were available for evaluating the ability of CHWs to identify seriously ill young infants/signs of serious illness. These studies suggest that sensitivity to identify serious illness ranged from 33.3 to 90.5% and specificity from 75.61 to 98.4%. For the outcome of improved care seeking from a health facility, after pooling the data from six RCTs with 4760 subjects in the intervention and 4398 subjects in the control arm, there was a significant improvement in care seeking in the home visit arm (RR=1.35; 95% CI=1.15 to 1.58). Moderate quality evidence indicated that home visits by trained CHWs were associated with improved care-seeking for sick young infants from health facilities by appropriate health care providers in resource-limited settings. However, there is a lack of data regarding successful identification of serious illness. Evidence from validation studies supports the implementation of home visits by trained CHWs for improving outcomes
Full Text Available Objective: to reveal and estimate dependence between a long waterless interval, infectious process at mother and pathology of newborn children. Material and Methods: Supervision and research have been carried out in Perinatal Center of Saratov region for the last 2 years. 167 women and 173 newborns were included in the research. The big group was composed by prematurely born children. Women were divided into 2 groups depending on infectious process of patrimonial ways and on duration of a waterless interval. Children were divided on gestation term. Results: fetoplacental insufficiency and threatened miscarriage are the main factors of extremely immature children birth. Under these conditions, prolongation of pregnancy and preparing a fetus to labor act are important factors for improving the adaptive capacity of a premature baby. One of the important factors of insolvency is membranes infection. It is a distinct disease or a result of complications of pregnancy prolongation in women with PROM, is a precursor of systemic inflammatory response and in the majority of newborns was realized in infectious process. Conclusion. Women with infectious pathology of birth canal should be thoroughly sanitized, preventive treatment should be carried out, it would prevent the implementation of fetus infection, reduce posthypoxic disorders and incidence of preterm birth and IUGR. Long PSU without infectious support contributes to a lesser extent implementation of infection in fetus and less effect on a child's neurological status.
RESULTS: Coverage and utilization for most of the antenatal care variables like minimum three antenatal visits, antenatal card availability, Tetanus Toxoid immunization and Iron Folic Acid consumption; intranatal care variables like accompanying of pregnant mothers for deliveries to institute by peripheral workers (RR [Relative Risk]=10.01; CI [Confidence Interval]=5.4-18 ; postnatal care variables like post-natal check-ups (RR=1.77; CI=1.54-2.03, and family planning (FP advices (RR=1.65; CI=1.47-1.86; and newborn care indicators like newborn check-ups (RR=1.86; CI=1.61-2.14, early breastfeeding initiation and birth registration were higher in rural areas compared to urban slums; but institutional delivery rate (RR=0.76; CI=0.68-0.84, use of FP methods (RR=0.58; CI=0.42-0.78 and prelacteal feed were better in urban slums. CONCLUSIONS: The study highlights that maternal and newborn care services utilization are poorer in urban slums compared to rural areas in Gujarat requiring attention to strategize policies toward reducing these gaps. [TAF Prev Med Bull 2014; 13(3.000: 217-224
... 42 Public Health 4 2010-10-01 2010-10-01 false Newborn children. 436.124 Section 436.124 Public... the Categorically Needy § 436.124 Newborn children. (a) The agency must provide Medicaid eligibility to a child born to a woman who has applied for, has been determined eligible and is...
Hudmon, Karen Suchanek; Addleton, Robert L.; Vitale, Frank M.; Christiansen, Bruce A.; Mejicano, George C.
This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the…
Tchounwou, Paul B.
This special issue of International Journal of Environmental Research and Public Health highlights selected papers presented at the Sixth International Symposium on Recent Advances in Environmental Health Research organized by Jackson State University (JSU) from September 13−16, 2009 at the Marriott Hotel in Jackson, Mississippi, USA. The Symposium was built upon the overwhelming success of previous symposia hosted by JSU and co-sponsored by the National Institutes of Health (NIH) RCMI-Center...
Araia, Makda H.; Potter, Beth K
The Internet is a potentially important medium for communication about public health programs including newborn screening. This study explores whether the information available on official newborn screening program websites is consistent with existing guidelines regarding educational content for parents. We conducted a systematic search of the public websites of newborn screening programs in the US and Canada, identifying web pages and downloadable brochures that contained educational informa...
Full Text Available Families in high mortality settings need regular contact with high quality services, but existing population-based measurements of contacts do not reflect quality. To address this, in 2012, we designed linked household and frontline worker surveys for Gombe State, Nigeria, Ethiopia, and Uttar Pradesh, India. Using reported frequency and content of contacts, we present a method for estimating the population level coverage of high quality contacts.Linked cluster-based household and frontline health worker surveys were performed. Interviews were conducted in 40, 80 and 80 clusters in Gombe, Ethiopia, and Uttar Pradesh, respectively, including 348, 533, and 604 eligible women and 20, 76, and 55 skilled birth attendants. High quality contacts were defined as contacts during which recommended set of processes for routine health care were met. In Gombe, 61% (95% confidence interval 50-72 of women had at least one antenatal contact, 22% (14-29 delivered with a skilled birth attendant, 7% (4-9 had a post-partum check and 4% (2-8 of newborns had a post-natal check. Coverage of high quality contacts was reduced to 11% (6-16, 8% (5-11, 0%, and 0% respectively. In Ethiopia, 56% (49-63 had at least one antenatal contact, 15% (11-22 delivered with a skilled birth attendant, 3% (2-6 had a post-partum check and 4% (2-6 of newborns had a post-natal check. Coverage of high quality contacts was 4% (2-6, 4% (2-6, 0%, and 0%, respectively. In Uttar Pradesh 74% (69-79 had at least one antenatal contact, 76% (71-80 delivered with a skilled birth attendant, 54% (48-59 had a post-partum check and 19% (15-23 of newborns had a post-natal check. Coverage of high quality contacts was 6% (4-8, 4% (2-6, 0%, and 0% respectively.Measuring content of care to reflect the quality of contacts can reveal missed opportunities to deliver best possible health care.
Full Text Available The research objective is to decrease the frequency of perinatal complications in mother, fetus and newborn. Methodology used is prospective study. Course of pregnancy, delivery, postnatal period and neonatal period has been studied at 50 women and children (the basic group, at 80 women and children (group of comparison. The state of mi-crocirculation was studied at the I- II trimesters of pregnancy before and after treatment by means of biomicroscopy of vessels of eye conjunctiva by slit lamp with computer data processing. Homocysteine was studied at the I- II trimesters of pregnancy before and after treatment, and children of The control group consisted of 63 pregnant women without complicated anamnesis and with somatic status who gave birth to 63 children. At the I trimester of pregnancy in risk groups of development of gestosis hyperhomocysteinemia, preclinical disturbances of processes of microcirculation were observed. The method of preventive treatment of gestosis in the basic group included anticoagulant - Vessl Due F, vitamin E, essenciale H, folic acid, vitamin B6, vitamin B12. The preventive treatment was directed on stabilization of function of vessel endothelium, improvement of processes of microcirculation leading to decrease in frequency and severity of gestosis, perinatal complications in mother and newborn
Paul B. Tchounwou
Full Text Available This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU from September 18-21, 2011 at the Marriott Hotel in Jackson, Mississippi. It was built upon the overwhelming success of seven previous symposia hosted by JSU. [...
Tchounwou, Paul B.
This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from 16–19 September, 2012 at the Marriott Hotel in Jackson, Mississippi, USA. It was built upon the overwhelming success of seven previous symposia hosted by JSU.
Tchounwou, Paul B.
This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from September 18-21, 2011 at the Marriott Hotel in Jackson, Mississippi. It was built upon the overwhelming success of seven previous symposia hosted by JSU. [...
Paul B. Tchounwou
Full Text Available This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU from 16–19 September, 2012 at the Marriott Hotel in Jackson, Mississippi, USA. It was built upon the overwhelming success of seven previous symposia hosted by JSU.
Tchounwou, Paul B.
This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Seventh International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from September 12–15, 2010 at the Marriott Hotel in Jackson, Mississippi. It was built upon the overwhelming success of previous symposia hosted by JSU and co-sponsored by the National Institute...
NITYA; PUSHPAM; MANINDER KAUR
In this paper we propose a system architecture for smart healthcare based on an advanced Wireless Sensor Network(WSN). It specifically targets assisted-living residents and others who may benefit from continuous, remote health monitoring .It presents best practices in wireless sensor network design for health care applications. Based on the most important aspects like power efficiency and security which guide the development of a wireless sensor network based applications.
U.S. Department of Health & Human Services — This table presents counts of disorders that have been diagnosed by the California Newborn Screening program during the five-year period from 2009 through 2014....
Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial
Full Text Available Abstract Background Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting. The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa. Methods/design The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional
Department of Education, Washington, DC.
This booklet offers guidance to parents in caring for their newborn babies. Advice is given on the following topics: (1) newborn health screening; (2) what a healthy newborn looks like; (3) newborn reflexes; (4) baby checkups; (5) fathers' role; (6) the baby blues; (7) sleeping position; (8) breast milk; (9) breast feeding; (10) bottle feeding;…
Tchounwou, Paul B
During the past century, environmental hazards have become a major concern, not only to public health professionals, but also to the society at large because of their tremendous health, socio-cultural and economic impacts. Various anthropogenic or natural factors have been implicated in the alteration of ecosystem integrity, as well as in the development of a wide variety of acute and/or chronic diseases in humans. It has also been demonstrated that many environmental agents, acting either independently or in combination with other toxins, may induce a wide range of adverse health outcomes. Understanding the role played by the environment in the etiology of human diseases is critical to designing cost-effective control/prevention measures. This special issue of International Journal of Environmental Research and Public Health includes the proceedings of the Twelfth International Symposium on Recent Advances in Environmental Health Research. The Symposium provided an excellent opportunity to discuss the scientific advances in biomedical, environmental, and public health research that addresses global environmental health issues. PMID:27153079
Henkelman, Wallace J.
Research has demonstrated that only a small proportion of individuals in the United States complete advance directives as part of their planning for end-of-life care. This study sought to determine if health literacy is a significant factor in advance directive completion as has been posited by previous researchers. Analysis of the data collected…
Rwashana, Agnes Semwanga; Nakubulwa, Sarah; Nakakeeto-Kijjambu, Margaret; Adam, Taghreed
Background Of the three million newborns that die each year, Uganda ranks fifth highest in neonatal mortality rates, with 43,000 neonatal deaths each year. Despite child survival and safe motherhood programmes towards reducing child mortality, insufficient attention has been given to this critical first month of life. There is urgent need to innovatively employ alternative solutions that take into account the intricate complexities of neonatal health and the health systems. In this paper, we ...
Werff, Albert; Hirsch, Gary; Barnard, Keith
The Advanced Research Institute on "Health Services Systems" was held under the auspices of the NATO Special Programme Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international cooperation. A special word is said in this respect supra by Pro fessor Checkland, Chairman of the Systems Science Panel. The Advanced Research Institute (ARI) was organized for the purpose of bringing together senior scientists to seek a consensus on the assessment of the present state of knowledge on the specific topic of "health services systems" and to present views and recom mendations for future health services research directions, which should be of value to both the scientific community and the people in charge of reorienting health services. The conference was structured so as to permit the assembly of a variety of complementary viewpoints through intensive group discussions to be the basis of this final report. Invitees were selected fr...
Paul B. Tchounwou
Full Text Available This special issue of International Journal of Environmental Research and Public Health highlights selected papers presented at the Sixth International Symposium on Recent Advances in Environmental Health Research organized by Jackson State University (JSU from September 13−16, 2009 at the Marriott Hotel in Jackson, Mississippi, USA. The Symposium was built upon the overwhelming success of previous symposia hosted by JSU and co-sponsored by the National Institutes of Health (NIH RCMI-Center for Environmental Health, the U.S. Department of Education Title III Graduate Education Program, the U.S. Environmental Protection Agency, the JSU Office of Academic Affairs, and the JSU Office of Research and Federal Relations. [...
Paul B. Tchounwou
Full Text Available This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Seventh International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU from September 12–15, 2010 at the Marriott Hotel in Jackson, Mississippi. It was built upon the overwhelming success of previous symposia hosted by JSU and co-sponsored by the National Institutes of Health (NIH RCMI-Center for Environmental Health, the U.S. Department of Education Title III Graduate Education Program, the U.S. Environmental Protection Agency, the JSU Office of Academic Affairs, and the JSU Office of Research and Federal Relations. [...
Scales, Charles D; Tasian, Gregory E; Schwaderer, Andrew L; Goldfarb, David S; Star, Robert A; Kirkali, Ziya
Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment. PMID:26964844
Perceptions and viewpoints on proceedings of the Fifteenth Assembly of Heads of State and Government of the African Union Debate on Maternal, Newborn and Child Health and Development, 25–27 July 2010, Kampala, Uganda
Full Text Available Abstract Background Out of 358000 maternal deaths that occurred globally in 2008, 57.8% occurred in continental Africa. Africa had a maternal mortality ratio of 590 compared to 14 in developed regions, 68 in Latin America and Caribbean, and 190 in Asia. This article reflects on the discussions held during the Fifteenth Assembly of the Heads of State and Government of the African Union on the reasons why the maternal mortality ratio is so high in Africa and what can be done to reduce it. Methods Methods employed included panel and open public discussions among the Heads of State and Government of the African Union. The article uses the WHO health systems strengthening framework, which consists of six pillars (information systems, leadership and governance, health workforce, financing, and medical products, vaccines and technologies, and health services to describe the proceedings of the discussions. Discussion The high maternal mortality ratios in countries were attributed to weak national health information systems; leadership and governance challenges related to poverty, health illiteracy, poor transport networks and communications infrastructure, risky cultural practices, armed conflicts and domestic violence, dearth of women empowerment; inadequate levels of skilled birth attendants; inadequate domestic and external funding; stock-outs of consumable inputs; and limited coverage of maternal and child health interventions. In order to accelerate progress towards MDGs 4 and 5, the Heads of State and Government recommended that countries should make maternal deaths notifiable and institutionalize maternal death audits; develop, fund and implement policies and strategies geared at improving maternal, newborn and child health; accelerate inter-sectoral action to address the broad health determinants; increase the number of skilled birth attendants; fulfil commitment to allocate at least 15% of the national budget to the health sector and allocate
Acharya, Arnab; Lalwani, Tanya; Dutta, Rahul; Rajaratnam, Julie Knoll; Ruducha, Jenny; Varkey, Leila Caleb; Wunnava, Sita; Menezes, Lysander; Taylor, Catharine; Bernson, Jeff
Objectives. We evaluated the effectiveness of the Sure Start project, which was implemented in 7 districts of Uttar Pradesh, India, to improve maternal and newborn health. Methods. Interventions were implemented at 2 randomly assigned levels of intensity. Forty percent of the areas received a more intense intervention, including community-level meetings with expectant mothers. A baseline survey consisted of 12 000 women who completed pregnancy in 2007; a follow-up survey was conducted for women in 2010 in the same villages. Our quantitative analyses provide an account of the project's impact. Results. We observed significant health improvements in both intervention areas over time; in the more intensive intervention areas, we found greater improvements in care-seeking and healthy behaviors. The more intensive intervention areas did not experience a significantly greater decline in neonatal mortality. Conclusions. This study demonstrates that community-based efforts, especially mothers' group meetings designed to increase care-seeking and healthy behaviors, are effective and can be implemented at large scale. PMID:25393175
Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H
Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals. PMID:26347092
... campuses in Maryland and Arizona Research Resources Protocols, repositories, mouse models, plasmids, and more Technology Advancement & Transfer ... through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, ...
Full Text Available Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31 of newborns had various congenital anomalies. Hydrocephalus (22.6%, anencephaly (12.9%, and spina bifida (9.7% were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8. Most of the anomalies (35.5% were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%; parities 2 to 4 had lower incidences (35.4%. The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination. Low intake of folic acid and a high consanguinity rate were the most common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy.
Andre W. Kushniruk (ACMI Fellow; CAHS Fellow)
This special issue of the KM&EL international journal is dedicated to coverage of novel advances in health professional education applying e-Learning, simulations and distance education technologies. Modern healthcare is beginning to be transformed through the emergence of new information technologies and rapid advances in health informatics. Advances such as electronic health record systems (EHRs), clinical decision support systems and other advanced information systems such as public health...
Ana Leticia Monteiro Gomes; Cristiane Rodrigues da Rocha; Danielle de Mendonça Henrique; Mirza Almeida Santos; Leila Rangel da Silva
Objective: analyzing the knowledge that families acquired on newborn care, before and after their participation in a mother-father-infant welcoming group. Methods: a quantitative and descriptive study that took place in a municipal health center, with 27 participants. Data were collected by a questionnaire applied before and after the educational activity, and was analyzed by comparing the answers of the items. Results: care actions properly modified were: the use of baby powder, soap, tea, o...
Kinney, Mary V; Cocoman, Olive; Dickson, Kim E; Daelmans, Bernadette; Zaka, Nabila; Rhoda, Natasha R; Moxon, Sarah G; Kak, Lily; Lawn, Joy E; Khadka, Neena; Darmstadt, Gary L
Progress in reducing newborn mortality has lagged behind progress in reducing maternal and child deaths. The Every Newborn Action Plan (ENAP) was launched in 2014, with the aim of achieving equitable and high-quality coverage of care for all women and newborns through links with other global and national plans and measurement and accountability frameworks. This article aims to assess country progress and the mechanisms in place to support country implementation of the ENAP. A country tracking tool was developed and piloted in October-December 2014 to collect data on the ENAP-related national milestones and implementation barriers in 18 high-burden countries. Simultaneously, a mapping exercise involving 47 semi-structured interviews with partner organizations was carried out to frame the categories of technical support available in countries to support care at and around the time of birth by health system building blocks. Existing literature and reports were assessed to further supplement analysis of country progress. A total of 15 out of 18 high-burden countries have taken concrete actions to advance newborn health; four have developed specific action plans with an additional six in process and a further three strengthening newborn components within existing plans. Eight high-burden countries have a newborn mortality target, but only three have a stillbirth target. The ENAP implementation in countries is well-supported by UN agencies, particularly UNICEF and WHO, as well as multilateral and bilateral agencies, especially in health workforce training. New financial commitments from development partners and the private sector are substantial but tracking of national funding remains a challenge. For interventions with strong evidence, low levels of coverage persists and health information systems require investment and support to improve quality and quantity of data to guide and track progress. Some of the highest burden countries have established newborn health
Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A
Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare
José Simon Camelo Junior
Full Text Available Este trabalho avalia a eficiência da adição do exame da galactosemia junto ao Teste do Pezinho. Baseado na incidência média estimada de galactosemia, de 1:19.984 recém-nascidos, no Estado de São Paulo, Brasil, este estudo desenvolve um modelo de análise de custo-benefício, utilizando a relação benefício/custo (B/C, a taxa de juros de 9,25% ao ano para descapitalização dos resultados obtidos. Também se realiza uma análise de sensibilidade, em função da variação da taxa de juros entre 0 e 20% e do intervalo de 95% de confiança da incidência da galactosemia (1:7.494 a 1:59.953 recém-nascidos. A economia obtida com a melhora da saúde das crianças doentes identificadas precocemente é superior aos custos (B/C = 1,33, caracterizando como eficiente a política de adição do exame neonatal para galactosemia no Teste do Pezinho. Quanto menor a taxa de juros vigente na economia, mais eficiente é a política de triagem neonatal, não considerados os custos sociais intangíveis evitados.This study assesses the efficiency of the galactosemia add-on test in neonatal screening performed on regular Guthrie card blood spots. Based on estimated average incidence of galactosemia (1:19,984 newborns in São Paulo State, Brazil, the study develops a cost-benefit analysis model, using a B/C ratio and a 9.25% annual interest rate in order to decapitalize the results. Sensitivity analysis is also performed, varying (as a function of the interest or discount rate from 0 and 20% and according to the 95% confidence interval (1:7,494-1:59,953 newborns. The results show that the savings obtained by improved health of galactosemic patients detected early by add-on neonatal screening is superior to the costs (B/C=1.33, characterizing galactosemia add-on testing in neonatal screening as an efficient policy. The lower the prevailing interest rate in the economy, the more efficient the neonatal screening policy.
King, Jaime S.; Smith, Monica E.
State newborn screening (NBS) programs routinely screen nearly all of the 4 million newborns in the United States each year for ~30 primary conditions and a number of secondary conditions. NBS could be on the cusp of an unprecedented expansion as a result of advances in whole-genome sequencing (WGS). As WGS becomes cheaper and easier and as our knowledge and understanding of human genetics expand, the question of whether WGS has a role to play in state NBS programs becomes increasingly relevant and complex. As geneticists and state public health officials begin to contemplate the technical and procedural details of whether WGS could benefit existing NBS programs, this is an opportune time to revisit the legal framework of state NBS programs. In this article, we examine the constitutional underpinnings of state-mandated NBS and explore the range of current state statutes and regulations that govern the programs. We consider the legal refinements that will be needed to keep state NBS programs within constitutional bounds, focusing on 2 areas of concern: consent procedures and the criteria used to select new conditions for NBS panels. We conclude by providing options for states to consider when contemplating the use of WGS for NBS. PMID:26729704
... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...
The 2013 Advanced Environmental Health/Advanced Food Technology (AEH/AFT) Standing Review Panel (from here on referred to as the SRP) participated in a WebEx/teleconference with members of the Space Human Factors and Habitability (SHFH) Element, representatives from the Human Research Program (HRP), and NASA Headquarters on November 22, 2013 (list of participants is in Section IX of this report). The SRP reviewed the updated research plans for the Risk of Adverse Health Effects Due to Alterations in Host-Microorganism Interactions (Host Microbe Risk) and the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System (Food Risk). The SRP also received a status update on the Risk of Adverse Health Effects of Exposure to Dust and Volatiles during Exploration of Celestial Bodies (Dust Risk). Overall, the SRP was impressed with the strong research plans presented by the scientists and staff associated with the SHFH Element. The SRP also thought that the updated research plans were thorough, well organized, and presented in a comprehensive manner. The SRP agrees with the changes made to the Host Microbe Risk and Food Risk portfolios and thinks that the targets for Gap closure are appropriate.
Necrotizing enterocolitis of newborn (NEC) remains a significant cause of morbidity and mortality in neonatal intensive care units.Although many advances have been made in the understanding of this disease,the pathophysiology remains incompletely clear,and treatment is mainly limited to supportive care.In recent years,studies have focussd on the role of the inflammatory mediators,signaling and their impacts on the disease process.Investigators also made some advances in the fields of intestinal proteome and probiotics.Early breasffeeding and probiotics are promoted to prevent and/or amehorate neonatal NEC.In this artical,we reviewed the advances in the above fields for helping to the pathogenesis and treatment of NEC.%新生儿坏死性小肠结肠炎(necrotizing enterocolitis of newborn,NEC)在新生儿期发病率及致死率均较高,其发病的病理生理学机制尚未完全阐明,治疗上主要限于对症支持治疗.近年来,较多研究发现大量炎症因子及其介导的信号途径在NEC发生发展过程中具有重要作用；另外,在蛋白质组学、肠道微生态等领域的研究也取得了一些进展.在NEC的防治上,提倡早期母乳喂养和应用微生态制剂.本文就上述领域的研究作一综述,为探讨NEC发病机制及防治奠定基础.
Full Text Available BACKGROUND: Accurate data on coverage of key maternal, newborn, and child health (MNCH interventions are crucial for monitoring progress toward the Millennium Development Goals 4 and 5. Coverage estimates are primarily obtained from routine population surveys through self-reporting, the validity of which is not well understood. We aimed to examine the validity of the coverage of selected MNCH interventions in Gongcheng County, China. METHOD AND FINDINGS: We conducted a validation study by comparing women's self-reported coverage of MNCH interventions relating to antenatal and postnatal care, mode of delivery, and child vaccinations in a community survey with their paper- and electronic-based health care records, treating the health care records as the reference standard. Of 936 women recruited, 914 (97.6% completed the survey. Results show that self-reported coverage of these interventions had moderate to high sensitivity (0.57 [95% confidence interval (CI: 0.50-0.63] to 0.99 [95% CI: 0.98-1.00] and low to high specificity (0 to 0.83 [95% CI: 0.80-0.86]. Despite varying overall validity, with the area under the receiver operating characteristic curve (AUC ranging between 0.49 [95% CI: 0.39-0.57] and 0.90 [95% CI: 0.88-0.92], bias in the coverage estimates at the population level was small to moderate, with the test to actual positive (TAP ratio ranging between 0.8 and 1.5 for 24 of the 28 indicators examined. Our ability to accurately estimate validity was affected by several caveats associated with the reference standard. Caution should be exercised when generalizing the results to other settings. CONCLUSIONS: The overall validity of self-reported coverage was moderate across selected MNCH indicators. However, at the population level, self-reported coverage appears to have small to moderate degree of bias. Accuracy of the coverage was particularly high for indicators with high recorded coverage or low recorded coverage but high specificity. The
Full Text Available Abstract Background The UN Millennium Development Goals call for substantial reductions in maternal and child mortality, to be achieved through reductions in morbidity and mortality during pregnancy, delivery, postpartum and early childhood. The MaiMwana Project aims to test community-based interventions that tackle maternal and child health problems through increasing awareness and local action. Methods/Design This study uses a two-by-two factorial cluster-randomised controlled trial design to test the impact of two interventions. The impact of a community mobilisation intervention run through women's groups, on home care, health care-seeking behaviours and maternal and infant mortality, will be tested. The impact of a volunteer-led infant feeding and care support intervention, on rates of exclusive breastfeeding, uptake of HIV-prevention services and infant mortality, will also be tested. The women's group intervention will employ local female facilitators to guide women's groups through a four-phase cycle of problem identification and prioritisation, strategy identification, implementation and evaluation. Meetings will be held monthly at village level. The infant feeding intervention will select local volunteers to provide advice and support for breastfeeding, birth preparedness, newborn care and immunisation. They will visit pregnant and new mothers in their homes five times during and after pregnancy. The unit of intervention allocation will be clusters of rural villages of 2500-4000 population. 48 clusters have been defined and randomly allocated to either women's groups only, infant feeding support only, both interventions, or no intervention. Study villages are surrounded by 'buffer areas' of non-study villages to reduce contamination between intervention and control areas. Outcome indicators will be measured through a demographic surveillance system. Primary outcomes will be maternal, infant, neonatal and perinatal mortality for the
Sagedal Linda Reme
Full Text Available Abstract Background The global obesity epidemic has led to increased attention on pregnancy, a period when women are at risk of gaining excessive weight. Excessive gestational weight gain is associated with numerous complications, for both mother and child. Though the problem is widespread, few studies have examined the effect of a lifestyle intervention in pregnancy designed to limit maternal weight gain. The Fit for Delivery study will explore the effectiveness of nutritional counseling coupled with exercise classes compared with standard prenatal care. The aims of the study are to examine the effect of the intervention on maternal weight gain, newborn birth weight, glucose regulation, complications of pregnancy and delivery, and maternal weight retention up to 12 months postpartum. Methods/design Fit for Delivery is a randomized controlled trial that will include 600 women expecting their first child. To be eligible, women must be 18 years of age or older, of less than 20 weeks gestational age, with a singleton pregnancy, and have a Body Mass Index (BMI ≥ 19 kg/m2. The women will be randomly allocated to either an intervention group or a control group. The control group will receive standard prenatal care. The intervention group will, in addition, receive nutritional counseling by phone, access to twice-weekly exercise sessions, and information on healthy eating and physical activity provided in pamphlets, evening meetings and an interactive website. Both groups will be monitored by weighing (including bioimpedance measurements of percent body fat, blood tests, self-report questionnaires and hospital record review. Discussion Weight gained in pregnancy affects the health of both the mother and her unborn child, and simple models for efficient intervention are in high demand. The Fit for Delivery intervention provides concrete advice on limiting energy intake and practical training in increasing physical activity. This lifestyle intervention
Hermansen, Christian L; Mahajan, Anand
Newborn respiratory distress presents a diagnostic and management challenge. Newborns with respiratory distress commonly exhibit tachypnea with a respiratory rate of more than 60 respirations per minute. They may present with grunting, retractions, nasal flaring, and cyanosis. Common causes include transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia, sepsis, pneumothorax, persistent pulmonary hypertension of the newborn, and delayed transition. Congenital heart defects, airway malformations, and inborn errors of metabolism are less common etiologies. Clinicians should be familiar with updated neonatal resuscitation guidelines. Initial evaluation includes a detailed history and physical examination. The clinician should monitor vital signs and measure oxygen saturation with pulse oximetry, and blood gas measurement may be considered. Chest radiography is helpful in the diagnosis. Blood cultures, serial complete blood counts, and C-reactive protein measurement are useful for the evaluation of sepsis. Most neonates with respiratory distress can be treated with respiratory support and noninvasive methods. Oxygen can be provided via bag/mask, nasal cannula, oxygen hood, and nasal continuous positive airway pressure. Ventilator support may be used in more severe cases. Surfactant is increasingly used for respiratory distress syndrome. Using the INSURE technique, the newborn is intubated, given surfactant, and quickly extubated to nasal continuous positive airway pressure. Newborns should be screened for critical congenital heart defects via pulse oximetry after 24 hours but before hospital discharge. Neonatology consultation is recommended if the illness exceeds the clinician's expertise and comfort level or when the diagnosis is unclear in a critically ill newborn. PMID:26760414
Twenty cases of hemothorax in newborns are reviewed in detail. This unusual cause of acute respiratory distress within the neonatal period was observed in 14 males and 6 females. Most of the patients were fullterm newborns. As causal factors hemorrhagic disease of the newborn (vitamin K deficiency), disseminated intravascular coagulation, arteriovenous malformations and pleural/vascular rupture are considered. The time of occurrence of bleeding symptoms ranged from 1 to 28 days of life. Sixteen out of 20 patients survived without sequelae, but in 4 cases the outcome was lethal. (orig.)
McAuliffe Eilish; Bradley Susan
Abstract Background Malawi has a chronic shortage of human resources for health. This has a significant impact on maternal health, with mortality rates amongst the highest in the world. Mid-level cadres of health workers provide the bulk of emergency obstetric and neonatal care. In this context these cadres are defined as those who undertake roles and tasks that are more usually the province of internationally recognised cadres, such as doctors and nurses. While there have been several studie...
At MDS Nordion we use nuclear science and technology to advance human life and health through a wide range of applications. We could not do this without the strong partnerships we have formed with the Canadian nuclear power industry. Together, we have developed and applied radioisotope technology in ways that have saved millions of lives around the world. This is a success story of which we all can be proud. It is a success story that we should share with others. As an industry, we are often challenged by activists , who fear and attack anything nuclear and who do not care to understand how vital nuclear energy and nuclear science are to an environmentally sound, economically healthy future. MDS Nordion has not escaped this kind of public scrutiny, but much of this criticism is muted by the tremendous contributions we have made to medicine and health care generally. That is why it is so important for you to see MDS Nordion's story as a success story that everyone in the industry has contributed to, in the support they have provided, and in the products or services they supply
... for yourself. When quiet and alert without other distractions, will your baby look at your face or ... your baby react to soft lullabies or other music? Even if your child passed the newborn hearing ...
... newborn needs, and all of its components — lactose, protein (whey and casein), and fat — are easily digested. Commercial ... quart, of formula a day may need additional vitamin D supplementation. Water, juice, and other foods usually aren't ...
The 2015 Advanced Environmental Health/Advanced Food Technology (AEH/AFT) Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on December 14 - 15, 2015. The SRP met with representatives from the Space Human Factors and Habitability (SHFH) Element and members of the Human Research Program (HRP) to review the updated research plans for the Risk of Adverse Health Effects Due to Host-Microorganism Interactions (MicroHost Risk) and the Risk of Performance Decrement and Crew Illness due to an Inadequate Food System (Food Risk). During the meeting, the SRP also met with the vehicle engineers to discuss possible food storage options. The SRP would like to commend Dr. Oubre and Dr. Douglas for their detailed presentations, as well the frank, refreshing, and comprehensive engineering presentation. This gave much needed perspective to the food storage issues and reassured the committee about NASA's approach to the problem. In terms of critiques, the SRP remains unconvinced about the rationale for probiotic use other than for specific applications supported by the literature. It is not clear what gap or problem is being addressed by the use of probiotics, and the rationale for their use needs to be clearly rooted in the available literature. The SRP thinks that if low-Earth orbit is associated with immune system impairment, then there may additional risks linked with the use of probiotics. It is not clear to the SRP how NASA will determine if probiotics are having their intended beneficial effect. A similar concern is raised as to what gaps or problems are being addressed by "functional foods". Mixed infections, rather than single species infections, which can augment severity of disease, also represent a significant concern. Overall, the SRP considers this to be a strong program that is well-organized, well-coordinated and generates valuable data.
Full Text Available Newborn screening is important for the early detection of many congenital genetic and metabolic disorders, aimed at the earliest possible recognition and management of affected newborns, to prevent the morbidity, mortality, and disabilities associated with an inherited metabolic disorder. This comprehensive system includes; testing, education, follow up, diagnosis, treatment, management, and evaluation. There are major differences among many of the disorders being considered for inclusion in newborn screening programs. In recent times, advances in laboratory technology such as tandem mass spectrometry (MS/MS, which is more specific, sensitive, reliable, and comprehensive than traditional assays, has increased the number of genetic conditions that can be diagnosed through neonatal screening programs at birth. With a single dried filter paper blood spot, MS/MS can identify more than 30 inherited metabolic disorders in around two to three minutes. Advances in the diagnosis and treatment and an increased understanding of the natural history of inborn errors of metabolism have produced pressure to implement expanded newborn screening programs in many countries. Even as many countries throughout the world have made newborn screening mandatory, in Iran, nationwide newborn screening for inherited metabolic disorders other than hypothyroidism has not been initiated, hence, there is little information about these diseases. This article aims to review the recent advances in newborn metabolic screening and its situation in Iran and other countries.
Peterka, Miroslav; Likovský, Zbyněk; Peterková, Renata
Vol. 23. Dordrecht: Springer, 2007 - (Nicolopoulou-Stamati, P.), s. 295-319 ISBN 978-1-4020-4830-2 Institutional research plan: CEZ:AV0Z50390512 Keywords : newborn sex ratio * spontaneous abortion s Subject RIV: DN - Health Impact of the Environment Quality
... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...
Background Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania. Methods We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data. Results We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts. Conclusions In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for
Solange Gould; Linda Rudolph
Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals a...
Heller, Jonathan; Givens, Marjory L; Yuen, Tina K; Gould, Solange; Jandu, Maria Benkhalti; Bourcier, Emily; Choi, Tim
Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193
Full Text Available Equity is a core value of Health Impact Assessment (HIA. Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1 the HIA process and products focused on equity; (2 the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3 the HIA resulted in a shift in power benefiting communities facing inequities; and (4 the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.
Full Text Available Background: A new cadre of village-based frontline health workers, called Accredited Social Health Activists (ASHAs, was created in India. However, coverage of selected community-based maternal, newborn and child health (MNCH services remains low. Objective: This article describes the process of development and formative evaluation of a complex mHealth intervention (ImTeCHO to increase the coverage of proven MNCH services in rural India by improving the performance of ASHAs. Design: The Medical Research Council (MRC framework for developing complex interventions was used. Gaps were identified in the usual care provided by ASHAs, based on a literature search, and SEWA Rural's1 three decades of grassroots experience. The components of the intervention (mHealth strategies were designed to overcome the gaps in care. The intervention, in the form of the ImTeCHO mobile phone and web application, along with the delivery model, was developed to incorporate these mHealth strategies. The intervention was piloted through 45 ASHAs among 45 villages in Gujarat (population: 45,000 over 7 months in 2013 to assess the acceptability, feasibility, and usefulness of the intervention and to identify barriers to its delivery. Results: Inadequate supervision and support to ASHAs were noted as a gap in usual care, resulting in low coverage of selected MNCH services and care received by complicated cases. Therefore, the ImTeCHO application was developed to integrate mHealth strategies in the form of job aid to ASHAs to assist with scheduling, behavior change communication, diagnosis, and patient management, along with supervision and support of ASHAs. During the pilot, the intervention and its delivery were found to be largely acceptable, feasible, and useful. A few changes were made to the intervention and its delivery, including 1 a new helpline for ASHAs, 2 further simplification of processes within the ImTeCHO incentive management system and 3 additional web
U.S. Department of Health & Human Services — This table presents counts of disorders that have been diagnosed by the California Newborn Screening program during the five-year period from 2009 through 2014....
U.S. Department of Health & Human Services — This table presents the disorders diagnosed by the California Newborn Screening Program during the five-year period from 2009 through 2014. The counts of disorders...
U.S. Department of Health & Human Services — The article, Trends In Complicated Newborn Hospital Stays and Costs, 2002-2009, Implications For the Future, published in Volume 4, Issue 4 of Medicare and Medicaid...
... pregnancy because it can cause the birth defect microcephaly -- where babies are born with a small head ... The newborn was delivered in Harris County, had microcephaly, and died shortly after birth, state health officials ...
A descriptive study of series of cases in 152 newborns was carried out at the maternity ward at V.I.Lenin hospital from January to March 2005, through fontanel echoencephalography and the health histories review, aimed at widening the radiologists' and neonatologists' general knowledge on intracranial haemorrhage.15.80 % of them had intraventricular haemorrhage, with predominant grade I, the diagnosis was done within the first 72 hours after birth,57.14 % were through instrumental labor and the most frequent ones were in the preterm labors. 64.29% of the newborns weighing between 1500 and 2500 grams had intraventricular haemorrhage. The authors recommended to do echoencephalographies to all newborns with risk factors within 72 hours after birth and a new strategy of follow up imaging intervention to the affected children was suggested
Kassab, Manal; Alnuaimi, Karimeh; Mohammad, Khitam; Creedy, Debra; Hamadneh, Shereen
Newborns who are compromised at birth require rapid attention to stabilize their respiration attempts. Lack of knowledge regarding basic newborn resuscitation is a contributing factor to poor newborn health outcomes and increased mortality. The purpose of this study was to explore Jordanian midwives' experiences, education, and support needs to competently perform basic newborn resuscitation. Qualitative descriptive methodology was used to analyze a convenience sample of 20 midwives. A thematic approach was used to analyze the data. Participants discussed their experiences of basic newborn resuscitation including knowledge, skills, and barriers and suggested solutions to improve practice. Four themes were revealed: lack of knowledge and skills in newborn resuscitation, organizational constraints, inadequate teamwork, and educational needs. The midwives perceived that their ability to perform newborn resuscitation was hindered by lack of knowledge and skills in newborn resuscitation, organizational constraints (such as lack of equipment), and poor co-ordination and communication among team members. PMID:26635311
Raquel Martins Maia
Full Text Available OBJETIVO: analisar o acompanhamento dos recém-nascidos quanto à promoção da saúde auditiva após a inserção da fonoaudiologia na Estratégia Saúde da Família. MÉTODO: estudo retrospectivo e documental com abordagem quantitativa com 88 recém-nascidos que realizaram o teste da orelhinha, no período de fevereiro a maio de 2010, a partir dos relatórios mensais de devolutiva do Serviço de Atenção a Saúde Auditiva do município, consolidados mensais e prontuários de um Centro de Saúde da Família em Sobral-Ce. RESULTADOS: dos recém-nascidos avaliados, 35 (39,77% falharam no teste, entre estes, 7 (20% apresentam indicador de risco para deficiência auditiva e 28 (80% não apresentavam nenhum risco. Verificou-se também divergências entre os dados do Serviço de Atenção a Saúde Auditiva e os prontuários do Centro de Saúde da Família quanto a classificação dos indicadores de risco para a perda auditiva. Observou-se ainda que, o número de encaminhamentos para o teste da orelhinha aumentou 8,33%. Em relação ao reteste, 1 (7,69% criança retornou nos meses de março a agosto de 2009 e entre os meses de setembro/2009 a fevereiro/2010 após a atuação da fonoaudiologia no CSF do Sumaré 17 (65,38% crianças realizaram o reteste. CONCLUSÃO: os dados sugerem a importância da presença do fonoaudiólogo na atenção primária, sendo fundamental no acompanhamento e monitoramento do diagnóstico precoce das alterações auditivas.PURPOSE: to analyze the monitoring of the newborn and the promotion of hearing health after insertion of speech therapy at the Family Health Strategy. METHOD: this is a retrospective documentary study with quantitative approach using 88 infants who underwent OAE testing in the period from February to May 2010, we examined the monthly reports’ devolution of the Health Hearing Service of the Municipality, consolidated monthly statements and the handbooks of the Center for Family Health in Sobral
Araia, Makda H; Potter, Beth K
The Internet is a potentially important medium for communication about public health programs including newborn screening. This study explores whether the information available on official newborn screening program websites is consistent with existing guidelines regarding educational content for parents. We conducted a systematic search of the public websites of newborn screening programs in the US and Canada, identifying web pages and downloadable brochures that contained educational information. Two researchers independently reviewed all documents to determine the extent to which they included 14 key recommended educational messages. We identified 85 documents containing educational information on 46 US and 6 Canadian newborn screening program websites. The documents contained from 1 to 14 of the recommended messages. The majority of identified materials emphasized the importance and benefits of screening. The differences between US and Canadian materials were related to the importance of parental involvement in follow-up and issues of consent and storage of blood spots. Our findings are consistent with studies of non-web-based newborn screening education materials. The results emphasize the need for further evaluation of newborn screening education, including internet-based resources, particularly in terms of the impact of particular messages on parental attitudes and behaviors. PMID:22109819
Full Text Available Abstract Background Malawi has a chronic shortage of human resources for health. This has a significant impact on maternal health, with mortality rates amongst the highest in the world. Mid-level cadres of health workers provide the bulk of emergency obstetric and neonatal care. In this context these cadres are defined as those who undertake roles and tasks that are more usually the province of internationally recognised cadres, such as doctors and nurses. While there have been several studies addressing retention factors for doctors and registered nurses, data and studies addressing the perceptions of these mid-level cadres on the factors that influence their performance and retention within health care systems are scarce. Methods This exploratory qualitative study took place in four rural mission hospitals in Malawi. The study population was mid-level providers of emergency obstetric and neonatal care. Focus group discussions took place with nursing and medical cadres. Semi-structured interviews with key human resources, training and administrative personnel were used to provide context and background. Data were analysed using a framework analysis. Results Participants confirmed the difficulties of their working conditions and the clear commitment they have to serving the rural Malawian population. Although insufficient financial remuneration had a negative impact on retention and performance, the main factors identified were limited opportunities for career development and further education (particularly for clinical officers and inadequate or non-existent human resources management systems. The lack of performance-related rewards and recognition were perceived to be particularly demotivating. Conclusion Mid-level cadres are being used to stem Africa's brain drain. It is in the interests of both the government and mission organizations to protect their investment in these workers. For optimal performance and quality of care they need to be
Camila Padilha Barbosa
professional participating (nurses, technicians and assistants working in a university hospital between March and September of 2011. All of the interviewees answered a semi-structured questionnaire before and after the educational actions. RESULTS: We observed a significant change in the knowledge of the nursing professionals after the educational activity in most of the variables; such as: ideal age to perform the newborn hearing screening; ideal age to diagnose hearing loss; ideal age to start intervention against hearing loss and risk indicators for hearing loss. CONCLUSION: It is believed that the methodology used in educational activities, based on problems found in professional practice, education may have contributed greatly to increase knowledge about hearing health, especially concerning neonates and infants.
... Hearing, Language, Voice, Balance Screening Newborns' Hearing Now Standard Past Issues / Fall 2013 Table of Contents Click ... the World from Spinning / Screening Newborns' Hearing Now Standard Fall 2013 Issue: Volume 8 Number 3 Page ...
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Krotoski, Danuta; Namaste, Sorrel; Raouf, Randa Kamal; El Nekhely, Ibrahim; Hindi-Alexander, Michele; Engelson, Gilian; Hanson, James W; Howell, R Rodney
The second conference of the Middle East and North Africa newborn screening initiative: partnerships for sustainable newborn screening infrastructure and research opportunities was held in Cairo, Arab Republic of Egypt on April 12 to 14, 2008. Policy makers, health ministry representatives, health care providers, and experts from the region, Europe, Asia, and North America participated. The primary outcome was development of country plans of action to implement or expand newborn screening programs. Country representatives were grouped by current levels of national newborn screening activities based on a Needs Assessment Survey for national newborn screening programs and assisted by international technical experts. The Needs Assessment Survey provided information on the level of newborn screening in each country, strengths and barriers to implementation of newborn screening programs, and identified areas for research. Newborn screening programs require an integrated system of laboratories, health care providers, and educators, thus, the infrastructure put in place to screen for one condition should support expansion to other conditions. Congenital hypothyroidism was selected for initiating newborn screening programs because of its high prevalence, availability of screening methods, and cost-effective intervention. To this end, the conference provided technical sessions on screening and treatment of congenital hypothyroidism, performance standards, quality assurance, follow-up interventions, and patient management. In addition, presentations highlighted the value of integrating research into newborn screening programs as they are established and in evaluating outcomes. Research opportunities were identified at a postconference workshop sponsored by the US Civilian Research Development Foundation. PMID:19606054
Wilder, Christine M; Swanson, Jeffrey W; Bonnie, Richard J; Wanchek, Tanya; McLaughlin, Laura; Richardson, Jeanita
An innovative Virginia health care law enables competent adults with serious mental illness to plan for treatment during incapacitating crises using an integrated advance directive with no legal distinction between psychiatric or other causes of decisional incapacity. This article reports results of a survey of 460 individuals in five stakeholder groups during the initial period of the law's implementation. All respondents held favorable views of advance directives for mental health care. Identified barriers to completing and using advance directives varied by group. We conclude that relevant stakeholders support implementation of advance directives for mental health, but level of baseline knowledge and perception of barriers vary. A multi-pronged approach will be needed to achieve successful implementation of advance directives for mental health. PMID:22240937
Andre W. Kushniruk
Full Text Available This special issue of the KM&EL international journal is dedicated to coverage of novel advances in health professional education applying e-Learning, simulations and distance education technologies. Modern healthcare is beginning to be transformed through the emergence of new information technologies and rapid advances in health informatics. Advances such as electronic health record systems (EHRs, clinical decision support systems and other advanced information systems such as public health surveillance systems are rapidly being deployed worldwide. The education of health professionals such as medical, nursing and allied health professionals will require an improved understanding of these technologies and how they will transform their healthcare practice. However, currently there is a lack of integration of knowledge and skills related to such technology in health professional education. In this issue of the journal we present articles that describe a set of novel approaches to integrating essential health information technology into the education of health professionals, as well as the use of advanced information technologies and e-Learning approaches for improving health professional education. The approaches range from use of simulations to development of novel Web-based platforms for allowing students to interact with the technologies and healthcare practices that are rapidly changing healthcare.
Science Teacher, 2005
Scientists using NASA's Swift satellite say they have found newborn black holes, just seconds old, in a confused state of existence. The holes are consuming material falling into them while somehow propelling other material away at great speeds. "First comes a blast of gamma rays followed by intense pulses of x-rays. The energies involved are much…
... this page: //medlineplus.gov/ency/article/001914.htm Nail care for newborns To use the sharing features on ... finger or toe instead of the nail. Baby's nails grow quickly, so you may have to cut the fingernails at least once a week. You may only need ... SG, Bedwell C, Cork MJ. Neonatal skin care and toxicology. In: Eichenfield LF, Frieden IJ, Mathes ...
Full Text Available Definition of pain. The International Association for the Study of Pain has defined pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage." The interpretation of pain is subjective. Each person forms an internal construct of pain through encountered injury. Pain and newborn. The issue of pain perception in newborns, its management and prevention has been neglected for decades. The inability of "self-report" of painful experience has contributed significantly to misunderstanding of the importance of this problem and inadequate treatment. The main characteristic of this 'critical window of brain development' period is rapid enlargement of brain volume and its great plasticity. Harmful short-term and long-term consequences can arise as a consequence of disturbance of the sophisticated balance between newborn and its surrounding. Neonatal pain indicators. As a response to a present painful stimulus, the newborn adapts to this acute stress with changes in endocrine, vegetative, immune and behavioral area. An ideal pain indicator in neonatal period does not exist. There are several different groups o them, namely contextual and developmental indicators (gestational age, contributed illness, medication, for example, physiological (heart rate, vagal tone, breathing rate, blood pressure, oxygen saturation, transcutaneous partial pressures of oxygen and carbon-dioxide, intracranial pressure, palm sweating and behavioral ones (face expression, movements of limbs, cry, several neonatal pain scales were constructed on the basis of these indicators. .
... to 4 days. Newborns usually have several poopy diapers a day if breastfed and fewer if formula-fed. What to Expect Being small or large at birth doesn't necessarily mean a baby will be small or large later in childhood or as an adult. Plenty of towering teenagers began life as small ...
In his perspective "Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health," Ooms argues that actions taken in the field of global health are dependent not only on available resources, but on the normative premise that guides how these resources are spent. This comment sets out how the application of a predominately biomedical positivist research tradition in global health, has potentially limited understanding of the value judgements underlying decisions in the field. To redress this critical social science, including health policy analysis has much to offer, to the field of global health including on questions of governance. PMID:27239873
Heyn, Holger; Li, Ning; Ferreira, Humberto J.; Moran, Sebastian; Pisano, David G.; Gomez, Antonio; Diez, Javier; Sanchez-Mut, Jose V.; Setien, Fernando; Carmona, F. Javier; Puca, Annibale A.; Sayols, Sergi; Pujana, Miguel A.; Serra-Musach, Jordi; Iglesias-Platas, Isabel; Formiga, Francesc; Fernandez, Agustin F.; Fraga, Mario F.; Heath, Simon C.; Valencia, Alfonso; Gut, Ivo G.; Wang, Jun; Esteller, Manel
Human aging cannot be fully understood in terms of the constrained genetic setting. Epigenetic drift is an alternative means of explaining age-associated alterations. To address this issue, we performed whole-genome bisulfite sequencing (WGBS) of newborn and centenarian genomes. The centenarian DNA had a lower DNA methylation content and a reduced correlation in the methylation status of neighboring cytosine—phosphate—guanine (CpGs) throughout the genome in comparison with the more homogeneously methylated newborn DNA. The more hypomethylated CpGs observed in the centenarian DNA compared with the neonate covered all genomic compartments, such as promoters, exonic, intronic, and intergenic regions. For regulatory regions, the most hypomethylated sequences in the centenarian DNA were present mainly at CpG-poor promoters and in tissue-specific genes, whereas a greater level of DNA methylation was observed in CpG island promoters. We extended the study to a larger cohort of newborn and nonagenarian samples using a 450,000 CpG-site DNA methylation microarray that reinforced the observation of more hypomethylated DNA sequences in the advanced age group. WGBS and 450,000 analyses of middle-age individuals demonstrated DNA methylomes in the crossroad between the newborn and the nonagenarian/centenarian groups. Our study constitutes a unique DNA methylation analysis of the extreme points of human life at a single-nucleotide resolution level. PMID:22689993
Stenberg, Karin; Axelson, Henrik; Sheehan, Peter; Anderson, Ian; Gülmezoglu, A Metin; Temmerman, Marleen; Mason, Elizabeth; Friedman, Howard S; Bhutta, Zulfiqar A; Lawn, Joy E; Sweeny, Kim; Tulloch, Jim; Hansen, Peter; Chopra, Mickey; Gupta, Anuradha; Vogel, Joshua P; Ostergren, Mikael; Rasmussen, Bruce; Levin, Carol; Boyle, Colin; Kuruvilla, Shyama; Koblinsky, Marjorie; Walker, Neff; de Francisco, Andres; Novcic, Nebojsa; Presern, Carole; Jamison, Dean; Bustreo, Flavia
A new Global Investment Framework for Women's and Children's Health demonstrates how investment in women's and children's health will secure high health, social, and economic returns. We costed health systems strengthening and six investment packages for: maternal and newborn health, child health, immunisation, family planning, HIV/AIDS, and malaria. Nutrition is a cross-cutting theme. We then used simulation modelling to estimate the health and socioeconomic returns of these investments. Increasing health expenditure by just $5 per person per year up to 2035 in 74 high-burden countries could yield up to nine times that value in economic and social benefits. These returns include greater gross domestic product (GDP) growth through improved productivity, and prevention of the needless deaths of 147 million children, 32 million stillbirths, and 5 million women by 2035. These gains could be achieved by an additional investment of $30 billion per year, equivalent to a 2% increase above current spending. PMID:24263249
Bloomfield, Victor A.; Kuhl, Michelle Wittcoff
In today's resource-scarce environment, science, technology, engineering, and mathematics (STEM) and health science disciplines must partner with institutional advancement offices to support two key components of research universities--research and graduate education. Framing the partnership in terms of societal needs helps advancement officers to…
Warren, Johanna B; Phillipi, Carrie A
The birth of an infant is one of the most memorable experiences a family shares. Pediatric health care professionals are privileged to participate in this experience and recognize it as a time to promote the health of the newborn and family. Ideally, a well-designed care system would be replete with comprehensive supports during the prenatal period, birth, and transition to home. Opportunities exist to improve the care we deliver with universal screening of all pregnant women; coordinated assessments of family health, including mental health; and access to coordinated supports and services for mother and infant. If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, it is estimated the United States would save billions of dollars per year and prevent more than 900 deaths, nearly all of which would be in infants. All infants, whether breastfed or formula fed, should receive 400 IU supplemental vitamin D. Influenza and TdaP vaccination of postpartum mothers and other caregivers helps cocoon the vulnerable infant from influenza and pertussis until he or she can be fully vaccinated. When children reach the highest weight or length allowed by the manufacturer of their infant-only seat, they should continue to ride rear-facing in a convertible seat. It is best for children to ride rear-facing as long as possible to the highest weight and height allowed by the manufacturer of their convertible seat. PMID:22210929
Becker, AJ; Marchant, T
Quality of care can be measured by seeing if skilled birth attendants use simple approaches to save lives. Skilled birth attendants range from trained community health workers to nurses, doctors and midwives. Findings from three low-income settings show quality of care for the newborn is low even when a skilled birth attendant is at the mother’s side during birth. Source: 2012 Baseline survey data, the IDEAS project, based at the London School of Hygiene & Tropical Medicine. Funded by the...
Anca Chiriac; Chiriac, Anca E; Piotr Brzezinski
A newborn, male gender, born at term, APGAR 10, was addressed to us for occipital alopecia observed since birth (Fig. 1). Mother was a young health person of 25 years old, primipara and the birth was non-Caesarian delivery. Alopecia was confirmed in the occipital area, with no signs of inflammation or other dermatological problems on the whole body. A diagnosis of frictional/pressure occipital alopecia was admitted and the family was reassured of the absence of any inquiry.
Limited informatics competency uptake is a recognized nursing leadership challenge impacting digital practice settings. The health system's inability to reap the promised benefits of EHRs is a manifestation of inadequate development of informatics competencies by chief nurse executives (CNEs) and other clinicians. Through the application of Transformational Leadership Theory (TL), this discussion paper explains how informatics competencies enable CNEs to become transformational nursing leaders in digital health allowing them to meet their accountabilities to lead integrated, high-quality care delivery through evidence based practices (EBPs). It is proposed that successful CNE eHealth sponsors will be those armed with informatics competencies who can drive health organizations' investment in technology and innovation. Finally, some considerations are suggested in how nurse informaticists globally play a critical role in preparing our existing and future CNEs to fulfill their transformational leader roles in the digital age. PMID:27332233
Rolland, John S
Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002). C. J. Peek has provided us with a masterful integration of Don Bloch's vision of collaborative family health care and the evolution over the past 20 years of the field. The current author was very fortunate to be part of the initial meeting at Wingspread in 1994. As a family systems-oriented community and public health-trained psychiatrist, my primary focus over 30 years has been on families facing chronic illness and disability and collaborative care efforts in specialty, primary, rehabilitation, and palliative care medicine. In my view, the ability of the health care consumer (patient and his or her family members) and professional worlds to collaborate in a more egalitarian and less hierarchical and wary manner remains a significant constraint to progress. PMID:26053574
Martin, Greg; MacLachlan, Malcolm; Labonté, Ronald; Larkan, Fiona; Vallières, Frédérique; Bergin, Niamh
Founded in 2005, Globalization and Health was the first open access global health journal. The journal has since expanded the field, and its influence, with the number of downloaded papers rising 17-fold, to over 4 million. Its ground-breaking papers, leading authors -including a Nobel Prize winner- and an impact factor of 2.25 place it among the top global health journals in the world. To mark the ten years since the journal's founding, we, members of the current editorial board, undertook a review of the journal's progress over the last decade. Through the application of an inductive thematic analysis, we systematically identified themes of research published in the journal from 2005 to 2014. We identify key areas the journal has promoted and consider these in the context of an existing framework, identify current gaps in global health research and highlight areas we, as a journal, would like to see strengthened. PMID:26961760
Hankivsky, Olena; Reid, Colleen; Cormier, Renee; Varcoe, Colleen; Clark, Natalie; Benoit, Cecilia; Brotman, Shari
Women's health research strives to make change. It seeks to produce knowledge that promotes action on the variety of factors that affect women's lives and their health. As part of this general movement, important strides have been made to raise awareness of the health effects of sex and gender. The resultant base of knowledge has been used to inform health research, policy, and practice. Increasingly, however, the need to pay better attention to the inequities among women that are caused by racism, colonialism, ethnocentrism, heterosexism, and able-bodism, is confronting feminist health researchers and activists. Researchers are seeking new conceptual frameworks that can transform the design of research to produce knowledge that captures how systems of discrimination or subordination overlap and "articulate" with one another. An emerging paradigm for women's health research is intersectionality. Intersectionality places an explicit focus on differences among groups and seeks to illuminate various interacting social factors that affect human lives, including social locations, health status, and quality of life. This paper will draw on recently emerging intersectionality research in the Canadian women's health context in order to explore the promises and practical challenges of the processes involved in applying an intersectionality paradigm. We begin with a brief overview of why the need for an intersectionality approach has emerged within the context of women's health research and introduce current thinking about how intersectionality can inform and transform health research more broadly. We then highlight novel Canadian research that is grappling with the challenges in addressing issues of difference and diversity. In the analysis of these examples, we focus on a largely uninvestigated aspect of intersectionality research - the challenges involved in the process of initiating and developing such projects and, in particular, the meaning and significance of social
Full Text Available Abstract Women's health research strives to make change. It seeks to produce knowledge that promotes action on the variety of factors that affect women's lives and their health. As part of this general movement, important strides have been made to raise awareness of the health effects of sex and gender. The resultant base of knowledge has been used to inform health research, policy, and practice. Increasingly, however, the need to pay better attention to the inequities among women that are caused by racism, colonialism, ethnocentrism, heterosexism, and able-bodism, is confronting feminist health researchers and activists. Researchers are seeking new conceptual frameworks that can transform the design of research to produce knowledge that captures how systems of discrimination or subordination overlap and "articulate" with one another. An emerging paradigm for women's health research is intersectionality. Intersectionality places an explicit focus on differences among groups and seeks to illuminate various interacting social factors that affect human lives, including social locations, health status, and quality of life. This paper will draw on recently emerging intersectionality research in the Canadian women's health context in order to explore the promises and practical challenges of the processes involved in applying an intersectionality paradigm. We begin with a brief overview of why the need for an intersectionality approach has emerged within the context of women's health research and introduce current thinking about how intersectionality can inform and transform health research more broadly. We then highlight novel Canadian research that is grappling with the challenges in addressing issues of difference and diversity. In the analysis of these examples, we focus on a largely uninvestigated aspect of intersectionality research - the challenges involved in the process of initiating and developing such projects and, in particular, the meaning
Sheridan, P G
The National Institute of Dental Research (NIDR) was created by President Harry S Truman on June 24, 1948, as the third of the National Institutes of Health. NIDR's legislation contained the mandate to conduct research and research training to improve oral health. An impetus for federally funded dental research was the finding in World War II that the major cause of rejection for military service was missing teeth. Because of the population's widespread tooth decay problems, early NIDR resear...
Tchounwou, Paul B.
During the past century, environmental hazards have become a major concern, not only to public health professionals, but also to the society at large because of their tremendous health, socio-cultural and economic impacts. Various anthropogenic or natural factors have been implicated in the alteration of ecosystem integrity, as well as in the development of a wide variety of acute and/or chronic diseases in humans. It has also been demonstrated that many environmental agents, acting either in...
This volume presents the contributions of the third International Conference on Advancements of Medicine and Health Care through Technology (Meditech 2014), held in Cluj-Napoka, Romania. The papers of this Proceedings volume present new developments in - Health Care Technology, - Medical Devices, Measurement and Instrumentation, - Medical Imaging, Image and Signal Processing, - Modeling and Simulation, - Molecular Bioengineering, - Biomechanics.
Sauer, Mark V
Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction. PMID:25934599
Full Text Available Child Health and Nutrition Research Initiative (CHNRI started as an initiative of the Global Forum for Health Research in Geneva, Switzerland. Its aim was to develop a method that could assist priority setting in health research investments. The first version of the CHNRI method was published in 2007–2008. The aim of this paper was to summarize the history of the development of the CHNRI method and its key conceptual advances.
Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have
... baby > Newborn screening tests for your baby Newborn screening tests for your baby E-mail to a ... be treated if found early. What is newborn screening? Before your baby leaves the hospital, he has ...
Rock, Michael J.; Levy, Hara; Zaleski, Christina; Farrell, Philip M.
Newborn screening is a public health policy program involving the centralized testing laboratory, infant and their family, primary care provider, and subspecialist for confirmatory testing and follow-up of abnormal results. Cystic fibrosis (CF) newborn screening has now been enacted in all 50 states and the District of Columbia and throughout many countries in the world. Although CF neonatal screening will identify the vast majority of infants with CF, there are many factors in the newborn sc...
Latika Nath Sinha
Full Text Available Background: In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs. ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits. Methods: A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi–structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing. Results: We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96% and delayed bathing (64% were better adopted than cord care (49%, safe breastfeeding (48%, hand washing (30%, kangaroo care (20% and eye care (9%. Cultural beliefs and traditional birth attendants influenced the mother’s practices. The lack of supervision by auxiliary nurse midwives (ANM, delayed referral and transportation were the other challenges. Conclusion: Knowledge–practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA–mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.
There is increasing interest in the early years as a focus for reducing health inequalities as well as one that is important for the children themselves. This paper describes the introduction in England of Sure Start Local Programmes, which included home visiting within a community development approach, and an intensive home visiting programme, the Nurse-Family partnership, for disadvantaged teenage mothers. It reflects on changes and challenges in service provision to mothers and their pre-s...
Friedman, Eric A; Gostin, Lawrence O; Buse, Kent
Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes. PMID:25006092
Lavin, Lindsay Roofe; Higby, Nicholas; Abramo, Thomas
Newborn screening programs were established in the United States in the early 1960s. Newborn screening programs were then developed by states and have continued to be the responsibility of the state. All states require a newborn screening, but what is required of these programs and screening panels has differed greatly by state. Historically, the most commonly screened disorders are the following: congenital hypothyroidism, congenital adrenal hyperplasia, sickle cell disease and associated hemoglobinopathies, biotinidase deficiency, galactosemia, cystic fibrosis and phenylketonuria, maple syrup urine disease, and homocystinuria. However, under new guidelines in 2006 and with new advances in technology, the scope of newborn screening programs has expanded to include at a minimum 9 organic acidurias, 5 fatty acid oxidation disorders, 3 hemoglobinopathies, and 6 other conditions. This CME article reviews the logistics of newborn screening and explores the effect of new technology and recent policy on state screens and what that means for providers. This article also highlights several of the disorders most relevant to emergency room physicians and discusses future considerations of newborn screening. PMID:26335232
Cadmium (Cd) is a well-known nephrotoxic environmental contaminant but there are indications that the developing nervous system might be even more sensitive to Cd than the kidneys in adults. Infants are exposed to Cd from various formulas and infant diets and the gastrointestinal Cd uptake is believed to be higher in newborns than in adults. Cd levels monitored in infant foods ranged between 0.74 and 27.0 µg/kg. Cow's milk formulas had the lowest levels and cereal-based formulas had up to 21 ...
Poulsen, Malene Wibe; Hedegaard, Rikke Susanne Vingborg; Andersen, Jeanette Marker;
of AGEs. Some AGEs interact with specific pro- or anti-inflammatory receptors. Most studies on the biological effects of AGEs have been carried out by administering heated foods. The pro-inflammatory and deteriorating biological effects of AGEs in these studies, therefore, need further confirmation......Advanced glycation endproducts (AGEs) form by Maillard-reactions after initial binding of aldehydes with amines or amides in heated foods or in living organisms. The mechanisms of formation may include ionic as well as oxidative and radical pathways. The reactions may proceed within proteins...... to form high-molecular weight (HMW) AGEs or among small molecules to form low-molecular weight (LMW) AGEs. All free amino acids form AGEs, but lysine or arginine side chains dominate AGE formation within proteins. The analysis of AGEs in foods and body fluids is most often performed by ELISA or LC...
Full Text Available ABSTRACT: A proliferating interest has been observed over the past years in the development of an accurate system for monitoring continuous human activities in the health care sectors, especially for the elderly. This paper conducts a survey of the various techniques and methods that are proposed to monitor the movements and activities of the elderly people. These techniques promise a useful and dependable detection system to give support and lessen the medical expenses of health care for the elderly. The detection approaches are divided into five main categories: wearable device based, wireless based, ambience device based, vision based and floor sensor / electric field sensors based. These techniques have focused on the pros and cons of the existing methods for recognizing the prospective scope of research in the domain of health monitoring systems. Apart from highlighting and analyzing the features of the existing techniques, perspectives on probable future studies have been detailed. ABSTRAK: Dewasa ini, pembangunan sistem yang tepat untuk memantau aktiviti berterusan terutamanya dalam sektor kesihatan warga tua mula mendapat tempat. Kaji selidik telah dijalankan dengan pelbagai teknik dan kaedah untuk meninjau pergerakan dan aktiviti golongan warga tua. Kaedah-kaedah ini memberikan sistem pengesanan yang berguna dan dipercayai untuk memberikan sokongan serta mengurangkan kos perubatan kesihatan bagi golongan tua. Pendekatan pengesanan dibahagikan kepada lima kategori utama; alatan yang dapat dipakai, alatan tanpa wayar, alatan berdasarkan persekitaran, alatan berasaskan penglihatan dan alatan berdasarkan pengesan pada lantai / medan elektrik. Teknik-teknik ini memfokuskan kepada pro dan kontra kaedah yang sedia ada untuk mengenalpasti skop prospektif penyelidikan dalam domain sistem pengawasan kesihatan. Selain daripada mengetengah dan menganalisa ciri-ciri teknik yang sedia ada, perspektif kajian akan datang juga diperincikan.KEYWORDS: health
Kanemoto, Shigeru; Watanabe, Masaya [The University of Aizu, Aizuwakamatsu (Japan); Yusa, Noritaka [Tohoku University, Sendai (Japan)
The present paper tries to evaluate the applicability of conventional sound analysis techniques and modern machine learning algorithms to rotating machine health monitoring. These techniques include support vector machine, deep leaning neural network, etc. The inner ring defect and misalignment anomaly sound data measured by a rotating machine mockup test facility are used to verify the above various kinds of algorithms. Although we cannot find remarkable difference of anomaly discrimination performance, some methods give us the very interesting eigen patterns corresponding to normal and abnormal states. These results will be useful for future more sensitive and robust anomaly monitoring technology.
The present paper tries to evaluate the applicability of conventional sound analysis techniques and modern machine learning algorithms to rotating machine health monitoring. These techniques include support vector machine, deep leaning neural network, etc. The inner ring defect and misalignment anomaly sound data measured by a rotating machine mockup test facility are used to verify the above various kinds of algorithms. Although we cannot find remarkable difference of anomaly discrimination performance, some methods give us the very interesting eigen patterns corresponding to normal and abnormal states. These results will be useful for future more sensitive and robust anomaly monitoring technology
The specialty of Psychiatry and the interdisciplinary work performed by psychiatrists in conjunction with other scientific and humanistic disciplines is being affected by some facts which lead to its stigmatization. There are both internal and external risks that are affecting the profession. Among the internal ones we may mention the different diagnostic criteria used by psychiatrists and the differences between treatments--as there is a wide variety of treatment options. Besides, the practice of psychiatry may differ enormously, according to the perspective--biological, psychological, social, cultural, and so on--of each psychiatrist. The internal inconsistencies give rise to some of the external risks psychiatry and psychiatrists have to face: patients' discontent or even mistrust, the intrusion of other professions in the field of psychiatry and the negative image psychiatry has among the public. Just as it occurred in many other places before, the passing of a new mental health law in Argentina has proved to be an occasion for deep debate. The passing of this law has caused big controversy, especially among professional associations, private mental health services, NGOs which represent users and their families, trade unions which represent health workers, political and economic decision makers, etc. In Argentina, the debate of ideas has always been rich. Even when political parties were forbidden, there were discussions taking place among groups which supported psychoanalytic and psychodynamic approaches. There are many who demonize the developments made in the field of psychiatry and they also campaign against such developments. They catch the public's attention and they convince legislators, thus spreading the idea that psychiatry may be dangerous. As a consequence, for example, the new law gives similar status to psychiatrists and psychologists when it states that the decision to confine a patient into hospital "should be signed by two professionals, one of
Yehia, Baligh R; Calder, Daniel; Flesch, Judd D; Hirsh, Rebecca L; Higginbotham, Eve; Tkacs, Nancy; Crawford, Beverley; Fishman, Neil
Academic health centers are strategically positioned to impact the health of lesbian, gay, bisexual and transgender (LGBT) populations by advancing science, educating future generations of providers, and delivering integrated care that addresses the unique health needs of the LGBT community. This report describes the early experiences of the Penn Medicine Program for LGBT Health, highlighting the favorable environment that led to its creation, the mission and structure of the Program, strategic planning process used to set priorities and establish collaborations, and the reception and early successes of the Program. PMID:26788778
Full Text Available According to holistic medical theory, the patient will heal when old painful moments, the traumatic events of life that are often called “gestalts”, are integrated in the present “now”. The advanced holistic physicians expanded toolbox has many different tools to induce this healing, some that are more dangerous and potentially traumatic than others. The more intense the therapeutic technique, the more emotional energy will be released and contained in the session, but the higher also is the risk for the therapist to lose control of the session and lose the patient to his or her own dark side. To avoid harming the patient must be the highest priority in holistic existential therapy, making sufficient education and training an issue of highest importance. The concept of “stepping up” the therapy by using more and more “dramatic” methods to get access to repressed emotions and events has led us to a “therapeutic staircase” with ten steps: (1 establishing the relationship; (2 establishing intimacy, trust, and confidentiality; (3 giving support and holding; (4 taking the patient into the process of physical, emotional, and mental healing; (5 social healing of being in the family; (6 spiritual healing — returning to the abstract wholeness of the soul; (7 healing the informational layer of the body; (8 healing the three fundamental dimensions of existence: love, power, and sexuality in a direct way using, among other techniques, “controlled violence” and “acupressure through the vagina”; (9 mind-expanding and consciousness-transformative techniques like psychotropic drugs; and (10 techniques transgressing the patient's borders and, therefore, often traumatizing (for instance, the use of force against the will of the patient.We believe that the systematic use of the staircase will greatly improve the power and efficiency of holistic medicine for the patient and we invite a broad cooperation in scientifically testing the
Full Text Available There is increasing interest in the early years as a focus for reducing health inequalities as well as one that is important for the children themselves. This paper describes the introduction in England of Sure Start Local Programmes, which included home visiting within a community development approach, and an intensive home visiting programme, the Nurse-Family partnership, for disadvantaged teenage mothers. It reflects on changes and challenges in service provision to mothers and their pre-school children in England, explaining that a long tradition of home visiting was, paradoxically, reduced as attention focused on the newer initiatives. This is now being addressed, with attention to a range of evidence based programmes and a specific focus on heath visitor provision.
Traberg, Andreas; Jacobsen, Peter
Purpose – The purpose of this paper is to develop a framework for health care performance evaluation that enables decision makers to identify areas indicative of corrective actions. The framework should provide information on strategic pro-/regress in an operational context that justifies the need......, and two internal and five external databases are used for a quantitative data collection. Findings – By aggregating performance outcomes, collective measures of performance are achieved. This enables easy and intuitive identification of areas not strategically aligned. In general, the framework has...... proven helpful in an MRI unit, where operational decision makers have been struggling with extensive amounts of performance information. Research limitations/implications – The implementation of the framework in a single case in a public and highly political environment restricts the generalizing...
Reavis, Kelly M; Tremblay, Kelly L; Saunders, Gabrielle
This commentary explores the role of public health programs and themes on hearing health care. Ongoing engagement within the hearing professional community is needed to determine how to change the landscape and identify important features in the evolution of population hearing health care. Why and how to leverage existing public health programs and develop new programs to improve hearing health in older individuals is an important topic. Hearing professionals are encouraged to reflect on these themes and recommendations and join the discussion about the future of hearing science on a population level. PMID:27232072
... First Test . What are some examples of the benefits of newborn screening? Many conditions included today in ... NIH Scientists Combine Efforts to Advance Birth Defects Research It’s in the DNA: Animal Models Offer Clues to Human Development All related ...
... around the clock, people who work in the health care industry provide care for millions of people, ... newborns to the very ill. In fact, the health care industry is one of largest providers of ...
... the Department of Health and Human Services with the development of newborn screening activities..., HRSA-funded prenatal family history project, and the Institute of Medicine meeting summary on assessing... Disorders in Newborns and Children; Notice of Meeting In accordance with section 10(a)(2) of the...
Nichols, Peter D.; Alexandra McManus; Kevin Krail; Andrew J. Sinclair; Matt Miller
The joint symposium of The Omega-3 Centre and the Australasian Section American Oil Chemists Society; Recent Advances in Omega-3: Health Benefits, Sources, Products and Bioavailability, was held November 7, 2013 in Newcastle, NSW, Australia. Over 115 attendees received new information on a range of health benefits, aquaculture as a sustainable source of supply, and current and potential new and novel sources of these essential omega-3 long-chain (LC, ≥C20) polyunsaturated fatty acid nutrients...
Mesquita, Maria Dos Anjos
The purpose of this article was to present a review of the effects of alcohol consumption by pregnant mothers on their newborn. Definitions, prevalence, pathophysiology, clinical features, diagnostic criteria, follow-up, treatment and prevention were discussed. A search was performed in Medline, LILACS, and SciELO databases using the following terms: "fetus", "newborn", "pregnant woman", "alcohol", "alcoholism", "fetal alcohol syndrome", and "alcohol-related disorders". Portuguese and English articles published from 2000 to 2009 were reviewed. The effects of alcohol consumed by pregnant women on newborns are extremely serious and occur frequently; it is a major issue in Public Health worldwide. Fetal alcohol spectrum disorders cause harm to individuals, their families, and the entire society. Nevertheless, diagnostic difficulties and inexperience of healthcare professionals result in such damage, being remembered rarely or even remaining uncovered. Alcohol-related injury to the fetus is fully avoidable; all it takes is for women not to drink alcoholic beverages during pregnancy. Therefore, detecting women who consume alcohol during pregnancy is paramount, as are specific programs to educate people about the consequences of alcohol use during pregnancy and breastfeeding. PMID:26760157
Jonathan Heller; Givens, Marjory L.; Yuen, Tina K.; Solange Gould; Maria Benkhalti Jandu; Emily Bourcier; Tim Choi
Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communit...
... Education Nursing Traineeship Program AGENCY: Health Resources and Services Administration (HRSA), HHS... Education Nursing Traineeship (AENT) program. Effective fiscal year (FY) 2014, AENT support for part-time... practitioners and nurse midwives. FOR FURTHER INFORMATION CONTACT: Joan Wasserman, DrPH, RN, Advanced...
Hardy, Sally; Jackson, Carrie; Webster, Jonathan; Manley, Kim
Over the past 20 years health care reform has influenced the development of advanced level practitioner roles and expectations. How advanced level practitioners work to survive the highly stimulating, yet sometimes overwhelming aspects of balancing high quality provision with political reform agendas, amidst economic constraint is considered. Transformational approaches (encompassing education and practice led service development) can provide, promote and 'provoke' a harnessing of complex issues workplace environment to produce creative solutions. Transformational Practice Development provides a structured, rigorous, systematic approach that practitioners, teams and health care consumers alike can utilise to achieve skills and attributes needed for successful innovation. The authors present case study materials from action orientated locally delivered Practice Development, as a complex strategic intervention approach to influence and promote advanced level practice expertise. Initiated through facilitation of transformational leadership, and resultant team based improvements, we present how strategic collaborative processes can harness work chaos and complexity to provide sustainable and productive workplace cultures of effectiveness. PMID:23453607
Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep
Background: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project.Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for as...
Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep
Background An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. Methods/design A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for ass...
Shankar Prinja; Ruby Nimesh; Aditi Gupta; Pankaj Bahuguna; Jarnail Singh Thakur; Madhu Gupta; Tarundeep Singh
Background: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for a...
Melikov, Arsen Krikor
-quality indoor environments at the same time as low-energy consumption. Advanced air distribution, designed to supply clean air where, when, and as much as needed, makes it possible to efficiently achieve thermal comfort, control exposure to contaminants, provide high-quality air for breathing and minimizing the......Indoor environment affects the health, comfort, and performance of building occupants. The energy used for heating, cooling, ventilating, and air conditioning of buildings is substantial. Ventilation based on total volume air distribution in spaces is not always an efficient way to provide high....... The focus is on advanced air distribution in spaces, its guiding principles and its advantages and disadvantages. Examples of advanced air distribution solutions in spaces for different use, such as offices, hospital rooms, vehicle compartments, are presented. The potential of advanced air...
... symmetry stimulate an infant's developing vision. As vision improves and babies gain more control over ... newborn to learn and play: Put on soothing music and hold your baby, gently swaying to the ...
Corbett, R P; Egner, J R
Three cases of gall bladder distention in asphyxiated newborns are described. Clinical and ultrasound examination showed this to be a benign, transient phenomenon. A causal relation between tissue hypoxia and gall bladder distention is proposed.
Lassi, Zohra S; Philippa F. Middleton; Bhutta, Zulfiqar A.; Crowther, Caroline
Background Lack of appropriate health care seeking for ill mothers and neonates contributes to high mortality rates. A major challenge is the appropriate mix of strategies for creating demand as well as provision of services. Design Systematic review and meta-analysis of experimental studies (last search: Jan 2015) to assess the impact of different strategies to improve maternal and neonatal health care seeking in low- and middle-income countries (LMIC). Results Fifty-eight experimental [rand...
Lassi, Zohra S; Philippa F. Middleton; Bhutta, Zulfiqar A.; Caroline Crowther
Background: Lack of appropriate health care seeking for ill mothers and neonates contributes to high mortality rates. A major challenge is the appropriate mix of strategies for creating demand as well as provision of services. Design: Systematic review and meta-analysis of experimental studies (last search: Jan 2015) to assess the impact of different strategies to improve maternal and neonatal health care seeking in low- and middle-income countries (LMIC). Results: Fifty-eight experimental [r...
Lassi, Zohra S; Philippa F. Middleton; Bhutta, Zulfiqar A.; Crowther, Caroline
Background: Lack of appropriate health care seeking for ill mothers and neonates contributes to high mortality rates. A major challenge is the appropriate mix of strategies for creating demand as well as provision of services.Design: Systematic review and meta-analysis of experimental studies (last search: Jan 2015) to assess the impact of different strategies to improve maternal and neonatal health care seeking in low- and middle-income countries (LMIC).Results: Fifty-eight experimental [ran...
Lown, Beth A; McIntosh, Sharrie; Gaines, Martha E; McGuinn, Kathy; Hatem, David S
Empathy and compassion provide an important foundation for effective collaboration in health care. Compassion (the recognition of and response to the distress and suffering of others) should be consistently offered by health care professionals to patients, families, staff, and one another. However, compassion without collaboration may result in uncoordinated care, while collaboration without compassion may result in technically correct but depersonalized care that fails to meet the unique emotional and psychosocial needs of all involved. Providing compassionate, collaborative care (CCC) is critical to achieving the "triple aim" of improving patients' health and experiences of care while reducing costs. Yet, values and skills related to CCC (or the "Triple C") are not routinely taught, modeled, and assessed across the continuum of learning and practice. To change this paradigm, an interprofessional group of experts recently recommended approaches and a framework for integrating CCC into health professional education and postgraduate training as well as clinical care. In this Perspective, the authors describe how the Triple C framework can be integrated and enhance existing competency standards to advance CCC across the learning and practice continuum. They also discuss strategies for partnering with patients and families to improve health professional education and health care design and delivery through quality improvement projects. They emphasize that compassion and collaboration are important sources of professional, patient, and family satisfaction as well as critical aspects of professionalism and person-centered, relationship-based high-quality care. PMID:26717505
Scherer, Charleni Inês; Scherer, Magda Duarte dos Anjos
ABSTRACT OBJECTIVE To analyze oral health work changes in primary health care after Brazil’s National Oral Health Policy Guidelines were released. METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people’s participation and social control; and intersectorial actions. CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities. PMID:26815162
Charleni Inês Scherer
Full Text Available ABSTRACT OBJECTIVE To analyze oral health work changes in primary health care after Brazil’s National Oral Health Policy Guidelines were released. METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people’s participation and social control; and intersectorial actions. CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.
Phenylketonuria, congenital hypothyroidism and haemoglobinopathies: public health issues for a Brazilian newborn screening program Fenilcetonúria, hipotireoidismo congênito e hemoglobinopatias: questões de saúde pública para um programa de triagem neonatal brasileiro
Judy Botler; Luiz Antonio Bastos Camacho; Marly Marques da Cruz
In this study, the frequency of detected congenital hypothyroidism, phenylketonuria and haemoglobinopathies in the State of Rio de Janeiro's (Brazil) Newborn Screening Program (NBSP) was analyzed between the years of 2005 and 2007. There were two Newborn Screening Reference Centers (named NSRC A and B) with programmatic differences. In 2007, overall detection coverage reached 80.7%. The increase in the incidence of congenital hypothyroidism (1:1,030 in 2007) was attributed to the reduction of...
Measuring Regional and District Variations in the Incidence of Pregnancy-induced Hypertension (PIH) in Ghana : Challenges, Opportunities and Implications for Maternal and Newborn Health Policy and Programs
Antwi, Edward; Klipstein-Grobusch, Kerstin; Asare, Gloria Quansah; Koram, Kwadwo A; Grobbee, Diederick; Agyepong, Irene Akua
OBJECTIVES: The objectives were to assess the quality of health management information system (HMIS) data needed for assessment of local area variation in pregnancy induced hypertension (PIH) incidence and to describe district and regional variations in PIH incidence. METHODS: A retrospective review
Taylor, Lee; Hutchinson, Delyse; Rapee, Ron; Burns, Lucy; Stephens, Christine; Haber, Paul S.
Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development. PMID:23227054
Bauer, Greta R
Intersectionality theory, developed to address the non-additivity of effects of sex/gender and race/ethnicity but extendable to other domains, allows for the potential to study health and disease at different intersections of identity, social position, processes of oppression or privilege, and policies or institutional practices. Intersectionality has the potential to enrich population health research through improved validity and greater attention to both heterogeneity of effects and causal processes producing health inequalities. Moreover, intersectional population health research may serve to both test and generate new theories. Nevertheless, its implementation within health research to date has been primarily through qualitative research. In this paper, challenges to incorporation of intersectionality into population health research are identified or expanded upon. These include: 1) confusion of quantitative terms used metaphorically in theoretical work with similar-sounding statistical methods; 2) the question of whether all intersectional positions are of equal value, or even of sufficient value for study; 3) distinguishing between intersecting identities, social positions, processes, and policies or other structural factors; 4) reflecting embodiment in how processes of oppression and privilege are measured and analysed; 5) understanding and utilizing appropriate scale for interactions in regression models; 6) structuring interaction or risk modification to best convey effects, and; 7) avoiding assumptions of equidistance or single level in the design of analyses. Addressing these challenges throughout the processes of conceptualizing and planning research and in conducting analyses has the potential to improve researchers' ability to more specifically document inequalities at varying intersectional positions, and to study the potential individual- and group-level causes that may drive these observed inequalities. A greater and more thoughtful incorporation
Kc, A; Thapa, K; Pradhan, Y V; Kc, N P; Upreti, S R; Adhikari, R K; Khadka, N; Acharya, B; Dhakwa, J R; Aryal, D R; Aryal, S; Starbuck, E; Paudel, D; Khanal, S; Devkota, M D
In Nepal, the proportion of under 5 deaths that are neonatal (0-28 days) has been increasing in the last decade, due to faster declines in infant and child mortality than in neonatal mortality. This trend is likely due to a focus on maternal and child survival programs that did not adequately address newborn health needs. Policy and actions to save newborn lives resulted from increased attention to newborn deaths in 2001, culminating in the endorsement of the National Neonatal Health Strategy in 2004, a milestone that established newborn health and survival as a national priority. Operationalization of the National Neonatal Health Strategy took place in 2007 with the development of the Community-Based Newborn Care Package (CB-NCP). This paper describes how national stakeholders used global, regional and in-country research and policies to develop the CB-NCP, thus outlining key ingredients to make newborn health programming a reality in Nepal. A technical working group was constituted to review existing evidence on interventions to improve newborn survival, develop a tool to prioritize neonatal interventions, and conduct program learning visits to identify key components appropriate to the Nepal context that should be included in the Community Based Integrated Newborn Care Package. The group identified interventions based on the evidence of impact on newborn survival, potential mechanisms within the existing health system to deliver the interventions, and linkages with existing programs and different tiers of the health system. Not only was Nepal one of the first countries in south-east Asia where government adopted a national strategy to reduce neonatal deaths, but it was also one of the first to endorse a package of neonatal interventions for pilot testing and scaling up through existing community-based health systems that provide basic health services throughout the country. CB-NCP was designed to be gradually scaled up throughout the country by integration with
Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise
This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338
Newborn screening is a mandatory state-based public health program that provides all newborns in the United States with presymptomatic testing and necessary follow-up health care for a variety of medical conditions. The goal of this essential public health program is to decrease morbidity and mortality by screening for disorders in which early intervention will improve neonatal and long-term health outcomes. The results of surveys and focus groups of expectant parents demonstrate that women and their families would like to receive information about newborn screening during their prenatal care visits. Providing newborn screening information during prenatal care visits can be accomplished in a number of ways and should be adapted to individual practice style. PMID:25560141
Full Text Available Yanni Hao,1 Verena Wolfram,2 Jennifer Cook2 1Novartis Pharmaceuticals, East Hanover, NJ, USA; 2Adelphi Values, Bollington, UK Background: Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods: Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases, online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center, and web sites of health technology assessment (HTA bodies. Publications were selected based on the search strategy and the overall study objectives. Results: A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D. Other utility measures, such as the direct methods standard gamble (SG, time trade-off (TTO, and visual analog scale (VAS, were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23, Functional Assessment of Cancer Therapy – General questionnaire (FACT-G, and Utility-Based Questionnaire-Cancer (UBQ-C; most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex
Adorno Elisângela Vitória
Full Text Available Hemoglobinopathies are hereditary disorders of the hemoglobin molecule with a high prevalence worldwide. Brazil has a prevalence of 0.1 to 0.3% of newborns with sickle cell anemia and 20.0 to 25.0% of heterozygous alpha2 thalassemia among African Brazilians. In the present study, we investigated the presence of variant hemoglobins and alpha2(3.7 Kb and alpha2(4.2 Kb thalassemia in newborns from Salvador, Bahia, Brazil. Samples of umbilical cord blood from a total of 590 newborns were analyzed, of which 57 (9.8% were FAS; 36 (6.5% FAC; one (0.2% SF; and five (0.9% FSC. One hundred fourteen (22.2% newborns had alpha2(3.7 Kb thalassemia, of whom 101 (19.7% were heterozygous and 13 (2.5% homozygous, showing statistical significance for hematological data between newborns with normal alpha genes and alpha2(3.7 Kb thalassemia carriers. The alpha2(4.2 Kb thalassemia was not found. Frequencies found in the present study confirm that hemoglobinopathies are a public health problem in Brazil, emphasizing the need for neonatal screening and genetic counseling programs.
Raquel de Souza MEZZAVILLA; Maria Helena HASSELMANN
ABSTRACT Objective To investigate the association between physical intimate partner violence and low birth weight. Methods This cross-sectional study included 604 children with approximately 30 days of age who visited four primary health care units in the city of Rio de Janeiro , Brazil, for the second dose of hepatitis B vaccine. Children with a birth weight below 2.500 g were considered underweight. Information regarding physical intimate partner violence was obtained by the Portuguese ve...
Vergnano Stefania; Malamba Florida; Chapota Hilda; Rosato Mikey; Mganga Andrew; Phiri Tambosi; Kazembe Peter; Mwansambo Charles; Lewycka Sonia; Newell Marie-Louise; Osrin David; Costello Anthony
Abstract Background The UN Millennium Development Goals call for substantial reductions in maternal and child mortality, to be achieved through reductions in morbidity and mortality during pregnancy, delivery, postpartum and early childhood. The MaiMwana Project aims to test community-based interventions that tackle maternal and child health problems through increasing awareness and local action. Methods/Design This study uses a two-by-two factorial cluster-randomised controlled trial design ...
Belasco, N.; Pool, S. L.
Delivery of quality health care to passengers of extended-mission spacecraft and to remote populations on earth (a major national problem) requires extending the knowledge and skills of the physician many kilometers distant from his physical location. The STARPAHC telemedicine system accomplishes this by using physician's assistants complemented with space technology in communications, data handling, and systems engineering. It is presently in operation and undergoing a 2-year evaluation on the Papago Indian Reservation, Arizona. Results have established its feasibility as a solution for remote area health care on earth, while providing information useful to the planners of advanced manned spacecraft missions.
Madsen, M K; Blide, L A
Ragins and Sundstrom suggest three major conclusions based on power and gender differences within organizations. The first is that power develops or detracts as individuals progress along their career track. HIM professionals who accept the challenges that changing roles bring can also develop a new sensitivity to the value of power as a tool. They can use their negotiating skills to avoid being placed in work roles that result in a decrease in power. The second difference between men and women within organizations is that obstacles often impede women's career paths more than men's. Perceptions by women and men of a woman as homemaker and mother create serious conflicts when jobs are demanding and time intensive. Lastly, Ragins and Sundstrom suggest that career progression is influenced by both intrinsic factors (personal and professional) and extrinsic factors (organizational and interpersonal). The interaction between these factors is often driven by gender differences allowing men to progress and succeed, whereas women remain beneath the glass ceiling. HIM professionals, like other women health professionals, are graduating from advanced programs in health care and business administration at a greater rate than ever before in the history of this country. Not all these graduates will be able to acquire top-level administrative positions in the traditional health care institutions (e.g., hospitals). Therefore, if they wish to advance, they may have to move to nontraditional work settings. This is especially true for HIM professionals. The expanding computerized environment in traditional and nontraditional health care settings presents great potential for the development of new roles and responsibilities that have not been identified as male roles. HIM professionals and women in other health care professions who aspire to advance to upper administrative positions in traditional and nontraditional settings must be willing to take the risks inherent in assuming
Lemoine, Marie-Eve; Ravitsky, Vardit
In Western countries today, a growing number of women delay motherhood until their late 30s and even 40s, as they invest time in pursuing education and career goals before starting a family. This social trend results from greater gender equality and expanded opportunities for women and is influenced by the availability of contraception and assisted reproductive technologies (ART). However, advanced maternal age is associated with increased health risks, including infertility. While individual medical solutions such as ART and elective egg freezing can promote reproductive autonomy, they entail significant risks and limitations. We thus argue that women should be better informed regarding the risks of advanced maternal age and ART, and that these individual solutions need to be supplemented by a public health approach, including policy measures that provide women with the opportunity to start a family earlier in life without sacrificing personal career goals. PMID:26575814
Fakoya, I; Álvarez-Del Arco, D.; Monge, S; Copas, A J; Gennotte, A. F.; Volny-Anne, A.; Göpel, S.; Touloumi, G.; Prins, M; Barros, H; Staehelin, C.; del Amo, J.; Burns, F. M.
BACKGROUND: Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. OBJECTIVE: We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify ...
Davis, Jeffrey R.; Richard, Elizabeth E.; Keeton, Kathryn E.
This paper describes a new business model for advancing NASA human health and performance innovations and demonstrates how open innovation shaped its development. A 45 percent research and technology development budget reduction drove formulation of a strategic plan grounded in collaboration. We describe the strategy execution, including adoption and results of open innovation initiatives, the challenges of cultural change, and the development of virtual centers and a knowledge management tool to educate and engage the workforce and promote cultural change.
This report is a summary and analysis of comments from the Advisory Panel at the FY 2006 DOE National Laboratory Advanced Combustion, Emission Control, Health Impacts, and Fuels Merit Review and Peer Evaluation, held May 15-18, 2006 at Argonne National Laboratory. The work evaluated in this document supports the FreedomCAR and Vehicle Technologies Program. The results of this merit review and peer evaluation are major inputs used by DOE in making its funding decisions for the upcoming fiscal year.
... PACKETS FOR ADDITIONAL NEWBORN SCREENING TESTS PACKETS FOR PARENTS: FREE ADDITONAL NEWBORN SCREENING PACKETS What is Newborn Screening (NBS)? NBS ... Packets for Additional Newborn Screening Tests Packets for Parents: Free Additional ... Initial Positive Screens FAQs Disorder Descriptions ...
Full Text Available The study was conducted in 10 towns and 17 villages of Mardin between 15-25 June 2009, with 159 married women in their own houses using interviewing technique. In this study, the answers of 155 women with kids were assessed. 42,8% of the interviewed women introduced themselves as Kurdish, while 31,4% introduced themselves as Arabic, 25,8% introduced themselves as Assyrian The interviewed women were 17-60 years old. It was found that half of the women were not literate and 40,5% were inbred. The purpose of the study is to present the similarities of the practices regarding newborns, according to ethnical identities. According to the findings, it was noticed from the tables that 85,7% of the people who introduced themselves as Kurdish, 14,3% of the people who introduced themselves as Arabic celebrated the birth of a male child by sacrificing an animal. 93,8% of the Arabic people and 6,3% of the Kurds were found to value the first cut hair piece of the babies with gold or paper note. 93,8% of the Arabs were found to name their babies after their dead relatives with a ceremony. The majority of the Kurds and Arabs name their babies after the prayer. The Assyrians were found to name their babies with the prayer of the priest, 3 days after they are born. The babies were named by the elderly in the Kurdish, Arabic and Assyrian societies. The majority of the people who swaddle their babies are the Kurds. According to our findings, it is possible for us to say that the people who express themselves with different ethnic and religious identities have similar cultural characteristics under the same geographical conditions.
Full Text Available AbstractThe study was conducted in 10 towns and 17 villages of Mardin between 15-25 June 2009, with 159 married women in their own houses using interviewing technique. In this study, the answers of 155 women with kids were assessed. 42,8% of the interviewed women introduced themselves as Kurdish, while 31,4% introduced themselves as Arabic, 25,8% introduced themselves as Syriac. The interviewed women were 17-60 years old. It was found that half of the women were not literate and 40,5% were inbred. The purpose of the study is to present the similarities of the practices regarding newborns, according to ethnical identities. According to the findings, it was noticed from the tables that 85,7% of the people who introduced themselves as Kurdish, 14,3% of the people who introduced themselves as Arabic celebrated the birth of a male child by sacrificing an animal. 93,8% of the Arabic people and 6,3% of the Kurds were found to value the first cut hair piece of the babies with gold or paper note. 93,8% of the Arabs were found to name their babies after their dead relatives with a ceremony. The majority of the Kurds and Arabs name their babies after the prayer. The Syriacs were found to name their babies with the prayer of the priest, 3 days after they are born. The babies were named by the elderly in the Kurdish, Arabic and Syriac societies. The majority of the people who swaddle their babies are the Kurds. According to our findings, it is possible for us to say that the people who express themselves with different ethnic and religious identities have similar cultural characteristics under the same geographical conditions.
Lawn, JE; Kinney, MV; Belizan, JM; Mason, E.; McDougall, L; Larson, J; Lackritz, E; Friberg, IK; Howson, CP; the Born Too Soon Preterm Birth Action Group (see acknowledgemen
DECLARATION This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was published in PDF format in the WHO Report "Born Too Soon: the global action report on preterm birth" (ISBN 978 92 4 150343 30), which i...
Riziwanguli Maitusong; Rukeya Japaer; ZHAO Zheng-yan; YANG Ru-lai; HUANG Xiao-lei; MAO Hua-qing
Background It has been 11 years since newborn screening started in Zhejiang in 1999.The aim of this study was to analyze and summarize the status of newborn screening in Zhejiang from 1999 to 2009.Methods Blood samples were collected from the heels of newborns 72 hours after birth.We have conducted laboratory tests that the congenital hypothyroidism (CH) and circulating levels of thyroid-stimulating hormone (TSH) was detected.Blood phenylalanine (Phe) was detected for phenylketonuria (PKU).Dissociation-enhanced lanthanide fluorescent immunoassay (DELFIA) was used for detection.Results From 1999 to 2009,3875228 newborns were screened and 2309 cases were confirmed as CH and 155 cases were confirmed as PKU.The incidence of CH and PKU were 1:1678 and 1:25 001 respectively.Conclusion In 11 years,the Zhejiang newborn screening center screened more than 3.8 million newboms,and helped more than 2000 CH and PKU patients to obtain early treatment in order to prevent physical disability and mental retardation.
Full Text Available Aim: Political decisions usually emerge from the competing interests of politicians, voters, and special interest groups. We investigated the applicability of an advanced methodological concept to determine whether certain institutional positions in a cooperating network have influence on the decision-making procedures. To that end, we made use of the institutional network of relevant health care and health governance institutions, concentrated in Belgrade, Serbia. Methods: We used a Principal Component Analysis (PCA based on a combination of measures for centrality in order to evaluate the positions of 25 players in Belgrade‟s institutional network. Their directed links were determined by a simulated position approach employing the authors‟ long-term involvement. Software packages used consisted of Visone 2.9, UCINET 6, and KeyPlayer 1.44. Results: In our analysis, the network density score in Belgrade was 71%. The PCA revealed two dimensions: control and attractiveness. The Ministry of Health exerted the highest level of control but displayed a low attractiveness in terms of receiving links from important players. The National Health Insurance Fund had less control capacity but a high attractiveness. The National Institute of Public Health‟s position was characterized by a low control capacity and high attractiveness, whereas the National Drug Agency, the National Health Council, and Non-Governmental Organisations were no prominent players. Conclusions: The advanced methodologies used here to analyse the health care policy network in Belgrade provided consistent results indicating that the intended decentralization of the health care network in Belgrade may be incomplete, still with low participation of civil society representatives. With the present study we set the stage for a broad-range survey based data collection applying the methodology piloted in Belgrade.
Frayne, Daniel J; Verbiest, Sarah; Chelmow, David; Clarke, Heather; Dunlop, Anne; Hosmer, Jennifer; Menard, M Kathryn; Moos, Merry-K; Ramos, Diana; Stuebe, Alison; Zephyrin, Laurie
Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements. PMID:27054935
... Core surveillance (ABCs) CDC Streptococcus Laboratory Sepsis Group B Strep Infection in Newborns Recommend on Facebook Tweet ... the difference between early- and late-onset group B strep diseases in newbornsâ€¦ How it Spreads and ...
von Voß, Hubertus
Full Text Available Introduction: Permanent congenital bilateral hearing loss (CHL of moderate or greater degree (≥40 dB HL is a rare disease, with a prevalence of about 1 to 3 per 1000 births. However, it is one of the most frequent congenital diseases. Reliance on physician observation and parental recognition has not been successful in the past in detecting significant hearing loss in the first year of life. With this strategy significant hearing losses have been detected in the second year of life. With two objective technologies based on physiologic response to sound, otoacoustic emissions (OAE and auditory brainstem response (ABR hearing screening in the first days of life is made possible. Objectives: The objective of this health technology assessment report is to update the evaluation on clinical effectiveness and cost-effectiveness of newborn hearing screening programs. Universal newborn hearing screening (UHNS (i, selective screening of high risk newborns (ii, and the absence of a systematic screening program are compared for age at identification and age at hearing aid fitting of children with hearing loss. Secondly the potential benefits of early intervention are analysed. Costs and cost-effectiveness of newborn hearing screening programs are determined. This report is intended to make a contribution to the decision making whether and under which conditions a newborn hearing screening program should be reimbursed by the statutory sickness funds in Germany. Methods: This health technology assessment report updates a former health technology assessment (Kunze et al. 2004 . A systematic review of the literature was conducted, based on a documented search and selection of the literature using predefined inclusion and exclusion criteria and a documented extraction and appraisal of the included studies. To assess the cost-effectiveness of the different screening strategies in Germany the decision analytic Markov state model which had been developed in
To determine the prevalence of Hypovitaminosis D in pregnant women and in cord blood of their newborns. Serum calcium, phosphorus and 25(OH) Vit D, were measured in 193 pregnant subjects between 16-45 years of age in third trimester admitted in Be'sat hospital. Same were measured in the cord blood of 193 newborns belonging to them. Mean maternal serum 25(OH) Vit D was 16.5+-14.2 ng/mL, and cord blood was 12+-0.2 ng/mL. Fifty-seven percent of pregnant women had 25(OH) Vit D values below the cutoff level. Seventy six percent of newborns had 25(OH) Vit D values below the cutoff level. Maternal serum 25(OH) Vit D correlated positively with cord 25(OH) Vit D (r=0.77, P<0.05). Mean maternal serum calcium was 8.89+-0.73 mg/ml and mean newborn serum calcium was 9.46+-0.93. Mean maternal serum calcium correlated with mean newborn serum calcium (r= 0.38, P<0.05). Twenty six percent of women and 37.8% of newborns had hypocalcemia. There was a high prevalence of significant hypovitaminosis D among pregnant women and their newborns. Our study emphasize the need of majority of pregnant women and their newborns to supplemental vitamin D and has significant public health implications. (author)
Voultsos, P; Chatzinikolaou, F
Advances in medicine can reduce active euthanasia of newborns with severe anomalies or unusual prematurity, but they cannot eliminate it. In the Netherlands, voluntary active euthanasia among adults and adolescents has been allowed since 2002, when the so-called Groningen Protocol (GP) was formulated as an extension of the law on extremely premature and severely ill newborns. It is maintained that, at bioethical level, it serves the principle of beneficence. Other European countries do not ac...
... the baby. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging, or ...
Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis
Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. PMID:21839552
Full Text Available Introduction. Non-immune hydrops fetalis is a condition of excessive accumulation of extravascular fluid without identifiable circulating antibody to erythrocytes membrane antigens. In newborn infants it is characterized by skin oedema and pleural, pericardial or peritoneal effusion. In the era of routine Rh immunization for the prevention of foetal erythroblastosis, non-immune pathophysiologic mechanisms are presented in 76-87% of all hydropic newborns. Non-immune hydrops fetalis can be associated with numerous and various disorders. The mortality rate may exceed 50%. This study was aimed at presenting our clinical experience in treating newborn infants with non-immune hydrops fetalis. Material and methods. A retrospective-prospective study included newborn infants with non-immune hydrops fetalis, who were treated in the Neonatal Intensive Care Unit of Mother and Child Health Institute of Serbia between January 1, 2001 and October 31, 2010. All valid data about aetiology, diagnosis, clinical course and outcome were recorded. Results. The diagnosis of non-immune hydrops fetalis was made in 11 newborns. The etiologic diagnosis was established in 8 patients: anaemia due to fetomaternal transfusion in 4 patients and conatal cytomegalovirus infection, intracranial haemorrhage, isolated pulmonary lymphangiectasia and diffuse skin and mediastinal lymphangiomatosis in the remaining 4 patients. Conclusion. Non-immune hydrops of newborn infant is associated with a high mortality rate and requires complex diagnostic and therapeutic procedures. An optimal management of neonates with non-immune hydrops fetalis demands a multidisciplinary approach to the treatment in a neonatal intensive care unit.
Full Text Available Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbilical artery catheterization, congenital renal structural malformation, renovascular disease, aortic coarctation, as well as acute kidney injury and certain medications. A careful diagnostic evaluation should lead to identification of the underlying cause of hypertension in most infants. Treatment options should be tailored to the severity; and underlying cause of hypertension, including intravenous and/or oral therapy. This review summarizes recent work in these areas, focusing on optimal BP measurement, definition, evaluation and management of hypertension as well as advances in drug therapy of neonatal hypertension.
Vimmerstedt, L J; Hammel, C J
Electrochemical capacitors are a candidate for traction power assists in hybrid electric vehicles (HEVs). Other advanced automotive applications, while not the primary focus of current development efforts, are also possible. These include load leveling high-energy batteries, power conditioning electronics, electrically hated catalysts, electric power steering, and engine starter power. Higher power and longer cycle life are expected for electrochemical capacitors than for batteries. Evaluation of environmental, health, and safety (EH and S) issues of electrochemical capacitors is an essential part of the development and commercialization of electrochemical capacitors for advanced vehicles. This report provides an initial EH and S assessment. This report presents electrochemical capacitor electrochemistry, materials selection, intrinsic material hazards, mitigation of those hazards, environmental requirements, pollution control options, and shipping requirements. Most of the information available for this assessment pertains to commercial devices intended for application outside the advanced vehicle market and to experiment or prototype devices. Electrochemical capacitors for power assists in HEVs are not produced commercially now. Therefore, materials for advanced vehicle electrochemical capacitors may change, and so would the corresponding EH and S issues. Although changes are possible, this report describes issues for likely electrochemical capacitor designs.
Ajoy Kumar Das
Full Text Available Some recent advances of a recently developed structural health assessment procedure proposed by the research team at the University of Arizona, commonly known as generalized iterative least-squares extended Kalman filter with unknown input (GILS-EKF-UI are presented. The procedure is a finite elements-based time-domain system-identification technique. It can assess structural health at the element level using only limited number of noise-contaminated responses. With the help of examples, it is demonstrated that the structure can be excited by multiple loadings simultaneously. The method can identify defects in various stages of degradation in single or multiple members and also relatively less severe defect. The defective element(s need not be in the substructure, but the defect detection capability increases if the defect spot is close to the substructure. Two alternatives are suggested to locate defect spot more accurately within a defective element. The paper advances several areas of GILS-EKF-UI to assess health of large structural systems.
... or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is ... even some allergic conditions. Infants should get the first shot of the ... schedule . When to Call the Doctor Don't hesitate to call your ...
Chawla, V.; Pandit, P B; Nkrumah, F K
We studied 53 newborn babies with congenital syphilis. The common clinical features seen were low birth weight, hepatosplenomegaly, anaemia, jaundice, and symmetrical superficial desquamation of the skin affecting palms and soles. The presence of these clinical signs is highly suggestive of early congenital syphilis. Hydrops fetalis without rhesus or ABO isoimmunisation should always arouse the suspicion of congenital syphilis.
Leo, Irene; Simion, Francesca
The aim of this study is to investigate whether newborns detect a face on the basis of a Gestalt representation based on first-order relational information (i.e., the basic arrangement of face features) by using Mooney stimuli. The incomplete 2-tone Mooney stimuli were used because they preclude focusing both on the local features (i.e., the fine…
Pettit, C. D.; Barkhoudarian, S.; Daumann, A. G., Jr.; Provan, G. M.; ElFattah, Y. M.; Glover, D. E.
In this study, we proposed an Advanced Health Management System (AHMS) functional architecture and conducted a technology assessment for liquid propellant rocket engine lifecycle health management. The purpose of the AHMS is to improve reusable rocket engine safety and to reduce between-flight maintenance. During the study, past and current reusable rocket engine health management-related projects were reviewed, data structures and health management processes of current rocket engine programs were assessed, and in-depth interviews with rocket engine lifecycle and system experts were conducted. A generic AHMS functional architecture, with primary focus on real-time health monitoring, was developed. Fourteen categories of technology tasks and development needs for implementation of the AHMS were identified, based on the functional architecture and our assessment of current rocket engine programs. Five key technology areas were recommended for immediate development, which (1) would provide immediate benefits to current engine programs, and (2) could be implemented with minimal impact on the current Space Shuttle Main Engine (SSME) and Reusable Launch Vehicle (RLV) engine controllers.
Full Text Available The research objective is rational (optimal time management in studying the course modules on Advanced Training of Health Care Administrators. Materials and methods. We conducted expert survey of 73 healthcare administrators from medical organizations of Saratov region. Branch-and-bound method was used for rescheduling the educational program. Results. Both direct and inverse problems have been solved. The direct one refers to time distribution for each module of the advanced Training of Healthcare Administrators course so that the total score is maximum and each module is marked not lower than "satisfactory". The inverse one resulted in achieving minimal time characteristics for varieties of average score. Conclusion. The offered approach allows to solve problems of managing time given for education.
Waisbren, Susan E.; Bäck, Danielle K.; Liu, Christina; Kalia, Sarah S.; Ringer, Steven A.; Holm, Ingrid A.; Green, Robert C.
Purpose We surveyed parents to ascertain interest in newborn genomic testing and determine whether these queries would provoke refusal of conventional newborn screening (NBS). Methods After brief genetics orientation, parents rated their interest in receiving genomic testing for their healthy newborn on a 5-point Likert scale and answered questions about demographics and health history. We used logistic regression to explore factors associated with interest in genomic testing and tracked any subsequent rejection of NBS. Results We queried 514 parents within 48 hours after birth while still in the hospital (mean age (sd) 32.7 (6.4) years, 65.2% female, 61.2% white, 79.3% married). Parents reported being not at all (6.4%), a little (10.9%), somewhat (36.6%), very (28.0%) or extremely (18.1%) interested in genomic testing for their newborns. None refused conventional NBS. Married participants and those with health concerns about their infant were less interested in newborn genomic testing (p=0.012 and p=0.030, respectively). Mothers’ and fathers’ degree of interest was discordant (≥ 2 categories different) in 24.4% of couples. Conclusions Interest in newborn genomic testing was high among parents of healthy newborns and the majority of couples had similar levels of interest. Surveying parents about genomic sequencing did not prompt rejection of NBS. PMID:25474344
Enweronu-Laryea Christabel C
Full Text Available Abstract Background Congenital malaria is defined as malaria parasitaemia in the first week of life. The reported prevalence of congenital malaria in sub-Saharan Africa is variable (0 - 46%. Even though the clinical significance of congenital malaria parasitaemia is uncertain, anti-malarial drugs are empirically prescribed for sick newborns by frontline health care workers. Data on prevalence of congenital malaria in high-risk newborns will inform appropriate drug use and timely referral of sick newborns. Methods Blood samples of untreated newborns less than 1 week of age at the time of referral to Korle Bu Teaching hospital in Accra, Ghana during the peak malaria seasons (April to July of 2008 and 2010 were examined for malaria parasites by, i Giemsa-stained thick and thin blood smears for parasite count and species identification, ii histidine-rich protein- and lactic dehydrogenase-based rapid diagnosis tests, or iii polymerase chain reaction amplification of the merozoite surface protein 2 gene, for identification of sub-microscopic parasitaemia. Other investigations were also done as clinically indicated. Results In 2008, nine cases of Plasmodium falciparum parasitaemia were diagnosed by microscopy in 405 (2.2% newborns. All the nine newborns had low parasite densities (≤50 per microlitre. In 2010, there was no case of parasitaemia by either microscopy or rapid diagnosis tests in 522 newborns; however, 56/467 (12% cases of P. falciparum were detected by polymerase chain reaction. Conclusion Congenital malaria is an uncommon cause of clinical illness in high-risk untreated newborns referred to a tertiary hospital in the first week of life. Empirical anti-malarial drug treatment for sick newborns without laboratory confirmation of parasitaemia is imprudent. Early referral of sick newborns to hospitals with resources and skills for appropriate care is recommended.
Bruce, Martha L
Looking back to 1993, the articles published in the American Journal of Geriatric Psychiatry's inaugural issue focused on central questions in geriatric psychiatry-from how age-related changes in brain structure and function affect illness etiology, expression, course, and outcomes(1) to how best to identify and address the unmet mental health needs in different populations of older adult.(2) Today's journal reflects both an enduring commitment to these questions and the growth of the field itself, both in terms of scientific advancement and the breadth of research that is relevant. Thus, questions with pressing clinical and public health significance continue to be addressed but with increasing sophistication in specificity to the questions and the availability of tools to investigate them. PMID:27160986
Fiorucci, Tony R.; Lakin, David R., II; Reynolds, Tracy D.; Turner, James E. (Technical Monitor)
The Real Time Vibration Monitoring System (RTVMS) is a 32-channel high speed vibration data acquisition and processing system developed at Marshall Space Flight Center (MSFC). It Delivers sample rates as high as 51,200 samples/second per channel and performs Fast Fourier Transform (FFT) processing via on-board digital signal processing (DSP) chips in a real-time format. Advanced engine health assessment is achieved by utilizing the vibration spectra to provide accurate sensor validation and enhanced engine vibration redlines. Discrete spectral signatures (such as synchronous) that are indicators of imminent failure can be assessed and utilized to mitigate catastrophic engine failures- a first in rocket engine health assessment. This paper is presented in viewgraph form.
Kukreja, Sunil L.; Bernstein, Dennis S.
Environmental conditions, cyclic loading, and aging contribute to structural wear and degradation, and thus potentially catastrophic events. The challenge of health monitoring technology is to determine incipient changes accurately and efficiently. This project addresses this challenge by developing health monitoring techniques that depend only on sensor measurements. Since actively controlled excitation is not needed, sensor-to-sensor identification (S2SID) provides an in-flight diagnostic tool that exploits ambient excitation to provide advance warning of significant changes. S2SID can subsequently be followed up by ground testing to localize and quantify structural changes. The conceptual foundation of S2SID is the notion of a pseudo-transfer function, where one sensor is viewed as the pseudo-input and another is viewed as the pseudo-output, is approach is less restrictive than transmissibility identification and operational modal analysis since no assumption is made about the locations of the sensors relative to the excitation.
Hao, Yanni; Wolfram, Verena; Cook, Jennifer
Background Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases), online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center), and web sites of health technology assessment (HTA) bodies. Publications were selected based on the search strategy and the overall study objectives. Results A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D). Other utility measures, such as the direct methods standard gamble (SG), time trade-off (TTO), and visual analog scale (VAS), were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL) instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23), Functional Assessment of Cancer Therapy – General questionnaire (FACT-G), and Utility-Based Questionnaire-Cancer (UBQ-C); most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex, income, and education, as well as disease progression, choice of utility elicitation method, and country settings, were identified
Cía, Alfredo H; Rojas, Rodrigo Córdoba; Adad, Miguel Abib
The history of Mental Health in Latin America is relatively young. It dates back to the mid nineteenth century and widely developed during the twentieth century, with formidable scientific, social, political, and ethical challenges. Latin American psychiatry has contributed in the fields of epidemiology, phenomenology, social psychiatry, psychiatric and epistemological research, and clinical genetics as well. More recent advances can also be seen in clinical psychotherapy and psychopharmacology. Now, there is a formal and informal recognition of various areas of expertise, such as children and adolescents, addictions, anxiety disorders, among others. However, we need to solve the health problems resulting from mental illnesses as well as the disorders related to the social, environmental, political, and economic factors of a continent marked by the precariousness of underdevelopment, which have a high impact on population health. Therefore, considering and trying to minimize the impact of those factors, contributing to the destigmatization of mental illnesses and their consequences, together with the growing number of non-governmental organizations (NGOs), human rights defenders, public figures, etc., and collaborating in building a society that guarantees the right to mental health and adequate treatment and rehabilitation are part of our present challenges in Latin America. PMID:20874063
Leonov, N P; Karas'kov, A M; Litasova, E E; Strunin, O V; Karmadonova, N A; Akopov, G D; Vishegorodtseva, L I
The study was carried out to diferentiate reference values for kaolin-activated thromboelastography in newborns with congenital heart disease. The study included two groups ofpatients. The first one consisted of 62 newborns with congenital heart disease and the second one consisted of 35 healthy newborns. The results of kaolin-activated thromboelastography implemented in groups are evaluated as condition of normal coagulation. The valuable diferences of homeostasis system in healthy newborns and newborns with congenital heart disease (without severe concomitant pathology) are not established. They have similar indicators of kaolin-activated thromboelastography. The derived results can be applied as standards in full-term newborns with congenital heart disease. PMID:27455561
Rovamo, Liisa; Nurmi, Elisa; Mattila, Minna-Maria; Suominen, Pertti; Silvennoinen, Minna
Background: Video analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50 % of cases. Multidisciplinary simulation is used as a first-rate tool for the improvement of teamwork among health professionals. In the study we evaluated the impact of the crisis resource management (CRM) and anesthesia non-technical skills instruction on teamwork during simulated newborn emergencies. Methods: Ninety-nine...
Luke C Mullany; Darmstadt, Gary L.; Khatry, Subarna K; James M. Tielsch
Mustard oil massage of newborns is an integral component of traditional care practices in many communities. Recent evidence suggests that this practice may have detrimental effects, particularly for preterm infants or for those whose skin barrier function is otherwise sub-optimal. Other natural oils such as sunflower, sesame or safflower seed oil may have a beneficial impact on newborn health and survival. Little is known, however, about cultural and other factors related to the acceptance an...
McCallum, Lindsay C., E-mail: firstname.lastname@example.org [University of Toronto, Department of Physical and Environmental Sciences, 1265 Military Trail, Toronto, Ontario M1C 1A4 (Canada); Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Ollson, Christopher A., E-mail: email@example.com [Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Stefanovic, Ingrid L., E-mail: firstname.lastname@example.org [Simon Fraser University, Faculty of Environment, 8888 University Drive, Burnaby, British Columbia V5A 1S6 (Canada)
Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.
Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada
Golshantafti, Mohammad; Yavari, Tahereh; Afrand, Mohammadhosain
Background: The most common reason of respiratory distress in the newborn is transient tachypnea of the newborn (TTN). There are some reports saying that TTN is associated with increased frequencies of wheezing attacks. Objectives: The aims of this study were to determine the risk factors associated with TTN and to determine the association between TTN and the development of wheezing syndromes in early life. Materials and Methods: In a historical cohort study, we recorded the characteristics of 70 infants born at the Shohadaye Kargar Hospital in Yazd between March 2005 and March 2009 and who were hospitalized because of TTN in the neonatal intensive-care unit. We called their parents at least four years after the infants were discharged from the hospital and asked about any wheezing attacks. Seventy other infants with no health problems during the newborn period were included in the study as the control group. Results: The rate of wheezing attacks in newborns with TTN was more than patients with no TTN diagnosis (P = 0.014). TTN was found to be an independent risk factor for later wheezing attacks (relative risk [RR] = 2.8). Conclusions: The most obvious finding of this study was that TTN was an independent risk factor for wheezing attacks. So long-term medical care is suggested for these patients who may be at risk, because TTN may not be as transient as has been previously thought. PMID:26848370
Osypuk, Theresa L.
Research on racial residential segregation and health typically uses multilevel, population-based, slice-in-time data. Although research using this approach, including that by Kershaw et al. (Am J Epidemiol. 2013;177(4):299–309), has been valuable, I argue that to advance our understanding of how residential segregation influences health and health disparities, it is critical to incorporate a life-course perspective and integrate social theory. Applying a life-course perspective would entail ...
Shirmohammadi, Adileh; Abdollahifard, Sedigeh; Chitsazi, Mohammad-Taghi; Behlooli, Sepideh
Purpose The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores. Methods One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal parameters of bleeding on probing (BOP), clinical attachment loss (CAL), probing depth (PD), birth weight, and Apgar scores were record...
Iganus, R.; Hill, Z; Manzi, F.; Bee, M.; Amare, Y.; Shamba, D; Odebiyi, A; Adejuyigbe, E.; Omotara, B; Skordis-Worrall, J.
Objectives. To explore roles and responsibilities in newborn care in the intra- and postpartum period in Nigeria, Tanzania and Ethiopia. Methods. Qualitative data were collected using in-depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses. Results. We found that birth attendants were the main decision-makers and care takers in the intrapartum period. Birth attenda...
Boesen, Martin Lehmann; Bygum, Anette; Hertz, Jens Michael; Zachariassen, Gitte
Epidermolysis bullosa (EB) is an inherited skin disease with four main subtypes that cannot be distinguished clinically at birth. All subtypes may present with widespread life-threatening blisters and fragile skin, making treatment and handling of the newborn with EB challenging. The prognosis of...... and nutrition. For immediate pain relief, intranasal fentanyl worked best and gabapentin was successfully used for chronic pain. The feeding difficulties were handled first by a nasogastric feeding tube. Later a normal feeding bottle proved to be adequate....
Full Text Available OBJECTIVE: A two year follow-up study of a cohort of adolescents on 9 health parameters. METHOD: 325 adolescents were enrolled in April 1999. In addition to answering a general social-demographic questionnaire, they answered Wallston's Multidimensional Locus of Control scale (MHLC and Olson's questionnaire on family dynamics (FACES III. 10 health indicators were recorded : two analogical visual assessments (VAS (general coping and feelings of well-being, their concern for their health on a five level Likert scale, Zung's Subjective Depression Scale, and having had to repeat a school year as an indirect indicator of self esteem. Two years later, the sample (n = 86 were re-evaluated through the same questionnaires, and answered a supplementary questionnaire addressing (1 additional medication taken since their initial evaluation, (2 the number of medical consultations they have been through since the baseline, and/or (3 hospitalisations they underwent. They also answered a VAS about their level of concern over their body. RESULTS: Numerous variables belonging to Wallston's MHLC scale as well as to Olson's FACES III questionnaire were found to correlate with health indicators two years later. It proved to also be the case for both several « subjective » values such as general coping and feelings of well-being, and being concerned with one's health, and with more « objective » parameters such as subjects' scores on the "Subjective Depression Feelings" form, or their intake of additional medications. CONCLUSION: It appears that it is may possible to predict two years in advance at-risk adolescents for whom preventive medicine is particularly necessary.
Full Text Available Background. This study was designed to understand the patterns and determinants of three essential newborn care practices: safe cord care, optimal thermal care, and neonatal feeding practices. Methods. A community-based cross-sectional study was carried out on a sample of 404 lactating mothers who have delivered a live baby at home within the past one year prior to the study. Results. Overall, the prevalence of essential newborn practices on safe cord care and optimal thermal care was exceptionally low. Of the 404 newborns, only 0.2% (1 had safe cord care, 5.2% (21 optimal thermal care, and 50.2% (203 were considered to have had adequate neonatal feeding. In logistic regression analysis, the main predictors of good neonatal feeding were maternal age, timing of the first antenatal care (ANC, and maternal knowledge of newborn danger signs. Women who could mention at least 4 danger signs of the neonate were 4 times more likely to give good neonatal feeding to their babies (AOR = 4.7, Cl: 2.43–9.28, P<0.001. Conclusion. Evidence from this study strongly suggests that the expected essential newborn care practices are not available to a substantial number of the newborns. Efforts should therefore be made by the Ghana Health Service (GHS to expand essential newborn care interventions beyond institutional level into the communities.
The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period
Marsh, David R; Sternin, Monique; Khadduri, Rolla; Ihsan, Tariq; Nazir, Raheel; Bari, Abdul; Lapping, Karin
A positive deviance (PD) inquiry identifies uncommon, model practices that a follow-on program can spread. PD has been used to rehabilitate malnourished children, but not for improving newborn health. Save the Children Federation/US (SC) conducted newborn PD cycles in communities (total population about 5,000 each) in two project areas in Haripur District, Pakistan among Afghan refugees and among local Pakistanis. Each PD cycle included planning, community orientation, situation analysis, PD inquiries, and community feedback with action planning. PD inquiries were in-depth interviews to identify uncommon behaviors among surviving asphyxiated newborns, thriving low birthweight babies, surviving newborns who had danger signs, and normal newborns. The Afghan caregivers showed better use of services and some household practices than their Pakistani counterparts, consistent with duration of SC presence (15 years vs. 18 months, respectively). The practices of both groups for clean delivery, thermal control, immediate and exclusive breastfeeding, and fathers' involvement were weak. But PD individuals, families, and/or birth attendants modeled good maternal care and immediate, routine and special newborn care. Communities enthusiastically committed to change behavior and form neighborhood support groups for better newborn care, including a demand for hygienic delivery. The PD approach for the newborn is more complex than for child nutrition. Yet this pilot-test proposed a conceptual framework for household newborn care, suggested tools and methods for information gathering, identified PDs in two settings of different risk, galvanized SC staff to the potential of the approach, mobilized communities for better newborn health, and drafted a newborn PD training curricula. PMID:12503239
Törüner, Ebru Kılıçarslan; Altay, Naime
Making appropriate and effective enteral feeding is decreasing the morbidity and mortality rates of risky newborns. Most important problems during enteral feeding in risky newborns are realizing the enteral feeding needs late, not following enteral feeding protocols and errors in medical practices (misconnections etc.). The aim of this review article is to describe the gastrointestinal development, nutrition requirements, enteral nutrition, feeding intolerance and care of risky newborns. ...
Allisyn C Moran
Full Text Available Neonatal mortality accounts for 43% of under-five mortality. Consequently, improving newborn survival is a global priority. However, although there is increasing consensus on the packages and specific interventions that need to be scaled up to reduce neonatal mortality, there is a lack of clarity on the indicators needed to measure progress. In 2008, in an effort to improve newborn survival, the Newborn Indicators Technical Working Group (TWG was convened by the Saving Newborn Lives program at Save the Children to provide a forum to develop the indicators and standard measurement tools that are needed to measure coverage of key newborn interventions. The TWG, which included evaluation and measurement experts, researchers, individuals from United Nations agencies and non-governmental organizations, and donors, prioritized improved consistency of measurement of postnatal care for women and newborns and of immediate care behaviors and practices for newborns. In addition, the TWG promoted increased data availability through inclusion of additional questions in nationally representative surveys, such as the United States Agency for International Development-supported Demographic and Health Surveys and the United Nations Children's Fund-supported Multiple Indicator Cluster Surveys. Several studies have been undertaken that have informed revisions of indicators and survey tools, and global postnatal care coverage indicators have been finalized. Consensus has been achieved on three additional indicators for care of the newborn after birth (drying, delayed bathing, and cutting the cord with a clean instrument, and on testing two further indicators (immediate skin-to-skin care and applications to the umbilical cord. Finally, important measurement gaps have been identified regarding coverage data for evidence-based interventions, such as Kangaroo Mother Care and care seeking for newborn infection.
Rosenfeld, Margaret; Sontag, Marci K; Ren, Clement L
The diagnosis of cystic fibrosis (CF) has evolved over the past decade as newborn screening has become universal in the United States and elsewhere. The heterogeneity of phenotypes associated with CF transmembrane conductance regulator (CFTR) dysfunction and mutations in the CFTR gene has become clearer, ranging from classic pancreatic-insufficient CF to manifestations in only 1 organ system to indeterminate diagnoses identified by newborn screening. The tools available for diagnosis have also expanded. This article reviews the newest diagnostic criteria for CF, newborn screening, prenatal screening and diagnosis, and indeterminate diagnoses in newborn-screened infants and symptomatic adults. PMID:27469178
Jennifer B. Phillips
Full Text Available Advances in genomics and next-generation sequencing have provided clinical researchers with unprecedented opportunities to understand the molecular basis of human genetic disorders. This abundance of information places new requirements on traditional disease models, which have the potential to be used to confirm newly identified pathogenic mutations and test the efficacy of emerging therapies. The unique attributes of zebrafish are being increasingly leveraged to create functional disease models, facilitate drug discovery, and provide critical scientific bases for the development of new clinical tools for the diagnosis and treatment of human disease. In this short review and the accompanying poster, we highlight a few illustrative examples of the applications of the zebrafish model to the study of human health and disease.
Gambarte, Maria Laura; Osornio, Alejandro Lopez; Martinez, Marcela; Reynoso, Guillermo; Luna, Daniel; de Quiros, Fernan Gonzlez Bernaldo
As the medical informatics field evolves, new functions appear as the focus of interest; a more advanced management of terminology is one of them. Using comprehensive and detailed terminology to represent clinical rules in computer systems, associated with patient information, would allow clinical software to provide patient specific recommendations or alerts. In order to uniform data collection through our HIS, and lay the foundations for future clinical decision support systems, we decided to move from our previous classification-based medical record into new terminology services built around Snomed CT, Spanish Language Version. This paper describes the characteristics of our Terminology Server. The most important achievements of our new terminology system are the centralization of knowledge representation, using a much more detailed terminology system. Clinical data entered at any place of the institution and level of care, is represented uniformly through the whole health information system. PMID:17911791
In Canada, as well as internationally, efficiency-focused organizational restructuring in healthcare has resulted in stressful job change for nurses, although nurses continue to work in a system that values technology-based, physician-provided services. Employed nurses have had to participate in organizational activities that undermine their professional values and goals. Nursing entrepreneurship presents an opportunity to explore nursing's professional potential in nursing practice that is uniquely independent. In this study, a focused ethnographic approach was used to explore the experiences of self-employed nurses, who see themselves as leaders in advancing the profession of nursing and its contribution to healthcare. Key themes in the findings include the responses of self-employed nurses to health system change, expanded roles for nurses, the consequences of this non-traditional approach to nursing work and the possibilities for change that arise from nursing entrepreneurship. This research has implications for healthcare policy, professional advocacy and nursing education. PMID:23809640
Advanced aerospace materials, including fiber reinforced polymer and ceramic matrix composites, are increasingly being used in critical and demanding applications, challenging the current damage prediction, detection, and quantification methodologies. Multiscale computational models offer key advantages over traditional analysis techniques and can provide the necessary capabilities for the development of a comprehensive virtual structural health monitoring (SHM) framework. Virtual SHM has the potential to drastically improve the design and analysis of aerospace components through coupling the complementary capabilities of models able to predict the initiation and propagation of damage under a wide range of loading and environmental scenarios, simulate interrogation methods for damage detection and quantification, and assess the health of a structure. A major component of the virtual SHM framework involves having micromechanics-based multiscale composite models that can provide the elastic, inelastic, and damage behavior of composite material systems under mechanical and thermal loading conditions and in the presence of microstructural complexity and variability. Quantification of the role geometric and architectural variability in the composite microstructure plays in the local and global composite behavior is essential to the development of appropriate scale-dependent unit cells and boundary conditions for the multiscale model. Once the composite behavior is predicted and variability effects assessed, wave-based SHM simulation models serve to provide knowledge on the probability of detection and characterization accuracy of damage present in the composite. The research presented in this dissertation provides the foundation for a comprehensive SHM framework for advanced aerospace materials. The developed models enhance the prediction of damage formation as a result of ceramic matrix composite processing, improve the understanding of the effects of architectural and
Sprague, Ann E; Dunn, Sandra I; Fell, Deshayne B; Harrold, Joann; Walker, Mark C; Kelly, Sherrie; Smith, Graeme N
Pregnancy, birth, and the early newborn period are times of high use of health care services. As well as opportunities for providing quality care, there are potential missed opportunities for health promotion, safety issues, and increased costs for the individual and the system when quality is not well defined or measured. There has been a need to identify key performance indicators (KPIs) to measure quality care within the provincial maternal-newborn system. We also wanted to provide automated audit and feedback about these KPIs to support quality improvement initiatives in a large Canadian province with approximately 140 000 births per year. We therefore worked to develop a maternal-newborn dashboard to increase awareness about selected KPIs and to inform and support hospitals and care providers about areas for quality improvement. We mapped maternal-newborn data elements to a quality domain framework, sought feedback via survey for the relevance and feasibility of change, and examined current data and the literature to assist in setting provincial benchmarks. Six clinical performance indicators of maternal-newborn quality care were identified and evidence-informed benchmarks were set. A maternal-newborn dashboard with "drill down" capacity for detailed analysis to enhance audit and feedback is now available for implementation. While audit and feedback does not guarantee individuals or institutions will make practice changes and move towards quality improvement, it is an important first step. Practice change and quality improvement will not occur without an awareness of the issues. PMID:23343794
Trarieux-Signol, Sophie; Moreau, Stéphane; Gourin, Marie-Pierre; Penot, Amélie; Edoux de Lafont, Geoffroy; Preux, Pierre-Marie; Bordessoule, Dominique
Background During the last few decades, patients’ rights have been reinforced in many countries by acts of law. Measures now include health care proxies to uphold the doctor-patient relationship and advance directives for end-of-life patients. These could be relevant tools as early as the initial diagnosis of haematological malignancies because of the uncertain disease course. The aim of this research was to assess the factors associated with the designation of a proxy and writing advance dir...
Yajima, Masahide; Asakawa, Yasuyoshi; Yamaguchi, Haruyasu
[Purpose] The aim of this study was to clarify the relations of morale and physical function to the presence/absence of advanced activities of daily living. [Subjects] The subjects were 86 elderly community residents participating in health promotion classes. [Methods] A questionnaire survey on age, gender, presence/absence of advanced activities of daily living, and Philadelphia Geriatric Center Morale Scale score was conducted, in addition to assessment of fitness, consisting of measurement...
... and Publications How do health care providers diagnose phenylketonuria (PKU)? Skip sharing on social media links Share this: ... test done on newborns. 1 Newborn Screening for PKU All 50 U.S. states and territories require that ...
Full Text Available Anthropometric dimensions are the basis of evaluation of health of new-borns. MATERIALS AND METHOD Head length and Head Width of three hundred sixty normal new-borns (180 male and 180 female belonging to three different endogamous groups, i.e. Jat Sikhs, Banias and Majhbi Sikhs were recorded and Cephalic Index was calculated. RESULTS The difference in mean Cephalic index was found to be highly significant in the three endogamous groups (p<0.001, whereas it was just significant in males and females. CONCLUSION Cephalic index varies with heredity and also shows sexual dimorphism. This variation can be used in forensic practice for identification of skeletal remains. It is also useful in plastic surgery, facial reconstruction, pediatrics, oral surgery, dentistry and various other craniofacial surgeries.
Full Text Available Iodine deficiency can be defined as the world’s greatest single cause of preventable brain damage. Fetal and neonatal hypothyroidism, caused by iodine deficiency can be prevented prior to conception and then during pregnancy and lactation when an adequate iodine supplementation is ensured. Extremely low birth weight preterm babies risk having a negative iodine balance status in the first weeks of life, exacerbating the hypothyroxinaemia of the prematurity. It is important to ensure that these babies are provided with an adequate iodine intake from the first days of life. Mothers and newborns should avoid environmental iodine excess during pregnancy or lactation.
Jequier, S.; Nogrady, M.B.; Wesenberg, R.L.
A newborn baby presented with hyaline membrane disease, interstitial pneumonia, jaundice, hepatosplenomegaly, and unusual bone manifestations with lytic and sclerotic bone lesions and virtually absent periosteal reaction. He subsequently developed intracranial calcifications and mental retardation. The pneumonia and hepatosplenomegaly resolved. At the time of the delivery, a sibling was suffering from a severe undetermined viral infection. The clinical evolution of the disease and the radiologic findings led us to believe that this patient has a prenatal viral infection. The laboratory tests and the histologic picture of the bone biopsy supported the diagnosis.
Vitamin K deficiency bleeding of the newborn (VKDB) is a bleeding disorder in babies. It most often develops shortly ... A lack of vitamin K may cause severe bleeding in newborn babies. Vitamin K plays an important role in blood clotting. Babies often have a ...
Gould, Solange M.
Climate change is a significant public health danger, with a disproportionate impact on low-income and communities of color that threatens to increase health inequities. Many important social determinants of health are at stake in California climate change policy-making and planning, and the distribution of these will further impact health inequities. Not only are these communities the most vulnerable to future health impacts due to the cumulative impacts of unequal environmental exposures a...
Full Text Available Background The aim of newborn bloodspot screening (NBS is to identify rare genetic and non-genetic conditions in children soon after birth in order to commence therapies that prevent the development of progressive, serious, and irreversible disabilities. Universal NBS programmes have been implemented in most countries, with minor adaptations to target conditions most relevant to the local healthcare environment. Aims In this article, we describe the initiatives of international and Australian governments to develop policies to address the expansion of NBS in their healthcare systems. Methods We have reviewed published public policies and literature to formulate recommendations based on clinical, social, legal, and ethical principles to inform a national governance and policy framework for Australia. Results Australian policy makers have been slow to develop a coordinated plan. While the experience from other governments can guide our national policy, there are specific areas that require further consideration by Australian health experts. Key reforms involve the separation of policy and operational activities, multidisciplinary decision-making and oversight by the Australian Health Ministers’ Advisory Council for policy direction. Conclusion A formal national policy framework will guide the coordination of NBS services that can adapt to the needs of Australian children and families.
Julian F. Guest
Full Text Available Soft tissue sarcomas are a rare type of cancer generally treated with palliative chemotherapy when in the advanced stage. There is a lack of published health utility data for locally advanced “inoperable”/metastatic disease (ASTS, essential for calculating the cost-effectiveness of current and future treatments. This study estimated time trade-off (TTO and standard gamble (SG preference values associated with four ASTS health states (progressive disease, stable disease, partial response, complete response among members of the general public in the UK (n=207. The four health states were associated with decreases in preference values from full health. Complete response was the most preferred health state (mean utility of 0.60 using TTO. The second most preferred health state was partial response followed by stable disease (mean utilities were 0.51 and 0.43, respectively, using TTO. The least preferred health state was progressive disease (mean utility of 0.30 using TTO. The utility value for each state was significantly different from one another (P<0.001. This study demonstrated and quantified the impact that different treatment responses may have on the health-related quality of life of patients with ASTS.
Fischer, Elizabeth A; Jayana, Krishnamurthy; Cunningham, Troy; Washington, Maryann; Mony, Prem; Bradley, Janet; Moses, Stephen
High-quality care during labor, delivery, and the postpartum period is critically important since maternal and child morbidity and mortality are linked to complications that arise during these stages. A nurse mentoring program was implemented in northern Karnataka, India, to improve quality of services at primary health centers (PHCs), the lowest level in the public health system that offers basic obstetric care. The intervention, conducted between August 2012 and July 2014, employed 53 full-time nurse mentors and was scaled-up in 385 PHCs in 8 poor rural districts. Each mentor was responsible for 6 to 8 PHCs and conducted roughly 6 mentoring visits per PHC in the first year. This paper reports the results of a qualitative inquiry, conducted between September 2012 and April 2014, assessing the program's successes and challenges from the perspective of mentors and PHC teams. Data were gathered through 13 observations, 9 focus group discussions with mentors, and 25 individual and group interviews with PHC nurses, medical officers, and district health officers. Mentors and PHC staff and leaders reported a number of successes, including development of rapport and trust between mentors and PHC staff, introduction of team-based quality improvement processes, correct and consistent use of a new case sheet to ensure adherence to clinical guidelines, and increases in staff nurses' knowledge and skills. Overall, nurses in many PHCs reported an increased ability to provide care according to guidelines and to handle maternal and newborn complications, along with improvements in equipment and supplies and referral management. Challenges included high service delivery volumes and/or understaffing at some PHCs, unsupportive or absent PHC leadership, and cultural practices that impacted quality. Comprehensive mentoring can build competence and improve performance by combining on-the-job clinical and technical support, applying quality improvement principles, and promoting team
In the lifespan of a human being the two extremes, the early childhood and old age are prone to septicaemia because of poorly functioning anti-infectious defensive mechanisms. In a newborn full term baby these mechanisms are all present but still unexperienced. The importance of both specific and nonspecific factors will be discussed. The etiologic agents, causing septicaemia in nurseries undergo continuous change. In Helsinki we have during the last 20 years experienced staphylococci to start with, changing then to Gram-negative rods, to streptococci group B and now we have increasing difficulties with hospital infections. In the treatment of these children antibiotics alone are not sufficient but repeated exchange transfusions and granulocyte transfusions are needed. In infants after the first month of life, septicaemias produce a clinical picture different from that in newborns but still different also from that in adults. Also in this age group a shift in etiology has been observed. Increasing resistance to antimicrobial agents in the bacteria encountered makes a reconsideration of therapeutic schemes necessary. PMID:7048513
Pastor Rodríguez, Jesús David; Pastor Bravo, María Del Mar; López García, Visitación; Cotes Teruel, María Isabel; Mellado, Jesús Eulogio; Cárceles, José Jara
A case is presented of a premature newborn of 27 weeks gestation and weighing 420 grams who was delivered as a result of a maternal pre-eclampsia and retarded intra-uterine growth. During the 125 days of hospitalisation, an individual care plan based on the Virginia Henderson model was devised and applied to both the child and her parents using NANDA diagnostics, interventions according to the NIC classification, and the expected results according to the NOC classification. The Marjory Gordon functional patterns were used for the initial assessment. By applying the pre-term newborn (PTNB) plan, all their needs were provided and were modified throughout the hospital stay, with new needs that were added to the established ones. These required a continuous assessment with the subsequent adapting of the care plan. Likewise, the care required by the parents varied from the initial grief due to the possible loss of their child to learning the alarm signs and the home care that their child would need. The child was finally discharged weighing 2900 grams and with normal neurological and psychomotor development, although with a lower weight appropriate to her age. Currently, at 2 years old, the child has a normal neurological and psychomotor development, but with weight and size lower than the P(3) percentile. She requires speech therapy treatment due to paralysis of the right vocal cord. PMID:20605104
Nichols, Peter D; McManus, Alexandra; Krail, Kevin; Sinclair, Andrew J; Miller, Matt
The joint symposium of The Omega-3 Centre and the Australasian Section American Oil Chemists Society; Recent Advances in Omega-3: Health Benefits, Sources, Products and Bioavailability, was held November 7, 2013 in Newcastle, NSW, Australia. Over 115 attendees received new information on a range of health benefits, aquaculture as a sustainable source of supply, and current and potential new and novel sources of these essential omega-3 long-chain (LC, ≥ C20) polyunsaturated fatty acid nutrients (also termed LC omega-3). The theme of "Food versus Fuel" was an inspired way to present a vast array of emerging and ground breaking Omega-3 research that has application across many disciplines. Eleven papers submitted following from the Omega-3 Symposium are published in this Special Issue volume, with topics covered including: an update on the use of the Omega-3 Index (O3I), the effects of dosage and concurrent intake of vitamins/minerals on omega-3 incorporation into red blood cells, the possible use of the O3I as a measure of risk for adiposity, the need for and progress with new land plant sources of docosahexaenoic acid (DHA, 22:6ω3), the current status of farmed Australian and New Zealand fish, and also supplements, in terms of their LC omega-3 and persistent organic pollutants (POP) content, progress with cheap carbon sources in the culture of DHA-producing single cell organisms, a detailed examination of the lipids of the New Zealand Greenshell mussel, and a pilot investigation of the purification of New Zealand hoki liver oil by short path distillation. The selection of papers in this Special Issue collectively highlights a range of forward looking and also new and including positive scientific outcomes occurring in the omega-3 field. PMID:25255830
Peter D. Nichols
Full Text Available The joint symposium of The Omega-3 Centre and the Australasian Section American Oil Chemists Society; Recent Advances in Omega-3: Health Benefits, Sources, Products and Bioavailability, was held November 7, 2013 in Newcastle, NSW, Australia. Over 115 attendees received new information on a range of health benefits, aquaculture as a sustainable source of supply, and current and potential new and novel sources of these essential omega-3 long-chain (LC, ≥C20 polyunsaturated fatty acid nutrients (also termed LC omega-3. The theme of “Food versus Fuel” was an inspired way to present a vast array of emerging and ground breaking Omega-3 research that has application across many disciplines. Eleven papers submitted following from the Omega-3 Symposium are published in this Special Issue volume, with topics covered including: an update on the use of the Omega-3 Index (O3I, the effects of dosage and concurrent intake of vitamins/minerals on omega-3 incorporation into red blood cells, the possible use of the O3I as a measure of risk for adiposity, the need for and progress with new land plant sources of docosahexaenoic acid (DHA, 22:6ω3, the current status of farmed Australian and New Zealand fish, and also supplements, in terms of their LC omega-3 and persistent organic pollutants (POP content, progress with cheap carbon sources in the culture of DHA-producing single cell organisms, a detailed examination of the lipids of the New Zealand Greenshell mussel, and a pilot investigation of the purification of New Zealand hoki liver oil by short path distillation. The selection of papers in this Special Issue collectively highlights a range of forward looking and also new and including positive scientific outcomes occurring in the omega-3 field.
Objective:To discuss the affection of health education used in patients' parental knowledge and nursing skills of newborn acute pneumonia. Methods: Chose 50 cases whose children were in hospital with acute pneumonia and check their master level of nursing in newborn acute pneumonia. Then systematic train the patients with traditional questions of acute pneumonia. Results: The master level of patients had significant difference before and after health education (P<0.05). Conclusion: The systematic train of patients whose child had acute pneumonia could effectively improve their knowledge and nursing skills for improving the children's health.%目的:探讨和分析健康教育对新生儿急性肺炎父母知识水平和护理技巧的影响.方法:选择符合标准的住院患儿父母50人,调查其对新生儿急性肺炎护理知识的了解和掌握情况,然后针对常见的新生儿急性肺炎问题进行系统的健康教育培训,然后再统计其对护理知识的知晓和掌握情况.结果:健康教育前后父母对婴幼儿肺炎护理知识的掌握程度有统计学差异(P＜0.05).结论:针对新生儿急性肺炎父母进行系统科学的健康教育培训,能有效提高其对新生儿急性肺炎的知识水平和护理技能,从而促进患儿的身体健康.
Thaysen, Henriette Vind; Jess, Per; Laurberg, Søren
Aim: A review of the literature was undertaken to provide an overview of Health-related quality of life (HRQoL) after surgery for primary advanced or recurrent rectal cancer and to outline proposals for future HRQoL studies in this area. Method: A systematic literature search was undertaken. Only...... studies concerning surgery for primary advanced or recurrent rectal cancer and describing methods used for measuring HRQoL were considered. Results Seven studies were identified including two prospective longitudinal, three cross-sectional and two based on qualitative data. Global quality of life...... time of impaired HRQoL and also if this is different after surgery for locally advanced or recurrent disease than after total mesorectal excision used for earlier tumours.. Conclusion Several aspects of HRQoL are impaired for a variable time after treatment for locally advanced or recurrence of rectal...
Rosen, Michael A; Pronovost, Peter J
Patients frequently do not receive recommended therapies because performance expectations are often unclear. Clinical guidelines provide exhaustive details and recommendations, but this information is not formatted in a way that supports decision making or bedside translation of therapies. When performance expectations are unclear, it is difficult for clinicians to assess their own or others' competence. Checklists offer hope because they codify interventions, remove ambiguity, and increase reliability of care processes. Schmutz and colleagues developed a robust methodology to create a checklist for evaluating clinical performance, which is described in this issue of Academic Medicine.In this commentary, the authors offer several points to consider as checklists become more prevalent in medical education and clinical practice. First, culture is a much larger part of the equation than the checklist; understanding what all stakeholders expect to gain will help engage checklist use. Second, the construction, validation, and maintenance of checklist evaluation tools is labor intensive, requiring innovative dissemination approaches to ensure maximum access and use of checklists. Third, integrated systems that evaluate technically specified and adaptive performance are needed because some aspects of clinical performance cannot be captured on a checklist. Fourth, checklists provide an opportunity to evaluate and improve an individual's performance concurrently with the context in which it is delivered. A tighter connection between education and training activities and process improvement strategies will accelerate improvements in safety and quality. Schmutz and colleagues have provided advancements in performance evaluation that will help health care achieve higher-quality and safer care. PMID:24826861
Oster, Matthew E; Aucott, Susan W; Glidewell, Jill; Hackell, Jesse; Kochilas, Lazaros; Martin, Gerard R; Phillippi, Julia; Pinto, Nelangi M; Saarinen, Annamarie; Sontag, Marci; Kemper, Alex R
Newborn screening for critical congenital heart defects (CCHD) was added to the US Recommended Uniform Screening Panel in 2011. Within 4 years, 46 states and the District of Columbia had adopted it into their newborn screening program, leading to CCHD screening being nearly universal in the United States. This rapid adoption occurred while there were still questions about the effectiveness of the recommended screening protocol and barriers to follow-up for infants with a positive screen. In response, the Centers for Disease Control and Prevention partnered with the American Academy of Pediatrics to convene an expert panel between January and September 2015 representing a broad array of primary care, neonatology, pediatric cardiology, nursing, midwifery, public health, and advocacy communities. The panel's goal was to review current practices in newborn screening for CCHD and to identify opportunities for improvement. In this article, we describe the experience of CCHD screening in the United States with regard to: (1) identifying the target lesions for CCHD screening; (2) optimizing the algorithm for screening; (3) determining state-level challenges to implementation and surveillance of CCHD; (4) educating all stakeholders; (5) performing screening using the proper equipment and in a cost-effective manner; and (6) implementing screening in special settings such as the NICU, out-of-hospital settings, and areas of high altitude. PMID:27244826
Full Text Available BACKGROUND : The fetal growth is the outcome of the maternal nutrient stores and efficient transport across the placenta. Hence, any variation in the placenta leads to disproportionate fetal growth leading to long term risk of chronic diseases in the newborn. This stud y was designed to explore influence of placental morphometry on newborn anthropometry . MATERIALS AND METHOD S : The study was conducted on 391 placentae of singleton newborn from a teaching hospital of North Karnataka, India. Data was collected from August 2 012 to January 2013 by using standard operating procedures in a pre - designed and pre - tested proforma. The distributions of placental morphology and newborn anthropometry are mentioned with their percentiles and Box plots. Analysis of variance is used to st udy the differences in means of placental morphometry in different groups of newborn anthropometry. RESULTS : The Means and standard deviations of placental morphometry; weight, volume, surface area and thickness were 440±100gm, 386±101 ml, 230±50 cm sq , an d 2.1±0.4cm respectively. Mean and standard deviations of birth weight and newborn length were 2700±500 gm. 46.6±2.5cm. Placental morphometry and newborn anthropometry increased significantly with gestation. CONCLUSIONS : This study infers that suboptimal g rowth of placenta leads to adverse pregnancy outcome.
Aritana Pereira Ramos
Full Text Available The study aimmed to estimate the predominance of congenital malformations in newborns of the Public Hospital in the Jequié city, Brazil. It was utilized spring of secondary facts, from the fact-gathering of available manuals in the Service of Medical Files of the hospital, in the period of January of 2005 to December of 2006. It was utilized instrument of collection standardized where information about characteristics they were collected of the mother, general characteristics of the newborn and bad-congenital formation. The results show predominance of 3.1% of born infants been with evil-congenital formation. Among these, it prevailed the of the male sex (64,0%, premature (56,7% of normal birth (56,7%, with adequate weight (70,0%, classified in the majority of isolated form (76,7%, of smaller clinical importance (63,0% and evolving for high hospital with 60.0% of the cases; 71.0% of the deaths occurred between the newborns were due to specific malformations of the nervous system, however this pathology next to of the osteomuscular system. The majority of the mothers had between 17 and 24 years (46,7%, carried out more of seven consults prenatal (30,0% and live in the urban zone of the town (60,0%; 71.0% of the deaths occurred between the newborns were due to specific malformations of the nervous system. Those finds are compatible with others finds described in the Brazilian scientific literature, what is going to reflect about the implementation of public politics with infrastructure qualified service implementation in the perspective of prevention, detection and cares of those individuals in all of the levels of the net of health.
Full Text Available BACKGROUND: Despite efforts by government and other agencies, neonatal morbidity and mortality continues to be high in India. Among other reasons, newborn care practices are major contributors for such high rates. AIMS: To find out the newborn care practices including delivery practices, immediate care given after birth and breast-feeding practices in an urban slum of Delhi. SETTINGS AND DESIGN : Community based, cross-sectional survey in a resettlement colony (a type of urban slum. MATERIALS AND METHODS : Semi-structured, pre-tested schedule was used to interview 82 mothers of newborns in the study area. STATISTICAL ANALYSIS : Data was analyzed using Epi - info version 6.04. Fischer exact test and c2 test were applied. A P value of less than 0.05 was considered significant. RESULTS AND CONCLUSION : More than half i.e. 26 (56.1% of home deliveries, which were mostly conducted by dais (24, 91.3% or relatives in 4 (8.7% of home deliveries. Bathing the baby immediately after birth was commonly practiced in 38 (82.6% of home deliveries. Finger was used to clean the air passage in most of the home deliveries (29, 63%. About 61% (28 of home delivered newborns were not weighed at birth. Rooming in was practiced in majority of the cases. A few of home delivered neonates (12 were given injection tetanus toxoid by unqualified practitioners. Use of clip, band or sterile thread to tie the cord and no application to the cord was significantly higher in institutional deliveries. Breast milk as the first feed was significantly more in institutional deliveries. There is an urgent need to reorient health care providers and to educate mothers on clean delivery practices and early neonatal care.
Full Text Available Background: Conjunctivitis of the newborn is defined as hyperemia and eye discharge in the neonates and is a common infection occurring in the neonates in the first month of life. In the United States, the incidence of neonatal conjunctivitis ranges from 1-2%, in India, the prevalence is 0.5-33% and varies in the world from 0.9-21% depending on the socioeconomic status. Aim: To study the organisms causing conjunctivitis of the newborn and to correlate the etiology with the mode of delivery. Design: Single center, prospective, observational study. Materials and Methods: A total of 300 mothers and their newborns, born over a period of one year, were included in the study. Of these 200 newborns were delivered through vaginal route (Group A and 100 (Group B delivered by lower segment caesarean section (LSCS. At the time of labour, high vaginal swabs were taken from the mothers. Two conjunctival swabs each from both eyes of the newborn were collected at birth and transported to Microbiology department in a candle jar immediately. Results: Eight babies in Group A, developed conjunctivitis at birth. None of the babies in Group B developed conjunctivitis, this difference was statistically highly significant (P<0.000. The organisms found in the conjunctiva of the newborns in Group A were Coagulase negative Staphylococcus, α hemolytic Streptococcus, Escherichia coli and Pseudomonas spps. However, the commonest organism leading to conjunctivitis in the newborn in this study was Coagulase negative Staphylococcus. It was observed that the mothers of 5 out of 8 babies (60% developing conjunctivitis gave history of midwife interference and premature rupture of membranes so the presence of risk factors contribute to the occurrence of conjunctivitis in the newborn. Conclusions: It is inferred that the mode of delivery and the presence of risk factors is responsible for conjunctivitis in the newborn.
In a report describing life ending fractures (255 horses) from the Livestock Disease Diagnostic Center, Kentucky (1993 and 1994), 32 foals had rib fractures. The purpose of our study was to examine the incidence of rib fractures in newborn foals on a Thoroughbred studfarm by physical and radiographic examination, to determine factors which may contribute to the problem and to document any clinical consequences. All foals (263) included were examined within 3 days of birth. The thoracic cage was palpated externally for abnormalities and all foals were placed in dorsal recumbency to evaluate thoracic cage symmetry. Radiographs were used to diagnose foals with thoraciccage asymmetry (TCA) and rib fracture (RF). A diagnosis of costochondral dislocation (CD) was made when no radiographic evidence of fracture was present but there was severe TCA, Fifty-five foals (20.1%) had TCA (9 RF), One to 5 ribs were fractured on 9 of 40 radiographic studies. No consequences of the thoracic trauma was detected clinically, radiographically or ultrasonographically in this group of foals or at a 2- and 4-week follow-up examination. The percentage of foals with a history of abnormal parturition was higher in the TCA foals (15%) compared to the normal foals (6.8%). There weremore primiparous dams in the TCA group than in the normal foal group. Fillies (56.6%) had a higher incidence of birth trauma than colts (43.4%), Thisstudy demonstrates that thoracic trauma is often present in newborn foals and may not always be of clinical significance. Dystocia foals and foals from primiparous mares should be considered high risk for thoracic trauma
The field of population and public health ethics (PPHE) has yet to fully embrace the generation of evidence as an important project. This article reviews the philosophical debates related to the 'empirical turn' in clinical bioethics, and critically analyses how PPHE has and can engage with the philosophical implications of generating empirical data within the task of normative inquiry. A set of five conceptual and theoretical issues pertaining to population health that are unresolved and could potentially benefit from empirical PPHE approaches to normative inquiry are discussed. Each issue differs from traditional empirical bioethical approaches, in that they emphasize (1) concerns related to the population, (2) 'upstream' policy-relevant health interventions - within and outside of the health care system and (3) the prevention of illness and disease. Within each theoretical issue, a conceptual example from population and public health approaches to HIV prevention and health promotion is interrogated. Based on the review and critical analysis, this article concludes that empirical-normative approaches to population and public health ethics would be most usefully pursued as an iterative project (rather than as a linear project), in which the normative informs the empirical questions to be asked and new empirical evidence constantly directs conceptualizations of what constitutes morally robust public health practices. Finally, a conceptualization of an empirical population and public health ethics is advanced in order to open up new interdisciplinary 'spaces', in which empirical and normative approaches to ethical inquiry are transparently (and ethically) integrated. PMID:25956917
Zargar, S; Prendiville, KJ; Martinez, E.
Purpose: We report a case of iris pigment epithelial cysts in a newborn and discuss the importance of an accurate diagnosis for prevention of amblyopia.Methods: We describe a case of an abnormal red reflex seen on a newborn exam.Results: A full-term female born via normal spontaneous vaginal delivery without any complications was seen in the newborn nursery. She was noted to have an abnormal eye exam. Pupils were large with circular dark excrescences of the iris pigment epithelium. She wa...
Katherine M Morrison
Full Text Available BACKGROUND: The influence of multiple maternal and pregnancy characteristics on offspring cardiometabolic traits at birth is not well understood and was evaluated in this study. METHODS AND FINDINGS: The Family Atherosclerosis Monitoring In earLY life (FAMILY Study prospectively evaluated 11 cardiometabolic traits in 901 babies born to 857 mothers. The influence of maternal age, health (pre-pregnancy weight, blood pressure, glycemic status, lipids, health behaviors (diet, activity, smoking and pregnancy characteristics (gestational age at birth, gestational weight gain and placental-fetal ratio were examined. Greater gestational age influenced multiple newborn cardiometabolic traits including cord blood lipids, glucose and insulin, body fat and blood pressure. In a subset of 442 singleton mother/infant pairs, principal component analysis grouped 11 newborn cardiometabolic traits into 5 components (anthropometry/insulin, 2 lipid components, blood pressure and glycemia, accounting for 74% of the variance of the 11 outcome variables. Determinants of these components, corrected for sex and gestational age, were examined. Baby anthropometry/insulin was independently predicted by higher maternal pre-pregnancy weight (standardized estimate 0.30 and gestational weight gain (0.30; both p<0.0001 and was inversely related to smoking during pregnancy (-0.144; p = 0.01 and maternal polyunsaturated to saturated fat intake (-0.135;p = 0.01. Component 2 (HDL-C/Apo Apolipoprotein1 was inversely associated with maternal age. Component 3 (blood pressure was not clustered with any other newborn cardiometabolic trait and no associations with maternal pregnancy characteristics were identified. Component 4 (triglycerides was positively associated with maternal hypertension and triglycerides, and inversely associated with maternal HDL and age. Component 5 (glycemia was inversely associated with placental/fetal ratio (-0.141; p = 0.005. LDL-C was a bridging
Barnes, Michael D; Heaton, Thomas L; Goates, Michael C; Packer, Justin M
The developmental origins of health and disease (DOHaD) theory and life course theory (LCT) are emerging fields of research that have significant implications for the public health and health promotion professions. Using a DOHaD/LCT perspective, social determinants of health (SDH) take on new critical meaning by which health promotion professionals can implement DOHaD/LCT guided interventions, including recommended policies. Through these interventions, public health could further address the sources of worldwide chronic disease epidemics and reduce such disease rates substantially if related policy, programs, and interdisciplinary and multi-sector collaboration are emphasized. Additional characteristics of the most effective interventions involve context-specific adaptation and societal structures that impact upstream, early life environments on a broad scale, influencing multiple locations and/or diseases. PMID:27417633
Prof. C Olsen, DVM; J Conway, MD; L DiPrete-Brown, MSc; F Hutchins, PhD; K Poulsen, DVM; K Solheim, PhD; C Kraus, PharmD; D Gaus, MD; T Silawan, PhD
Background: Since 2003, the University of Wisconsin-Madison Global Health Institute, together with collaborating campus and in-country partners, has offered immersive, multidisciplinary, faculty-led, global health field courses in Ecuador and Thailand. These courses aim to help students to develop a working understanding of integrative one-health approaches and acquire the skills to work effectively across disciplines. That is, we aim to foster an appreciation of the role of culture in percep...
Gilson, L; Elloker, S; Olckers, P; Lehmann, U
Background New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors’ sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides examples of leadership practices that promote sensemaking and power use in support of PHC. Methods The...
Alaimo, Katherine; Beavers, Alyssa W; Crawford, Caroline; Snyder, Elizabeth Hodges; Litt, Jill S
The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions. PMID:27379424
Congenital hypothyroidism is a condition that, if left untreated, can cause lifelong human suffering as a result of severe mental retardation and deficiency of growth. With the involvement of the IAEA, screening programmes to detect congenital hypothyroidism in newborn infants have been introduced successfully in a large number of countries. The cornerstone of these programmes is accurate and reliable screening methods involving isotope techniques and simple medical treatment. The suffering - and heavy social and economic burden - caused by congenital hypothyroidism prompted many countries to institute a formalized screening programme directed at newborns, just as a vaccination programme has become an integral part of child health care. In many other countries however, this type of formalized service has not yet been established. For these countries, the implementation of a neonatal screening programme will bring about a considerable improvement in child health care. It is hoped that the guidance in this publication will be especially useful to the signatories of the United Nations Convention on the Rights of the Child. Several factors that prevail in a country - the climate, political environment, economic development, level of health care and the transportation system - have an influence on the overall operational systems, design and implementation of a screening programme. As such, the design of such a programme will differ greatly from country to country. Nevertheless, neonatal screening programmes have many elements in common. This book draws on the IAEA's experience in this area over more than a decade, and on the results of a regional technical cooperation programme on neonatal screening for congenital hypothyroidism in East Asia (IAEA Project RAS6032). This publication provides guidance aimed specifically at implementing and sustaining programmes for the screening of newborn infants
Álvarez-del Arco, Débora; Monge, Susana; Copas, Andrew J; Gennotte, Anne-Francoise; Volny-Anne, Alain; Göpel, Siri; Touloumi, Giota; Prins, Maria; Barros, Henrique; Staehelin, Cornelia; del Amo, Julia; Burns, Fiona M
Background Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. Objective We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify the structural, cultural, and financial barriers to HIV prevention, diagnosis, and treatment and to determine the likely country of HIV acquisition in HIV-positive migrant populations. Methods We delivered 2 cross-sectional electronic surveys across 10 countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Switzerland, and United Kingdom). A clinic survey aimed to recruit up to 2000 HIV-positive patients from 57 HIV clinics in 9 countries. A unique study number linked anonymized questionnaire data to clinical records data (viral loads, CD4 cell counts, viral clades, etc). This questionnaire was developed by expert panel consensus and cognitively tested, and a pilot study was carried out in 2 countries. A Web-based community survey (n=1000) reached those living with HIV but not currently accessing HIV clinics, as well as HIV-negative migrants. It was developed in close collaboration with a community advisory group (CAG) made up of representatives from community organizations in 9 of the participating countries. The CAG played a key role in data collection by promoting the survey to higher-risk migrant groups (sub-Saharan Africans, Latin Americans, men who have sex with men, and people who inject drugs). The questionnaires have considerable content overlap, allowing for comparison. Questions cover ethnicity, migration, immigration status, HIV testing and treatment, health-seeking behavior, sexual risk, and drug use. The electronic questionnaires
Owor, Michael O.; Joseph K. B. Matovu; Murokora, Daniel; Wanyenze, Rhoda K; Waiswa, Peter
Background Beneficial newborn care practices can improve newborn survival. However, little is known about the factors that affect adoption of these practices. Methods Cross-sectional study conducted among 1,616 mothers who had delivered in the past year in two health sub-districts (Luuka and Buyende) in Eastern Uganda. Data collection took place between November and December 2011. Data were collected on socio-demographic and economic characteristics, antenatal care visits, skilled delivery at...
Ndu, Ikenna K; Ibeziako, Stella N; Obidike, Egbuna O; Adimora, Gilbert N.; Edelu, Benedict O.; Chinawa, Josephat M.; Asinobi, Isaac N; Uleanya, Nwachinemere D
Background The World Health Organisation has recommended the use of anthropometric measurements as birth weight surrogates. However, it has been found that cut-off points for these anthropometric measurements vary across nations and ethnic groups. Objectives To determine the predictive values of chest circumference (CC), occipito-frontal circumference (OFC) and their combinations for low birth weight (LBW) detection in Igbo newborns. Methods Live newborns of Igbo origin were recruited within ...
Connors, Elizabeth Halsted; Stephan, Sharon Hoover; Lever, Nancy; Ereshefsky, Sabrina; Mosby, Amanda; Bohnenkamp, Jill
Standardized health performance measurement has increasingly become an imperative for assuring quality standards in national health care systems. As compared to somatic health performance measures, behavioral health performance measures are less developed. There currently is no national standardized performance measurement system for monitoring…
VanderArk, Stephen T.; Leveton, Lauren B.
In organizations that engage in both operations and applied research, with operational needs guiding research questions and research informing improved operations, the ideal goal is a synergy of ideas and information. In reality, this ideal synergy is often lacking. Real-time operational needs driving day-to-day decisions, lack of communication, lag time in getting research advances plugged into operations can cause both areas to suffer from this gap between operations and research. At Johnson Space Center, the Behavior Health and Performance group (BHP) strives to bridge this gap by following a Human Research Program framework: Expectations of future operational needs identify the knowledge gaps; the gaps in turn guide research leading to a product that is transitioned into operations. Thus, the direction those of us in research take is in direct response to current and future needs of operations. Likewise, those of us in operations actively seek knowledge that is supported by evidence-based research. We make an ongoing effort to communicate across the research and operations gap by working closely with each other and making a conscious effort to keep each other informed. The objective of the proposed panel discussion is to demonstrate through the following presentations the results of a successful collaboration between research and operations and to provide ASMA members with more practical knowledge and strategies for building these bridges to serve our field of practice well. The panel will consist of six presenters from BHP operations, internal BHP research, and external research instigated by BHP who together represent the entire BHP Research Transition to Operations Framework
... the mother during pregnancy. You may feel firm, disc-shaped lumps of tissue beneath the nipples and, ... a foul odor or discharge develops. Umbilical (navel) hernias are common in newborns, particularly in infants of ...
Bishop, R F; Cameron, D J; Barnes, G L; Holmes, I H; Ruck, B J
Diarrhoea is a common problem in newborn infants in hospital nurseries. In the past, sporadic diarrhoea was often attributed to dietary indiscretion by the mother, and epidemic diarrhoea was though to be caused by an unknown infectious agent. Techniques with which to locate non-cultivable viruses and untypable enteropathogenic strains of Escherichia coli allow reevaluation of the aetiology of diarrhoea in newborn infants. Preliminary results from Melbourne, Australia, suggest that most diarrhoea in newborn infants is induced by a specific infectious agent. During 1975 the agent most often identified from sporadic and epidemic diarrhoea in hospital nurseries was a reovirus-like particle ("duovirus"). Enterotoxin-producing strains of E. coli were rarely isolated. Future attempts to protect newborn infants from developing diarrhoea must be based on an accurate understanding of the aetiology of this disease. PMID:186236
Full Text Available The authors describe a case of complete albinism in a Podarcis muralis newborn, from Chieti (Abruzzo, central Italy in September 2004. This is the first complete albinism case in a Podarcis spp. In the world.
Introduction: The system dynamics that are driving changes in health and health care in the United States are not well captured by standard data-collection activities. We need data systems that can inform policy and program development and can reflect the increasing recognition that all aspects of people’s lives—their work, families, and communities and not just formal health and health care services—support active and healthy living. Culture of Health Action Areas: Within the Culture of Heal...
Trzcielińska-Lorych, J; Jackowiak, H; Skieresz-Szewczyk, K; Godynicki, S
The paper presents a comparison of the microscopic structure and morphometric traits of gustatory and mechanical lingual papillae in newborn and adult frugivorous Egyptian fruit bats (Rousettus aegyptiacus). All of the four types of lingual papillae found in adult animals were observed on the tongue surface in the newborn Egyptian fruit bats. After the birth, the gustatory papillae (fungiform and vallate papillae) were especially well-developed, as their structural characteristics, such as morphology of the epithelium and presence of the taste buds, indicate that they have reached almost complete functional traits. Mechanical papillae, particularly filiform papillae, in newborns are still fetal in character. Keratinization processes in the epithelium of these papillae are not advanced and specific structures, such as elongated processes, are missing. The morphometric analysis of the size of papillae and thickness of the mucosal epithelium showed that a complete development of keratinized structures in Egyptian fruit bats occurs at later stages of postnatal development. PMID:19681832
Spangenberg, Kathryn; Wobil, Priscilla; Betts, Cassandra L; Wiesner, Theodore F; Gold, Katherine J
Intimate partner violence (IPV) is a major public health problem estimated to affect 15%-71% of women worldwide. We sought to elicit IPV risks among mothers of sick newborns in Ghana. As part of a broader study on postpartum depression, we conducted semistructured surveys of 153 women in a mother-baby unit, assessing demographics, depression, social support, and IPV with the present partner. Forty-six percent of mothers reported some form of violence, mostly emotional (34%), followed by physical (17%), and sexual (15%). The study highlights the frequency of perinatal IPV and the associated risk factors of depression and poor social support. PMID:25864483
Farroni, Teresa; Menon, Enrica; Rigato, Silvia; Johnson, Mark H.
The ability of newborns to discriminate and respond to different emotional facial expressions remains controversial. We conducted three experiments in which we tested newborns’ preferences, and their ability to discriminate between neutral, fearful, and happy facial expressions, using visual preference and habituation procedures. In the first two experiments, no evidence was found that newborns discriminate, or show a preference between, a fearful and a neutral face. In the third experiment, ...
Abdolreza Malek; Nargess Afzali; Mojtaba Meshkat; Nadieh Yazdi Hosseini
Objective:Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in newborns under mechanical ventilation. Methods:This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care un...
Maria dos Anjos Mesquita; Conceição Aparecida de Mattos Segre
Objective: To identify the presence of fetal alcohol syndrome, other alcohol-related congenital defects, and/or neurodevelopment disorders in newborns of mothers who consumed alcohol during gestation. Methods: In a public maternity in the city of São Paulo, 1,964 puerperal women were interviewed and 654 had consumed alcohol at some point during gestation. The newborns were clinically and laboratorially examined in order to identify the occurrence of fetal alcohol syndrome, congenital defects ...
High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)
Waltman, Ludo; van Raan, Anthony F. J.; Smart, Sue
We investigate the extent to which advances in the health and life sciences (HLS) are dependent on research in the engineering and physical sciences (EPS), particularly physics, chemistry, mathematics, and engineering. The analysis combines two different bibliometric approaches. The first approach to analyze the ‘EPS-HLS interface’ is based on term map visualizations of HLS research fields. We consider 16 clinical fields and five life science fields. On the basis of expert judgment, EPS resea...
Kruja Jera; Vyshka Gentian
Abstract Background The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment refusal and do-not-resuscitate decisions are still extremely uncommon in Albania. Medical teams cannot abstain from inter...
Mullany, Luke C; Darmstadt, Gary L; Khatry, Subarna K; Tielsch, James M
Mustard oil massage of newborns is an integral component of traditional care practices in many communities. Recent evidence suggests that this practice may have detrimental effects, particularly for preterm infants or for those whose skin barrier function is otherwise sub-optimal. Other natural oils such as sunflower, sesame or safflower seed oil may have a beneficial impact on newborn health and survival. Little is known, however, about cultural and other factors related to the acceptance and uptake of alternative, more beneficial oils for massage of the newborn. A questionnaire concerning the usage and reasons for application of mustard and other oils to newborn skin was administered to the caretakers of 8580 newborns in Sarlahi district of rural Nepal. Four focus group discussions among representative groups were conducted to describe the perceived benefits of oil massage and the factors involved in the decision to apply oil. The potential for the introduction of alternative natural oils was explored. Approximately 99 per cent of newborns were massaged at least once with mustard oil in the 2 weeks after birth, and 80 per cent were massaged at least twice daily. Promotion of strength, maintenance of health, and provision of warmth were the most commonly cited reasons for application of mustard oil. Focus group discussion participants noted that smell, oiliness, mode of pre-massage preparation, and perceived absorptive potential on the skin are important contextual factors involved in the practice. Caretakers are willing to consider adaptation of established traditions for the promotion of positive health outcomes if essential contextual criteria are met. An understanding of cultural, social, and economic factors that shape the context of traditional healthcare practices is essential to the design and implementation of intervention trials examining the relative efficacy of application of oils in reducing neonatal mortality and morbidity. PMID:15677372
..., counseling, testing, or specialty services for newborns and children at risk for heritable disorders; (b) experts in ethics and heritable disorders who have worked and published material in the area of public health and genetic conditions; and (c) members from the public sector who have expertise,...
..., testing, or specialty services for newborns and children at risk for heritable disorders; (b) experts in ethics and heritable disorders who have worked and published material in the area of public health and genetic conditions; and (c) members from the public sector who have expertise, either professional...
Munoz, Flor M.; Weisman, Leonard E.; Read, Jennifer S.; Siberry, George; Kotloff, Karen; Friedman, Jennifer; Higgins, Rosemary D.; Hill, Heather; Seifert, Harry; Nesin, Mirjana
A panel of experts convened by the Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, developed proposed guidelines for the evaluation of adverse events in newborns of women participating in clinical trials of maternal immunization in the United States.
Hodapp, Robert M.; Urbano, Richard C.
Although important for public health policy, ethnic/racial disparities have rarely been examined among families of young children with Down syndrome. This study compared 144 African-American mothers with 726 European-heritage mothers of newborns with Down syndrome using official birth records in one American state from 1990 through 2002; outcome…
Kinney, MV; Kerber, KJ; Black, RE; Cohen, B.; Nkrumah, F; Coovadia, H; Nampala, PM; Lawn, JE; Science in Action: Saving the lives of Africa's Mothers, Newborn; Axelson, H; Bergh, AM; Chopra, M; R. Diab; Friberg, I; Odubanjo, O
In the first article in a series on maternal, newborn, and child health in sub-Saharan Africa, Joy Lawn and colleagues outline where and why deaths among mothers and children occur and what known interventions can be employed to prevent these deaths.
The human population residing in the monazite bearing high level natural background radiation (HLNBR) areas of Kerala, along the South-West coast of India provides unique opportunities of assessing directly in man, the health effects of chronic low-level radiation exposure. The per capita dose received by this population is nearly four times the normal background radiation level. While this is the average dose, the radiation levels prevailing in these HLNBR areas are in the range of 1 to over 35 mGy per year. Chromosomal aberration studies in the lymphocytes of newborns and adults from these areas have been in progress for two decades. So far, 4156 newborn babies from HLNBR and 7321 from normal background radiation (NBR) areas have been screened for the incidence of chromosomal aberrations (dicentrics and rings). The mean frequency of dicentrics and rings did not show any significant difference between the newborns in the control and the HLNBRA population. Assessment of the frequency of micronuclei in cytochalasin-B blocked binucleated lymphocytes of 49 newborns from control areas and 131 newborns from radioactive areas also showed similar values. While an age-dependent increase in chromosome aberration frequency was observed in the adult samples from control and the study areas, the regression analysis of the data indicated a marginally higher slope for the samples from HLNBRA. Karyotype anomalies recorded so far among the newborns have not revealed any significant difference in the incidence of numerical (including Down syndrome) and structural alterations between the control and the exposed populations. A noteworthy observation, herein reported for the first time from any HLNBR area is that there is no discernible increase in the incidence of micronuclei and chromosomal aberrations in the peripheral lymphocytes of newborn babies hailing from HLNBR areas, where their ancestral generations have lived for several hundreds of years. (author)
Full Text Available Despite the important advances in perinatal care in the past decades, asphyxia remains a severe condition leading to significant mortality and morbidity. Perinatal asphyxia has an incidence of 1 to 6 per 1,000 live full-term births, and represents the third most common cause of neonatal death (23% after preterm birth (28% and severe infections (26%. Many preconceptional, antepartum and intrapartum risk factors have been shown to be associated with perinatal asphyxia. The standard for defining an intrapartum hypoxic-ischemic event as sufficient to produce moderate to severe neonatal encephalopathy which subsequently leads to cerebral palsy has been established in 3 Consensus statements. The cornerstone of all three statements is the presence of severe metabolic acidosis (pH < 7 and base deficit ≥ 12 mmol/L at birth in a newborn exhibiting early signs of moderate or severe encephalopathy. Perinatal asphyxia may affect virtually any organ, but hypoxic-ischemic encephalopathy (HIE is the most studied clinical condition and that is burdened with the most severe sequelae. The feasibility of providing neuroprotection after HIE has been proven by hypothermia therapy, which is able to reduce the risk of death or major neurodevelopmental disability. Many promising neuroprotective agents might contribute to reduce hypoxic-ischemic brain injury through different mechanisms of action, but further studies are required to confirm their efficacy. The prognosis is dependent on the severity of the perinatal asphyxia. Only a minority of infants with severe HIE survive without handicap. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken
Stella, L; Israel, G L; Vecchio, A; Stella, Luigi; Oss, Simone Dall'; Israel, GianLuca; Vecchio, Alberto
There is growing evidence that two classes of high-energy sources, the Soft Gamma Repeaters and the Anomalous X-ray Pulsars contain slowly spinning ``magnetars'', i.e. neutron stars whose emission is powered by the release of energy from their extremely strong magnetic fields (>10^15 G. We show here that the enormous energy liberated in the 2004 December 27 giant flare from SGR1806-20 (~5 10^46 erg), together with the likely recurrence time of such events, requires an internal field strength of > 10^16 G. Toroidal magnetic fields of this strength are within an order of magnitude of the maximum fields that can be generated in the core of differentially-rotating neutron stars immediately after their formation, if their initial spin period is of a few milliseconds. A substantial deformation of the neutron star is induced by these magnetic fields and, provided the deformation axis is offset from the spin axis, a newborn fast-spinning magnetar would radiate for a few weeks a strong gravitational wave signal the fr...
A detailed case study from the field of social entrepreneurship is used to illustrate the network approach, which does not require more resources but rather makes better use of existing resources. Leaders in public health can use networks to overcome some of the barriers that inhibit the widespread adoption of a population health approach to community health. Public health leaders who embrace social entrepreneurship may be better able to accomplish their missions by building their networks rather than just their organizations. PMID:20950527
Full Text Available Abstract Background About 98% of newborn deaths occur in developing countries, where most newborns deaths occur at home. In Nepal, approximately, 90% of deliveries take place at home. Information about reasons for delivering at home and newborn care practices in urban areas of Nepal is lacking and such information will be useful for policy makers. Methods A cross-sectional survey was carried out in the immunisation clinics of Pokhara city, western Nepal during January and February, 2006. Two trained health workers administered a semi-structured questionnaire to the mothers who had delivered at home. Results A total of 240 mothers were interviewed. Planned home deliveries were 140 (58.3% and 100 (41.7% were unplanned. Only 6.2% of deliveries had a skilled birth attendant present and 38 (15.8% mothers gave birth alone. Only 46 (16.2% women had used a clean home delivery kit and only 92 (38.3% birth attendants had washed their hands. The umbilical cord was cut after expulsion of placenta in 154 (64.2% deliveries and cord was cut using a new/boiled blade in 217 (90.4% deliveries. Mustard oil was applied to the umbilical cord in 53 (22.1% deliveries. Birth place was heated throughout the delivery in 88 (64.2% deliveries. Only 100 (45.8% newborns were wrapped within 10 minutes and 233 (97.1% were wrapped within 30 minutes. Majority (93.8% of the newborns were given a bath soon after birth. Mustard oil massage of the newborns was a common practice (144, 60%. Sixteen (10.8% mothers did not feed colostrum to their babies. Prelacteal feeds were given to 37(15.2% newborns. Initiation rates of breast-feeding were 57.9% within one hour and 85.4% within 24 hours. Main reasons cited for delivering at home were 'preference' (25.7%, 'ease and convenience' (21.4% for planned deliveries while 'precipitate labor' (51%, 'lack of transportation' (18% and 'lack of escort' during labor (11% were cited for the unplanned ones. Conclusion High-risk home delivery and
A protocol for a pragmatic randomized controlled trial using the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) platform approach to promote person-focused primary healthcare for older adults
Dolovich, Lisa; Oliver, Doug; Lamarche, Larkin; Agarwal, Gina; Carr, Tracey; Chan, David; Cleghorn, Laura; Griffith, Lauren; Javadi, Dena; Kastner, Monika; Longaphy, Jennifer; Mangin, Dee; Papaioannou, Alexandra; Ploeg, Jenny; Raina, Parminder
Background Healthcare systems are not well designed to help people maintain or improve their health. They are generally not person-focused or well-coordinated. The objective of this study is to evaluate the effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach in older adults. The overarching hypothesis is that using the Health TAPESTRY approach to achieve better integration of the health and social care systems into a person’s life t...
When newborn screening started in the U.S. 50 years ago, many questioned whether it was even possible to test every baby born in every state. Today, all states screen babies for at least 29 disorders that can be detected through laboratory testing. In this podcast, Dr. Carla Cuthbert talks about CDCâs Newborn Screening Quality Assurance Program and the role laboratories play in keeping babies healthy. Created: 9/3/2013 by National Center for Environmental Health (NCEH). Date Released: 9/3/2013.
Mallory O Johnson
Full Text Available The Health Care Empowerment Model offers direction for the investigation of patient-controlled engagement and involvement in health care. At the core of the model is the construct of Health Care Empowerment (HCE, for which there exist no validated measures. A set of 27 candidate self-report survey items was constructed to capture five hypothesized inter-related facets of HCE (informed, engaged, committed, collaborative, and tolerant of uncertainty. The full item set was administered to 644 HIV-infected persons enrolled in three ongoing research studies. Exploratory and confirmatory factor analyses resulted in a two factor solution comprising four items each on two subscales: (1 HCE: Informed, Committed, Collaborative, and Engaged HCE ICCE and (2 HCE Tolerance of Uncertainty (HCE TU. Subscale scores were evaluated for relationships with relevant constructs measured in the three studies, including depression, provider relationships, medication adherence, and HIV-1 viral load. Findings suggest the utility of this 8-item Health Care Empowerment Inventory (HCEI in efforts to measure, understand, and track changes in the ways in which individuals engage in health care.
Johnson, Mallory O; Rose, Carol Dawson; Dilworth, Samantha E; Neilands, Torsten B
The Health Care Empowerment Model offers direction for the investigation of patient-controlled engagement and involvement in health care. At the core of the model is the construct of Health Care Empowerment (HCE), for which there exist no validated measures. A set of 27 candidate self-report survey items was constructed to capture five hypothesized inter-related facets of HCE (informed, engaged, committed, collaborative, and tolerant of uncertainty). The full item set was administered to 644 HIV-infected persons enrolled in three ongoing research studies. Exploratory and confirmatory factor analyses resulted in a two factor solution comprising four items each on two subscales: (1) HCE: Informed, Committed, Collaborative, and Engaged HCE ICCE) and (2) HCE Tolerance of Uncertainty (HCE TU). Subscale scores were evaluated for relationships with relevant constructs measured in the three studies, including depression, provider relationships, medication adherence, and HIV-1 viral load. Findings suggest the utility of this 8-item Health Care Empowerment Inventory (HCEI) in efforts to measure, understand, and track changes in the ways in which individuals engage in health care. PMID:23029184
Mackert, Michael; Guadagno, Marie; Champlin, Sara
Communication researchers, recognizing the message sent is not necessarily the same as the message received, have incorporated the perspective of advertising professionals into the study of advertising effects. Health marketing research could similarly benefit from incorporating this largely absent perspective into the academic and policy debate surrounding the impact of advertising on health issues ranging from obesity to alcohol use. This commentary serves as a call to action to stakeholders in this academic and policy debate: focus on the perspective of advertising professionals to enrich health marketing and public health research in which advertising is the delivery vehicle for health messages. PMID:26368300
Phenylketonuria, congenital hypothyroidism and haemoglobinopathies: public health issues for a Brazilian newborn screening program Fenilcetonúria, hipotireoidismo congênito e hemoglobinopatias: questões de saúde pública para um programa de triagem neonatal brasileiro
Full Text Available In this study, the frequency of detected congenital hypothyroidism, phenylketonuria and haemoglobinopathies in the State of Rio de Janeiro's (Brazil Newborn Screening Program (NBSP was analyzed between the years of 2005 and 2007. There were two Newborn Screening Reference Centers (named NSRC A and B with programmatic differences. In 2007, overall detection coverage reached 80.7%. The increase in the incidence of congenital hypothyroidism (1:1,030 in 2007 was attributed to the reduction of neonatal TSH value limits over time. The incidence discrepancy of phenylketonuria between NSRC A (1:28,427 and B (1:16,522 might be partially explained by the small number of cases. The incidence of sickle cell disease and its traits were uniformly high (1:1,288 and 1:21, respectively. This was coherent with the ethnic composition of the population. The differences in laboratory methods and critical values, in addition to other programmatic issues, may explain the variances in the results and limited analysis of the role of biological and environmental determinants in the occurrence of these diseases.Neste estudo, foi analisada a frequência de detecção do hipotireoidismo congênito, fenilcetonúria e hemoglobinopatias no Programa de Triagem Neonatal do Estado do Rio de Janeiro, Brasil, entre 2005 e 2007. Havia dois Serviços de Referência em Triagem Neonatal (designados SRTN A e B com diferenças programáticas. Em 2007, a cobertura alcançou 80,7%. O aumento na incidência do hipotireoidismo congênito (1:1.030 em 2007 foi atribuído à redução no valor de corte do TSH ao longo do tempo. As incidências discrepantes da fenilcetonúria entre os modelos (SRTN A - 1:28.427; SR-TN B - 1:16.522 podem ser parcialmente explicadas pelo pequeno número de casos. A incidência da doença falciforme e do traço falcêmico foi uniformemente elevada (1:1.288 e 1:21, respectivamente, sendo coerente com a composição étnica da população. As diferenças nos m
Bekemeier, Betty; Walker Linderman, Tessa; Kneipp, Shawn; Zahner, Susan J
National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. PMID:25284433
McGowan, Angela K; Lee, Mary M; Meneses, Cristina M; Perkins, Jane; Youdelman, Mara
To improve health in the twenty-first century, to promote both access to and quality of health care services and delivery, and to address significant health disparities, legal and policy approaches, specifically those focused on civil rights, could be used more intentionally and strategically. This review describes how civil rights laws, and their implementation and enforcement, help to encourage health in the United States, and it provides examples for peers around the world. The review uses a broad lens to define health for both classes of individuals and their communities-places where people live, learn, work, and play. Suggestions are offered for improving health and equity broadly, especially within societal groups and marginalized populations. These recommendations include multisectorial approaches that focus on the social determinants of health. PMID:26789383
Zhang, Xiulan; Bloom, Gerald; Xu, Xiaoxin; Chen, Lin; Liang, Xiaoyun; Wolcott, Sara J
Background This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. Methods The study draws on several sources of data including a review of official policy doc...
Rezvanizaniani, Seyed Mohammad; Liu, Zongchang; Chen, Yan; Lee, Jay
As hybrid and electric vehicle technologies continue to advance, car manufacturers have begun to employ lithium ion batteries as the electrical energy storage device of choice for use in existing and future vehicles. However, to ensure batteries are reliable, efficient, and capable of delivering power and energy when required, an accurate determination of battery performance, health, and life prediction is necessary. This paper provides a review of battery prognostics and health management (PHM) techniques, with a focus on major unmet needs in this area for battery manufacturers, car designers, and electric vehicle drivers. A number of approaches are presented that have been developed to monitor battery health status and performance, as well as the evolution of prognostics modeling methods. The goal of this review is to render feasible and cost effective solutions for dealing with battery life issues under dynamic operating conditions.
The high rate of infant mortality, defined as the number of deaths in the first year of life for every 1000 babies born alive (WHO, 1981), is recognized as an extremely serious problem in the developing world. Worldwide decreases in the number of infant deaths are occurring; however, the gap continues to increase in countries with high socioeconomic baselines and those with low per capita income. This article discusses ways in which relevant health care policies and the use of newborn assessment tools can decrease infant mortality in Malawi Central Africa. The description of the tool, Newborn History and Physical Examination Form, for assessing the newborn and documenting care from birth until discharge in this setting, is included. Post delivery care and the components of a history and physical examination are amplified. PMID:8286766
Full Text Available Methods: This study was conducted to determine whether the beginning of atopic march is related to transient tachypnea of the newborn (TTN. Seventy-eight term infants were treated in the newborn Intensive Care Unit due to TTN. A case-matched control group of 78 term newborns without any health problem was selected. Results: There were no statistically significant differences between groups in terms of demographic and clinical characteristics. The rate of childhood asthma and atopic dermatitis among patients with a diagnosis of TTN was found to be higher than the controls (odds ratio [OR]=5.87, 95% confidence interval [CI]=2.88–11.98, P<0.01; OR=2.87, 95% CI=1.30–6.37, P<0.05, respectively. Conclusion: This study showed that TTN may be the first presentation of atopic march and large-scale studies should be performed to elucidate this possible relation.
Berry, Susan A; Brown, Christine; Grant, Mitzie; Greene, Carol L; Jurecki, Elaina; Koch, Jean; Moseley, Kathryn; Suter, Ruth; van Calcar, Sandra C; Wiles, Judy; Cederbaum, Stephen
Fifty years after the implementation of universal newborn screening programs for phenylketonuria, the first disease identified through newborn screening and considered a success story of newborn screening, a cohort of adults with phenylketonuria treated from birth provides valuable information about effects of long-term treatment for inborn errors of metabolism in general, and phenylketonuria specifically. For phenylketonuria, newborn screening allows early implementation of the phenylalanine-restricted diet, eliminating the severe neurocognitive and neuromotor impairment associated with untreated phenylketonuria. However, executive function impairments and psychiatric problems are frequently reported even for those treated early and continuously with the phenylalanine-restricted diet alone. Moreover, a large percentage of adults with phenylketonuria are reported as lost to follow-up by metabolic clinics. While a group of experts identified by the National Institutes of Health convenes to update treatment guidelines for phenylketonuria, we explore individual patient, social, and economic factors preventing >70% of adult phenylketonuria patients in the United States from accessing treatment. As more conditions are identified through newborn screening, factors affecting access to treatment grow in importance, and we must continue to be vigilant in assessing and addressing factors that affect patient treatment outcomes and not just celebrate amelioration of the most severe manifestations of disease. PMID:23470838
Fucic, Aleksandra; Stojković, Ranko; Miškov, Snježana; Zeljezic, Davor; Markovic, Darko; Gjergja, Romana; Katic, Jelena; Jazbec, Ana Marija; Bakulic, Tomislav Ivicevic; Demarin, Vida
Antiepileptic drugs (AED) as transplacental agents are known to have adverse effects on fetal development. Genotoxicity of AEDs is still not fully understood. The aim of present study was to investigate the transplacental genotoxicity of valproate on animal model and in 21 mothers and their newborns receiving AED. In both studies, in vivo micronucleus (MN) assay was used. Pregnant dams were exposed to Na-valproate (100mg/kg) on gestational days 12-14. Dams and pups receiving Na-valproate showed a significantly increased MN frequency (5.17 ± 1.17/1000; 5.20 ± 1.48/1000) compared to the control (1.0 ± 0.58/1000; 1.67 ± 1.03/1000). In mother/newborn study a significant increase of MN frequency was detected in newborns of mothers taking AEDs (3.09 ± 0.49/10,000) compared to the referent newborns (1.56 ± 0.22/10,000). The results of this study suggest that AEDs may act as transplacental genotoxins. Launching the mother/newborn cohorts for genotoxicological monitoring may give a significant new insight in health effects of AEDs. PMID:20955786
Mitra, Amal K; Rodriguez-Fernandez, Gisela
To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC. PMID:20623022
Amal K. Mitra
Full Text Available To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs, that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1 eradicating extreme poverty and hunger; (2 achieving universal primary education; (3 promoting gender equality; (4 reducing child mortality; (5 improving maternal health; (6 combating HIV/AIDS, malaria and other diseases; (7 ensuring environmental sustainability; and (8 developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC. The paper also identifies areas of deficits for the achievement of MDGs in LAC.
Buchan, James; Calman, Lynn
An important potential contribution to the efficient use of the health workforce, is the possibility of "skill mix" changes. "Skill mix" is a relatively broad term which can refer to the mix of staff in the workforce or the demarcation of roles and activities among different categories of staff. Most of the policy attention on using skill-mix…
Schwind, Jessica S.; Gilardi, Kirsten V. K.; Beasley, Val R.; Mazet, Jonna A. K.; Smith, Woutrina A.
Objectives: The objectives of this study were to assess whether the Envirovet programme served to increase the number of practising ecosystem health professionals, as well as to measure the lasting professional and personal impact of the programme on participants. Design: Impact programme evaluation. Setting: An emerging strategy among global…
Kim, Sang Hyuck; Shin, Dong Wook; Kim, So Young; Yang, Hyung Kook; Nam, Eunjoo; Jho, Hyun Jung; Ahn, Eunmi; Cho, Be Long; Park, Keeho; Park, Jong-Hyock
Purpose Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients’ cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general populatio...
Suzana Lopes de Melo
Full Text Available The aim of this study was to describe the evaluation of health professionals about a prototype glass to administer liquids to newborns. It was a descriptive, exploratory study, which was carried out at the maternity of a university hospital, in Uberaba, MG, Brazil. Semi-structured questionnaires were applied to 75 health professionals, after administering a glass of milk to newborns, in the months of July and August, 2011. Quantitative data were analyzed descriptively and subjected to qualitative content analysis, three categories emerged: positive aspects, with 269 of the register units; negative aspects, with 11 units and suggestions to improve the glass, with six. Statistical analysis showed that the concepts ‘good’ and ‘excellent’, related to the prototype glass, presented rates over 90%. The perception of the participants demonstrated a positive evaluation of the prototype glass, which proved to be a practical tool, the design and safe material for the execution of the ‘technique of the little glass’.
Full Text Available Antibiotic resistance has become an urgent and global issue, with 700,000 deaths attributable to multidrug-resistance occurring each year worldwide. The overuse of antibiotics, both in animal industry and in clinical settings, and the generated selective pressure, are the main factors implicated in the emergence of resistant strains. The Centers for Disease Control and Prevention (CDC have pointed out that more than half of hospital patients receive an antibiotic during their stay, and nearly a third receive a broad-spectrum antibiotic. In neonatal units, previous antibiotic exposure to third-generation cephalosporin and carbapenem were identified as independent risk factors for infection caused by multi-drug resistant strains. While resistant ‘superbugs’ emerge, the arsenal to fight these microorganisms is progressively shrinking, as the number of newly discovered antibiotics approved by the Food and Drug administration each year is dropping. In face of global spread of antibiotic resistance and of the limited development of new drugs, policies and rules are under study by agencies (CDC, World Health Organization and governments, in order to: i facilitate and foster the discovery of new antibiotic compounds; ii develop new, alternative therapies able to potentiate or modulate the host immune response or to abrogate the resistance and virulence factors in the microorganisms; and iii prevent the emergence of resistance through antibiotic stewardship programs, educational programs, and reduction of antibiotic use in livestock; the field of neonatal medicine will need its own, newborn-tailored, antibiotic stewardship programs to be implemented in the NICUs. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai
Lung ultrasound (LU) is becoming a bedside point-of-care technique in critical care and emergency medicine as it is performed and immediately interpreted by the clinician. LU is quick, easy, relatively inexpensive, and provides accurate diagnostic information when compared with conventional lung imaging methods, such as CT scans and chest radiographs, with the additional advantage of being non-irradiating, adapted to bedside use, and easily repeatable with no side effects for the patient. LU is easy to learn, does not require sophisticated ultrasound machines or settings, and shows low intra- and interobserver variability when a standardized approach is used. A comprehensive and standardized ultrasound semiology has been described and validated in both adults and children. In summary, LU allows for quick easy recognition of a normally aerated lung in contrast to an interstitial or alveolar pattern. Recognition of these patterns may be even easier in neonates due to their small size and the absence of obesity and heavy musculature. Specific LU findings have been described for some types of neonatal lung injury, such as neonatal respiratory distress syndrome, transient tachypnea of the neonate, meconium aspiration syndrome, and neonatal pneumonia. In the newborn, LU has proved its usefulness in predicting the need for hospital admission and/or intubation based on simple LU patterns. A recently proposed LU score, adapted for the neonate, correlates well with oxygenation status, independently of gestational age and underlying respiratory condition. The score reliably predicts the need for surfactant treatment in preterm babies less than 34 weeks gestation treated with nasal CPAP from birth. LU is a promising tool with numerous potential applications that warrant future studies. However, like every technique, LU has its limitations and should not completely replace standard radiography. LU can nevertheless largely reduce exposure to ionizing radiation by limiting the
Full Text Available Health is a human right. Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential. Addressing the multi-faceted health needs of ethnically and culturally diverse individuals in the United States is a complex issue that requires inventive strategies to reduce risk factors and buttress protective factors to promote greater well-being among individuals, families, and communities. With growing diversity concerning various ethnicities and nationalities; and with significant changes in the constellation of multiple of risk factors that can influence health outcomes, it is imperative that we delineate strategic efforts that encourage better access to primary care, focused community-based programs, multi-disciplinary clinical and translational research methodologies, and health policy advocacy initiatives that may improve individuals’ longevity and quality of life.
Ejaz, Iram; Shaikh, Babar Tasneem
According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care. PMID:20357556
Smith, Stephanie L
Bolivia is expected to achieve United Nations Millennium Development Goal Four, reducing under-five child mortality by two-thirds between 2021 and 2025. However, progress on child mortality reduction masks a disproportionately slow decline in newborn deaths during the 2000s. Bolivia's neonatal mortality problem emerged on the policy agenda in the mid-1990s and grew through 2004 in relationship to political commitments to international development goals and the support of a strong policy network. Network status declined later in the decade. This study draws upon a framework for analysing determinants of political priority for global health initiatives to understand the trajectory of newborn survival policy in Bolivia from the early 1990s. A process-tracing case study methodology is used, informed by interviews with 26 individuals with close knowledge of newborn survival policy in the country and extensive document analysis. The case of newborn survival in Bolivia highlights the significance of political commitments to international development goals, health policy network characteristics (cohesion, composition, status and key actor support) and political transitions and instability in shaping agenda status, especially decline-an understudied phenomenon considering the transitory nature of policy priorities. The study suggests that the sustainability of issue attention therefore become a focal point for health policy networks and analyses. PMID:24122129
Cardona, Carol; Travis, Dominic A.; Berger, Kavita; Coat, Gwenaële; Kennedy, Shaun; Steer, Clifford J; Murtaugh, Michael P.; Sriramarao, P.
Numerous interspecies disease transmission events, Ebola virus being a recent and cogent example, highlight the complex interactions between human, animal, and environmental health and the importance of addressing medicine and health in a comprehensive scientific manner. The diversity of information gained from the natural, social, behavioral, and systems sciences is critical to developing and sustainably promoting integrated health approaches that can be implemented at the local, national, a...
Linda Neuhauser; Dawn Richardson; Sonja Mackenzie; Meredith Minkler
Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional public health training has tended to focus more narrowly on diseases and risk factors, and has not adequately leveraged the rich contributions of soc...
SANTOS, MARICEL G.; Handley, Margaret A; OMARK, KARIN; Schillinger, Dean
A reliance on the conceptualization of health literacy as functional skill has limited our views of the adult English-as-a-Second-Language (ESL) context as a site for health literacy interventions. To explore the contributions of alternative views of literacy as social practice to health literacy research, we examined teacher survey data and learner outcomes data collected as part of a multi-year collaboration involving The California Diabetes Program (CDP), university researchers, and adult ...
Full Text Available Hyperbilirubinemia is one of the common causes of admission in newborns. There is concern about an increasing incidence of hyperbilirubinemia and possibility of kernicterus even in healthy term newborns. Thus , early prediction of newborns at risk for developing significant hyperbilirubinemia may be helpful in early intervention . This study was done to find out the association between cord blood bilirubin and hyperbilirubinemia at 72 hours of life and also the association between cord Hb and Hb at sixth month of life along with screening babies for congenital hypothyroidism by TSH assay at birth. MATERIALS AND METHODS : 120 term healthy newborn babies delivered in a tertiary care centre (MES Medical College, Perinthalmanna , were included in this study. They were screened at birth for cord blood Hb, bilirubin and TSH values. Thes e values were compared with bilirubin values at 72 hours of life and Hb at sixth month. Chi - square and correlation tests were used and data analyzed using Epi Info software. RESULTS : Our study showed a strong association between cord blood bilirubin ( >2 mg /dL and significant hyperbilirubinemia ( >14 mg/dL at 72 hours of life with a p value of 0.009. No association was found between cord Hb and Hb at sixth month. CONCLUSION : A cord blood bilirubin value above 2 mg/dL is a useful predictor of significant hyp erbilirubinemia ( >14 mg/dL in healthy term newborns
Pickett, R. D.
This effort demonstrates that health management can be taken to the component level for electromechanical systems. The same techniques can be applied to take any health management system to the component level, based on the practicality of the implementation for that particular system. This effort allows various logic schemes to be implemented for the identification and management of failures. By taking health management to the component level, integrated vehicle health management systems can be enhanced by protecting box-level avionics from being shut down in order to isolate a failed computer.
National Aeronautics and Space Administration — In providing an innovative solution to improving information technologies and health management systems, AGNC is proposing a significant technological achievement...
Neuhauser, Linda; Richardson, Dawn; Mackenzie, Sonja; Minkler, Meredith
Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional…
The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) recognizes that unlicensed assistive personnel (UAP) also known as nursing assistive personnel (NAP) can function as supportive members of the health care team under the direction of the professional registered nurse (AWHONN, 2010). The professional registered nurse is ultimately responsible for the coordination and delivery of nursing care to women and newborns. PMID:26815808
Full Text Available Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1 explore connections between cultural ecosystem services and social determinants of health; (2 examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3 recommend areas for future research examining links between urban green space and public health within the context of environmental justice.
Jennings, Viniece; Larson, Lincoln; Yun, Jessica
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365
Jennings, Viniece; Larson, Lincoln; Yun, Jessica
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365
Sharp, Crystal; Gwadry-Sridhar, Femida
The evolving structure and business of health care services and delivery need the functionality and capability offered by electronic health record (EHR) systems. By electronically diffusing the traditional patient record, however, this new model blurs the long-established medical data home, raising concerns about data ownership, confidentiality, access and individual rights. In 2008 the Lawson Health Research Institute began the process of instituting a robust health informatics and collaborative research infrastructure, now known as I-THINK Research. As data are migrated to the platform and policies are developed, we are forced to confront the complexity of issues around protection of individual rights. The paper presents, in a broader context, the main issues surrounding the privacy debate and the need for education, accountability and new legislation to help define and protect individual rights as new e-health business models emerge.
LEONG, Yin Hui; GAN, Chee Yuen; TAN, Mohd Adi Firdaus; MAJID, Mohamed Isa Abdul
Newborn screening (NBS) program is an important tool for the early diagnosis and preventive treatment of life-long impairments. NBS is one of the strategies recommended by the World Health Organization to promote the primary prevention of congenital anomalies and the health of children with these conditions. However, NBS initiation and implementation in developing countries, especially South-East Asian and North African regions, are slow and challenging. Expanded NBS is not mandatory and has ...
Full Text Available We review oxidative stress-related newborn disease and the mechanism of oxidative damage. In addition, we outline diagnostic and therapeutic strategies and future directions. Many reports have defined oxidative stress as an imbalance between an enhanced reactive oxygen/nitrogen species and the lack of protective ability of antioxidants. From that point of view, free radical-induced damage caused by oxidative stress seems to be a probable contributing factor to the pathogenesis of many newborn diseases, such as respiratory distress syndrome, bronchopulmonary dysplasia, periventricular leukomalacia, necrotizing enterocolitis, patent ductus arteriosus, and retinopathy of prematurity. We share the hope that the new understanding of the concept of oxidative stress and its relation to newborn diseases that has been made possible by new diagnostic techniques will throw light on the treatment of those diseases.
Ozsurekci, Yasemin; Aykac, Kubra
We review oxidative stress-related newborn disease and the mechanism of oxidative damage. In addition, we outline diagnostic and therapeutic strategies and future directions. Many reports have defined oxidative stress as an imbalance between an enhanced reactive oxygen/nitrogen species and the lack of protective ability of antioxidants. From that point of view, free radical-induced damage caused by oxidative stress seems to be a probable contributing factor to the pathogenesis of many newborn diseases, such as respiratory distress syndrome, bronchopulmonary dysplasia, periventricular leukomalacia, necrotizing enterocolitis, patent ductus arteriosus, and retinopathy of prematurity. We share the hope that the new understanding of the concept of oxidative stress and its relation to newborn diseases that has been made possible by new diagnostic techniques will throw light on the treatment of those diseases. PMID:27403229
van Dam van Isselt, Eléonore F; Spruit, Monica; Groenewegen-Sipkema, Karin H; Chavannes, Niels H.; Achterberg, Wilco P.
Aims: To evaluate outcomes of the Clinical Chronic obstructive pulmonary disease (COPD) Questionnaire (CCQ) in patients with advanced COPD admitted for a post-acute pulmonary rehabilitation (PR) programme and to relate (change in) health status to lung function, degree of dyspnoea and (change in) functional capacity. Methods: This is a prospective observational study in patients with advanced COPD admitted for a post-acute PR programme in a skilled nursing facility. Health status (CCQ) and fu...
Full Text Available Abstract Background Data from epidemiological and animal model studies suggest that nutrition during pregnancy may affect the health status of subsequent generations. These transgenerational effects are now being explained by disruptions at the level of the epigenetic machinery. Besides in vitro environmental exposures, the possible impact on the reprogramming of methylation profiles at imprinted genes at a much earlier time point, such as during spermatogenesis or oogenesis, has not previously been considered. In this study, our aim was to determine associations between preconceptional obesity and DNA methylation profiles in the offspring, particularly at the differentially methylated regions (DMRs of the imprinted Insulin-like Growth Factor 2 (IGF2 gene. Methods We examined DNA from umbilical cord blood leukocytes from 79 newborns, born between July 2005 and November 2006 at Duke University Hospital, Durham, NC. Their mothers participated in the Newborn Epigenetics Study (NEST during pregnancy. Parental characteristics were obtained via standardized questionnaires and medical records. DNA methylation patterns at two DMRs were analyzed by bisulfite pyrosequencing; one DMR upstream of IGF2 (IGF2 DMR, and one DMR upstream of the neighboring H19 gene (H19 DMR. Multiple regression models were used to determine potential associations between the offspring's DNA methylation patterns and parental obesity before conception. Obesity was defined as body mass index (BMI ≥30 kg/m2. Results Hypomethylation at the IGF2 DMR was associated with paternal obesity. Even after adjusting for several maternal and newborn characteristics, we observed a persistent inverse association between DNA methylation in the offspring and paternal obesity (β-coefficient was -5.28, P = 0.003. At the H19 DMR, no significant associations were detected between methylation patterns and paternal obesity. Our data suggest an increase in DNA methylation at the IGF2 and H19 DMRs among
Full Text Available Introduction. Insecticides are toxines by which we destroy harmful insects. The most frequent insecticides which are used today are organophosphorus pesticides. This group of compounds make substances whose activity mechanism is based on the inhibition of acetylcholinesterase in nerve synapsis, thus producing holynergic syndrome, resulting from the accumulation of acetylcholine which developed due to the absence of decomposition under the influence of cholinesterase. In the clinical picture of acute toxication by cholinesterase inhibitors there is a clear difference between muscarinic and nicotine effects. The basic aim of the study was to establish the effects of organophosphorus pesticides present in blood and breast milk of mothers on newborns morbidity. Material and methods. The study group consisted of 18 newborns whose mothers had isolated organophosphorus pesticides in their blood and breastmilk on the third day after delivery, and the control group consisted of 84 newborns whose mothers did not have isolated organophosphorus pesticides in their blood and breastmilk. Results. Morbidity is three times greater, often in combination with some disorders of the central nervous system, and the relative risk for its appearance is eight time greater in newborns exposed to organophosphorus pesticides. Disscusion. Disorders that appear in newborns exposed to pesticides are mutagenic, cancerogenic and neurotoxic and some agenses could disturb the immune system which is reflected in morbidity increase, primarly of the central nervous system. Conclusion. The presence of organophosphorus pesticides in blood and breast milk has negative effects on newborns. In addition to acetylcholinesterase inhibition, organophosphorus pesticides react by means of other mechanisms as well.
Saurabh R. Shrivastava
Full Text Available Practice of rooming-in meant that baby and mother stayed together in the same room day and night in the hospital, right from the time of delivery till the time of discharge. Adoption of rooming-in offers multiple benefits to the newborn, mother, and mother-child as a unit. It is a cost-effective approach wherefewer instruments are required and spares additional manpower. Rooming-in endeavors the opportunity to contribute signifi cantly in the child’s growth, development and survival by assisting in timely initiation of breastfeeding. To ensure universal application of rooming-in in hospitals, a comprehensive and technically sound strategy should be formulated and implemented with active participation of healthcare professionals. Measures such as advocating institutional delivery through outreach awareness activities; adoption of baby-friendly hospital initiative; inculcating a sense of ownership among health professionals, can be strategically enforced for better maternal and child health related outcomes.
Santos, Maricel G; Handley, Margaret A; Omark, Karin; Schillinger, Dean
A reliance on the conceptualization of health literacy as functional skill has limited researchers' views of the adult English-as-a-second-language (ESL) context as a site for health literacy interventions. To explore the contributions of alternative views of literacy as social practice to health literacy research, the authors examined teacher survey data and learner outcomes data collected as part of a multiyear collaboration involving the California Diabetes Program, university researchers, and adult ESL teachers. The survey results (n=144 teachers) indicated that ESL teachers frequently model effective pedagogical practices that mediate social interaction around health content, the basis for acquiring new literacy skills and practices. In the classroom pilot (n=116 learners), the majority of learners reported they had learned about diabetes risk factors and prevention strategies, which affirmed existing healthy behaviors or prompted revision of unhealthy ones. About two thirds of the learners reported sharing preventive health content with members of out-of-school social networks. This study represents a first step in research efforts to account more fully for the mechanisms by which social interaction and social support facilitate health literacy outcomes in ESL contexts, which should complement what is already known about the development of health literacy as functional skill. PMID:25315586
Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.
Esra Arun Ozer
Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.
Barnhart, S.; Coq, R. N.; Frederic, R.; DeRiel, E.; Camara, H.; Barnhart, K. R.
Haiti is considered particularly vulnerable to the effects of climate change, but directly linking climate change to health effects is limited by the lack of robust data and the multiple determinants of health. Worsening storms and rising temperatures in this rugged country with high poverty is likely to adversely affect economic activity, population growth and other determinants of health. For the past two years, the Univ. of Washington has supported the public hospital in the department of Grand'Anse. Grand'Anse, a relatively contained region in SW Haiti with an area of 11,912 km2, is predominantly rural with a population of 350,000 and is bounded to the south by peaks up to 2,347 m. Grand'Anse would serve as an excellent site to assess the interface between climate change and health. The Demographic and Health Survey (DHS) shows health status is low relative to other countries. Estimates of climate change for Jeremie, the largest city in Grand'Anse, predict the mean monthly temperature will increase from 26.1 to 27.3 oC while mean monthly rainfall will decrease from 80.5 to 73.5 mm over the next 60 years. The potential impact of these changes ranges from threatening food security to greater mortality. Use of available secondary data such as indicators of climate change and DHS health status are not likely to offer sufficient resolution to detect positive or negative impacts of climate change on health. How might a mixed methods approach incorporating secondary data and quantitative and qualitative survey data on climate, economic activity, health and determinants of health address the hypothesis: Climate change does not adversely affect health? For example, in Haiti most women deliver at home. Maternal mortality is high at 350 deaths/100,000 deliveries. This compares to deliveries in facilities where the median rate is less than 100/100,000. Thus, maternal mortality is closely linked to access to health care in this rugged mountainous country. Climate change
Schembari, Anna; de Hoogh, Kees; Pedersen, Marie; Dadvand, Payam; Martinez, David; Hoek, Gerard; Petherick, Emily S; Wright, John; Nieuwenhuijsen, Mark J
BACKGROUND: Exposure to ambient air pollution has been associated with reduced newborn's size, however the modifying effect of maternal ethnicity remains little explored among South Asians. OBJECTIVES: To investigate ethnic differences in the association between ambient air pollution and newborn...... associations of ambient PM exposures with newborn size and adiposity differ between White British and Pakistani origin infants....
Rosentstein, Diana; Oster, Harriet
Investigated the distinctiveness and recognizability of taste-elicited facial expressions in 12 newborns two hours of age. Findings demonstrated that newborns differentiate sour and bitter from each other and from salty, and discriminate between sweet and nonsweet. Judges accurately identified newborns' responses to sucrose, but systematically…
Leland, Natalie E.; Crum, Karen; Phipps, Shawn; Roberts, Pamela; Gage, Barbara
The authors set forth a foundation on which to build further dialogue and evidence to highlight occupational therapy’s distinctive contribution, significance, and viability as health care policies shift to focus on quality and value.
National Aeronautics and Space Administration — In a successful Phase 1 project for NASA SBIR topic A1.05, "Data Mining for Integrated Vehicle Health Management," Michigan Aerospace Corporation (MAC) demonstrated...
Pomeranz, Jennifer L
Consumption of sugar-sweetened beverages (SSBs) has increased worldwide. As public health studies expose the detrimental impact of SSBs, consumer protection and public health advocates have called for increased government control. A major focus has been on restricting marketing of SSBs to children, but many innovative policy options--legally defensible ways to regulate SSBs and support public health--are largely unexplored. We describe the public health, economic, and retail marketing research related to SSBs (including energy drinks). We review policy options available to governments, including mandatory factual disclosures, earmarked taxation, and regulating sales, including placement within retail and food service establishments, and schools. Our review describes recent international initiatives and classifies options available in the United States by jurisdiction (federal, state, and local) based on legal viability. PMID:21866177
Hall, Margaux J
Scholars have increasingly recognized the ways in which climate change threatens the human rights of people around the world, with a disproportionate burden on the rights of already vulnerable persons. At particular risk to these populations is the right to health, as well as to interconnected human rights. Yet, scholars have generally not provided a thorough assessment of precisely how human rights law can catalyze a response to climate change to effectively avert health harms. This article suggests that human rights law is better suited to guide procedural responses to climate change and its health harms than it is to guide substantive decision-making. This article describes the ways in which climate change implicates the right to health and then analyzes human rights law's response. While acknowledging the intrinsic value of human rights in prompting climate change action, the article focuses its analysis on human rights' instrumental value in this arena. PMID:25474612
Enormous quantities of food and agricultural produce are spoiled by microbial activity, which is a major challenge to food security today. Besides, contamination of foods by pathogens or their toxins pose serious problems affecting food safety worldwide. Development of cost effective, reliable, and user friendly methods for detection and identification of microbial pathogens has always remained a challenge in microbiology. Microbial research has also aided development of probiotics, prebiotics and nutraceuticals, which are important for health. The objective of the symposium was to address and dwell upon the recent advances in some of the mentioned research areas pertaining to microbiology of food, agriculture, health and environment. The major themes of the symposium were: Adaptation to Stresses, Host-Pathogen Interactions, Sustainable Agriculture, Food Safety, Food Security and Nutrition, Environmental Microbiology etc. Papers relevant to INIS are indexed separately
Viniece Jennings; Lincoln Larson; Jessica Yun
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultu...
Nicolas Zdanowicz; Denis Jacques; Christine Reynaert
Objective : A two year follow-up study of a cohort of adolescents on 9 health parameters. Method : 325 adolescents were enrolled in April 1999. In addition to answering a general social-demographic questionnaire, they answered Wallston's Multidimensional Locus of Control scale (MHLC) and Olson's questionnaire on family dynamics (FACES III). 10 health indicators were recorded : two analogical visual assessments (VAS) (general coping and feelings of well-being), their concern for their healt...
Puhl, Rebecca M; Luedicke, Joerg; Grilo, Carlos M.
Objective This study examined weight bias among students training in health disciplines and its associations with their perceptions about treating patients with obesity, causes of obesity, and observations of weight bias by instructors and peers. Design and Methods Students (N = 107) enrolled in a post-graduate health discipline (Physician Associate, Clinical Psychology, Psychiatric Residency) completed anonymous questionnaires to assess the above variables. Results Students reported that pat...
Lancaster, Jason W.; Stein, Susan M.; MacLean, Linda Garrelts; Van Amburgh, Jenny; Persky, Adam M.
Within health science programs there has been a call for more faculty development, particularly for teaching and learning. The primary objectives of this review were to describe the current landscape for faculty development programs for teaching and learning and make recommendations for the implementation of new faculty development programs. A thorough search of the pertinent health science databases was conducted, including the Education Resource Information Center (ERIC), MEDLINE, and EMBAS...
Mai, Volker; Draganov, Peter V.
The complex gut microbial flora harbored by individuals (microbiota) has long been proposed to contribute to intestinal health as well as disease. Pre- and probiotic products aimed at improving health by modifying microbiota composition have already become widely available and acceptance of these products appears to be on the rise. However, although required for the development of effective microbiota based interventions, our basic understanding of microbiota variation on a population level a...
Davidson, Joseph; Mo, Changki
This paper reviews recent developments in energy harvesting technologies for structural health monitoring applications. Many industries have a great deal of interest in obtaining technology that can be used to monitor the health of machinery and structures. In particular, the need for autonomous monitoring of structures has been ever-increasing in recent years. Autonomous SHM systems typically include embedded sensors, data acquisition, wireless communication, and energy harvesting systems. A...
It is a great time for prevention. As the United States explores what health in our country should look like, it is an extraordinary time to highlight the role of prevention in improving health, saving lives, and saving money. The Affordable Care Act's investment in prevention has spurred innovation by communities and states to keep people healthy and safein the first place This includes growing awareness that community conditions are critical in determining health and that there is now a strong track record of prevention success. Community prevention strategies create lasting changes by addressing specific policies and practices in the environments and institutions that shape our lives and our health-from schools and workplaces to neighborhoods and government. Action at the community level also fosters health equity-the opportunity for every person to achieve optimal health regardless of identity, neighborhood, ability, or social status-and is often the impetus for national-level decisions that vitally shape the well-being of individuals and populations. PMID:27037285
Turco, Mary G; Baron, Robert B
The 2016 World Congress on Continuing Professional Development: Advancing Learning and Care in the Health Professions took place in San Diego, California, March 17-19, 2016. Hosts were the Association for Hospital Medical Education (AHME), Alliance for Continuing Education in the Health Professionals (ACEhp), and Society for Academic Continuing Medical Education (SACME). The target audience was the international community working to improve medical (CME), nursing (CNE), pharmacy (CPE), and interprofessional (CIPE) continuing education (CE) and continuing professional development (CPD). Goals included: addressing patients' concerns and needs; advancing global medical and interprofessional health sciences education; utilizing learning to address health disparities; and promoting international cooperation. The five keynote speakers were: patient advocate Alicia Cole ("Why What We Do Matters: The Patients Voice"); linguist Lorelei Lingard ("Myths about Healthcare Teamwork and Their Implications for How We Understand Competence"); futurist and philosopher Alex Jadad ("What Do We Need to Protect at All Costs in the 21st Century?"); ethicist and change agent Zeke Emanuel ("Learn to Change: Teaching Toward a Shifting Healthcare Horizon"); and technology innovator Stephen Downes ("From Individual to Community: The Learning Is in the Doing"). Organizers announced the new Dave Davis Distinguished Award for Excellence in Mentorship in Continuing Professional Development to honor the career of David Davis, MD, in CME/CPD scholarship in Canada, the United States, and beyond. Participants valued the emphasis on interprofessional education and practice, the importance of integrating the patient voice, the effectiveness of flipped classroom methods, and the power of collective competency theories. Attendee-respondents encouraged Congress planners to continue to strive for a broad global audience and themes of international interest. PMID:27584068
Thakur, Neha; Batra, Prerna; Gupta, Piyush
Noise, a modern day curse of advancing infrastructure and technology, has emerged as an important public health problem. Exposure to noise during pregnancy may result in high-frequency hearing loss in newborns, growth retardation, cochlear damage, prematurity and birth defects. Newborns exposed to sound above 45 decibels may experience increase in blood pressure, heart rate, respiratory rate; decreased oxygen saturation; and increased caloric consumption. Noise exposure in older children may result in learning disabilities, attention difficulties, insulin resistance, hypertension, stress ulcers and cardiovascular diseases. Sudden exposure to loud noise can lead to rupture of eardrum. The damaging effects of noise pollution are more noticeable in large metropolitan cities, the hubs of urban settlements and industrial growth. Another concern is noise pollution inside the hospitals (particularly intensive care areas) that can lead to serious health consequences both for caregivers and for children. The issue needs to be addressed by both researchers and policy makers on an urgent basis. PMID:26897139
Christine K. Nalwadda
Full Text Available Background: The first week of life is the time of greatest risk of death and disability, and is also associated with many traditional beliefs and practices. Identifying sick newborns in the community and referring them to health facilities is a key strategy to reduce deaths. Although a growing area of interest, there remains a lack of data on the role of sociocultural norms and practices on newborn healthcare-seeking in sub-Saharan Africa and the extent to which these norms can be modified. Objective: This study aimed to understand the community's perspective of potential sociocultural barriers and facilitators to compliance with newborn referral. Method: In this qualitative study, focus group discussions (n=12 were conducted with mothers and fathers of babies aged less than 3 months. In addition, in-depth interviews (n=11 were also held with traditional birth attendants and mothers who had been referred by community health workers to seek health-facility-based care. Participants were purposively selected from peri-urban and rural communities in two districts in eastern Uganda. Data were analysed using latent content analysis. Results: The community definition of a newborn varied, but this was most commonly defined by the period between birth and the umbilical cord stump falling off. During this period, newborns are perceived to be vulnerable to the environment and many mothers and their babies are kept in seclusion, although this practice may be changing. Sociocultural factors that influence compliance with newborn referrals to seek care emerged along three sub-themes: community understanding of the newborn period and cultural expectations; the role of community health actors; and caretaker knowledge, experience, and decision-making autonomy. Conclusion: In this setting, there is discrepancy between biomedical and community definitions of the newborn period. There were a number of sociocultural factors that could potentially affect compliance
Nonyane, Bareng As; Kc, Ashish; Callaghan-Koru, Jennifer A; Guenther, Tanya; Sitrin, Debora; Syed, Uzma; Pradhan, Yasho V; Khadka, Neena; Shah, Rashed; Baqui, Abdullah H
Community-based maternal and newborn care interventions have been shown to improve neonatal survival and other key health indicators. It is important to evaluate whether the improvement in health indicators is accompanied by a parallel increase in the equitable distribution of the intervention activities, and the uptake of healthy newborn care practices. We present an analysis of equity improvements after the implementation of a Community Based Newborn Care Package (CB-NCP) in the Bardiya district of Nepal. The package was implemented alongside other programs that were already in place within the district. We present changes in concentration indices (CIndices) as measures of changes in equity, as well as percentage changes in coverage, between baseline and endline. The CIndices were derived from wealth scores that were based on household assets, and they were compared usingt-tests. We observed statistically significant improvements in equity for facility delivery [CIndex: -0.15 (-0.24, -0.06)], knowledge of at least three newborn danger signs [-0.026(-0.06, -0.003)], breastfeeding within 1 h [-0.05(-0.11, -0.0001)], at least one antenatal visit with a skilled provider [-0.25(-0.04, -0.01)], at least four antenatal visits from any provider [-0.15(-0.19, -0.10)] and birth preparedness [-0.09(-0.12, -0.06)]. The largest increases in practices were observed for facility delivery (50%), immediate drying (34%) and delayed bathing (29%). These results and those of similar studies are evidence that community-based interventions delivered by female community health volunteers can be instrumental in improving equity in levels of facility delivery and other newborn care behaviours. We recommend that equity be evaluated in other similar settings within Nepal in order to determine if similar results are observed. PMID:26303057
Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami
Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. PMID:26115858
Bloemraad, Irene; Terriquez, Veronica
A rich civic infrastructure of community-based organizations (CBOs) can help generate, diffuse and maintain a culture of engagement and health that benefits marginalized populations most at risk for illness, disability, and poor health. Attention to CBOs advances "meso-level" frameworks for understanding health cultures and outcomes by going beyond attention to social networks and social identities. We focus on three mechanisms: CBOs can (1) empower individuals by developing civic capacity and personal efficacy; (2) foster solidarity by building networks, social identities and a shared commitment to collective well-being; and (3) mobilize people to have a voice in health-related policies and programming, thereby affecting community well-being. We draw on theory and research in sociology, political science and psychology, and we illustrate the utility of a CBO approach by examining survey and semi-structured interview data from participants in youth civic groups in 13 low-income, predominantly immigrant communities in California. Interview data illustrate the ways in which CBOs enhance members' civic capacities, provide a sense of empowerment and efficacy to engage in healthy behaviors, develop solidarity among diverse participants, and elaborate networks among those committed to community well-being. We also discuss CBO-led campaigns in which youth mobilized for change in policies and practices of local institutions to illustrate possible community-wide health consequences of CBO engagement. CBOs can thus generate individual-level well-being effects, and reduce structural barriers to good health through changes in the broader environment. PMID:26898114
Volker Mai; Peter V Draganov
The complex gut microbial flora harbored by individuals (microbiota) has long been proposed to contribute to intestinal health as well as disease. Pre- and probiotic products aimed at improving health by modifying microbiota composition have already become widely available and acceptance of these products appears to be on the rise. However, although required for the development of effective microbiota based interventions, our basic understanding of microbiota variation on a population level and its dynamics within individuals is still rudimentary. Powerful new parallel sequence technologies combined with other efficient molecular microbiota analysis methods now allow for comprehensive analysis of microbiota composition in large human populations. Recent findings in the field strongly suggest that microbiota contributes to the development of obesity, atopic diseases, inflammatory bowel diseases and intestinal cancers. Through the ongoing National Institutes of Health Roadmap 'Human of the world, a large coordinated effort is currently underway to study how microbiota can impact human health. Translating findings from these studies into effective interventions that can improve health,possibly personalized based on an individuals existing microbiota, will be the task for the next decade(s).
Mai, Volker; Draganov, Peter V
The complex gut microbial flora harbored by individuals (microbiota) has long been proposed to contribute to intestinal health as well as disease. Pre- and probiotic products aimed at improving health by modifying microbiota composition have already become widely available and acceptance of these products appears to be on the rise. However, although required for the development of effective microbiota based interventions, our basic understanding of microbiota variation on a population level and its dynamics within individuals is still rudimentary. Powerful new parallel sequence technologies combined with other efficient molecular microbiota analysis methods now allow for comprehensive analysis of microbiota composition in large human populations. Recent findings in the field strongly suggest that microbiota contributes to the development of obesity, atopic diseases, inflammatory bowel diseases and intestinal cancers. Through the ongoing National Institutes of Health Roadmap 'Human Microbiome Project' and similar projects in other parts of the world, a large coordinated effort is currently underway to study how microbiota can impact human health. Translating findings from these studies into effective interventions that can improve health, possibly personalized based on an individuals existing microbiota, will be the task for the next decade(s). PMID:19115471
Mullan, Patricia B; WILLIAMS, Joy; Malani, Preeti N.; RIBA, MICHELLE; Haig, Andrew; Perry, Julie; Kolars, Joseph C; Mangrulkar, Rajesh; Williams, Brent
Background The move to frame medical education in terms of competencies – the extent to which trainees “can do” a professional responsibility - is congruent with calls for accountability in medical education. However, the focus on competencies might be a poor fit with curricula intended to prepare students for responsibilities not emphasized in traditional medical education. This study examines an innovative approach to the use of potential competency expectations related to advancing global ...
Full Text Available A case of multiple congenital defects in a newborn foal is reported. The animal showed hypoplasia of the left pelvic limb bones, uterus unicornis, congenital diaphragmatic hernia, and unilateral renal and ureteral agenesis. This report includes the macroscopic and microscopic lesions observed in the case.
J.F. Silva; R. Serakides; S.A. França; J.N. Boeloni; N.M. Ocarino
A case of multiple congenital defects in a newborn foal is reported. The animal showed hypoplasia of the left pelvic limb bones, uterus unicornis, congenital diaphragmatic hernia, and unilateral renal and ureteral agenesis. This report includes the macroscopic and microscopic lesions observed in the case.
de Haas, M.; Thurik, F. F.; Koelewijn, J. M.; van der Schoot, C. E.
Haemolytic Disease of the Fetus and Newborn (HDFN) is caused by maternal alloimmunization against red blood cell antigens. In severe cases, HDFN may lead to fetal anaemia with a risk for fetal death and to severe forms of neonatal hyperbilirubinaemia with a risk for kernicterus. Most severe cases ar
Turati, Chiara; Bulf, Hermann; Simion, Francesca
The study investigated the origins of the ability to recognize faces despite rotations in depth. Four experiments are reported that tested, using the habituation technique, whether 1-to-3-day-old infants are able to recognize the invariant aspects of a face over changes in viewpoint. Newborns failed to recognize facial perceptual invariances…
Dutt, Rajdhar; Dutt, Chandrakala
1 days newborn presents with abdominal distention, excessive cry, respiratory distress and off fed, abdominal - distended, tenders, tympanic and bowel sound high present were present. Chest X-ray - Gas between below the right colic angle between liver and right diaphragm. Treatment - Conservatives.
Heyn, Holger; Li, Ning; Ferreira, Humberto J.;
Human aging cannot be fully understood in terms of the constrained genetic setting. Epigenetic drift is an alternative means of explaining age-associated alterations. To address this issue, we performed whole-genome bisulfite sequencing (WGBS) of newborn and centenarian genomes. The centenarian D...
Gooding, Julie R; McClead, Richard E
This article summarizes the initial assessment of normal newborns and describes a few of the common variations that may occur. These variations require a pediatric provider to reassure anxious new parents and provide follow-up communication with the subsequent primary care provider. PMID:25836702
Ward, Robert M; Sherwin, Catherine M T
Drug studies in developing pediatric patients, especially newborns, create many ethical challenges that can be analyzed in terms of respect for persons, justice, and beneficence/maleficence as outlined in the Belmont Report. This report describes some of the ethical challenges in conducting drug studies in pediatric patients that must be considered when planning studies and offers some solutions to meet those challenges. Methods of optimal study design should be utilized to limit the number of patients and the number of blood samples. Parental permission should be obtained with equipoise, although the parents of a sick newborn may feel an internal pressure for their child to participate in a study of a new and potentially superior therapy. If appropriate to the study, consent before labor and delivery when parents are less stressed is optimal. It may be difficult or impossible to know all the risks and benefits accompanying studies in newborns due to the limited number of randomized controlled studies in this population. Many more carefully designed, randomized controlled studies of drugs are needed to address the therapeutic needs of the developing pediatric population. For sick newborns cared for in the neonatal intensive care unit (NICU), those studies should be better focused on the drugs used daily in their cares. PMID:25354989
Full Text Available Purpose: We report a case of iris pigment epithelial cysts in a newborn and discuss the importance of an accurate diagnosis for prevention of amblyopia.Methods: We describe a case of an abnormal red reflex seen on a newborn exam.Results: A full-term female born via normal spontaneous vaginal delivery without any complications was seen in the newborn nursery. She was noted to have an abnormal eye exam. Pupils were large with circular dark excrescences of the iris pigment epithelium. She was referred to a pediatric ophthalmologist where she was noted to fixate and follow faces. No afferent pupillary defect was seen. OD red reflex was normal whereas OS red reflex was blocked mostly by dark excrescences. A 2– dark brown lesion was seen in the OD iris and a 3–5 mm dark brown lesion was seen in the OS iris, consistent with a pupillary iris pigment epithelial cyst. Central visual axis was clear OU. Glaucoma was not present and patching was not performed. Observations and clinical photographs were recommended with follow-up in three months.Conclusion: Iris pigment epithelial cysts are uncommonly seen in children. The primary care provider first seeing a newborn must be aware of lesions obscuring a red reflex with appropriate follow-up. Follow-up in three months with IOP measurements is recommended. Iris pigment epithelial cysts in children may be a cause of amblyopia, thus prompt evaluation is important for prognostic purposes and the prevention of amblyopia.
Berne-Audéoud, Frédérique; Marcus, Leila; Lejeune, Fleur; Gentaz, Edouard; Debillon, Thierry
How does the premature newborn perceive the outside world? The first sense developed by the foetus is touch. Through the physiology of sensoriality and brain maturation, touch can constitute an essential vector in communicating with and caring for the premature child. PMID:20925301
Perdue, Michael L; Bright, Rick A
Since 2005, the Government of the United States of America has provided more than US$ 50 million to advance influenza vaccine development in low-resourced countries. This programme has provided a unique opportunity for the US Government to develop a comprehensive view of, and to understand better the challenges and future needs for influenza vaccines in the developing world. The funding for this programme has been primarily through a cooperative agreement with the World Health Organization (WHO) to support directly its capacity-building grants to government-owned or -supported vaccine manufacturers in developing countries. A second cooperative agreement with the Program for Appropriate Technologies in Health (PATH) was initiated to accelerate the completion of a current Good Manufacturing Practice cGMP production facility, along with supporting facilities to obtain a reliable source of eggs, and to conduct clinical trials of influenza vaccine manufactured in Vietnam. This mechanism of utilizing cooperative agreements to support capacity-building for vaccine development in low-resourced settings has been novel and unique and has yielded fruitful returns on minimal investment. The information derived from this programme helps to clarify not only the development challenges for influenza vaccines and how the United States may assist in meeting those challenges, but also other vaccine development issues common to manufacturers in developing countries. While building the initial capacity to produce influenza vaccines can be a straightforward exercise, the sustainability of the enterprise and expansion of subsequent markets will be the key to future usefulness. There is hope for expansion of the global influenza vaccine market. Ongoing burden of disease studies are elucidating the impact of influenza infections, particularly in children, and more countries will take note and respond accordingly, since respiratory diseases are now the number one killer of children under
Full Text Available Objective: Hyperbilirubinemia is a common and, in most cases, benign problem in newborns. Nonetheless, untreated, severe indirect hyperbilirubinemia is potentially neurotoxic. The aim of this study is to evaluate the etiological factors and clinical characteristics of newborns with indirect hyperbilirubinemia. Material and Methods: In this study, 319 newborns with indirect hyperbilirubinemia were investigated prospectively at Vakıf Gureba Education and Research Hospital. Blood groups, infection criteria, hemotocrits, direct Coombs tests, reticulocyte values, glucose-6-phosphatase (G6PD levels, thyroid-stimulating hormone and thyroxin levels were determined. In newborns with indirect hyperbilirubinemia, phototherapy was initiated according to the guidelines proposed by the American Academy of Pediatrics. Results: The gender and gestational age of the infants were 202 (%63.3 male, 117 (%36.7 female; 266 (%83.4 term, 53 (%16.6 preterm. When etiological factors were considered, 109 cases (%34.1 were idiopatic, 67 cases (%21 were ABO incompatibility, 15 cases (%4.7 were Rh incompatibility, 7 case (%2.3 were ABO and Rh incompatibility, 43 cases (%13.5 were prematurity, 25 cases (% 7.8 were polycythemia, 30 cases (%9.4 were infection, 9 cases (%2.8 were cephalohematoma, 4 cases (%1.2 were G6PD deficiency, 5 cases (%1.5 were infant of a diabetic mother, 2 cases (%0.7 were trisomy 21, 3 cases (%1 were hypothyroidism. Bilirubin levels higher than 25 mg/dl were detected in 7 (% 2.3 cases. The highest bilirubin level was 28 mg/dl, and this case had the urinary infection. In only one of the cases exchance transfusion was applied there was a fast rise in the bilirubin levels in the first 24 hours and as there was no respons to phototherapy. Conclusion: Hyperbilirubinemia frequently encountered problem in the newborn is not only the result of blood group incompatibility, but may also be due to sepsis, urinary tract infection, hypothyroidism, polycythemia and
Kalluri, Radha; Abdala, Carolina
This study presents the first reported measurements of stimulus frequency emissions (SFOAEs) in 15 human newborns and compares their magnitudes and phase-gradient delays to those reported in adults. SFOAEs in newborns were measured at stimulus levels as low as 15 dB sound pressure level (SPL). Responses were compared between adults and newborns at stimulus levels where SFOAEs in both age groups demonstrated approximately linear growth (<40 dB SPL for newborns, <25 dB SPL for adults). Neonates had adult-like SFOAE delays when compared in this fashion, which compensates for newborn middle ear inefficiencies. PMID:25618103
Kunovskaya L. M.
Full Text Available The role and value of the bacterial factor in development pre-natal infection of newborns is studied. It is considered microflora of patrimonial ways of pregnant women, as basic pathogenesis factor of an ascending way infection of newborns. On an example of the spent bacteriological researches correlation communication between microflora of patrimonial ways, placenta and an ascending way infection of newborns is shown. At crops gastric swallowing at newborn children with pre-natal infection of newborns it is ascertained growth aerobic and аanaerobic microflora in the majority (87,7 % supervision in the form of microbes associations gramme-positive coccus Staphylococcus epidermidis and Staphylococcus aureus and Candida. The inclusion in the treatment of Saccharomyces boulardіi contributes to the restoration of intestinal microflora in 90 % of newborns. Found significant growth of the colonies of Bifidobacterium spp. (3.7-4,9 lg CFU/ml and Lactobacillus spp. (7.2 lg CFU/ml.
Han, Shujing; Yang, Xiaojian; Zhou, Yi; Hao, Jinsheng; Shen, Adong; Xu, Fang; Chu, Ping; Jin, Yaqiong; Lu, Jie; Guo, Yongli; Shi, Jin; Liu, Haihong; Ni, Xin
Objective To determine the incidence of congenital hearing loss (HL) in newborns by the rate of deafness-related genetic mutations. Design Clinical study of consecutive newborns in Beijing using allele-specific polymerase chain reaction-based universal array. Study sample This study tested 37 573 newborns within 3 days after birth, including nine sites in four genes: GJB2 (35 del G, 176 del 16, 235 del C, 299 del AT), SLC26A4 (IVS7-2 A > G, 2168 A > G), MTRNR1 (1555 A > G, 1494 C > T), and GJB3 (538 C > T). The birth condition of infants was also recorded. Results Of 37 573 newborns, 1810 carried pathogenic mutations, or 4.817%. The carrier rates of GJB2 (35 del G, 176 del 16, 235 del C, 299 del AT), GJB3 (538 C > T), SLC26A4 (IVS7-2 A > G, 2168 A > G), and MTRNR1 (1555 A > G, 1494 C > T) mutations were 0.005%, 0.104%, 1.924%, 0.551%, 0.295%, 0.253%, 1.387%, 0.024%, and 0.274%, respectively. Logistic regression analysis indicated no statistically significant relationship between mutations and infant sex, premature delivery, twin status, or birth weight. Conclusions The 235delC GJB2 mutation was the most frequent deafness-related mutation in the Chinese population. Genetic screening for the deafness gene will help detect more cases of newborn congenital HL than current screening practices. PMID:26766211
Full Text Available Objective:Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in newborns under mechanical ventilation.Methods:This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered.Findings:Among 400 patients under mechanical ventilation, 102 neonates developed pneumothorax (26%. Fifty six (54.9% of them were boys and 46 (45.1% girls. 54.9% of newborns with pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs. 32% of newborns without pneumothorax. The most common type (62.7% of ventilation leading to pneumothorax was Inspiratory Positive Pressure Ventilation (IPPV. Surfactant replacement therapy was recorded in 32.4% of cases with pneumothorax compared to 60.4% of neonates under ventilation without pneumothorax, which was significantly different (P= 0.017.Conclusion:In newborns surfactant replacement therapy can reduce the risk of pneumothorax caused by mechanical ventilation.
Nadieh Yazdi Hosseini
Full Text Available Objective:Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in newborns under mechanical ventilation. Methods:This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered. Findings:Among 400 patients under mechanical ventilation, 102 neonates developed pneumothorax (26%. Fifty six (54.9% of them were boys and 46 (45.1% girls. 54.9% of newborns with pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs. 32% of newborns without pneumothorax. The most common type (62.7% of ventilation leading to pneumothorax was Inspiratory Positive Pressure Ventilation (IPPV. Surfactant replacement therapy was recorded in 32.4% of cases with pneumothorax compared to 60.4% of neonates under ventilation without pneumothorax, which was significantly different (P= 0.017. Conclusion:In newborns surfactant replacement therapy can reduce the risk of pneumothorax caused by mechanical ventilation.
Altpeter, Mary; Mitchell, James F.; Pennell, Joan
This study provides the basis for customizing culturally responsive social work health promotion programs aimed at eliminating breast cancer screening and mortality disparities between white and African American women. Survey data collected from a random sample of 853 women in rural North Carolina were used to explore the impact of psychosocial…
Full Text Available Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional public health training has tended to focus more narrowly on diseases and risk factors, and has not adequately leveraged the rich contributions of sociology, anthropology, economics, geography, communication, political science, and other disciplines. Further, students are often not sufficiently trained to work across sectors to translate research findings into effective, large-scale sustainable actions.During the past 2 decades, national and international organizations have called for more effective interdisciplinary, transdisciplinary, and translational approaches to graduate education. Although it has been difficult to work across traditional academic boundaries, some promising models draw on pedagogical theory and feature cross-disciplinary training focused on real-world problems, linkage between research, professional practice, community action, and cultivation of leadership skills.We describe the development the Doctor of Public Health program at the University of California, Berkeley, USA and its efforts to improve transdisciplinary and translational research education. We stress the need for international collaboration to improve educational approaches and better evaluate their impact.
Haines, Andy; Smith, Kirk R; Anderson, Dennis; Epstein, Paul R; McMichael, Anthony J; Roberts, Ian; Wilkinson, Paul; Woodcock, James; Woods, Jeremy
The absence of reliable access to clean energy and the services it provides imposes a large disease burden on low-income populations and impedes prospects for development. Furthermore, current patterns of fossil-fuel use cause substantial ill-health from air pollution and occupational hazards. Impending climate change, mainly driven by energy use, now also threatens health. Policies to promote access to non-polluting and sustainable sources of energy have great potential both to improve public health and to mitigate (prevent) climate disruption. There are several technological options, policy levers, and economic instruments for sectors such as power generation, transport, agriculture, and the built environment. However, barriers to change include vested interests, political inertia, inability to take meaningful action, profound global inequalities, weak technology-transfer mechanisms, and knowledge gaps that must be addressed to transform global markets. The need for policies that prevent dangerous anthropogenic interference with the climate while addressing the energy needs of disadvantaged people is a central challenge of the current era. A comprehensive programme for clean energy should optimise mitigation and, simultaneously, adaption to climate change while maximising co-benefits for health--eg, through improved air, water, and food quality. Intersectoral research and concerted action, both nationally and internationally, will be required. PMID:17868819
Fischer, Elizabeth A; Jayana, Krishnamurthy; Cunningham, Troy; Washington, Maryann; Mony, Prem; Bradley, Janet; Moses, Stephen
Trained nurse mentors catalyzed quality improvements in facility-based maternal and newborn care by: (1) encouraging use of self-assessment checklists and team-based problem solving, (2) introducing case sheets to ensure adherence to clinical guidelines, and (3) strengthening clinical skills through on-site demonstrations and bedside teaching. Inadequate leadership and staffing were challenges in some facilities. Some social norms, such as client resistance to referral and to staying 48 hours...
Buratti, Paolo; Gammella, Elena; Rybinska, Ilona; Cairo, Gaetano; Recalcati, Stefania
Iron is necessary for physiological processes essential for athletic performance, such as oxygen transport, energy production, and cell division. However, an excess of "free" iron is toxic because it produces reactive hydroxyl radicals that damage biological molecules, thus leading to cell and tissue injury. Therefore, iron homeostasis is strictly regulated; and in recent years, there have been important advancements in our knowledge of the underlying processes. Hepcidin is the central regulator of systemic iron homeostasis and exerts its function by controlling the presence of the iron exporter ferroportin on the cell membrane. Hepcidin binding induces ferroportin degradation, thus leading to cellular iron retention and decreased levels of circulating iron. As iron is required for hemoglobin synthesis, the tight link between erythropoiesis and iron metabolism is particularly relevant to sports physiology. The iron needed for hemoglobin synthesis is ensured by inhibiting hepcidin to increase ferroportin activity and iron availability and hence to make certain that efficient blood oxygen transport occurs for aerobic exercise. However, hepcidin expression is also affected by exercise-associated conditions, such as iron deficiency, anemia or hypoxia, and, particularly, inflammation, which can play a role in the pathogenesis of sports anemia. Here, we review recent advances showing the relevance of iron for physical exercise and athletic performance. Low body iron levels can cause anemia and thus limit the delivery of oxygen to exercising muscle, but tissue iron deficiency may also affect performance by, for example, hampering muscle oxidative metabolism. Accordingly, a hemoglobin-independent effect of iron on exercise capacity has been demonstrated in animal models and humans. Here, we review recent advances showing the relevance of iron for physical exercise and athletic performance. PMID:25494391
Di Sante, Raffaella
In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS) have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same system, and the possibility to be integrated within the material. However, more effort is still needed to bring the technology to a fully mature readiness level. In this paper, recent research and applications in structural health monitoring of composite aircraft structures using FOS have been critically reviewed, considering both the multi-point and distributed sensing techniques. PMID:26263987
Raffaella Di Sante
Full Text Available In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same system, and the possibility to be integrated within the material. However, more effort is still needed to bring the technology to a fully mature readiness level. In this paper, recent research and applications in structural health monitoring of composite aircraft structures using FOS have been critically reviewed, considering both the multi-point and distributed sensing techniques.
Pezzoli, Keith; Tukey, Robert; Sarabia, Hiram; Zaslavsky, Ilya; Miranda, Marie Lynn; Suk, William A.; Lin, Abel; Ellisman, Mark
Background Two devastating hurricanes ripped across the Gulf Coast of the United States during 2005. The effects of Hurricane Katrina were especially severe: The human and environmental health impacts on New Orleans, Louisiana, and other Gulf Coast communities will be felt for decades to come. The Federal Emergency Management Agency (FEMA) estimates that Katrina’s destruction disrupted the lives of roughly 650,000 Americans. Over 1,300 people died. The projected economic costs for recovery an...
Jones, Deborah J.; Forehand, Rex; Cuellar, Jessica; Kincaid, Carlye; Parent, Justin; Fenton, Nicole; Goodrum, Nada
Disruptive behaviors of childhood are among the most common reasons for referral of children to mental health professionals. Behavioral parent training (BPT) is the most efficacious intervention for these problem behaviors, yet BPT is substantially underutilized beyond university research and clinic settings. With the aim of addressing this research-to-practice gap, this article highlights the considerable, but largely unrealized, potential for technology to overcome the two most pressing cha...
Raffaella Di Sante
In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS) have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same s...
Jon P. Christophersen
The objective of this work is to develop methodologies that will accurately estimate state-of-health (SOH) and remaining useful life (RUL) of electrochemical energy storage devices using both offline and online (i.e., in-situ) techniques through: · A statistically robust offline battery calendar life estimator tool based on both testing and simulation, and · Novel onboard sensor technology for improved online battery diagnostics and prognostics.
Lin, Angela Yu-Chen; Huang, Susana Tzy-Ying; Wahlqvist, Mark L
Economic growth inevitably influences the food chain. Growing demand with changes in lifestyle and health consciousness encourage use of packaged and pre-prepared foods. The needs of environmental protection from waste generated are largely overlooked, and a lack of knowledge about the impact on the environment and its health effects constitute food security/safety problems. Food production and waste generation directly affect resource (i.e., energy and water) consumption and often contaminate the environment. More pressure on food production has inculcated the use of pesticides, herbicides, antibiotics and chemical fertilizers which add to current global pollution. At least half of food grown is discarded before and after it reaches consumers. It is estimated that one third to half of landfill waste comes from the food sector. This landfill releases green house gases (GHG) as well as leachate which worsen soil and water quality and safety. Pharmaceutical and chemical contaminations from residential, industrial and agricultural sources make their way into nearby water and soil and can eventually affect our food systems. Phthalates, PFOA, BPA, commonly used in plastics and personal care products, are found in unacceptable concentrations in Taiwanese waters. They, too, contribute to food contamination and long-term health risk. Existing waste management strategies warrant more stringent norms for waste reduction at source. Awareness through education could reduce food waste and its consequences. This review encompasses impacts of food production systems on the environment, pollution which results from food waste, costs and economic advantages in food waste management, and health consequences of waste. PMID:19965345
Mariana Monteiro de Castro; Helba Helena Santos Prezoto; Elisa Furtado Fernandes; Odair Correa Bueno; Fábio Prezoto
Ants inhabit several types of natural and urban habitats, where they successfully nest. In urban environments, the hospitals should be considered priority for studies, as ants pose risks to human health due to their pathogen carrying potential. We aimed at surveying the literature about studies on ants in hospital settings in Brazil in the past 20 years. We found 40 papers in 22 journals, the first one published in 1993. Among them, 26 papers assessed pathogenic microorganisms on ants. We rec...
Full Text Available Abstract Background The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment refusal and do-not-resuscitate decisions are still extremely uncommon in Albania. Medical teams cannot abstain from intervening even when the patient explicitly and repeatedly solicits therapeutic abstinence. The Albanian law on health care has no provisions regarding limits or withdrawal of treatment. This restricts the individual's healthcare choices. Discussion The question of 'medically futile' interventions and pointless life-prolonging treatment has been discussed by several authors. Dutch physicians call such interventions 'medisch zinloos' (senseless, and the Netherlands, as one of the first states to legislate on end-of-life situations, actually regulates such issues through appropriate laws. In contrast, leaving an 'advance directive' is not a viable option for Albanian ailing individuals of advanced age. Verbal requests are provided during periods of mental competence, but unfortunately such instructions are rarely taken seriously, and none of them has ever been upheld in a legal or other official forum. Summary End-of-life decisions, treatment refusal and do-not-resuscitate policies are hazardous options in Albania, from the legal point of view. Complying with them involves significant risk on the part of the physician. Culturally, the application of such instructions is influenced from a mixture of religious beliefs, death coping-behaviors and an immense confusion concerning the role of proxies as decision-makers. Nevertheless, Albanian tradition is familiar with the notion of 'amanet', a sort of living will that mainly deals the property and inheritance issues
Full Text Available Allo-anti-M often has an immunoglobulin G (IgG component but is rarely clinically significant. We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. The aim was to diagnose and successfully manage hemolytic disease of newborn (HDN due to maternal alloimmunization. Direct antiglobulin test (DAT, antigen typing, irregular antibody screening and identification were done by polyspecific antihuman globulin cards and standard tube method. At presentation, the newborn twins (T1, T2 had HDN with resultant low reticulocyte count and prolonged anemia, which continued for up to 70 days of life. Blood group of the twins and the mother was O RhD positive. DAT of the both newborns at birth was negative. Anti-M was detected in mothers as well as newborns. Type of antibody in mother was IgG and IgM type whereas in twins it was IgG type only. M antigen negative blood was transfused thrice to twin-1 and twice to twin-2. Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. Anti-M is capable of causing HDN as well as prolonged anemia (red cell aplasia due to its ability to destroy the erythroid precursor cells. Newborns with anemia should be evaluated for all the possible causes to establish a diagnosis and its efficient management. Mother should be closely monitored for future pregnancies as well.
Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G
The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion. PMID:27054385
Ahsan Karar Zunaid
Full Text Available Abstract Background Urbanization is occurring at a rapid pace, especially in low-income countries. Dhaka, Bangladesh, is estimated to grow to 50 million by 2015, with 21 million living in urban slums. Although health services are available, neonatal mortality is higher in slum areas than in urban non-slum areas. The Manoshi program works to improve maternal, newborn, and child health in urban slums in Bangladesh. This paper describes newborn care practices in urban slums in Dhaka and provides program recommendations. Methods A quantitative baseline survey was conducted in six urban slum areas to measure newborn care practices among recently delivered women (n = 1,256. Thirty-six in-depth semi-structured interviews were conducted to explore newborn care practices among currently pregnant women (n = 18 and women who had at least one delivery (n = 18. Results In the baseline survey, the majority of women gave birth at home (84%. Most women reported having knowledge about drying the baby (64%, wrapping the baby after birth (59%, and cord care (46%. In the in-depth interviews, almost all women reported using sterilized instruments to cut the cord. Babies are typically bathed soon after birth to purify them from the birth process. There was extensive care given to the umbilical cord including massage and/or applying substances, as well as a variety of practices to keep the baby warm. Exclusive breastfeeding was rare; most women reported first giving their babies sweet water, honey and/or other foods. Conclusion These reported newborn care practices are similar to those in rural areas of Bangladesh and to urban and rural areas in the South Asia region. There are several program implications. Educational messages to promote providing newborn care immediately after birth, using sterile thread, delaying bathing, and ensuring dry cord care and exclusive breastfeeding are needed. Programs in urban slum areas should also consider interventions to improve
Christina A Markunas
Full Text Available Offspring of older mothers are at increased risk of adverse birth outcomes, childhood cancers, type 1 diabetes, and neurodevelopmental disorders. The underlying biologic mechanisms for most of these associations remain obscure. One possibility is that maternal aging may produce lasting changes in the epigenetic features of a child's DNA. To test this, we explored the association of mothers' age at pregnancy with methylation in her offspring, using blood samples from 890 Norwegian newborns and measuring DNA methylation at more than 450,000 CpG sites across the genome. We examined replication of a maternal-age finding in an independent group of 1062 Norwegian newborns, and then in 200 US middle-aged women. Older maternal age was significantly associated with reduced methylation at four adjacent CpGs near the 2nd exon of KLHL35 in newborns (p-values ranging from 3x10-6 to 8x10-7. These associations were replicated in the independent set of newborns, and replicated again in women 40 to 60 years after their birth. This study provides the first example of parental age permanently affecting the epigenetic profile of offspring. While the specific functions of the affected gene are unknown, this finding opens the possibility that a mother's age at pregnancy could affect her child's health through epigenetic mechanisms.
Full Text Available Background: weight of the baby at birth is considered to be a major determinant of future health and survival of the child. It is one of the important factors which determine the readiness with which the newborn baby adjusts to its surrounding. Many maternal socio-biological factors influence birth weight. Objective: To determine maternal socio-biological factors influencing birth weight of newborn. Methodology: Hospital based cross- sectional study undertaken in Obstetrics and Gynaecology ward of Nehru hospital, Gorakhpur. The study period extended from July 2011 to August 2012. The study subject included recently delivered mothers and data was collected on semi-structured interview schedule to know various socio-biological variables such as mother’s age, parity, inter-pregnancy interval etc, influencing the low birth weight of newborn. Chi-Square test was applied to observe the significance of association. Results: The overall proportion of low birth weight baby came out to be 32.06%. Out of various socio-biological factors taken the factors which came out to be statistically significant were age of mother, parity, inter-pregnancy interval, SLI, education. The factors which were not statistically significant were father’s education, religion. Conclusions: It was concluded that teenage pregnancy, non-utilization of antenatal care practices, anaemia, illiteracy are unfavorable predictors of birth weight of newborn babies.
Full Text Available Abstract Background The perfusion index, derived from the pulse oximeter signal, seems to be an accurate predictor for high illness severity in newborns. The aim of this study was to determine the perfusion index values of clinically and hemodynamically stable preterm newborns in the first week of life. Methods Perfusion index recordings were performed on the first, third and seventh day of life on 30 preterm newborns. Their state of health was assessed according to clinical and behaviour evaluation and to the Score for Neonatal Acute Physiology. Results The median(interquartile range perfusion index values were 0.9(0.6 on the first, 1.2(1.0 on the third, and 1.3(0.9 on the seventh day, with a significant increase between the first and the third day. Conclusions Perfusion index proved to be an easily applicable, non-invasive method for monitoring early postnatal changes in peripheral perfusion. Its trend during the first week of life suggests that its clinical application should take age into account. Further studies are needed to obtain reference perfusion index values from a larger sample of preterm newborns, to identify specific gestational age-related cut-off values for illness and to test the role of perfusion index in monitoring critically ill neonates.
Wilcox, Allen J.; Xu, Zongli; Joubert, Bonnie R.; Harlid, Sophia; Panduri, Vijayalakshmi; Håberg, Siri E.; Nystad, Wenche; London, Stephanie J.; Sandler, Dale P.; Lie, Rolv T.; Wade, Paul A.; Taylor, Jack A.
Offspring of older mothers are at increased risk of adverse birth outcomes, childhood cancers, type 1 diabetes, and neurodevelopmental disorders. The underlying biologic mechanisms for most of these associations remain obscure. One possibility is that maternal aging may produce lasting changes in the epigenetic features of a child’s DNA. To test this, we explored the association of mothers’ age at pregnancy with methylation in her offspring, using blood samples from 890 Norwegian newborns and measuring DNA methylation at more than 450,000 CpG sites across the genome. We examined replication of a maternal-age finding in an independent group of 1062 Norwegian newborns, and then in 200 US middle-aged women. Older maternal age was significantly associated with reduced methylation at four adjacent CpGs near the 2nd exon of KLHL35 in newborns (p-values ranging from 3x10-6 to 8x10-7). These associations were replicated in the independent set of newborns, and replicated again in women 40 to 60 years after their birth. This study provides the first example of parental age permanently affecting the epigenetic profile of offspring. While the specific functions of the affected gene are unknown, this finding opens the possibility that a mother’s age at pregnancy could affect her child’s health through epigenetic mechanisms. PMID:27383059
Full Text Available Objectives: To study the knowledge of mothers about recognition of danger signs and care seeking behaviour during illness of newborn child in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (76.9% of the mothers said that if the baby was very cold to touch or running temperature is a danger sign during newborn period followed by absence of sucking (68.9% in previously sucking newborn as danger sign. Majority (71.9% of the mothers consulted local doctor for any problem during neonatal period. Only 12 percent of the mothers approached Govt. doctor for the treatment . It was observed that Hing was given by 86.2 percent mothers in case of stomachache. 82.8 percent mothers had given salt and sugar solutions in the case of diarrhoea\t. Conclusion: In majority of cases correct knowledge and care seeking behaviour during illness of newborn were lacking among mothers and this should be promoted through improved coverage with existing health services.
Victora, Cesar G; Requejo, Jennifer Harris; Barros, Aluisio J D; Berman, Peter; Bhutta, Zulfiqar; Boerma, Ties; Chopra, Mickey; de Francisco, Andres; Daelmans, Bernadette; Hazel, Elizabeth; Lawn, Joy; Maliqi, Blerta; Newby, Holly; Bryce, Jennifer
Conceived in 2003 and born in 2005 with the launch of its first report and country profiles, the Countdown to 2015 for Maternal, Newborn, and Child Survival has reached its originally proposed lifespan. Major reductions in the deaths of mothers and children have occurred since Countdown's inception, even though most of the 75 priority countries failed to achieve Millennium Development Goals 4 and 5. The coverage of life-saving interventions tracked in Countdown increased steadily over time, but wide inequalities persist between and within countries. Key drivers of coverage such as financing, human resources, commodities, and conducive health policies also showed important, yet insufficient increases. As a multistakeholder initiative of more than 40 academic, international, bilateral, and civil society institutions, Countdown was successful in monitoring progress and raising the visibility of the health of mothers, newborns, and children. Lessons learned from this initiative have direct bearing on monitoring progress during the Sustainable Development Goals era. PMID:26477328
Valentine, Gregory; Marquez, Lucila; Pammi, Mohan
On February 1, 2016, Zika virus (ZIKV) was designated as a Public Health Emergency of International Concern by the director of the World Health Organization. Zika virus has spread to numerous countries throughout the Americas, affecting up to an estimated 1.3 million people since the first reports from Brazil in early 2015. Although ZIKV infections are self-limiting, fetal microcephaly and ophthalmic anomalies have been associated with ZIKV infection as a possible result of perinatal transmission. The causal link between maternal ZIKV infection and newborn microcephaly and eye lesions has not been proven beyond doubt and is currently debated. We discuss the possibility of causality by ZIKV using Koch's postulates and the more appropriate Bradford Hill criteria. In this review, we summarize and consolidate the current literature on newborn microcephaly and eye lesions associated with ZIKV infection and discuss current perspectives and controversies. PMID:27405738
Strekalova, Yulia A
Cystic fibrosis (CF) is a genetic disease that has no manifestations for carriers but is terminal for those diagnosed with it. CF is identified through newborn screening (NBS) tests, and most families have no knowledge about CF before their contact with a NBS program. Acknowledging the Internet as a popular health information source, this study examined information exchange about CF in online community forums. This article, guided by self-determination theory, aimed at providing understanding of psychological needs and motivation for health information seeking and active communication about CF. Through online communication with other families who share similar experience, caregivers of newborns diagnosed with CF sought and received support for their competence, autonomy, and relatedness needs during the initial CF testing and diagnosis reconciliation process. Online communities play an important role in the information seeking related to CF diagnosis and could become active partners in strategic knowledge dissemination efforts. PMID:26612888
Full Text Available Subjective wellbeing is an important issue on the preventive medicine and political agenda and for mutual communication, information, and interaction in society and its individuals “requires new tools for measuring phenomena previously believed unmeasurable, as well as conceptual frameworks for interpreting such measurements…considering both happiness and misery.” The task is difficult, however, due to the great span of parameters and variables of age and gender, settings, socioeconomic conditions, wellness and illness, activities and functions, roles and habits, thoughts and feelings, and experiences and expectations involved over the panorama. HealthOmeter is a clinically tested and validated instrument with design and capacity in distinct coherent chapters to meet the new measurement and interpretation demands both contentwise and operationwise. Over the range of subjective and objective health it enables, in a uniform normalized layout in quintile balance between positive and negative, an all-round self-assessment and counsel in multimedia, preferably computer/mobile app distribution including storage, collation, and follow-up in full integrity and secrecy on the individual and aggregated level.
Minayo, Maria Cecília de Souza
This article debates the performance of the Collective Health Post-Graduation in the last 12 years. It is based on a wide evaluative research performed by a group of researches of the area, through a project financed by CNPq, during the years of 2008-2009. This proposal is a sequence of another study with the same importance that occurred among the years of 1994-1997 taking it in comparison. The investigation realized in 2008-2009 analyzed the field construction, the demand, and the alumnus, the teaching staff profile, the scientific production and the internationalization of the area. There was field work and the utilization of secondary sources, mainly from Cadernos CAPES. The study showed a field that is in growing organization and powerful on the point of view of the demand, the number of masters and PhDs being titled, the content adequacy and the teaching staff as well as the scientific production. Among the persistent problems are: the high concentration of programs in the southeast region, the difference in quality among them, the difficult to absorption of the number of titled and the erratic investment in international cooperation. The Collective Health Post-Graduation is increasingly more oriented to the improvement of SUS. PMID:20694311
Armstrong, F. Daniel; Kemper, Alex R.; Skinner, Debra; Warren, Steven F.
Objective As technology advances, newborn screening will be possible for conditions not screened today. With an expansion of screening, strategies will be needed to support family adaptation to unexpected and possibly uncertain genetic information provided shortly after birth. Method Although candidate conditions for expanded newborn screening will typically be associated with increased morbidity or mortality, for most there is no proven medical treatment that must be implemented quickly. Many will have clinical features that gradually emerge and for which the severity of impact is not predictable. Parents will seek guidance on information, support, and treatment possibilities. This article summarizes issues evoked by expanded newborn screening and suggests strategies for supporting families of identified children. Results We propose four components necessary to support family adaptation to pre-symptomatic and “untreatable” conditions in an era of expanded newborn screening: (1) accurate and understandable information; (2) formal and informal support; (3) active surveillance; and (4) general and targeted interventions. We argue that no condition is “untreatable” and that a well-designed program of prevention and support has the potential to maximize benefit and minimize harm. Conclusions Pediatric psychologists can play important roles in an era of expanded newborn screening by helping families understand genetic information, make informed decisions about genetic testing, and cope with the potential psychosocial consequences of genetic information. PMID:18378512
Graham-Pedersen, Maya; Olesen, Hanne Vebert; Højte, Christine;
Objectives Denmark has a highly developed fully government funded health system and centralised high standard CF care. However, newborn screening (NBS) for CF is not implemented. We describe the results of this lack of early diagnosis. Methods Patients diagnosed with CF in 2010–2014 were reviewed...... bronchiectasis and infection. NBS would prevent malnutrition in the majority of cases and would allow treatment to prevent chronic lung damage....
Full Text Available An urgent priority in maternal, newborn and child health is to accelerate the scale–up of cost–effective essential interventions, especially during labor, the immediate postnatal period and for the treatment of serious infectious diseases and acute malnutrition. Tracking intervention coverage is a key activity to support scale– up and in this paper we examine priorities in coverage measurement, distinguishing between essential interventions that can be measured now and those that require methodological development.
Pedersen, Marie; Basaga??a Flores, Xavier; Cirach, Marta; Sunyer Deu, Jordi; Nieuwenhuijsen, Mark J.; Kogevinas, Manolis; Slama, R??my
BACKGROUND: The health effects of suspended particulate matter (PM) may depend on its chemical composition. Associations between maternal exposure to chemical constituents of PM and newborn's size have been little examined. OBJECTIVE: We aimed to investigate the associations of exposure to elemental constituents of PM with term low birth weight (LBW; weight < 2,500 g among births after 37 weeks of gestation), mean birth weight, and head circumference, relying on standardized fine-scale exposu...
Background: Neonatal sepsis is an important cause of morbidity and mortality in India. Neonatal health programmes such as the Essential Newborn Care Package focus on preventative and curative care for the reduction of neonatal sepsis. However, neonates continue to die as a consequence of sepsis, many of which deaths are preventable. This critical review examines the factors that impact on neonatal sepsis and evaluates the effectiveness of this package aimed at preventing neonatal death....
Lee, C. K.; Stockler, M R; Coates, A. S.; Gebski, V.; Lord, S J; Simes, R J
Background: Baseline health-related quality of life (QL) is associated with survival in advanced breast cancer. We sought to identify patients who were less likely to respond to chemotherapy and at greater risk of toxicity on the basis of their QL. Methods: We used data from three advanced breast cancer trials in which patients (n=378) were treated with cyclophosphamide, methotrexate and 5-fluouracil. Patients self-rated their QL using LASA scales for physical well-being (PWB), mood, pain, na...
Soares A.; Karapurkar S; Suresh S.
This report details the management of a newborn with nesidioblastosis who underwent a 95% pancreatectomy under general anaesthesia. The baby presented with hypoglycemic convulsions, due to hyperinsulinism, and was treated with 12.5% dextrose infusions, glucagon and anticonvulsants. Intraoperatively and postoperatively the baby remained hyperglycemic. A postoperative osmotic diuresis necessitated the use of insulin for brief period. The infant remained euglycemic and convulsion f...
Spasojević Slobodan; Stojanović Vesna; Savić Radojica; Doronjski Aleksandra
Intracranial hemorrhage remains an important factor of premature newborns’ morbidity. Its incidence is significantly influenced by adequate perinatal care and safe neonatal transport. Risk factors for the development of intracranial hemorrhage in premature newborns after neonatal transport were analyzed in the retrospective transversal clinical study. Out of 150 study subjects, 60% (n=90/150) had intracranial hemorrhage with a statistically significant difference in relation to Apgar sc...
Gray, Peter B; Reece, Jody-Ann; Coore-Desai, Charlene; Dinnall-Johnson, Twana; Pellington, Sydonnie; Samms-Vaughan, Maureen
Background While a growing body of research has addressed pregnancy and postpartum impacts on female sexuality, relatively little work has been focused upon men. A few studies suggest that a fraction of men report decreases in libido during a partner’s pregnancy and/or postpartum, with alterations in men’s sexual behavior also commonly aligning with those of a partner. Here, we investigate sexuality among fathers of newborn children in Jamaica. In Jamaica, as elsewhere in the Caribbean, relat...