Lampel, Heather P; Jacob, Sharon E
The systemic toxicity of phthalates has been extensively reported. Although rarely sensitizing, phthalates have been implicated in promoting the development of both atopy and contact dermatitis in animal models. Dermal absorption of phthalates may contribute to overall chemical burden. Infants may be particularly susceptible to chemical exposures. Baby skin care products may be a significant source of phthalate exposure. We measured the phthalate content of 30 skin care products intended for babies and children. Nineteen leave-on and 11 wash-off baby skin care products were analyzed for 17 unique phthalates by an independent laboratory using standard gas chromatographic mass spectrometry. Of 30 products tested, four had phthalate levels above the reporting limit (0.1-0.5 ppm); of these, only one had levels above 1 ppm (44 ppm). There was no statistical significance of phthalate detection in leave-on versus wash-off products (p = .578). The majority (26 of 30) of the baby skin care products analyzed did not have detectable phthalate levels. Four products had detectable phthalate levels. In baby skin care products, levels of the 17 phthalates tested are low overall, but occasional products may contain higher phthalate levels. Monitoring products to ensure safety standards are met may be warranted.
Mukasa, G K
The author's visit to "kangaroo care" programs in Guatemala and Colombia has led Uganda's University of Kampala to consider the introduction of this innovation in its neonatal special care unit. Such programs, which place premature infants in direct contact with their mother's skin during breastfeeding, represents a simple, inexpensive strategy for infant survival in developing countries and eliminates the need for mechanical incubators. Research conducted at the Hospital Universitario de Valle in Cali, Colombia, found that falls in the infant's body temperature. In the Latin American programs, premature infants are entered into the breastfeeding program immediately after delivery.
This paper presents the successful management of 750 grammes low birth weight baby using kangaroo mother care in the hospital and at home. The baby had suffered a variety of morbidities associated with prematurity in the early neonatal period. Key words: Kangaroo mother care, low birth weight babies ...
José Elías García Sánchez
Full Text Available The worst misfortune that can befall an old, tormented and fearful boxing trainer is that the pupil he is training and of whom he is very fond should have a lesion as serious as a quadriplegia. This is the crux of the plot in Million Dollar Baby. A person who suffers a quadriplegia sees how most of her physical and sensorial abilities disappear and habitually suffers psychological disturbances requiring palliative medical care. Relatives are subjected to great stress and suffering. All these aspects are reflected, in general accurately, in the film.
Guberman, Nancy; Lavoie, Jean-Pierre; Blein, Laure; Olazabal, Ignace
Purpose: Many Baby Boomers are faced with the care of aging parents, as well as that of disabled or ill spouses or children. This study examines how Baby Boomers in Quebec, Canada, perceive and play their role as caregivers and how this might differ from their parents' generation. Design and methods: This was a qualitative and empirical study…
Lígia Ebner Melchiori; Zélia Maria Mendes Biasoli Alves
The purpose of this study is to explore the views of day care center educators on how they act when babies cry, if they are able to identify the causes of crying and what are the subjection reasons that make them take action or not. Twenty-one caretakers were interviewed about each of the ninety babies, aged 4 to 24 months, under their care, using a semi-structured guide. The results show that overall the proportion of babies that do not cry significantly increases with age. However, crying f...
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Lígia Ebner Melchiori
Full Text Available The purpose of this study is to explore the views of day care center educators on how they act when babies cry, if they are able to identify the causes of crying and what are the subjection reasons that make them take action or not. Twenty-one caretakers were interviewed about each of the ninety babies, aged 4 to 24 months, under their care, using a semi-structured guide. The results show that overall the proportion of babies that do not cry significantly increases with age. However, crying for primary needs, in the view of the educators, tends to decrease as the average age increases, whilst crying for secondary needs tends to increase. Most of the time, the educators try to eliminate the needs that provoke crying, giving priority to the baby’s welfare. The article discusses the caretakers’ educative practices with data found in literature. Keywords: day care; educative practices; educators.
Full Text Available ... fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for your baby Feeding your ... fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for your baby Feeding your ...
As part of a supplement entitled "Born Too Soon", this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care. We outline a series of packages of care that build on essential care for every newborn comprising support for immediate and exclusive breastfeeding, thermal care, and hygienic cord and skin care. For babies who do not breathe at birth, rapid neonatal resuscitation is crucial. Extra care for small babies, including Kangaroo Mother Care, and feeding support, can halve mortality in babies weighing Neonatal intensive care units in high income settings are de-intensifying care, for example increasing use of continuous positive airway pressure (CPAP) and this makes comprehensive preterm care more transferable. For health systems in low and middle income settings with increasing facility births, district hospitals are the key frontier for improving obstetric and neonatal care, and some large scale programmes now include specific newborn care strategies. However there are still around 50 million births outside facilities, hence home visits for mothers and newborns, as well as women's groups are crucial for reaching these families, often the poorest. A fundamental challenge is improving programmatic tracking data for coverage and quality, and measuring disability-free survival. The power of parent's voices has been important in high-income countries in bringing attention to preterm newborns, but is still missing from the most affected countries. Declaration This article is part of a supplement jointly funded by Save the Children
Jönson, Håkan; Jönsson, Anders
The aim of the study was to investigate media presentations of baby boomers as future care users. The Swedish baby boomer generation, born in the 1940s, and known as the '40s generation, has been characterized as youthful and powerful, and a question investigated in the study was whether boomers are supposed to display these characteristics as care users. We analyzed 481 articles in Swedish newspapers, published between 1995 and 2012, with a qualitative content analysis. The results showed that the '40s generation was predicted to become a new breed of demanding, self-aware care users. These claims were supported by descriptions of the formative events and typical characteristics of these individuals, which were then projected onto their future behavior as care users. Such projections tended to portray contemporary care users as passive, submissive, and partly responsible for problems associated with elder care. Consequently, approaches that focus on differences between cohorts need to incorporate a constructionist dimension to highlight the problem of generationism. Copyright © 2015 Elsevier Inc. All rights reserved.
... baby's progress? Is wi-fi access available for smartphones and other devices? Can we use our cellphones ... you also want to allow periods of undisturbed sleep. Let your baby set the pace for your ...
Coret, Catherine D; Suero, Michael B; Tierney, Neena K
Catherine D Coret, Michael B Suero, Neena K Tierney Johnson & Johnson Consumer Companies, Inc, Skillman, NJ, USA Purpose: To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Materials and methods: Healthy, full-term infants and toddlers aged 1–36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30), a lightly fragranced natural baby shampoo (n=30), or a lightly...
Zhu, Xiaomeng; Wang, Xu
The main purpose of this study was to find out suitable marketing strategy for our online shop which is named Baby Care selling baby products mainly. As ‘E-Commerce’ calls growing rapidly in China, online shops pattern is slowly recognized and accepted by consumers. Baby products’ marketing also becomes more and more popular and competitive. Today our online shop with traditional retailers is not only to partake in network counterparts, but also, it occupies a place to implement. Thus we need...
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Salera-Vieira, Jean; Zembo, Cynthia T
The protection that breast-feeding affords both mother and infant against acute and chronic illness is well documented. The grassroots, public health, and governmental supports for breast-feeding have influenced changes in maternal and newborn care. History indicates that the additional influence has come in the form of governmental workshops and initiatives, professional organizations, as well as The Joint Commission. This includes the influence that the Baby-Friendly® Hospital Initiative and the Ten Steps to Successful Breastfeeding have had on infant care throughout the years. The requirements that hospitals must follow to implement all, or some, of the Ten Steps lead to change in care that not only increases breast-feeding rates but also leads to health improvements. This article reviews how an upward trend in the adoption of Baby-Friendly practices to support breast-feeding impacts infant care.
Srinivasan, Mythili; Hamvas, Corrine; Coplen, Douglas
To determine rates of complications after newborn circumcision by performing a retrospective chart review of patients circumcised at a well-baby nursery, neonatal intensive care units (NICU), and special care nursery (SCN) from 2007 to 2012. A total of 5129 babies (73%) were circumcised at the well-baby nursery and 1909 babies (27%) at the NICU and SCN. Forty-seven patients (0.67%, 95% CI 0.49% to 0.89%) had circumcision-related complications: 5 (0.07%) patients with acute and 42 (0.6%) with late complications. Babies in the NICU/SCN had increased odds of complication (OR 4.00, 95% CI 2.23 to 7.19) compared with those in well-baby nursery. There were increased odds of complications in babies with Caucasian ethnicity (OR 2.60, 95% CI 1.48 to 4.89) compared with African American babies and in babies with private insurance (OR 4.0, 95% CI 2.1 to 7.5) compared with nonprivate insurance. The rates of complications after newborn circumcisions were low. Babies in the NICU/SCN had increased odds of complication. © The Author(s) 2015.
Faulkner, K.; Barry, J.L.; Smalley, P.
The skin entrance dose to neonates on a special care baby unit was estimated from a knowledge of the technique factors, X-ray tube output and backscatter factors. Normalized organ dose data were employed to estimate radiation dose to a number of critical organs. Methods of reducing radiation dose to neonates were investigated. Initially, this involved changing the radiographic technique factors and introducing a lead rubber adjustable collimator, placed on top of the incubator, in addition to light beam diaphragms on the X-ray tube. These modifications to the examination technique appeared to reduce average entrance dose per radiograph from 92 μGy, to 58 μGy, a reduction of 37%. Later, a rare-earth film-screen combination was introduced to replace existing fast calcium tungstate screens. This enabled average entrance dose per radiograph to be reduced to 39 μGy, a further reduction of 33%. The mean radiation dose to a neonate is mainly determined by the number of radiographs. (author)
Faulkner, K.; Barry, J.L.; Smalley, P.
The skin entrance dose to neonates on a special care baby unit was estimated from a knowledge of the technique factors, X-ray tube output and backscatter factors. Normalized organ dose data were employed to estimate radiation dose to a number of critical organs. Methods of reducing radiation dose to neonates were investigated. Initially, this involved changing the radiographic technique factors and introducing a lead rubber adjustable collimator, placed on top of the incubator, in addition to light beam diaphragms on the X-ray tube. These modifications to the examination technique appeared to reduce average entrance dose per radiograph from 92 ..mu..Gy, to 58 ..mu..Gy, a reduction of 37%. Later, a rare-earth film-screen combination was introduced to replace existing fast calcium tungstate screens. This enabled average entrance dose per radiograph to be reduced to 39 ..mu..Gy, a further reduction of 33%. The mean radiation dose to a neonate is mainly determined by the number of radiographs.
FOR THE DENTAL PATIENT ... From baby bottle to cup Choose training cups carefully, use them temporarily T ooth decay can ... should encourage their children to drink from a cup by their first birthday. As you make the ...
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Lim, Teresa; Schumacher, Rachel
State child care policies can promote the quality and continuity of early childhood experiences and foster the healthy growth and development of babies and toddlers in all child care settings, especially if they are informed by research. The quality of the relationship between children and those who care for them influences every aspect of young…
Davey, Janet; King, Chloe; Fitzpatrick, Mary
Marketers have been slow to customize their strategies for the influential consumer segment of aging baby boomers. This qualitative research provides insights on New Zealand baby boomers' perceptions of glasses as a health care product. Appearance was a dominant theme; status was not a major concern, although style and fashion were. Wearing glasses had negative associations related to aging; however, both male and female participants recognized that glasses offered improved quality of life. Data relating to the theme of expense indicated that these New Zealand baby boomers made sophisticated perceptual associations and subsequent pragmatic trade-offs between price, quality, and style.
Cooke, Alison; Bedwell, Carol; Campbell, Malcolm; McGowan, Linda; Ersser, Steven J; Lavender, Tina
to identify what skin practices are important for the protection of baby skin in healthy term babies (0-6 months) and generate evidence-based conclusions to inform health professionals and parents. eleven databases were searched for all empirical quantitative and qualitative research published between 2000-2015 which explored baby skin care for bathing and cleansing, nappy care, hair and scalp care, management of dry skin or baby massage, for healthy term babies up to 6 months old. Papers not published in English were excluded. A total of 3062 papers were identified. Pairs of reviewers assessed all citations and extracted data independently. There were 26 included papers: 16 RCTs, 3 non-randomised experimental studies, 1 mixed-methods study and 6 qualitative studies. Primary and secondary outcome measures were analysed using meta-analysis or narrative descriptive statistics. Synthesis of qualitative data was not possible due to disparity of the evidence. from the small numbers of studies with comparable data, there was no evidence of any significant differences between tested wash products and water or tested baby wipes and water. There was some evidence to suggest that daily use of full-body emollient therapy may help to reduce the risk of atopic eczema in high risk babies with a genetic predisposition to eczema; however, the use of olive oil or sunflower oil for baby dry skin may adversely affect skin barrier function. There was no evidence about hair/scalp care or baby massage. Qualitative research indicates that parents and health professionals believe that water alone is best. meta-analysis was restricted due to the lack of consistency of study outcome measures. Although there is considerable RCT evidence comparing the use of specific products against water alone, or another product, for bathing, cleansing and nappy care, the power of this evidence is reduced due to inconsistency of outcome measures in terms of outcome, treatment site or time-point. The
Luegmair, Karolina; Zenzmaier, Christoph; Oblasser, Claudia; König-Bachmann, Martina
to evaluate women's satisfaction with care at the birthplace in Austria and to provide reference data for cross-country comparisons within the international Babies Born Better project. a cross-sectional design was applied. The data were extracted from the Babies Born Better survey as a national sub-dataset that included all participants with Austria as the indicated country of residence. an online survey targeting women who had given birth within the last five years and distributed primarily via social media. In addition to sociodemographic and closed-ended questions regarding pregnancy and the childbirth environment, the women's childbirth experiences and satisfaction with the birthplace were obtained with three open-ended questions regarding (i) best experience of care, (ii) required changes in care and (iii) honest description of the experienced care. five hundred thirty-nine women who had given birth in Austria within the last five years. based on the concepts of public health, salutogenesis and self-efficacy, a deductive coding framework was developed and applied to analyse the qualitative data of the Babies Born Better survey. Regarding honest descriptions of the experienced care at the birthplace, 82% were positive, indicating that most of the respondents were mostly satisfied with the care experienced. More than 95% of the survey participants' positive experiences and more than 87% of their negative experiences with care could be assigned to the categories of the deductive coding framework. Whereas positive experiences mainly addressed care experienced at the individual level, negative experiences more frequently related to issues of the existing infrastructure, breastfeeding counselling or topics not covered by the coding framework. Evaluation of these unassigned responses revealed an emphasis on antenatal and puerperal care as well as insufficient reimbursements of expenses by health insurance funds and the desire for more midwifery-led care. although the
Galzote, Carlos; Thomas, Mini; Sachdev, Mukta
Ethnic differences in skin sensitivity suggest that greater emphasis be focused on understanding a product's effect in diverse populations. The irritation and/or sensitization potential of 8 baby skin care products in Indian adults were evaluated using cumulative irritation tests (CIT) and human repeat insult patch testing (HRIPT) protocols. Healthy males or females aged 18 to 65 years of Indian ethnicity were treated with each of 6 products (cream, hair oil, lotion, body wash, shampoo, and baby soap) using CIT (n = 25) and HRIPT (n = 200). Baby powder and baby oil were evaluated by CIT (n = 25) and HRIPT (n = 107) in separate studies. CITs were conducted over 14 days; HRIPTs were conducted over 10 weeks. In both CIT and HRIPT, most products were considered mild, with no irritation. Baby soap and powder elicited reactions in the HRIPT induction phase, with positive challenge phase reactions (3 subjects), but were affirmed to be nonallergenic in the rechallenge phase. In these studies, 8 baby skin care products were evaluated by both CIT and HRIPT in Indian adults. The results of the studies indicated that all of the tested products were nonallergenic and nonirritating. J Drugs Dermatol. 2016;15(10):1244-1248.
Minnesota Univ., Minneapolis. Fairview Health Services.
Prepared by the Maternal and Newborn Services staff at a health care system affiliated with the University of Minnesota, this book is designed as several resources in one, encompassing pregnancy, childbirth, infant care, child development, baby keepsakes, medical records, and journal-keeping. The book provides authoritative, up-to-date information…
Lim, Teresa; Schumacher, Rachel
State child care policies--including licensing, subsidy, and quality enhancement strategies--can promote the quality and continuity of early childhood experiences and foster the healthy growth and development of babies and toddlers in child care settings, especially if they are informed by research. One of the policy levers states may use to…
Full Text Available ... Baby Caring for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & ... health research Prematurity research centers For providers NICU Family Support® Prematurity Campaign Collaborative Info for your patients ...
Newborn care - baby supplies ... wintertime. Mobile. This can entertain and distract a baby who is fussy or is having a hard ... rainfall). These sounds can be soothing for the baby and can help him sleep.
Full Text Available ... questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your baby E- ... We're working to radically improve the health care they receive. We're pioneering research to find ...
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Coret, Catherine D; Suero, Michael B; Tierney, Neena K
To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Healthy, full-term infants and toddlers aged 1-36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30), a lightly fragranced natural baby shampoo (n=30), or a lightly fragranced natural baby lotion (n=32) were assessed over 2 weeks. In study 2, a lightly fragranced natural baby hair and body wash and a lightly fragranced natural baby lotion (n=33) were assessed as a regimen over 4 weeks. The wash and shampoo were used three or more times per week, but not more than once daily. Lotions were applied in the morning or after a bath. Clinicians assessed the arms, legs, torso, or scalp for erythema, dryness, peeling/flakiness (study 1 only), tactile roughness, edema (study 1 only), rash/irritation (study 2 only), and overall skin condition (study 2 only) at baseline, week 1, and weeks 2 or 4. Parents completed skin assessment questionnaires. In study 2, stratum corneum hydration was measured. Subjects were monitored for adverse events. No significant changes in clinical grading scores were observed, indicating that all products were well tolerated. By the end of each study, >90% of parents/caregivers believed each product was mild and gentle. In study 2, improvement in stratum corneum hydration was observed (+37% at week 1 and +48% at week 4, Pproduct-related adverse events. The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen.
van den Berg, Angarath; Boere-Boonekamp, Magdalena M.; IJzerman, Maarten Joost; Haasnoot-Smallegange, Riet M.E.; Reijneveld, Sijmen A.
Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for
This paper therefore, examines the roles of Yoruba health related songs on pregnancy, labour, delivery and baby care during the health literacy classes in selected hospitals in southwestern Nigeria. Interviews, participant observation, cultural history and lyrical analysis of the recorded songs during such training were done.
There is little or no report of preterm (babies born less than 37 completed weeks of gestation) admission from this part of Sahel Savannah of Nigeria. This study of four-year period is presented to identify areas that require improvement, such as in the Labour ward and neonatal care. The case files of the 428 preterm ...
van der Zee-van den Berg, Angarath I.; Boere-Boonekamp, Magda M.; IJzerman, Maarten J; Haasnoot-Smallegange, Riet M. E.; Reijneveld, Sijmen A.
Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for
Gao, Xiang; Simpson, Eric L
Although the U.S. pediatric skin care market is a $1.7 billion industry, little is known regarding the usage pattern of skin care products in very young children. We have begun to recognize that common over-the-counter skin care products may have positive or negative effects on skin barrier function. Thus, knowing what and how skin care products are used early in life is important. The goal of the current study was to better understand skin care product use in the United States using market research data. We found that the prevalence of use was greater than 50% for all skin care product categories and age groups. Premoistened cleansing wipes and cloths were the most frequently used product, followed by baby oil and lotion and body and baby powder. Baby bath and shampoo products were used at least five times per week per household, and caregivers generally preferred products that were fragrance-free and made for sensitive skin. Lower-income households reported a higher frequency of product use and were less likely to purchase fragrance-free products or ones that were made for sensitive skin. Our findings suggest that the prevalence of pediatric skin care product use is high and conflicts with current recommended skin care guidelines. Product use and preferences may also vary according to race and ethnicity and household income level. © 2014 Wiley Periodicals, Inc.
Full Text Available ... The Prematurity Campaign About us Annual report Our work Community impact Global programs Research Need help? Frequently ... Nutrition, weight & fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for your baby ...
Ireland, Susan; Ray, Robin; Larkins, Sarah; Woodward, Lynn
Survival at extreme prematurity is becoming increasingly common. Neurodisability is an increasing risk with decreasing gestation. This review outlines the risks of extreme prematurity and the attitudes of health care providers and families in Australia of periviable babies. High quality data is difficult to find due to differing definitions and methods of assessment of disability. Meta-analyses of outcomes of prematurity published from 2008 to 2013, including babies born from 1990 onwards, suggest a severe disability rate of around 20 % at 22 to 26 weeks completed gestation, with moderate disability decreasing with increasing gestation. Studies show that Australian health care providers underestimate the survival and positive outcomes of these babies. The majority of Australian health care providers state that parental preference would determine the decision to offer care to babies at 23 weeks gestation, however, all had a threshold above which parental preference would be ignored in favour of resuscitation .This ranged from 22 to 27 completed weeks gestation. The few studies examining Australian parental involvement in resuscitation decisions, showed that the majority of parents felt that health professionals alone had made the decision to resuscitate their extremely preterm babies and the parents themselves did not wish to be the primary decision makers in withholding care. The babies progressed better than parents had expected following antenatal counselling. The attitudes of health care providers, experiences and opinions of parents seem to be at odds with the current move to increase parental decision making at the most extremes of gestation. Current Australian guidelines suggest parental decision making below 25 weeks gestation, and primarily clinician decision making over this gestation. The increased risks of prematurity and adverse outcomes for the North Queensland population is also explored. This population has a high proportion of Aboriginal and
Lee, Eunyoung; Yun, Jongbok; Ha, Jaehyoun; Park, Byung Cheol; Park, Gyeong Hun; Kim, Hak Rim; Hong, Seung Phil; Kim, Kyu Bong; Kim, Myung Hwa
Assessment of exposure to cosmetic products via the skin is important for evaluating the risks associated with the use of these products. However, few exposure studies have been conducted with babies, particularly in Asia. The aim of our study was to assess the exposure to selected cosmetic products in babies under the age of 36 months, over both winter and summer months. We evaluated exposure for seven cosmetic baby care products identified in a previous web-based survey as being commonly used by Korean parents. Parents were instructed to use their baby's products as per their usual habit, recording usage for each product on a daily basis over a 14-day period. Products were weighed at the start and completion of the study, with the change in weight used to determine the total amount of product used. Descriptive statistics for daily exposure were calculated. In this study, daily exposure for different products was influenced by sex, age groups and seasons. Of specific note, 3.51% of the lotion in a wet wipe was transferred to the skin. In conclusion, we provide baseline exposure data for baby products, with exposure being based on parents' usual use of the products. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Catherine D Coret, Michael B Suero, Neena K Tierney Johnson & Johnson Consumer Companies, Inc, Skillman, NJ, USA Purpose: To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Materials and methods: Healthy, full-term infants and toddlers aged 1–36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30, a lightly fragranced natural baby shampoo (n=30, or a lightly fragranced natural baby lotion (n=32 were assessed over 2 weeks. In study 2, a lightly fragranced natural baby hair and body wash and a lightly fragranced natural baby lotion (n=33 were assessed as a regimen over 4 weeks. The wash and shampoo were used three or more times per week, but not more than once daily. Lotions were applied in the morning or after a bath. Clinicians assessed the arms, legs, torso, or scalp for erythema, dryness, peeling/flakiness (study 1 only, tactile roughness, edema (study 1 only, rash/irritation (study 2 only, and overall skin condition (study 2 only at baseline, week 1, and weeks 2 or 4. Parents completed skin assessment questionnaires. In study 2, stratum corneum hydration was measured. Subjects were monitored for adverse events. Results: No significant changes in clinical grading scores were observed, indicating that all products were well tolerated. By the end of each study, >90% of parents/caregivers believed each product was mild and gentle. In study 2, improvement in stratum corneum hydration was observed (+37% at week 1 and +48% at week 4, P<0.05 for both. In study 1, one baby experienced mild erythema on the neck and scalp after using the shampoo (possibly related to treatment. In study 2, there were no product-related adverse events. Conclusion: The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen. Keywords: bath, cleanser, natural, infant, lotion, shampoo
Hamman, Mary Kathryn
The American Academy of Pediatrics recommends children receive six well-baby visits between ages 1 month and 1 year, yet by age 14 months less than 10% of infants have received all six visits. Cost sharing under public and private insurance is very low. Low compliance rates despite the low cost of care suggest other factors, such as time costs, may be important. This paper examines the relationship between maternal employment and receipt of well-baby care. The Medical Expenditure Panel Survey contains rich information on use of preventive care, maternal employment, and other economic and non-economic factors that may influence care decisions. Several approaches, including a proxy variable strategy and instrumental variables analysis, are used to attempt to address the potential endogeneity of maternal employment and examine the sensitivity of findings. Findings indicate mothers who work full-time take their children to 0.18 fewer visits (or 9% fewer at the mean) than those who have quit their jobs. Mothers with employer provided paid vacation leave take their children to 0.20 more visits (or 9% more at the mean) than other working mothers. Time appears to be an important factor in determining well-baby care receipt. Policies that extend paid leave to more employed women may improve compliance with preventive care recommendations.
Full Text Available We developed a method for pattern recognition of baby's emotions (discomfortable, hungry, or sleepy expressed in the baby's cries. A 32-dimensional fast Fourier transform is performed for sound form clips, detected by our reported method and used as training data. The power of the sound form judged as a silent region is subtracted from each power of the frequency element. The power of each frequency element after the subtraction is treated as one of the elements of the feature vector. We perform principal component analysis (PCA for the feature vectors of the training data. The emotion of the baby is recognized by the nearest neighbor criterion applied to the feature vector obtained from the test data of sound form clips after projecting the feature vector on the PCA space from the training data. Then, the emotion with the highest frequency among the recognition results for a sound form clip is judged as the emotion expressed by the baby's cry. We successfully applied the proposed method to pattern recognition of baby's emotions. The present investigation concerns the first stage of the development of a robotics baby caregiver that has the ability to detect baby's emotions. In this first stage, we have developed a method for detecting baby's emotions. We expect that the proposed method could be used in robots that can help take care of babies.
Thierry-Chef, I.; Maccia, C.; Thierry-Chef, I.; Laurier, D.; Tirmarche, M.; Costil, J.
Purpose. Because of frequent radiological investigations performed in 1 neonatal intensive care unit, a dosimetry study was carried out to assess the level of doses received by premature babies. Materials and methods. In vivo measurements were performed and effective doses were evaluated for single radiographs. Individual cumulative doses received over the period of stay were then estimated, for each premature baby entering the intensive care unit in 2002, taking into account the number of radiographs they underwent. Results. On average, babies stayed for a week and more than one radio-graph was taken per day. Results showed that, even if average doses per radiograph were relatively low (25μSv), cumulative doses strongly depended on the length of stay, and can reach a few mSv. Conclusion. Even if doses per radiograph are in agreement with European recommendations, optimisation of doses is particularly important because premature babies are more sensitive to radiation than adults and because they usually undergo further radiological examinations in other services. On the basis of the results of this dosimetry study, the implementation of a larger study is being discussed. (author)
A review of all preterm admissions into the Special Care Bay Unit of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, over a period of 29 months (May 1998 October 2000) was carried out. Out of a total of 699 neonatal admissions, 133 (19 percent) were preterms with gestational ages ranging from 24 to ...
Benoit, Britney; Semenic, Sonia
To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). Qualitative, descriptive design. Two university-affiliated level-III NICUs in Canada. A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Regina Helena Vitale Torkomian Joaquim
Full Text Available Introduction: This study approaches the process of teaching-learning of a group of occupational therapy students to act in the care of mothers of babies at risk in the hospital context. It is linked to a community project, supported by the ‘Programa de Extensao Universitaria’. Objective: It aimed to qualify the students for understanding the risk rising, the initial mother-baby bond in the hospital environment, the monitoring of the child development and troubleshooting, as well as to see themselves as subjects of their own training. Method: Participants were six students, three teachers, 26 mothers and their 28 babies. The procedures had been developed in three articulated axles: practice, theoretical basis and invitation to reflection, each axle guided by one of three teachers. There were 65 meetings; 27 of the group of mothers, 11 of the group for theoretical overviews and 27 of the reflection group. Six students have completed their participation in the study, having achieved qualification for the care of occupational therapy to mothers of babies at risk during hospitalization and at home after discharge, as well as the co-responsibility with people and served family. All 26 mothers received care in the nursery; 25 of them in addition to the nursery, were treated at mothers group and 6 in addition to the nursery and the group, were visited at home. Conclusion: This study made it possible to contemplate two subjects with the same priority: the mother and her baby, as subjects of the attention and care of an occupational therapist and the student, as the subject of the attention and care of the teacher of occupational therapy.
Goouch, Kathleen; Powell, Sacha
This article has emerged from a research and development project, The Baby Room, which was designed to examine how babies are cared for in daycare settings. Within the project, a form of professional development was created which designated a central space for dialogic encounter, primarily to enable the baby room practitioners who participated in…
Purnendu Kumar Singh
Full Text Available Kangaroo Mother Care (KMC is a practical technique for nursing of low birth weight babies by direct skin to contact with the mother. This study was undertaken to observe and record the effect of KMC with focus on increase in weight of at term low birth weight (LBW babies weighing less than 2000 grams. The study was conducted over thirty six month’s period from July 2011 to June 2014. The method of care consisted of skin to skin contact between the mother and the infant along with exclusive breast milk. Upon implementation of KMC babies under observation showed satisfactory gain in weight of average 25grams per day and an average hospital stay of 10 days. KMC aims towards achieving good weight gain in LBW babies. It is a simple hassle free technique which can be implemented at all levels of health care.
Corry, Maureen P; Jolivet, Rima
When defined within the context of maternity care, the Institute of Medicine's six aims for health-care quality improvement provide a framework for Childbirth Connection's Maternity Quality Matters Initiative, a multipronged program agenda intended to foster a maternity care system that delivers care of the highest quality and value in order to achieve optimal health outcomes and experiences for mothers and babies. These aims also provide childbirth educators and others in the maternity care community with an ethical framework for efforts to serve childbearing women and families and ensure the best outcomes for women, babies, and families. PMID:19436596
Full Text Available Background: Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU, and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. Objectives: The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Method: Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Results: Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. Recommendations: Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. Conclusion: Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents’ relationships.
Steyn, Erika; Poggenpoel, Marie; Myburgh, Chris
Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU), and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents' relationships.
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Sgandurra, Giuseppina; Bartalena, Laura; Cecchi, Francesca
BACKGROUND: CareToy is an intelligent system, inspired by baby gyms, aimed to provide an intensive, individualized, home-based and family-centred early intervention (EI) program. AIMS: A pilot study was carried out to explore the feasibility of CareToy intervention in preterm infants, aged 3....... An adequately powered randomized clinical trial is warranted....
Purnendu Kumar Singh; Kumar Amritanshu; Bijoy Mukherjee
Kangaroo Mother Care (KMC) is a practical technique for nursing of low birth weight babies by direct skin to contact with the mother. This study was undertaken to observe and record the effect of KMC with focus on increase in weight of at term low birth weight (LBW) babies weighing less than 2000 grams. The study was conducted over thirty six month’s period from July 2011 to June 2014. The method of care consisted of skin to skin contact between the mother and the infant along ...
Full Text Available Aim: To evaluate traditional baby care practices employed by mothers in the Turkish province of Trabzon. Materials and methods: This descriptive study was planned around babies born in the provincial center of Trabzon between 1 June and 31 December, 2005, and aged 6-12 months at the time of the research. Data were collected in July-September 2006. In order to determine sampling size the prevalence of mothers using traditional practices was calculated at 50%, with a deviation of 0.05, giving a sample size of 384 mothers, the final number being put at 400. The study was performed at six clinics selected on the basis of settlement location and socioeconomic level out of 11 health clinics in the city center of the province of Trabzon. Data in the study are presented as numbers, and percentage distributions as mean±standard deviation. Results: It was determined that 69.8% of mothers breastfed their babies immediately and that 91.3% gave them colostrum. It was also determined that 3.7% of mothers resorted to various practices in order to ensure a male or female baby, 44.5% in order to facilitate labor, 25% in order to avoid puerperal fever, 63.5% in order eliminate postnatal pain, 88% to prevent their babies smelling, 86.2% for the shedding of the umbilical cord, 54.2% to protect their babies against jaundice, 73.7% to protect their babies from the evil eye, 26.2% so their babies would be good-looking and 40.7% to safely complete the first 40 days after childbirth. The main practices having a harmful effect on health in the study were swaddling, salting the baby, waiting for the call to prayer before breastfeeding the baby after birth and not giving colostrum. Conclusions: Traditions were observed to have an impact and to be persisting in child care in Trabzon. This suggests it will be useful for health personnel working in the field of infant care to evaluate the traditional characteristics in the locations where they work and to correct negative
Cacciatore, J; Erlandsson, Kerstin; Rådestad, Ingela
This study was designed to evaluate fathers' experiences of stillbirth and psychosocial care. Data were collected between 27 March 2008 and 1 April 2010 via a questionnaire posted on the homepage of the Swedish National Infant Foundation. The responses to the following open-ended questions were analyzed using content analysis: "Are you grateful today for anything that health care professionals did in connection with the birth of your child?" and "Are you sad, hurt or angry today about something personnel did in connection with the birth of your baby?". 113/131 (86%) fathers reported feelings of being grateful. Only 22/131 (16%) fathers reported feeling sad, hurt, or angry. Fathers expressed gratitude when health care professionals treated their newborn "with respect and without fear", "with extraordinary reverence", and when their fatherhood was validated by providers. They were also grateful when providers helped them to create memories of their baby. Fathers also reported feeling sad, hurt, or angry when providers were nonchalant and indifferent and when they perceived providers to be uncaring and disrespectful toward their baby. Bereaved fathers experience overall gratitude for person-centered psychosocial care in the aftermath of stillbirth, particularly when they feel validated as a grieving father and their child is acknowledged with reverence. Health care professionals should support fathers by treating the baby who died with respect and dignity and by validating and acknowledging both his grief experiences and his fatherhood just as they would for a grieving mother. Copyright © 2012 Elsevier Ltd. All rights reserved.
de Tychey, Claude; Vandelet, Elena; Laurent, Mélanie; Lighezzolo-Alnot, Joelle; Prudent, Cécile; Evrard, Renaud
The aim of this article is to present a French psychoanalytic model of how and to what extent the sequellae of sexual abuse by a male during a girl's childhood are transmitted to the next generation, as a function of the gender of the abused mother's children. The authors conducted a qualitative exploratory study based on the longitudinal follow-up of a woman who had two boys and a girl. They focused on the impact of two general sequellae: separation anxiety and negativity-disqualification of the paternal and/or male figures. From the methodological standpoint, they used a clinical interview to assess the mother, and a projective tool, a storytelling test, to assess the child's personality using content analysis. The results confirm both the merits of the theoretical framework and the relevance of the projective methodology for grasping sequellae transmitted to the child. The sequellae turned out to be markedly different for the two baby genders: rejection for the male, overprotection and ghostly encryption for the female. Avenues for using this tool and model in future quantitative, comparative studies are suggested.
Lai, Ya-Ling; Hung, Chich-Hsiu; Stocker, Joel; Chan, Te-Fu; Liu, Yi
This study compares women's postpartum fatigue, baby-care activities, and maternal-infant attachment following vaginal and cesarean births in rooming-in settings. Postpartum women admitted to baby-friendly hospitals are asked to stay with their babies 24 hours a day and to breastfeed on demand regardless of the type of childbirth. The study used a descriptive cross-sectional study design. A total of 120 postpartum women were recruited from two accredited baby-friendly hospitals in southern Taiwan. Three structured questionnaires were used to collect data, on which an analysis of covariance was conducted. Women who experienced a cesarean birth had higher postpartum fatigue scores than women who had given birth vaginally. Higher postpartum fatigue scores were correlated with greater difficulty in baby-care activities, which in turn resulted in weaker maternal-infant attachment as measured in the first 2 to 3 days postpartum. Hospitals should implement rooming-in in a more flexible way by taking women's postpartum fatigue and physical functioning into consideration. Copyright © 2014 Elsevier Inc. All rights reserved.
Chapple, C.-L.; Faulkner, K.
Neonates in a special care baby unit may receive a large number of X-rays and their dosimetry is of particular importance. A method of calculating energy imparted to neonates has been developed and a survey carried out in one unit, over a period of 18 months. Entrance dose was calculated from the technique factors used and measurement of tube output. Technique factors were recorded by the radiographer for each exposure taken, and output was measured both with and without an incubator present. Field size was determined by measurements made retrospectively from the radiograph, and a Monte Carlo simulation was used to determine factors for conversion to imparted energy. 119 neonates were included in the survey, and the mean total energy imparted was found to be 0.09 mJ. The maximum value was a factor of nine greater than this. The study also highlighted the potential for dose reduction with regard to better collimation and shielding. (author)
Fabiana Pinheiro Ramos
Full Text Available Abstract: Coping is defined by actions of self-regulation of emotions, cognitions, behaviors, and motivational orientation under stress. This study analyzed the maternal coping with hospitalization of premature and low birth weight infants at the Neonatal Intensive Care Unit (NICU, using the Motivational Theory of Coping. A questionnaire, a scale and an interview were applied to 25 mothers three times between birth and hospital discharge. The results showed that the mothers’ first visit to the NICU had strong emotional impact; longer hospitalization periods were linked to the decrease in Delegation coping strategies. There was more Support Seeking after the hospital discharge. Multiparous mothers and those who had a job appeared to be more vulnerable to stress. Predominantly adaptive coping responses were identified, even among two mothers whose babies had died, including Self-Reliance strategies, which were mediated by religious beliefs.
Chapple, C.-L.; Faulkner, K. (Newcastle General Hospital (United Kingdom). Regional Medical Physics Dept.); Hunter, E.W. (Royal Victoria Infirmary, Newcastle-upon-Tyne (United Kingdom))
Neonates in a special care baby unit may receive a large number of X-rays and their dosimetry is of particular importance. A method of calculating energy imparted to neonates has been developed and a survey carried out in one unit, over a period of 18 months. Entrance dose was calculated from the technique factors used and measurement of tube output. Technique factors were recorded by the radiographer for each exposure taken, and output was measured both with and without an incubator present. Field size was determined by measurements made retrospectively from the radiograph, and a Monte Carlo simulation was used to determine factors for conversion to imparted energy. 119 neonates were included in the survey, and the mean total energy imparted was found to be 0.09 mJ. The maximum value was a factor of nine greater than this. The study also highlighted the potential for dose reduction with regard to better collimation and shielding. (author).
Khalifian, S; Golden, W C; Cohen, B A
Skin provides several important homeostatic functions to the developing neonate. However, no consensus guidelines exist in the United States for skin care in the healthy term newborn. We performed a study of skin and umbilical cord care (including bathing practices, vernix removal and antiseptic cord application) in newborn nurseries and mother-baby units throughout the state of Maryland to determine practices in a variety of clinical settings and assess if uniformity in skin care exists. These data were then assessed in the context of a review of the current literature. We received responses from over 90% of nurseries across the state. In our cohort, practices varied widely between institutions and specific populations, and often were not evidence-based or were contrary to best practices discussed in the scientific literature. The frequent departures from evidence that occur regarding the aforementioned practices are likely due to a lack of consensus on these issues as well as limited data on such practices, further highlighting the need for data-driven guidelines on newborn skin care.
Machuca, Hildred; Arevalo, Sandra; Hackley, Barbara; Applebaum, Jo; Mishkin, Arielle; Heo, Moonseong; Shapiro, Alan
Nationally, approximately 24% of preschool children are overweight or obese, with low-income communities disproportionately affected. Few interventions to prevent obesity in children at greatest risk have demonstrated positive results. Therefore, we evaluated the effectiveness of a novel group well-child care intervention for primary obesity prevention at age 2 years. Well Baby Group (WBG) is an alternative to traditional well-child care offered at a federally qualified health center in the South Bronx. Facilitated by a pediatrician and nutritionist, WBG fosters positive dietary behaviors, responsive parenting and feeding practices, and peer support during the first 18 months of life. Multivariable logistic regression was conducted to test the effect of WBG on rates of overweight/obesity at 2 years (BMI-for-age ≥85th percentile) using a nonrandomized comparison group of children receiving traditional care at our center over the same period. Characteristics of mothers and infants were comparable between intervention (n = 47) and comparison (n = 140) groups. Children enrolled in WBG were significantly less likely to be overweight/obese at 2 years than children receiving traditional well-child care (2.1% vs. 15.0%; OR 0.12; 95% CI 0.02-0.94; p = 0.02). In multivariable regression analysis, WBG remained a significant independent protective factor (OR 0.12; 95% CI 0.02-0.93; p = 0.04), adjusting for birthweight and parity. WBG, a replicable model integrated into primary care visits, affords a unique opportunity to intervene consistently and early, providing families in at-risk communities with increased provider time, intensive education, and ongoing support. Further study of group well-child care for primary obesity prevention is warranted to confirm the effectiveness of the model.
Perez-Botella, Mercedes; Downe, Soo; Magistretti, Claudia Meier; Lindstrom, Bengt; Berg, Marie
Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of well-being as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision. The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women. A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to 1 year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (database inception--April 2011 and May 2011-February 2013). Included studies were subject to narrative analysis. Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky's theory. The remaining studies used discrete aspects of the theory. Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide. Copyright © 2014 Elsevier B.V. All rights reserved.
Callie A Scott
Full Text Available BACKGROUND: Zambia adopted Option A for prevention of mother-to-child transmission of HIV (PMTCT in 2010 and announced a move to Option B+ in 2013. We evaluated the uptake, outcomes, and costs of antenatal, well-baby, and PMTCT services under routine care conditions in Zambia after the adoption of Option A. METHODS: We enrolled 99 HIV-infected/HIV-exposed (index mother/baby pairs with a first antenatal visit in April-September 2011 at four study sites and 99 HIV-uninfected/HIV-unexposed (comparison mother/baby pairs matched on site, gestational age, and calendar month at first visit. Data on patient outcomes and resources utilized from the first antenatal visit through six months postpartum were extracted from site registers. Costs in 2011 USD were estimated from the provider's perspective. RESULTS: Index mothers presented for antenatal care at a mean 23.6 weeks gestation; 55% were considered to have initiated triple-drug antiretroviral therapy (ART based on information recorded in site registers. Six months postpartum, 62% of index and 30% of comparison mother/baby pairs were retained in care; 67% of index babies retained had an unknown HIV status. Comparison and index mother/baby pairs utilized fewer resources than under fully guideline-concordant care; index babies utilized more well-baby resources than comparison babies. The average cost per comparison pair retained in care six months postpartum was $52 for antenatal and well-baby services. The average cost per index pair retained was $88 for antenatal, well-baby, and PMTCT services and increased to $185 when costs of triple-drug ART services were included. CONCLUSIONS: HIV-infected mothers present to care late in pregnancy and many are lost to follow up by six months postpartum. HIV-exposed babies are more likely to remain in care and receive non-HIV, well-baby care than HIV-unexposed babies. Improving retention in care, guideline concordance, and moving to Option B+ will result in
Kamphuis, M.E.; Korfker, D.G.; Detmar, S.B.; Hindori, M.P.; Boere-Boonekamp, M.M.; Vondeling, H.; Hindori-Mohangoo, A.D.
Background: Every year approximately 10,000 babies are born in Suriname of which an estimated 400 die in the perinatal period. The main purpose of the Perisur project is to improve perinatal outcomes and improve under-five and maternal health. This study focused on introducing preconception care in
Alderdice, Fiona; Gargan, Phyl; McCall, Emma; Franck, Linda
Online resources are a source of information for parents of premature babies when their baby is discharged from hospital. To explore what topics parents deemed important after returning home from hospital with their premature baby and to evaluate the quality of existing websites that provide information for parents post-discharge. In stage 1, 23 parents living in Northern Ireland participated in three focus groups and shared their information and support needs following the discharge of their infant(s). In stage 2, a World Wide Web (WWW) search was conducted using Google, Yahoo and Bing search engines. Websites meeting pre-specified inclusion criteria were reviewed using two website assessment tools and by calculating a readability score. Website content was compared to the topics identified by parents in the focus groups. Five overarching topics were identified across the three focus groups: life at home after neonatal care, taking care of our family, taking care of our premature baby, baby's growth and development and help with getting support and advice. Twenty-nine sites were identified that met the systematic web search inclusion criteria. Fifteen (52%) covered all five topics identified by parents to some extent and 9 (31%) provided current, accurate and relevant information based on the assessment criteria. Parents reported the need for information and support post-discharge from hospital. This was not always available to them, and relevant online resources were of varying quality. Listening to parents needs and preferences can facilitate the development of high-quality, evidence-based, parent-centred resources. © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd.
Armpilia, C.I.; Fife, I.A.J.; Croasdale, P.L.
Radiographs are most commonly taken in the neonatal period to assist in the diagnosis and management of respiratory difficulties. Frequent accurate radiographic assessment is required and a knowledge of the radiation dose is necessary to make the justification of such exposures. A survey of radiation doses to neonates from diagnostic X-ray examinations (chest and abdomen) has been carried out in the special care baby unit (SCBU) of the Royal Free Hospital. Entrance surface dose (ESD) was calculated from Quality Control measurements on the X-ray set itself. Direct measurement of radiation doses was also performed using highly sensitive thermoluminescence dosimeters (LiF:Mg,Cu,P), calibrated and tested for consistency in sensitivity. The mean ESD per radiograph was calculated to be 36μGy (with a standard deviation of 6μGy), averaged over 95 X-ray examinations. The ESD's as derived from the TLD crystals, ranged from 18μGy to 60μGy. The mean energy imparted (EI) and the mean whole body dose per radiograph were estimated to be 14μJ and 10μGy respectively. Assuming that neonates and foetuses are equally susceptible to carcinogenic effects of radiation (it involves an overestimation of risk), the radiation risk of childhood cancer from a single radiograph was estimated to be of the order (0.3-1.3)x10 -6 . Radiation doses compared favourably with the reference value of 80μGy ESD published by CEC in 1996. (author)
Cangelosi, Pamela R
As the first of the Baby Boomer generation turns 65 this year, there is rising fear that a crisis awaits related to many mental health resources. This article describes the characteristics of Baby Boomers, their future mental health needs, and the extent of the impending insufficiency of mental health resources to meet those needs. Recommendations to address the unprecedented mental health demands of this generation are presented. Copyright 2011, SLACK Incorporated.
Full Text Available Introduction: Involving the parents in caring of premature newborns is one of the best and effective manners for preventing the hospitalization of premature newborns. The present study aimed to evaluate the effect of mother – baby skin- to- skin care on neonatal outcomes in preterm infants, in Kosar hospital. Methods: This was a descriptive comparative study conducted on 400 nulliparous women with premature infants admitted to neonatal intensive care unit of Kosar hospital during April 2012 and March 2015. Sampling was performed via convenience sampling. Sample population divided into two groups, one of them 200, the kangaroo care and non- care groups. The data were obtained by a researcher prepared check list, including mother’s demographic characteristics and neonatal outcomes. Both descriptive and statistical analysis methods were applied. For analyzing the data, chi-square test, t-test, and logistic regression tests was applied (P 0.05. In the intervention group, the relationship between maternal variables and neonatal outcome was significant (P <0.05. Conclusion: Mother – baby skin- to- skin care has a positive effect on neonatal outcomes. Thus, supporting and awareness of premature infants’ mothers in order to implement this type of care can reduce the neonatal complications. Moreover, it is effective in decreasing the treatment costs.
Full Text Available Background Low birth weight (LBW is important risk factor for childhood morbidity and mortality thus an important public health concern. Aim To identify the maternal determinants associated with LBW of babies Setting M.G.M Medical college & L.S.K Hospital Kishanganj ,Bihar. Design Hospital based cross sectional study Study period January 2014 to March 2014 Methodology Institution based descriptive cross sectional study from February 2014 to April 2014. All postnatal women (190 with singleton apparently healthy babies during the study period were selected for study. Birth weight of babies was recorded, mothers were interviewed and antenatal cards were reviewed. Result 34% of newborns were found to be low birth weight in our study. Statistically significant association was found between Low birth weight of babies and mother’s age, religion, literacy of mother, consumption of IFA tablets and regular ANC checkup during pregnancy. Conclusion The study suggests various maternal factors influence the birth weight of newborn babies and by improving antenatal care services both in coverage and quality we can reduce infant mortality in country.
Faghihi, R.; Mehdizadeh, S.; Sina, S.; Alizadeh, F. N.; Zeinali, B.; Kamyab, G. R.; Aghevlian, S.; Khorramdel, H.; Namazi, I.; Heirani, M.; Moshkriz, M.; Mahani, H.; Sharifzadeh, M.
Radiographic imaging has a significant role in the timely diagnosis of the diseases of neonates in intensive care units. The estimation of the dose received by the infants undergoing radiographic examination is of great importance, due to greater more radiosensitivity and longer life expectancy of the neonates and premature babies. In this study, the values of entrance skin dose (ESD), dose area products (DAPs), energy imparted (EI), whole-body dose, effective dose and risk of childhood cancer were estimated using three methods including direct method [using thermoluminescence dosimetry (TLD) chips], indirect method (using tube output) and Monte Carlo (MC) method (using MCNP4C code). In the first step, the ESD of the neonates was directly measured using TLD-100 chips. Fifty neonates, mostly premature, with different weights and gestational ages in five hospitals mostly suffering from respiratory distress syndrome and pneumonia were involved in this study. In the second step, the values of ESD to neonates were indirectly obtained from the tube output in different imaging techniques. The imaging room, incubator, neonates and other components were then simulated in order to obtain the ESD values using the MCNP4C code. Finally, the values of ESD assessed by the three methods were used for calculation of DAP, EI, whole-body dose, effective dose and risk of childhood cancer. The results indicate that the mean ESD per radiograph estimated by the direct, indirect and MC methods are 56.6±4.1, 50.1±3.1 and 54.5±3.3 μGy, respectively. The mean risk of childhood cancer estimated in this study varied between 4.21x10 -7 and 2.72x10 -6 . (authors)
Barabach, Lynn; Ludington-Hoe, Susan M; Dowling, Donna; Lotas, Marilyn
The objective of this pilot study was to determine women's perceptions of their levels of maternal role competence at discharge from a Baby-Friendly hospital. A convenience sample of 30 women completed two self-report questionnaires: a demographic questionnaire and the Perceived Maternal Parenting Self-Efficacy scale. Women report that they perceived high levels of maternal role competence with a mean total score of 69.80 (standard deviation = 6.86) out of 80. As women experience breastfeeding in Baby-Friendly hospitals, maternal role competence may develop with appropriate support. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.
Nyqvist, Kerstin H; Häggkvist, Anna-Pia; Hansen, Mette N
In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different...... provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers' access to breastfeeding support during the infants' whole hospital stay are important. Mother......'s own milk or donor milk (when available) is the optimal nutrition. Efforts should be made to minimize parent-infant separation and facilitate parents' unrestricted presence with their infants. The initiation and continuation of breastfeeding should be guided only by infant competence and stability...
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Aim: To audit the services of the neonatal Unit since its inception and determine the causes of morbidity and mortality among the neonates. Methods: This was a retrospective study. Case notes of all babies admitted into the neonatal Unit for the three-year study period were retrieved from the medical records department of ...
Shelov, Steven P., Ed.; Hannemann, Robert E., Ed.
This book, prepared by the American Academy of Pediatrics, is designed to provide parents with the most accurate and up-to-date information about the health and well-being of their young children from birth through age 5. The titles of the book's 30 chapters are: (1) "Preparing for a New Baby"; (2) "Birth and the First Moments…
Norman Awalludin; Leo Kwee Wah; Abu Bakar Mhd Ghazali
This paper describes the test of the HT system (from X-ray machine) for usage of the mini EBM (Electron Beam Machine). It consists the procedures of the installation, the safety procedures when deals with HT, modification of the system for testing purpose and the technique/method for testing the HT system. As a result, the voltage for the HT system and the electron gun (filament) current can be measured. Based on the results, suitability of the machine for baby EBM could be confirmed. (Author)
Adejuyigbe, Ebunoluwa Aderonke; Bee, Margaret Helen; Amare, Yared; Omotara, Babatunji Abayomi; Iganus, Ruth Buus; Manzi, Fatuma; Shamba, Donat Dominic; Skordis-Worrall, Jolene; Odebiyi, Adetanwa; Hill, Zelee Elizabeth
Recommendations for care in the first week of a newborn's life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries. Data were collected in the same way in each site and included 16-20 narrative interviews with recent mothers, eight observations of neonatal bathing, and in-depth interviews with 12-16 mothers, 9-12 grandmothers, eight health workers and 0-12 birth attendants in each site. We found similarities across sites in relation to understanding the importance of warmth, a lack of opportunities for skin to skin care, beliefs about the importance of several baths per day and beliefs that the Vernix caseosa was related to poor maternal behaviours. There was variation between sites in beliefs and practices around wrapping and drying after delivery, and the timing of the first bath with recent behavior change in some sites. There was near universal early bathing of babies in both Nigerian sites. This was linked to a deep-rooted belief about body odour. When asked about keeping the baby warm, respondents across the sites rarely mentioned recommended thermal care practices, suggesting that these are not perceived as salient. More effort is needed to promote appropriate thermal care practices both in facilities and at home. Programmers should be aware that changing deep rooted practices, such as early bathing in Nigeria, may take time and should utilize the current beliefs in the importance of neonatal warmth to facilitate behaviour change.
Pandey, Sanjay K
The role of the state government and the character of federal-state relations in social policy have evolved considerably. Frank Thompson uses the phrase compensatory federalism to describe increased activity by state governments to make up for a diminished federal role. For compensatory federalism to work, it is essential for states to take leadership roles in key policy areas. Few studies examine whether states have risen to the challenge of compensatory federalism in social policy. This paper examines an emerging issue of great significance in social policy-challenges involved in meeting future long-term care needs for the baby boomer generation. The paper provides an in-depth case study of attempts by Maryland to meet the challenges of financing long-term care needs for the baby boomer generation. The detailed description of the agenda-setting and problem-structuring process in Maryland is followed by an analysis that uses three different frameworks to assess the policy development processes. These models are rooted in a bureaucratic politics perspective, an agenda-setting perspective and an interest group politics perspective. The paper concludes with a discussion of the limitations and possibilities of state leadership in the social policy sphere.
Davison, Kirsten K.; Hesketh, Kathryn; Taveras, Elsie M.; Gillman, Matthew W.; Benjamin Neelon, Sara E.
Abstract Background: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity. Methods: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation. Results: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2–21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7–6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8–6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09–0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51–32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34–9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05–25.06) or fast foods (OR, 11.56; 95% CI, 3.20–41.80). Conclusions: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods. PMID:25918873
Onarheim, Kristine Husøy; Sisay, Mitike Molla; Gizaw, Muluken; Moland, Karen Marie; Miljeteig, Ingrid
Despite efforts to improve access to and quality of care for newborns, the first month after birth remains the most dangerous period of life. Given high neonatal mortality in low-income countries, saving newborn lives is a key priority for global and national health policy agendas. However, little is known about how these policies resonate with local understandings, experiences and household priorities. In this qualitative study we examined families' decision making and health-care-seeking in Butajira, Ethiopia. Data were collected through observation in hospital, in-depth interviews (41), and focus group discussions (7) with family members, health-care workers, and community members (October-November 2015). Transcripts and field notes were analyzed inductively using qualitative content analysis. Findings indicate that newborn health was not always the family's priority. Local perceptions of newborns as not yet useful members of the household alongside costly health-care services delayed decision making and care-seeking. While sickness was recognized as dangerous for the ill newborn, seeking health-care could be harmful for the economic survival of the family. In a resource-constrained setting, families' focused on productive assets in order to minimize long-term risks, and waited before seeking newborn health-care services. Until the baby had survived the first vulnerable weeks and months of life, the unknown newborn was not yet seen as a social person by the community. Personhood evolved progressively as the baby became a part of the family. A newborn death was surrounded by silence, and families received minimal support from traditional financial associations, iddirs. Decisions regarding health-care were contingent upon families' understandings of newborns and their resource-constrained circumstances. Improving newborn health involves recognizing why families choose to (not) seek health-care, and their actual opportunities and constraints in making such
Konerman, Monica A; Thomson, Mary; Gray, Kristen; Moore, Meghan; Choxi, Hetal; Seif, Elizabeth; Lok, Anna S F
Despite effective treatment for chronic hepatitis C, deficiencies in diagnosis and access to care preclude disease elimination. Screening of baby boomers remains low. The aims of this study were to assess the impact of an electronic health record-based prompt on hepatitis C virus (HCV) screening rates in baby boomers in primary care and access to specialty care and treatment among those newly diagnosed. We implemented an electronic health record-based "best practice advisory" (BPA) that prompted primary care providers to perform HCV screening for patients seen in primary care clinic (1) born between 1945 and 1965, (2) who lacked a prior diagnosis of HCV infection, and (3) who lacked prior documented anti-HCV testing. The BPA had associated educational materials, order set, and streamlined access to specialty care for newly diagnosed patients. Pre-BPA and post-BPA screening rates were compared, and care of newly diagnosed patients was analyzed. In the 3 years prior to BPA implementation, 52,660 baby boomers were seen in primary care clinics and 28% were screened. HCV screening increased from 7.6% for patients with a primary care provider visit in the 6 months prior to BPA to 72% over the 1 year post-BPA. Of 53 newly diagnosed patients, all were referred for specialty care, 11 had advanced fibrosis or cirrhosis, 20 started treatment, and 9 achieved sustained virologic response thus far. Implementation of an electronic health record-based prompt increased HCV screening rates among baby boomers in primary care by 5-fold due to efficiency in determining needs for HCV screening and workflow design. Streamlined access to specialty care enabled patients with previously undiagnosed advanced disease to be cured. This intervention can be easily integrated into electronic health record systems to increase HCV diagnosis and linkage to care. (Hepatology 2017;66:1805-1813). © 2017 by the American Association for the Study of Liver Diseases.
Full Text Available Collodion baby is a rare congenital disorder characterized by parchment like taught membrane covering the whole body. Other findings in our case include ectropion, eversion of lips, and flattening of nose and ears. Skin biopsy showed features consistant with the diagnosis of collodion baby. The child was treated with supportive measures like antibiotics, intravenous fluids, humidification, and application of emollients.
Full Text Available ... intensive care unit (NICU) Birth defects & other health conditions Loss & grief ... health of all moms and babies. We're advocating for policies to protect them. We're working to radically improve the health care they receive. ...
Schofield Deborah J
Abstract Background The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement. Methods Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS) censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future a...
In The Netherlands, it is openly acknowledged that the parents' ability to take care of their child plays a role in the decision-making process over administration of life-prolonging treatment to severely defective newborn babies. Unlike other aspects of such decision-making process up until the
Nyqvist, Kerstin H; Häggkvist, Anna-Pia; Hansen, Mette N; Kylberg, Elisabeth; Frandsen, Annemi L; Maastrup, Ragnhild; Ezeonodo, Aino; Hannula, Leena; Haiek, Laura N
In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers' access to breastfeeding support during the infants' whole hospital stay are important. Mother's own milk or donor milk (when available) is the optimal nutrition. Efforts should be made to minimize parent-infant separation and facilitate parents' unrestricted presence with their infants. The initiation and continuation of breastfeeding should be guided only by infant competence and stability, using a semi-demand feeding regimen during the transition to exclusive breastfeeding. Pacifiers are appropriate during tube-feeding, for pain relief, and for calming infants. Nipple shields can be used for facilitating establishment of breastfeeding, but only after qualified support and attempts at the breast. Alternatives to bottles should be used until breastfeeding is well established. The discharge program should include adequate preparation of parents, information about access to lactation and breastfeeding support, both professional and peer support, and a plan for continued follow-up.
Schofield Deborah J
Full Text Available Abstract Background The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement. Methods Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future age structure of the population and the growth and age distribution of the pool of labour from which future nurses will be drawn. Results Attrition rates for nurses aged 45 and over are projected to be significantly higher between the base year of 2006 and 2026, than they were between 1986 and 2001 (p Between 2006 and 2026 the growth in the labour force aged 20 to 64 is projected to slow from 7.5 per cent every five years to about 2 per cent, and over half of that growth will be in the 50 to 64 year age group. Over this period Australia is projected to lose almost 60 per cent of the current nursing workforce to retirement, an average of 14 per cent of the nursing workforce every five years and a total of about 90,000 nurses. Conclusion The next 20 years will see a large number of nursing vacancies due to retirement, with ageing already impacting on the structure of the nursing workforce. Retirement income policies are likely to be a key driver in the retirement rate of nurses, with some recent changes in Australia having some potential to slow retirement of nurses before the age of 60 years. However, if current trends continue, Australia can expect to have substantially fewer nurses than it needs in 2026.
Howell, Brittany R; Styner, Martin A; Gao, Wei; Yap, Pew-Thian; Wang, Li; Baluyot, Kristine; Yacoub, Essa; Chen, Geng; Potts, Taylor; Salzwedel, Andrew; Li, Gang; Gilmore, John H; Piven, Joseph; Smith, J Keith; Shen, Dinggang; Ugurbil, Kamil; Zhu, Hongtu; Lin, Weili; Elison, Jed T
The human brain undergoes extensive and dynamic growth during the first years of life. The UNC/UMN Baby Connectome Project (BCP), one of the Lifespan Connectome Projects funded by NIH, is an ongoing study jointly conducted by investigators at the University of North Carolina at Chapel Hill and the University of Minnesota. The primary objective of the BCP is to characterize brain and behavioral development in typically developing infants across the first 5 years of life. The ultimate goals are to chart emerging patterns of structural and functional connectivity during this period, map brain-behavior associations, and establish a foundation from which to further explore trajectories of health and disease. To accomplish these goals, we are combining state of the art MRI acquisition and analysis techniques, including high-resolution structural MRI (T1-and T2-weighted images), diffusion imaging (dMRI), and resting state functional connectivity MRI (rfMRI). While the overall design of the BCP largely is built on the protocol developed by the Lifespan Human Connectome Project (HCP), given the unique age range of the BCP cohort, additional optimization of imaging parameters and consideration of an age appropriate battery of behavioral assessments were needed. Here we provide the overall study protocol, including approaches for subject recruitment, strategies for imaging typically developing children 0-5 years of age without sedation, imaging protocol and optimization, a description of the battery of behavioral assessments, and QA/QC procedures. Combining HCP inspired neuroimaging data with well-established behavioral assessments during this time period will yield an invaluable resource for the scientific community. Copyright © 2018 Elsevier Inc. All rights reserved.
Full Text Available We were recently intrigued by a baby born at Kalafong Hospital with fused lower extremities resembling a mermaid, which caused us to search for the background and origin of this entity called sirenomelia.
Jan 24, 2018 ... mass media have the power to easily propagate ideas on social change ... issue of 'baby factory' is becoming everyday news affecting the right of ... according to recent mass media reports, teenage girls and young women are.
Powell, Douglas R.
One of the important influences on a child's development is the quality of his or her early care and education experiences. It is estimated that more than 1 million children in the U.S. are cared for while their parents are at work by nonlicensed caregivers who are family, friends, or neighbors - and these caregivers can be difficult to reach…
Full Text Available INTRODUCTION: Linkage of HIV-infected pregnant women to HIV care remains critical for improvement of maternal and child outcomes through prevention of maternal-to-child transmission of HIV (PMTCT and subsequent chronic HIV care. This study determined proportions and factors associated with intra-facility linkage to HIV care and Early Infant Diagnosis care (EID to inform strategic scale up of PMTCT programs. METHODS: A cross-sectional review of records was done at 2 urban and 3 rural public health care facilities supported by the Infectious Diseases Institute (IDI. HIV-infected pregnant mothers, identified through routine antenatal care (ANC and HIV-exposed babies were evaluated for enrollment in HIV clinics by 6 weeks post-delivery. RESULTS: Overall, 1,025 HIV-infected pregnant mothers were identified during ANC between January and June, 2012; 267/1,025 (26% in rural and 743/1,025 (74% in urban facilities. Of these 375/1,025 (37% were linked to HIV clinics [67/267(25% rural and 308/758(41% urban]. Of 636 HIV-exposed babies, 193 (30% were linked to EID. Linkage of mother-baby pairs to HIV chronic care and EID was 16% (101/636; 8/179 (4.5%] in rural and 93/457(20.3% in urban health facilities. Within rural facilities, ANC registration <28 weeks-of-gestation was associated with mothers' linkage to HIV chronic care [AoR, 2.0 95% CI, 1.1-3.7, p = 0.019] and mothers' multi-parity was associated with baby's linkage to EID; AoR 4.4 (1.3-15.1, p = 0.023. Stigma, long distance to health facilities and vertical PMTCT services affected linkage in rural facilities, while peer mothers, infant feeding services, long patient queues and limited privacy hindered linkage to HIV care in urban settings. CONCLUSION: Post-natal linkage of HIV-infected mothers to chronic HIV care and HIV-exposed babies to EID programs was low. Barriers to linkage to HIV care vary in urban and rural settings. We recommend targeted interventions to rapidly improve linkage to
... with the opportunity to assess the mother’s current physical health, including the status of pregnancy-related conditions like gestational diabetes, screen for postpartum depression, provide counseling on infant care and family planning ...
Smith-Nielsen, Johanne; Lønfeldt, Nicole; Guedeney, Antoine
Background: Infant socioemotional development is often held under informal surveillance, but a formal screening program is needed to ensure systematic identification of developmental risk. Even when screening programs exist, they are often ineffective because health care professionals do not adhe...
Klaessens, John H.; van den Born, Marlies; van der Veen, Albert; Sikkens-van de Kraats, Janine; van den Dungen, Frank A.; Verdaasdonk, Rudolf M.
For infants and neonates in an incubator vital signs, such as heart rate, breathing, skin temperature and blood oxygen saturation are measured by sensors and electrodes sticking to the skin. This can damage the vulnerable skin of neonates and cause infections. In addition, the wires interfere with the care and hinder the parents in holding and touching the baby. These problems initiated the search for baby friendly 'non-contact' measurement of vital signs. Using a sensitive color video camera and specially developed software, the heart rate was derived from subtle repetitive color changes. Potentially also respiration and oxygen saturation could be obtained. A thermal camera was used to monitor the temperature distribution of the whole body and detect small temperature variations around the nose revealing the respiration rate. After testing in the laboratory, seven babies were monitored (with parental consent) in the neonatal intensive care unit (NICU) simultaneously with the regular monitoring equipment. From the color video recordings accurate heart rates could be derived and the thermal images provided accurate respiration rates. To correct for the movements of the baby, tracking software could be applied. At present, the image processing was performed off-line. Using narrow band light sources also non-contact blood oxygen saturation could be measured. Non-contact monitoring of vital signs has proven to be feasible and can be developed into a real time system. Besides the application on the NICU non-contact vital function monitoring has large potential for other patient groups.
Full Text Available ... Global Map Premature Birth Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? ... Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth The newborn intensive ...
McDonald, John S; Noback, Carl R; Cheng, Drew; Lee, T K; Nenov, Val
We are developing a dynamic prototype visual communication system for the operating room environs. This has classically been viewed as an isolated and impenetrable workplace. All medical experiences and all teaching remain in a one to one closed loop with no recall or subsequent sharing for the training and education of other colleagues. The "Anesthesia Point of Care" (APOC) concept embraces the sharing of, recording of, and presentation of various physiological and pharmacological events so that real time memory can be shared at a later time for the edification of other colleagues who were not present at the time of the primary learning event. In addition it also provides a remarkably rapid tool for fellow faculty to respond to obvious stress and crisis events that can be broadcast instantly at the time of happening. Finally, it also serves as an efficient and effective means of paging and general communication throughout the daily routines among various healthcare providers in anesthesiology who work as a team unit; these include the staff, residents, CRNAs, physician assistants, and technicians. This system offers a unique opportunity to eventually develop future advanced ideas that can include training exercises, presurgical evaluations, surgical scheduling and improvements in efficiency based upon earlier than expected case completion or conversely later than expected case completion and even as a unique window to development of improved billing itemization and coordination.
S. Temel (Sevilay)
markdownabstractPreconception Care (PCC) entails risk assessment, health promotion, counselling, and intervention. The Dutch Health Council categorized PCC into general PCC targeted at couples planning a pregnancy within the general population, and specialist PCC for couples with a known or
This paper discusses how the subject of baby universes and their effects on spacetime coupling constants is in its infancy and rapidly developing. The subject is based on the non-existent (even by physicists' standards) Euclidean formulation of quantum gravity, and it is therefore necessary to make a number of assumptions in order to proceed. Nevertheless, the picture which has emerged is quite appealing: all spacetime coupling constants become dynamical variables when the effects of baby universes are taken into account. This fact might even solve the puzzle of the cosmological constant. The subject therefore seems worth further investigation
Younossi, Zobair M; LaLuna, Louis L; Santoro, John J; Mendes, Flavia; Araya, Victor; Ravendhran, Natarajan; Pedicone, Lisa; Lio, Idania; Nader, Fatema; Hunt, Sharon; Racila, Andrei; Stepanova, Maria
Estimates suggest that only 20 % of HCV-infected patients have been identified and gastroenterology practices in patients previously unscreened for HCV. After obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions. We screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations. Implementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of HCV+ individuals as well as an efficient process of linking them to care.
Hyssälä, L; Rautava, P; Helenius, H; Sillanpää, M
The study population consists of the fathers of the families which took part in the project 'The Finnish Family Competence Study', conducted by the Department of Public Health, University of Turku. The initial phase of the study included 1279 men. At the onset of the study project their families were expecting their first baby. When examining the fathers' use of alcohol, it was found that those with the highest level of basic education and those in professional occupations had the highest frequency of alcohol use, but they only consumed small amounts of alcohol at a time. In contrast, industrial employees and those with a lower level of education used alcohol less frequently, but they used larger amounts at a time. Thirty-two per cent of the respondents reduced their drinking after the onset of the wife's pregnancy. Of the respondents 43.7% were smokers, 8.4% of whom stopped smoking after the onset of the wife's pregnancy. Smoking cessation by the father was statistically significantly explained by the fact that the wife had not smoked before pregnancy or that she had stopped smoking after the onset of pregnancy, in which case the father did the same. When the fathers were divided into two categories according to their alcohol use, i.e. lighter and heavier users, it was found that the latter group had a more negative attitude towards their children. Similarly, smoking fathers were found to have a more negative attitude towards their children that the non-smoking ones.(ABSTRACT TRUNCATED AT 250 WORDS)
Full Text Available ... for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ... for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...
Full Text Available ... our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please ... been added to your dashboard . Time to eat! Feeding your baby helps her grow healthy and strong. ...
... for Educators Search English Español Bringing Your Baby Home KidsHealth / For Parents / Bringing Your Baby Home What's ... recall your baby's seemingly endless crying episodes. The Home Front Introducing your baby to others at home ...
In many countries, women are poorly nourished and have a high rate of reproductive morbidity. However, during war and other disaster situations, women and children become even more vulnerable. Most of the world's refugees and internally displaced people are women and children. Many women refugees are malnourished and during the emergency and exodus phases, many are starving. Severe malnutrition in a pregnant woman causes fetal malnutrition. Infants born to a malnourished mother are of low birth weight and will grow up malnourished if they stay in the same deprived environment as their mothers. Households headed by women tend to obtain the least food and the children of such households tend to be poorly nourished. Many of the problems and obstacles women face during peacetime and non-emergency situations are simply exacerbated during disasters and war. It may not be possible to head off disasters which result in massive social upheaval, but preparations can nonetheless be made to mollify conditions once disaster hits. Responsible organizations and agencies should research the situation and plan for the worst. This paper discusses how women lose social and economic power during periods of armed conflict, the often lack of even basic reproductive health care during armed conflict and emergencies, coping in an emergency, and living in a refugee camp.
In The Netherlands, it is openly acknowledged that the parents' ability to take care of their child plays a role in the decision-making process over administration of life-prolonging treatment to severely defective newborn babies. Unlike other aspects of such decision-making process up until the present time, the 'ability to take care' has not received specific attention in regulation or in empirical research. The present study is based on interviews with neonatologists in two Dutch NICUs concerning their definition of the ability to take care and its relevance in non-treatment decisions. All of the respondents think that the ability to take care consists of more than one factor. Most doctors mention the parents' emotional state, social network and cognitive abilities. Some doctors mention the presence of psychological conditions in the parents, their financial situation and physical condition. A few refer to the parents' experience and age, their chances to have another baby and their cultural background. Most doctors think the ability to take care has a secondary relevance in the decision-making process, while the primary concern is assessing the condition of the child. A substantial minority thinks the ability to take care does not play any role, while one doctor thinks it is a factor of primary importance. The study constitutes an important stepping-stone for future research in The Netherlands and elsewhere.
Fingerman, Karen L; Pillemer, Karl A; Silverstein, Merril; Suitor, J Jill
As Baby Boomers enter late life, relationships with family members gain importance. This review article highlights two aspects of their intergenerational relationships: (a) caregiving for aging parents and (b) interactions with adult children in the context of changing marital dynamics. The researchers describe three studies: (a) the Within Family Differences Study (WFDS) of mothers aged 65-75 and their multiple grown children (primarily Baby Boomers) ongoing since 2001; (b) the Family Exchanges Study (FES) of Baby Boomers aged 42-60, their spouses, parents, and multiple grown children ongoing since 2008; and (c) the Longitudinal Study of Generations (LSoG) of 351 three-generation families started when the Baby Boomers were teenagers in 1971, with interviews every 3-5 years from 1985 to 2005. These studies show that the Baby Boomers in midlife navigate complex intergenerational patterns. The WFDS finds aging parents differentiate among Baby Boomer children in midlife, favoring some more than others. The FES shows that the Baby Boomers are typically more involved with their children than with their aging parents; Boomers' personal values, family members' needs, and personal rewards shape decisions about support. The LSoG documents how divorce and remarriage dampen intergenerational obligations in some families. Moreover, loosening cultural norms have weakened family bonds in general. Reviews of these studies provide insights into how the Baby Boomers may negotiate caregiving for aging parents as well as the likelihood of family care they will receive when their own health declines in the future.
Khatami, Annelie; Rosengren, Kristina
The purpose of this paper is to describe staff experiences in an on-going improvement project regarding patients with ureteral stones. A qualitative descriptive study based on eight group interviews and 48 narratives, was performed. Data were analysed using qualitative content analysis. Trustworthiness was ensured by using a well-documented improvement process method during six months. The results formed three categories: an absent comprehensive view; complexity; and vulnerability within the organisation. A holistic perspective regarding urological care at the micro-, meso- and macro-levels is needed to improve planning and caring processes. This study includes one team (six members, different health professionals) within the same urology department. Results show that staff need information, such as guidelines and support throughout the improvement work to deliver high-quality care. Moreover, there is a need for evidence-based guidelines at national level to support improvement work. Healthcare staff need to pay attention to all team member needs to improve urological care. Organisational and managerial aspect are needed to support clear and common goals regarding healthcare improvement work. Urological improvement projects, generally, are lacking, which is why this study is important to improve nephrolithiasis patient care.
Full Text Available In July 2008, five people were killed by a tragic flash flood caused by a local torrential heavy rainfall in a short time in Toga River. From this tragic accident, we realized that a system which can detect hazardous rain-cells in the earlier stage is strongly needed and would provide an additional 5 to 10 min for evacuation. By analyzing this event, we verified that a first radar echo aloft, by volume scan observation, is a practical and important sign for early warning of flash flood, and we named a first echo as a “baby-rain-cell” of Guerrilla-heavy rainfall. Also, we found a vertical vorticity criterion for identifying hazardous rain-cells and developed a heavy rainfall prediction system that has the important feature of not missing any hazardous rain-cell. Being able to detect heavy rainfall by 23.6 min on average before it reaches the ground, this system is implemented in XRAIN in the Kinki area. Additionally, to resolve the relationship between baby-rain-cell growth and vorticity behavior, we carried out an analysis of vorticity inside baby-rain-cells and verified that a pair of positive and negative vertical vortex tubes as well as an updraft between them existed in a rain-cell in the early stage.
Katia de Souza Amorim
's first period in a day care thus implies the emergence and creation of new meanings which are attributed to, assumed by, confronted to and negotiated in the interactions established by all participants. A model was developed to analyse this process based on a research project on the insertion of 26 infants (5 to 18 months old into a day care. Video recordings, observational reports, as well as interviews with mothers, caregivers and technicians were made during the babies' first year at an university day care centre. The model focus on three main personages: mother, child and caregiver and on their mutual relationships which create three interconnected fields. The mother-child field is inserted in a larger network, the family scenery. The other two, caregiver-child and mother-caregiver fields are located in the day-care scenery. Both scenarios are impregnated by a wider social-historical matrix created in complex cultural, economic and political systems. The various elements are interconnected in a semiotic network of meanings, which continuously transforms and structures human development, allowing varied paths of behavior for each individual.
Person, Donald Ames
US Associated/Affiliated Pacific Islands (USAPI) include three freely associated states: Marshall Islands, Federated States of Micronesia, Palau, and three Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands. The Pacific Island Health Care Project (PIHCP) provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands. In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center. This application allowed image attachment to email consultations. More than 8000 Pacific Islanders have benefited from the program. Three thousand Pacific Islanders prior to telemedicine (1990-1997) and since store-and-forward telemedicine (1997-present), the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database. The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific Islands with advanced medical and surgical care available at a major US military teaching hospital. (The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.).
Donald Ames Person
Full Text Available Introduction/BackgroundUS Associated/Affiliated Pacific Islands (USAPI include 3 Freely Associated States: Marshall Islands, Federated States of Micronesia, Palau and 3 Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands. ObjectiveThe Pacific Island Health Care Project (PIHCP provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands. Methods In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center (TAMC. This application allowed image attachment to email consultations. ResultsMore than 8000 Pacific Islanders have benefited from the program. 3000 Pacific Islanders prior to telemedicine (1990-1997 and since store-and-forward telemedicine (1997-present, the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database. Conclusion The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific islands with advanced medical and surgical care available at a major US military teaching hospital.(The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.
Full Text Available ... baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a ... for your baby during the first year of life. Learn how to breastfeed and why breast milk ...
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... your baby breast milk only (no formula, juice, cow's milk, solid foods, or water). Give your baby ... vitamin D. Babies need vitamin D for healthy bone growth. Even if you take extra vitamin D, ...
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Breastfeeding, baby friendliness and birth in transition in North Western Russia: a study of women's perceptions of the care they receive when giving birth in six maternity homes in the cities of Archangelsk and Murmansk, 1999.
Helsing, E; Chalmers, B E; Dinekina, T J; Kondakova, N I
Women's own views on the quality of the birthing care they received were recorded in a small study in the cities of Archangelsk and Murmansk in February 1999. Six maternity wards took part; one hospital had already been designated as a Baby Friendly Hospital (BFH) according to the strict global criteria of the WHO/UNICEF-recommended Baby Friendly Hospital Initiative (BFHI). Two of the hospitals had made profound changes in feeding routines and were by their own reckoning close to achieving this distinction, and were included in the BFH group. Three maternity wards were far from being in compliance with the BFHI approach and were grouped as the Non-Baby-Friendly Hospitals (NBFH). A total of 180 newly delivered mothers answered a 60-item questionnaire about their birthing and breastfeeding experiences. The questions were chosen from an existing protocol, the WEB (Women's Experiences of Birth) developed by one of the authors (BC). The study was part of an informal evaluation of five years of BFHI activities in the Barents Region, supported by Norway, and also aimed at recording any positive carry-over effect of the BFHI into obstetric routines as a whole. It was found that the project definitely had had an impact; feeding practices at the BFH were markedly closer to the international BFHI recommendations than at the NBFH. BFH mothers, however, reported suffering from breastfeeding problems just as often or more so than NBFH mothers. Possible explanations are discussed; it is concluded that this cross-sectional study may depict a transitory situation in the BFH. At the two hospitals not yet assessed, although staff felt that they had made profound changes, they may not yet have grasped the full extent and stringency of the changes required. The study shows that, despite good will, some practical details had not yet been worked out, resulting in a mixed outcome for the mothers. There was no noticeable carry-over of the attitudes and basic ideas of the project into
Murry, Jaclyn B; Machini, Kalotina; Ceyhan-Birsoy, Ozge; Kritzer, Amy; Krier, Joel B; Lebo, Matthew S; Fayer, Shawn; Genetti, Casie A; Vannoy, Grace E; Yu, Timothy W; Agrawal, Pankaj B; Parad, Richard B; Holm, Ingrid A; McGuire, Amy L; Green, Robert C; Beggs, Alan H; Rehm, Heidi L; Project, The BabySeq
Here, we report a newborn female infant from the well-baby cohort of the BabySeq Project who was identified with compound heterozygous BTD gene variants. The two identified variants included a well-established pathogenic variant (c.1612C>T, p.Arg538Cys) that causes profound biotinidase deficiency (BTD) in homozygosity. In addition, a novel splice variant (c.44+1G>A, p.?) was identified in the invariant splice donor region of intron 1, potentially predictive of loss of function. The novel variant was predicted to impact splicing of exon 1; however, given the absence of any reported pathogenic variants in exon 1 and the presence of alternative splicing with exon 1 absent in most tissues in the GTEx database, we assigned an initial classification of uncertain significance. Follow-up medical record review of state mandated newborn screen (NBS) results revealed an initial out-of-range biotinidase activity level. Levels from a repeat NBS sample barely passed cut-off into the normal range. To determine whether the infant was biotinidase deficient, subsequent diagnostic enzyme activity testing was performed, confirming partial BTD, and resulted in a change of management for this patient. This led to reclassification of the novel splice variant based on these results. In conclusion, combining the genetic and NBS results together prompted clinical follow-up that confirmed partial biotinidase deficiency, and informed this novel splice site's reclassification emphasizing the importance of combining iterative genetic and phenotypic evaluations. Cold Spring Harbor Laboratory Press.
The Healthy Homes-Healthy Business project is a recipient of a Level II CARE cooperative agreement. The communities of focus for this CARE level II project are the adjacent neighborhoods of Southwest Detroit and South Dearborn.
Fingerman, Karen L.; Pillemer, Karl A.; Silverstein, Merril; Suitor, J. Jill
Purpose: As Baby Boomers enter late life, relationships with family members gain importance. This review article highlights two aspects of their intergenerational relationships: (a) caregiving for aging parents and (b) interactions with adult children in the context of changing marital dynamics. Design and Methods: The researchers describe three studies: (a) the Within Family Differences Study (WFDS) of mothers aged 65–75 and their multiple grown children (primarily Baby Boomers) ongoing since 2001; (b) the Family Exchanges Study (FES) of Baby Boomers aged 42–60, their spouses, parents, and multiple grown children ongoing since 2008; and (c) the Longitudinal Study of Generations (LSoG) of 351 three-generation families started when the Baby Boomers were teenagers in 1971, with interviews every 3–5 years from 1985 to 2005. Results: These studies show that the Baby Boomers in midlife navigate complex intergenerational patterns. The WFDS finds aging parents differentiate among Baby Boomer children in midlife, favoring some more than others. The FES shows that the Baby Boomers are typically more involved with their children than with their aging parents; Boomers’ personal values, family members’ needs, and personal rewards shape decisions about support. The LSoG documents how divorce and remarriage dampen intergenerational obligations in some families. Moreover, loosening cultural norms have weakened family bonds in general. Implications: Reviews of these studies provide insights into how the Baby Boomers may negotiate caregiving for aging parents as well as the likelihood of family care they will receive when their own health declines in the future. PMID:22250130
Full Text Available ... In This Topic Breastfeeding help Breastfeeding is best Food allergies and baby Formula feeding How to breastfeed Keeping breast milk safe and healthy Problems and discomforts when breastfeeding Starting your baby on solid foods Using a breast pump Baby Feeding your baby ...
An interactive baby bottle with an electronic unit is disclosed. The electronic unit comprises a sensor unit configured to sense the heart beat of a person bottle feeding a baby and an actuator unit configured to transmit the sensed heart beat to the baby. The disclosed interactive baby bottle can
Full Text Available ... In This Topic Breastfeeding help Breastfeeding is best Food allergies and baby Formula feeding How to breastfeed Keeping a breastfeeding log Keeping breast milk safe and healthy Problems and discomforts when breastfeeding Starting your baby on solid foods Using a breast pump Baby Feeding your baby ...
Beach, Scott R; Schulz, Richard; Matthews, Judith T; Courtney, Karen; Dabbs, Annette DeVito
Quality of Life technology (QoLT) stresses humans and technology as mutually dependent and aware, working together to improve task performance and quality of life. This study examines preferences for technology versus human assistance and control in the context of QoLT. Data are from a nationally representative, cross-sectional web-based sample of 416 US baby boomers (45-64) and 114 older adults (65+) on preferences for technology versus human assistance and control in the performance of kitchen and personal care tasks. Multinomial logistic regression and ordinary least squares regression were used to determine predictors of these preferences. Respondents were generally accepting of technology assistance but wanted to maintain control over its' operation. Baby boomers were more likely to prefer technology than older adults, and those with fewer QoLT privacy concerns and who thought they were more likely to need future help were more likely to prefer technology over human assistance and more willing to relinquish control to technology. Results suggest the need for design of person- and context-aware QoLT systems that are responsive to user desires for level of control over operation of the technology. The predictors of these preferences suggest potentially receptive markets for the targeting of QoLT systems.
Fernando C Barros
Full Text Available OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.
Chao, Shin Margaret; Donatoni, Giannina; Bemis, Cathleen; Donovan, Kevin; Harding, Cynthia; Davenport, Deborah; Gilbert, Carol; Kasehagen, Laurin; Peck, Magda G
This article provides an example of how Perinatal Periods of Risk (PPOR) can provide a framework and offer analytic methods that move communities to productive action to address infant mortality. Between 1999 and 2002, the infant mortality rate in the Antelope Valley region of Los Angeles County increased from 5.0 to 10.6 per 1,000 live births. Of particular concern, infant mortality among African Americans in the Antelope Valley rose from 11.0 per 1,000 live births (7 cases) in 1999 to 32.7 per 1,000 live births (27 cases) in 2002. In response, the Los Angeles County Department of Public Health, Maternal, Child, and Adolescent Health Programs partnered with a community task force to develop an action plan to address the issue. Three stages of the PPOR approach were used: (1) Assuring Readiness; (2) Data and Assessment, which included: (a) Using 2002 vital records to identify areas with the highest excess rates of feto-infant mortality (Phase 1 PPOR), and (b) Implementing Infant Mortality Review (IMR) and the Los Angeles Mommy and Baby (LAMB) Project, a population-based study to identify potential factors associated with adverse birth outcomes. (Phase 2 PPOR); and (3) Strategy and Planning, to develop strategic actions for targeted prevention. A description of stakeholders' commitments to improve birth outcomes and monitor infant mortality is also given. The Antelope Valley community was engaged and ready to investigate the local rise in infant mortality. Phase 1 PPOR analysis identified Maternal Health/Prematurity and Infant Health as the most important periods of risk for further investigation and potential intervention. During the Phase 2 PPOR analyses, IMR found a significant proportion of mothers with previous fetal loss (45%) or low birth weight/preterm (LBW/PT) birth, late prenatal care (39%), maternal infections (47%), and infant safety issues (21%). After adjusting for potential confounders (maternal age, race, education level, and marital status), the
This article offers a methodological reflection on how "baby-cam" enhanced ethically reflective attitudes in a large-scale research project that set out to research with infants in Australian early childhood education and care settings. By juxtaposing digital images produced by two different digital-camera technologies and drawing on…
Association for Library Service to Children, Chicago, IL.
The "Born To Read" project helps parents raise children with healthy bodies and minds. Public librarians and health care professionals form partnerships and reach out to at-risk expectant and new parents. The video provides techniques and tips to plan successful programs for babies, including a segment for libraries to use with the…
Honig, Alice Sterling
Evolution has provided babies with wonderful ways to get the loving attention and care that they need from adults. When a baby is distressed, his cry is the most primitive and powerful tool for bringing help. By the time a baby is 2 or 3 months old, his dazzling smile and crooked grin evokes tenderness, smiles, and nurturance from adults who are…
Piette, B.M.A.G.; Schroers, B.J.; Zakrzewski, W.J.
Baby Skyrmions are topological solitons in a (2+1)-dimensional field theory which resembles the Skyrme model in important respects. We apply some of the techniques and approximations commonly used in discussions of the Skyrme model to the dynamics of baby Skyrmions and directly test them against numerical simulations. Specifically we study the effect of spin on the shape of a single baby Skyrmion, the dependence of the forces between two baby Skyrmions on the baby Skyrmions' relative orientation and the forces between two baby Skyrmions when one of them is spinning. ((orig.))
NASA's Phoenix Mars Lander's Surface Stereo Imager took this image on Sol 11 (June 5, 2008), the eleventh day after landing. It shows the trenches dug by Phoenix's Robotic Arm. The trench on the left is informally called 'Dodo' and was dug as a test. The trench on the right is informally called 'Baby Bear.' The sample dug from Baby Bear will be delivered to the Phoenix's Thermal and Evolved-Gas Analyzer, or TEGA. The Baby Bear trench is 9 centimeters (3.1 inches) wide and 4 centimeters (1.6 inches) deep. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.
... 5 MB] Read the MMWR Science Clips Safe Sleep for Babies Eliminating hazards Recommend on Facebook Tweet ... Page Problem Every year, there are thousands of sleep-related deaths among babies. View large image and ...
... a Member Home Resources & Services Professional Resource Baby Brain Map Mar 17, 2016 The Brain Map was adapted in 2006 by ZERO TO ... supports Adobe Flash Player. To view the Baby Brain Map, please visit this page on a browser ...
Full Text Available ... a valid e-mail address. Your information: Your recipient's information: Your personal message: Thank you! Your e- ... good for babies. You and your baby may need time and practice to get comfortable breastfeeding, but ...
Full Text Available ... and your partner to bond with her. Breast milk is the best food for your baby during ... life. Learn how to breastfeed and why breast milk is so good for babies. You and your ...
... is a severe form of head injury caused by the baby's brain rebounding inside of the baby's skull when shaken. In this injury there is bruising of the brain, swelling, pressure, and bleeding (intracerebral hemorrhage). This can easily lead ...
... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... for sensitive skin.) Unless your baby has allergies , eczema/atopic dermatitis , or another condition causing sensitive skin, ...
The Charleston County Area Project Impact is the recipient of a Level II CARE cooperative agreement. The project is under the direction of the Charleston County Building Services Department, in Charleston, S.C.
... care including minor illness or injury for Active Duty Family Members enrolled in TRICARE Prime or.... Current data indicates that the ADFMs frequently need urgent care while traveling to new duty stations for... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Prime Urgent Care Demonstration Project...
... Safe Videos for Educators Search English Español Your Baby's Growth: 12 Months KidsHealth / For Parents / Your Baby's ... doubled his or her birth weight. Is My Baby Growing Normally? Babies' growth begins to slow as ...
... Safe Videos for Educators Search English Español Your Baby's Growth: 5 Months KidsHealth / For Parents / Your Baby's ... a cause for concern. How Much Will My Baby Grow? By 5 months, your baby's birth weight ...
... Issues Health Issues Health Issues Conditions Injuries & Emergencies Vaccine Preventable Diseases ... Children > Safety & Prevention > Immunizations > Immunizations For Preterm Babies Safety & ...
Full Text Available Abstract Background Gaps between research knowledge and practice have been consistently reported. Traditional ways of communicating information have limited impact on practice changes. Strategies to disseminate information need to be more interactive and based on techniques reported in systematic reviews of implementation of changes. There is a need for clarification as to which dissemination strategies work best to translate evidence into practice in neonatal units across England. The objective of this trial is to assess whether an innovative active strategy for the dissemination of neonatal research findings, recommendations, and national neonatal guidelines is more likely to lead to changes in policy and practice than the traditional (more passive forms of dissemination in England. Methods/design Cluster randomised controlled trial of all neonatal units in England (randomised by hospital, n = 182 and stratified by neonatal regional networks and neonatal units level of care to assess the relative effectiveness of active dissemination strategies on changes in local policies and practices. Participants will be mainly consultant lead clinicians in each unit. The intervention will be multifaceted using: audit and feedback; educational meetings for local staff (evidence-based lectures on selected topics, interactive workshop to examine current practice and draw up plans for change; and quality improvement and organisational changes methods. Policies and practice outcomes for the babies involved will be collected before and after the intervention. Outcomes will assess all premature babies born in England during a three month period for timing of surfactant administration at birth, temperature control at birth, and resuscitation team (qualification and numbers present at birth. Trial registration Current controlled trials ISRCTN89683698
... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Access to Care Demonstration Project AGENCY... is to advise interested parties of a 2-year extension of the demonstration project in which the... project will continue through May 4, 2015. ADDRESSES: TRICARE Management Activity, Health Plan Operations...
de Klerk, J.; Moyer, E.
As part of the chronic disease paradigm now widely used for HIV in sub-Saharan Africa, antiretroviral treatment programs emphasize self-care. In the informal settlements of Mombasa, Kenya, the management of stress—associated with economic precariousness—plays a significant role in self-care practices and ideologies. Based on ethnographic fieldwork, we examine how local narratives of stress and self-care intertwine with social responsibilities of older HIV-positive people. For older Mombassans...
Full Text Available ... baby formula , find out how to choose the best one for your baby and how to make bottle-feeding safe. And then get ready for solid foods ! In This Topic Breastfeeding help Breastfeeding is best Food allergies and baby Formula feeding How to ...
This book for beginning readers tells the story of a South African priest and his wife who are ashamed when their daughter tells them she is going to have a baby. They refuse to have anything to do with her when she is pregnant. However, when the baby comes, everything changes and they come to accept and love the baby. Large black and white…
Full Text Available ... bond with her. Breast milk is the best food for your baby during the first year of life. Learn how to breastfeed and why breast milk is so good for babies. You and your baby may need time and practice to get comfortable breastfeeding, but you’ll get ...
Full Text Available ... food for your baby during the first year of life. Learn how to breastfeed and why breast milk is so good for babies. You and your baby may need time and practice to get comfortable breastfeeding, but you’ll get the hang of it! Don’t be afraid to ask for ...
Sahn, David J; Kinney, James; Puntel, Robert
... & Science University in Portland will test the hypothesis that trained primary care practitioners or nurses can with telemedicine supervision perform cardiac ultrasound exams on neonates at risk...
Sahn, David J
... & Science University in Portland, will test the hypothesis that trained primary care practitioners or nurses can, with telemedicine supervision, perform cardiac ultrasound exams on neonates at risk...
Sahn, David J; Kinney, James; Puntel, Robert
... & Science University in Portland will test the hypothesis that trained primary care practitioners or nurses can with telemedicine supervision perform cardiac ultrasound exams on neonates at risk...
ARÉVALO SÁNCHEZ, ELIZABETH
The purposeofthisresearch istovalue thecarepractices that mothers perform on themselves and on the baby to whom she is going to give birth. 150 pregnant women that go to the Centro Operativo Local Engativá medical facility, registered on project 7317: "Preganant Families: healthy and desired babies of the Administrative DepartmentofSocialWellbeing", using a quantitative and descriptive methodology. We applied the "Instrument to value those care practices that are performed on themselves and o...
Ruysschaert, Sofie; van Andel, Tinde; Van de Putte, Kobeke; Van Damme, Patrick
Young children are vulnerable to a range of illnesses and evil forces. Ethnobotanical folk remedies often play a major role in combating these afflictions. Here we show that plant use is highly valued and practiced within the Saramaccan Maroon Society in Suriname to maintain the general health and well-being of children. To assess the plant use importance in child care, we (1) quantified diversity and current status of herbal pharmacopoeia used in child care and (2) elucidated the reasons why care takers (mostly mothers) use these plants. We collected botanical vouchers of plants used in child care, carried out an ethnobotanical household survey with 105 women and interviewed 19 key informants. A total of 178 plant species were used in child care for different purposes. Preventive practices were preferred over curing remedies and plants were most frequently used to keep young children strong and healthy. Child care had a strong magical connotation. Bathing proved to be the most important type of application, often combined with drinking small amounts of the bath water. Plants play an important role in child care, but more research is needed on how Maroon plant use reflects actual health problems in young children in the Surinamese interior.
The mining business is booming in Yukon. However, Yukon has been thinly explored, both onshore and offshore. The challenge for Yukon's mining industry is that the domestic energy resources are not sufficient to provide power for the mines that are proposed. A natural gas solution is proposed for developing an energy industry in the Yukon. Pipelines are planned to provide access to oil and gas which will be an incentive for companies. Rather than waiting on the construction of pipelines, a project has been launched by the government to map Yukon's hydrocarbon potential. It is believed that natural gas from Eagle Plain could meet Yukon's energy requirements into the foreseeable future. Furthermore, a Chinese company has invested in Northern Cross.
Telemedicine & Advanced Technology Research Center (TATRC). The additional funds are being used to extend the life of the TeleEcho Project in order to...practitioners for the Tele-ECHO project. This is held at Madigan Army Medical Center in the clinic and the NICU . Learning objectives: 1. Learners will...support and expertise. Funding is provided through AMEDD Advanced Medical Technology Initiative (AAMTI) FY09, APC-T690 Special Fund for TeleEcho. The
... al. Organic foods: Health and environmental advantages and disadvantages. Pediatrics. 2012;130:e1406. Morin K. Organic baby ... Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...
Clean Air Communities (CAC) is the recipient of a Level II CARE cooperative agreement to implement recommendations by the state’s Environmental Justice Task Force and the Air Toxics Pilot Project to reduce environmental risks.
Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L
Through discussions with chief financial officers of leading health care systems, insights are offered on preferences for project financing and development efforts. Data from these same systems provide at least anecdotal evidence in support of pecking-order theory.
METI/AMED are conducting a project on the development and deployment of robotic devices for nursing care to enhance the autonomy of elderly persons and assist care givers. An evaluation protocol is presented and the devices developed in the project are introduced. The devices consist of transfer assist devices (wearable/non-wearable), walking assist devices (outdoor/indoor), safety surveillance sensors (nursing home/private home), bath lift and toilet assist.
Hameury, Laurence; Delavous, Patrice; Leroy, Cathy
Hippotherapy uses relationships with horses as a mediation method. The care treatment aims to act on the psychological functioning of children affected by relational disorders, especially in order to help the development of communication and emotions. A partnership has been established between the paedopsychiatric university centre at the CHRU in Tours (37) and a horse-riding centre.
Ostegenesis Imperfecta Foundation, Inc., Manchester, NH.
Three pamphlets provide basic information on the care and education of children with osteogenesis imperfecta (OI) a lifelong liability to fractures due to imperfectly formed "brittle bones." The first brochure, a guide to education for children with OI, addresses the importance of attitudes, the value of early education, public school…
... Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids and Teens Pregnancy and Childbirth ... Pregnancy: First TrimesterTaking Care of You and Your Baby While You’re PregnantChanges in Your Body During ...
Cress, Ronald J.
The project described offers an approach to providing occupational skills to socially and educationally handicapped youth, specifically the skills necessary for a service station attendant in driveway salesmanship and auto care. The 10-page evaluation report presents project goals and objectives with evaluation data (represented graphically) and…
The Baby Skyrmion model is a two-dimensional analogue of the full three-dimensional Skyrme model. It is not just useful for guiding investigations in the Skyrme model, it also has applications in condensed matter physics. Previous results on multi-charged Baby Skyrmion solutions have pointed to a modular structure, comprised of charge two rings and single charge one Skyrmions, which combine to form higher charged structures. In this paper we present alternative numerical solutions that correspond to new finite Baby Skyrmion chains, which have lower energy than those found previously, and are also good candidates for the global minimum energy solutions. We then proceed from the infinite plane, to Baby Skyrmions on a cylinder and then a torus, to obtain the solutions of periodic Baby Skyrmions, of which periodic segments will correspond to sections of large charge Baby Skyrmions in the plane
Medical anthropology has long appreciated the clinical encounter as a rich source of data and a key site for critical inquiry. It is no surprise, then, that a number of physician-anthropologists have used their clinical insights to make important contributions to the field. How does this duality challenge and enhance the moral practice and ethics of care inherent both to ethnography and to medicine? How do bureaucratic and professional obligations of HIPAA and the IRB intersect with aspirations of anthropology to understand human experience and of medicine to heal with compassion? In this paper, I describe my simultaneous fieldwork and clinical practice at an urban women's jail in the United States. In this setting, being a physician facilitates privileged access to people and spaces within, garners easy trust, and enables an insider perspective more akin to observant participation than participant observation. Through experiences of delivering the infants of incarcerated pregnant women and of being with the mothers as they navigate drug addiction, child custody battles, and re-incarceration, the roles of doctor and anthropologist become mutually constitutive and transformative. Moreover, the dual practice reveals congruities and cracks in each discipline's ethics of care. Being an anthropologist among informants who may have been patients reworks expectations of care and necessitates ethical practice informed by the dual roles.
Wieczorek, Christina C; Marent, Benjamin; Dorner, Thomas E; Dür, Wolfgang
The health benefits of breastfeeding for mothers and babies are well documented in the scientific literature. Research suggests that support of breastfeeding during pre- and postnatal maternity care is an important determinant of breastfeeding initiation and duration. To support and promote breastfeeding on maternity units, the Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. In Austria, however, less than one fifth of hospitals with a maternity unit are currently BFHI-certified. Implementation of BFHI and adjunct changes in work practices seem to represent a major challenge to maternity units. This article builds upon previous research that has identified a number of facilitators of and barriers to BFHI implementation in Austria. A major barrier has been the lack of intra- and inter-professional collaboration. Therefore, this article investigates the ways in which different healthcare professionals struggle to work together to successfully integrate the BFHI into practice. In this study, a qualitative research approach was used. Thirty-six semi-structured interviews with 11 midwives, 11 nurses, 13 physicians, and one quality manager, working across three maternity units, were interviewed on-site. Data analysis followed thematic analysis. Midwives, nurses, and physicians had diverse approaches to childbirth and breastfeeding (medicalization vs. naturalness) and worked along different jurisdictions that became manifest in strict spatial divisions of maternity units. In their engagement within the BFHI, midwives, nurses, and physicians pursued different strategies (safeguarding vs. circumvention strategies). These differences hindered inter-professional teamwork and collaboration and, therefore, the integration of BFHI into practice. Differing approaches to childbirth and breastfeeding, deep seated professional jurisdictions, as well as spatial constraints, challenge inter-professional teamwork and collaboration on maternity units. Inter
Ioannidou, Theodora; Lechtenfeld, Olaf
We subject the baby Skyrme model to a Moyal deformation, for unitary or Grassmannian target spaces and without a potential term. In the Abelian case, the radial BPS configurations of the ordinary noncommutative sigma model also solve the baby Skyrme equation of motion. This gives a class of exact analytic noncommutative baby Skyrmions, which have a singular commutative limit but are stable against scaling due to the noncommutativity. We compute their energies, investigate their stability and determine the asymptotic two-Skyrmion interaction.
Kaufman, Darren S
Effective care of each patient throughout a hospital admission involves executing a specific set of tasks to produce a favorable outcome within an appropriate time frame. The ProjectRounds methodology, which can be implemented using widely available software, incorporates the principles of project management in planning and control hospital inpatient care. It consists of four stages--clinical assessment, planning, scheduling, and tracking. OVERVIEW OF PROJECTROUNDS AND EXAMPLE: As an example, a 68-year-old-man is admitted with pneumonia. In clinical assessment, the admitting physician uses an assessment tool that prompts her to list all the patient's clinical issues, define the conditions that need to be met to discharge the patient, highlight special problems, and list any consultations, diagnostic tests, and procedures that are planned. In planning, the work breakdown structure--a tabulation of all the tasks in the "project" (the admission)--is created. In scheduling, a project schedule is generated, and in tracking, the clinical team evaluates and monitors the project's course. During interdisciplinary clinical rounds, the progress of the patient's hospital care can be tracked and quantified by employing the percent complete method. Tracking can be used as a "dashboard," providing a concise summary of the care that needs to be and has been rendered to the patient. Applying the tenets of project management can optimize the process of providing health care to hospital inpatients.
Riverin, Bruno; Li, Patricia; Rourke, Leslie; Leduc, Denis; Rourke, James
Abstract Objective To update the 2011 edition of the Rourke Baby Record (RBR) by reviewing current best evidence on health supervision of infants and children from birth to 5 years of age. Quality of evidence The quality of evidence was rated with the former (until 2006) Canadian Task Force on Preventive Health Care classification system and GRADE (grading of recommendations, assessment, development, and evaluation) approach. Main message New evidence has been incorporated into the 2014 RBR recommendations related to growth monitoring, nutrition, education and advice, development, physical examination, and immunization. Growth is monitored with the World Health Organization growth charts that were revised in 2014. Infants’ introduction to solid foods should be based on infant readiness and include iron-containing food products. Delaying introduction to common food allergens is not currently recommended to prevent food allergies. At 12 months of age, use of an open cup instead of a sippy cup should be promoted. The education and advice section counsels on injuries from unstable furniture and on the use of rear-facing car seats until age 2, and also includes information on healthy sleep habits, prevention of child maltreatment, family healthy active living and sedentary behaviour, and oral health. The education and advice section has also added a new environmental health category to account for the effects of environmental hazards on child health. The RBR uses broad developmental surveillance to recognize children who might be at risk of developmental delays. Verifying tongue mobility and patency of the anus is included in the physical examination during the first well-baby visit. The 2014 RBR also provides updates regarding the measles-mumps-rubella, live attenuated influenza, and human papillomavirus vaccines. Conclusion The 2014 RBR is the most recent update of a longstanding evidence-based, practical knowledge translation tool with related Web-based resources
Carmen Lúcia de Bartolo Costa
Full Text Available O objetivo desta pesquisa foi desenvolver um instrumento digital - aqui denominado Sistema BabyCare - para coleta, armazenamento e apoio à decisão dos profissionais de saúde e demais envolvidos na assistência primária infantil em comunidades carentes. Esse sistema baseia-se em tecnologias de dispositivos móveis para utilização local em unidades básicas de saúde em comunidades carentes, assistidos ou não pelo Programa/Estratégia Saúde da Família (PSF, organizações não governamentais, ambulatórios e hospitais. Utilizou-se Java como linguagem de programação. Foram realizadas avaliações sobre o uso do sistema na cidade de São Paulo, envolvendo 62 usuários com diferentes formações, incluindo voluntários da Pastoral da Criança e do PSF. Os questionários aplicados resultam em alto índice de aceitação geral (98,3%; treinamento in loco considerado adequado (91,9%; percepção na melhoria na rotina e na redução de tempo da consulta (100,0% e na redução no volume de documentos (96,7%. Conclusão: o protótipo apresentou-se robusto e eficiente para uso em comunidades carentes com infraestrutura precária de informática e telecomunicação.The purpose of this work was to develop a digital device - referred as BabyCare System - for the collection, storage, and decision support for healthcare professionals and other concerned people, in order to assist patients in primary child care in deprived communities. This system is based on handheld device technologies to be used locally in basic healthcare units in deprived communities, whether assisted or not by the Family Health Program/Strategy (PSF, as well as in ambulatory facilities and hospitals. Java was used as programming language. Evaluations have been conducted regarding 62 users at São Paulo city including volunteers from the Pastoral da Criança, an ecumenical institution for children. The applied questionnaires resulted in a high level of general acceptance (98
Annas, G J
A professor of health law criticizes the decisions of New Jersey Superior Court Judge Harvey R. Sorkow which culminated in his awarding permanent custody of Baby M to her biological father, William Stern. Annas quotes from the In re Baby M decision and from the contract between Stern and his wife and surrogate mother Mary Beth Whitehead to support his contention that Sorkow "rendered a sermon filled with contradictions, double-standards, inapt analogies, and unsupported conclusions." He argues that legally Mrs. Whitehead could not have prospectively waived her right to rear a child she bore, that Sorkow was biased in favor of the "upper-middle-class Sterns," and that consideration should be given to returning Baby M to Mrs. Whitehead. He urges state legislatures to outlaw the sale of children, to affirm the legal status of the gestational mother, and to forbid a surrogate's relinquishment of parental rights until after her child's birth.
Schmidt-Wolf, G; Elsner, F; Lindena, G; Hilgers, R-D; Heussen, N; Rolke, R; Ostgathe, C; Radbruch, L
With a priority programme the German Cancer Aid supported the development of quality-assured outpatient palliative care to cover the whole country. The 12 regional pilot projects funded with the aim to improve outpatient palliative care in different models and different frameworks were concurrently monitored and evaluated. The supported projects, starting and ending individually, documented all patients who were cared for using HOPE (Hospice and palliative care evaluation) and MIDOS (Minimal documentation system for palliative patients). Total data were analyzed for 3239 patients decriptively. In addition to the quantitative data the experiences of the projects were recorded in a number of workshops (2008, 2009, 2010, and 2012). In particular, the experiences reported in the final meeting in July 2012 were considered for this article as well as the final reports for the German Cancer Aid. In the quantitative evaluation 85.6% of 3239 palliative care patients had a cancer diagnosis. In all model projects the goal of a network with close cooperation of primary providers, social support, and outpatient and inpatient specialist services has been achieved. For all projects, the initial financing of the German Cancer Aid was extremely important, because contracts with health insurance funds were negotiated slowly, and could then be built on the experiences with the projects. The participants of the project-completion meeting emphasized the need to carry out a market analysis before starting palliative care organizations considering the different regional structures and target groups of patients. Education, training and continuing education programs contribute significantly to the network. A reliably funded coordination center/case management across all institutions is extremely important. © Georg Thieme Verlag KG Stuttgart · New York.
Many women quit smoking when they become pregnant. However, about 40 percent start smoking again 6 months after they have their baby. Quitting smoking has benefits for you and your baby that last longer than the 9 months of your pregnancy.
Maybe you quit smoking during your pregnancy. Or maybe you struggled and weren’t able to stay quit. Now that your baby is here, trying to stay away from smoking is still important. That’s because the chemicals in smoke can make it harder for your baby to grow like he or she should.
Home; Journals; Pramana – Journal of Physics. T P Nafeesa Baby. Articles written in Pramana – Journal of Physics. Volume 80 Issue 2 February 2013 pp 289-294 Research Articles. Plasma excitations in a single-walled carbon nanotube with an external transverse magnetic field · K A Vijayalakshmi T P Nafeesa Baby.
Haematological Indices in Healthy Appropriate For-Gestational-Age (AGA) Pre Term Babies. ... International Journal of Medicine and Health Development. Journal Home ... Patient and Methods: All consecutive healthy pre-term new born babies delivered at UNTH and admitted into the hospital NBSCU were included.
SA JOURNAL OF RADIOLOGY • September 2010. Abstract. We were recently intrigued by a baby born at Kalafong Hospital with fused lower extremities resembling a mermaid, which caused us to search for the background and origin of this entity called sirenomelia. Case report. A 40-year-old woman delivered a baby at 36 ...
... baby syndrome. Information from the National Library of Medicine’s MedlinePlus Child Abuse × What research is being done? The National ... baby syndrome. Information from the National Library of Medicine’s MedlinePlus Child Abuse See More About Research The National Institute ...
... I'm breast-feeding my newborn and her bowel movements are yellow and mushy. Is this normal for baby poop? Answers from Jay L. Hoecker, M.D. Yellow, mushy bowel movements are perfectly normal for breast-fed babies. Still, ...
Lowell, Anne; Kildea, Sue; Liddle, Marlene; Cox, Barbara; Paterson, Barbara
The Strong Women, Strong Babies, Strong Culture Program (the Program) evolved from a recognition of the value of Aboriginal knowledge and practice in promoting maternal and child health (MCH) in remote communities of the Northern Territory (NT) of Australia. Commencing in 1993 it continues to operate today. In 2008, the NT Department of Health commissioned an evaluation to identify enabling factors and barriers to successful implementation of the Program, and to identify potential pathways for future development. In this paper we focus on the evaluation findings related specifically to the role of Aborignal cultural knowledge and practice within the Program. A qualitative evaluation utilised purposive sampling to maximise diversity in program history and Aboriginal culture. Semi-structured, in-depth interviews with 76 participants were recorded in their preferred language with a registered Interpreter when required. Thematic analysis of data was verified or modified through further discussions with participants and members of the evaluation team. Although the importance of Aboriginal knowledge and practice as a fundamental component of the Program is widely acknowledged, there has been considerable variation across time and location in the extent to which these cultural dimensions have been included in practice. Factors contributing to this variation are complex and relate to a number of broad themes including: location of control over Program activities; recognition and respect for Aboriginal knowledge and practice as a legitimate component of health care; working in partnership; communication within and beyond the Program; access to transport and working space; and governance and organisational support. We suggest that inclusion of Aboriginal knowledge and practice as a fundamental component of the Program is key to its survival over more than twenty years despite serious challenges. Respect for the legitimacy of Aboriginal knowledge and practice within health
Lenney, Warren; Clayton, Sadie; Gilchrist, Francis J; Price, David; Small, Iain; Smith, Judy; Sutton, Emma J
Asthma is a very common disease that can occur at any age. In the UK and in many other countries it is mainly managed in primary care. The published evidence suggests that the key to improving diagnosis and management lies in better training and education rather than in the discovery of new medications. An asthma improvement project managed through the British Lung Foundation is attempting to do this. The project has three pilot sites: two in England supported by the Department of Health and one in Scotland supported by the Scottish Government. If the project is successful it will be rolled out to other health areas within the UK. The results of this project are not yet available. This article highlights the challenges encountered in setting up the project and may well be applicable to other areas in the UK and to other countries where similar healthcare systems exist. The encountered challenges reflect the complex nature of healthcare systems and electronic data capture in primary care. We discuss the differences between general practices in their ability and willingness to support the project, the training and education of their staff on asthma management, governance issues in relation to information technology systems, and the quality of data capture. Virtually all the challenges have now been overcome, but discussing them should ensure that others become aware of them at an early stage should they wish to undertake similar projects in the future.
The impact of training non-physician clinicians in Malawi on maternal and perinatal mortality: a cluster randomised controlled evaluation of the enhancing training and appropriate technologies for mothers and babies in Africa (ETATMBA project
Full Text Available Abstract Background Maternal mortality in much of sub-Saharan Africa is very high whereas there has been a steady decline in over the past 60 years in Europe. Perinatal mortality is 12 times higher than maternal mortality accounting for about 7 million neonatal deaths; many of these in sub-Saharan countries. Many of these deaths are preventable. Countries, like Malawi, do not have the resources nor highly trained medical specialists using complex technologies within their healthcare system. Much of the burden falls on healthcare staff other than doctors including non-physician clinicians (NPCs such as clinical officers, midwives and community health-workers. The aim of this trial is to evaluate a project which is training NPCs as advanced leaders by providing them with skills and knowledge in advanced neonatal and obstetric care. Training that will hopefully be cascaded to their colleagues (other NPCs, midwives, nurses. Methods/design This is a cluster randomised controlled trial with the unit of randomisation being the 14 districts of central and northern Malawi (one large district was divided into two giving an overall total of 15. Eight districts will be randomly allocated the intervention. Within these eight districts 50 NPCs will be selected and will be enrolled on the training programme (the intervention. Primary outcome will be maternal and perinatal (defined as until discharge from health facility mortality. Data will be harvested from all facilities in both intervention and control districts for the lifetime of the project (3–4 years and comparisons made. In addition a process evaluation using both quantitative and qualitative (e.g. interviews will be undertaken to evaluate the intervention implementation. Discussion Education and training of NPCs is a key to improving healthcare for mothers and babies in countries like Malawi. Some of the challenges faced are discussed as are the potential limitations. It is hoped that the findings
Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.
Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626
Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan
PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health
Foote, Frederick O; Benson, Herbert; Berger, Ann; Berman, Brian; DeLeo, James; Deuster, Patricia A; Lary, David J; Silverman, Marni N; Sternberg, Esther M
In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the "Epidaurus 2" Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and "Star Glyphs." This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine.
Beauheim, R.L.; Hassinger, B.W.; Klaiber, J.A.
Borehole Cabin Baby-1 was originally drilled to a depth of 4159.0 feet below kelly bushing (8.0 feet above ground surface) in 1974 and 1975 as a ''wildcat'' hydrocarbon exploratory well. Control of the borehole was given to the US Department of Energy (DOE) after it was found to be a ''dry hole''. Cabin Baby-1 was reentered, deepened, and hydrologically tested in August and September 1983. The well is located in Section 5, T23S, R31E, just outside the limit of WIPP Zone III, approximately 2.5 miles south of the WIPP exploratory shaft. The deepening and testing of Cabin Baby-1 was undertaken for several reasons: to provide data on the hydrologic properties, including hydrostatic head potential of selected permeable zones in the Bell Canyon Formation; to provide representative fluid samples from selected permeable zones in the Bell Canyon Formation for determination of fluid composition and density; and to define further the stratigraphy of the upper Bell Canyon Formation at the Cabin Baby-1 location. The borehole was deepened from the previous total depth to a new depth of 4298.6 feet below kelly bushing by continuous coring. Field operations related to deepening and logging of the borehole began August 12, 1983 and were completed August 30, 1983. Hydrologic testing activities began August 30, 1983 and were completed September 29, 1983. Drill-stem tests were conducted in four zones in the Bell Canyon Formation, and one test of the Salado Formation was performed. Fluid samples were collected from the Hays and Olds sandstones of the Bell Canyon Formation
Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas
Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.
... your baby is 1 year old before feeding him cow’s milk. m Hold your baby while feeding him breast milk or formula in a bottle. m ... your baby is 1 year old before giving him juice. m When your baby is around 4 ...
... struggle with learning, gross motor (crawling, walking), and fine motor (picking up things, feeding themselves) development. They will eventually catch up. However, it may take them longer to learn those skills. Questions to ask your doctor If my first ...
Full Text Available ... Our work Community impact Global programs Research Need help? Frequently asked questions Contact us Tools & Resources Born ... your dashboard . Time to eat! Feeding your baby helps her grow healthy and strong. It’s also a ...
Full Text Available ... baby Formula feeding How to breastfeed Keeping breast milk safe and healthy Problems and discomforts when breastfeeding ... health & safety ') document.write('') } Ask our experts! Have a ...
... milk is easier to digest than formula. • Breast milk contains antibodies that protect infants from certain illnesses, such as ear infections, diarrhea, respiratory illnesses, and allergies. The longer your baby breastfeeds, ...
Full Text Available ... Saving Just a moment, please. You've saved this page It's been added to your ... milk is the best food for your baby during the first year of life. Learn how to breastfeed and why ...
... sharing on social media links Babies Need Tummy Time! Page Content Tummy Time is not only an ... of your baby’s normal growth. What Is Tummy Time? Tummy Time describes the times when you place ...
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The Ububele Baby Mat Service is a community-based, parent–infant mental health intervention offered at five primary health care clinics in Alexandra Township, in Johannesburg. The aim of the intervention is to promote healthy caregiver-infant attachments. There has been a steady increase in the number of mother-baby ...
Studies real household income after the birth of a baby reporting median child care expenses were zero in first and $6 in fourth quarter; mean expenses in fourth quarter were $210. Fertility rate of women aged 18-44 without high school education who had baby in 1988 was 87, compared to 63 for women with college degree. (LB)
Full Text Available Sudden increase in the number of live births after the Second World War due to an increase in fertility rates has led to the formation of cohorts with specific characteristics or baby boom generation. This generation is unique in the history of the demographic phenomenon that has affected and affects the functioning of many segments of society. The aim of this paper is to assess structure of baby boomers who are few years away from retirement, using demographic data. Impact of baby boomer age structure of current and future retirees is described with a graphical display of current and projected age pyramid of baby boomers. Demographic pattern that women live longer than men is evident in the projected pyramid. In addition, the number of baby boomers will lead to a "younger" old population. The imbalance in the number of men and women pensioners, as well as older cohorts of women and female baby boomers was analyzed. As a result, an increasing trend of women's age pensioners who are members of the baby boom generation was clearly observed, which is opposite to the older cohort of women who often were family pensioners. Different circumstances and conditions in which female boomers lived and worked will form a new "pension model" because they will gain their benefits as well as men, for the first time in significant number, unlike their mothers, which gained the right to retire after they become widows. Number of women age pensioners is getting greater comparing to men, as the result of changes in the economic activities of women in the last half of the 20th century. When baby boomers retire and exit the working population, this will create a vacuum, because the numerically smaller generations will enter working population, while the sudden and very shortly, the number of population older than 60 or 65 will increase, most of them will likely to acquire the right to a pension. It is undeniable that baby boomers had impact on demographic structure
Ratcliff, Cathy; Thyle, Ann; Duomai, Savita; Manak, Manju
EMMS International and Emmanuel Hospital Association (EHA) implemented a pilot project, poverty reduction in India through palliative care (PRIPCare). A total of 129 interviews with patients and family enrolled in palliative care at three EHA hospitals (in Fatehpur, Lalitpur and Utraula) and staff discussions established that 66% of palliative care patients had lost livelihoods due to illness, 26% of patients' families had members who had lost livelihoods due to the illness, 98% of enrolled households had debts, 59% had loans for which they had sold assets, 69% of households took out debt after their family member fell ill, many patients do not know about government benefits and lack necessary documents, many village headmen require bribes to give people access to benefits, and many bereaved women and children lose everything. Palliative care enabled 85% of patients and families to spend less on medicines, 31% of patients received free medicines, all patients reduced use of out-patient departments (OPDs), 20% reduced use of inpatient departments (IPDs), and therefore spent less on travel, 8% of patients had started earning again due to improved health, members of 10% of families started earning again, and one hospital educated 171 village headmen and increased by 5% the number of patients and their families receiving government benefits. If only 0.7% of needy adults are receiving palliative care, these benefits could be delivered to 143 times more families, targeted effectively at poverty reduction. Palliative care has great scope to reduce that most desperate poverty in India caused by chronic illness. This article concerns a study by the UK NGO EMMS International and Indian NGO EHA, to assess whether palliative care reduces household poverty. EHA staff had noticed that many patients spend a lot on ineffective treatment before joining palliative care, many families do not know their entitlement to government healthcare subsidies or government pensions, and many
Bolivia is one of the poorest countries in Latin America. Health indicators are very poor, communicable diseases are prevalent and, coupled with malnutrition, remain the major killers of children under 5 years old. The Integrated Primary Health Care Project (PROISS) was a US$39 million project executed by the Ministry of Health (MOH), 50% financed by the World Bank and aimed at improving primary health care in the four largest Bolivian municipalities. The implementation of the project started in 1990 and ended in 1997. During implementation it went through three distinct phases: Phase 1 (1990-94) was a period characterized by conflict and confusion; Phase 2 (1995-mid-1996) documented major improvements in coverage and service quality; and Phase 3 (mid-1996-97) witnessed the decline of the project. This paper explores the factors that contributed to the success and the decline of the project, draws lessons for project managers and international agencies involved in the definition and implementation of social sector projects, and discusses the unlikelihood that externally financed projects can have a sustainable impact on the development of the health sector of recipient countries.
Lazure, G; Vissandjée, B; Pepin, J; Kérouac, S
This paper aims to illustrate how Leininger's Theory of Culture Care Diversity and Universality has influenced the research process of a study that emerged from a care management partnership between Canadian nursing teachers and Tunisian nurses. The purpose of the study was to investigate the meanings of care as viewed by university hospital-based Tunisian nurses. The qualitative analysis of data gathered through observation-participation and interviews highlights recurrent patterns and reveals three major professional care themes. For Tunisian nurses care means to secure the patient's cooperation towards the medical regimen within established rules in the hospital; to contribute to curing the patient by using current technology as well as by maintaining their technical skills and improving their medical knowledge; to take charge of the patient to assist the physician in treating disease. This study showed that Tunisian nurses emphasize curing rather than widely shared community values such as interdependence, intercommunication, understanding, presence and responsibility for others. Discussion of the study's findings draws upon the perspective provided by Freire's Oppressed Group Theory. In order to promote cultural congruence within the Care Management Partnership Project in Tunisia, the three predicted modes of care within Leininger's theory guide the decisions and actions for future nursing research and partnership activities.
CARE, an ambitious and coordinated project of accelerator research and developments oriented towards High Energy Physics projects, has been launched in January 2004 by the main European laboratories and the European Commission with the 6th Framework Programme. This project aims at improving existing infrastructures dedicated to future projects such as linear colliders, upgrades of hadron colliders and high intensity proton drivers An important part of this programme is devoted to advancing the performance of the superconducting technology, both in the fields of RF cavities for electron and proton acceleration and of high field magnets, as well as to developing high intensity electron and proton injectors. We describe the plans of the four main Joint Research Activities and report on the results and progress obtained so far. The CARE project also includes three adjacent Networking Activities whose main goal is to organize a forum of discussions and to provide the strategic plans in the fields of the Linear Collider, intense Neutrino Beams, and future Hadron Colliders
Introduction. This article is about how to recognize obstructed labour and deal with it in a way that preserves the life and health of mother and child. It is for midwives and others who work in maternity care and is based on our experiences in Yei, South Sudan. Obstructed labour means that the baby is too big to pass through ...
Preconception health means taking care of your own health now so youâll be healthy for yourself and your future baby. Created: 10/1/2012 by National Center on Birth Defects and Developmental Disabilities (NCBDDD). Date Released: 10/1/2012.
Preconception health means taking care of your own health now so youâll be healthy for yourself and your future baby. Created: 10/1/2012 by National Center on Birth Defects and Developmental Disabilities (NCBDDD). Date Released: 10/1/2012.
Oishi, Kenichi; Chang, Linda; Huang, Hao
The baby brain is constantly changing due to its active neurodevelopment, and research into the baby brain is one of the frontiers in neuroscience. To help guide neuroscientists and clinicians in their investigation of this frontier, maps of the baby brain, which contain a priori knowledge about neurodevelopment and anatomy, are essential. "Brain atlas" in this review refers to a 3D-brain image with a set of reference labels, such as a parcellation map, as the anatomical reference that guides the mapping of the brain. Recent advancements in scanners, sequences, and motion control methodologies enable the creation of various types of high-resolution baby brain atlases. What is becoming clear is that one atlas is not sufficient to characterize the existing knowledge about the anatomical variations, disease-related anatomical alterations, and the variations in time-dependent changes. In this review, the types and roles of the human baby brain MRI atlases that are currently available are described and discussed, and future directions in the field of developmental neuroscience and its clinical applications are proposed. The potential use of disease-based atlases to characterize clinically relevant information, such as clinical labels, in addition to conventional anatomical labels, is also discussed. Copyright © 2018. Published by Elsevier Inc.
Oladapo, Olufemi T; Souza, João Paulo; Bohren, Meghan A; Tunçalp, Özge; Vogel, Joshua P; Fawole, Bukola; Mugerwa, Kidza; Gülmezoglu, A Metin
As most pregnancy-related deaths and morbidities are clustered around the time of childbirth, quality of care during this period is critical to the survival of pregnant women and their babies. Despite the wide acceptance of partograph as the central tool to optimize labour outcomes for over 40 years, its use has not successfully improved outcomes in many settings for several reasons. There are also increasing questions about the validity and applicability of its central feature - "the alert line" - to all women regardless of their labour characteristics. Apart from the known deficiencies in labour care, attempts to improve quality of care in low resource settings have also failed to address and integrate women's birth experience into quality improvement processes. It was against this background that the World Health Organization (WHO) embarked on the Better Outcomes in Labour Difficulty (BOLD) project to improve the quality of intrapartum care in low- and middle-income countries. The main goal of the BOLD project is to reduce intrapartum-related stillbirths, maternal and newborn mortalities and morbidities by addressing the critical barriers to the process of good quality intrapartum care and enhancing the connection between health systems and communities. The project seeks to achieve this goal by (1) developing an evidence-based, easy to use, labour monitoring-to-action decision-support tool (currently termed Simplified, Effective, Labour Monitoring-to-Action - SELMA); and (2) by developing innovative service prototypes/tools, co-designed with users of health services (women, their families and communities) and health providers, to promote access to respectful, dignified and emotionally supportive care for pregnant women and their companions at the time of birth ("Passport to Safer Birth"). This two-pronged approach is expected to positively impact on important domains of quality of care relating to both provision and experience of care. In this paper, we briefly
Feijen, Michelle M W; Claessens, Edith A W M Habets; Dovens, Anke J Leenders; Vles, Johannes S; van der Hulst, Rene R W J
Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option.
Holder, H D; Cisler, R A; Longabaugh, R; Stout, R L; Treno, A J; Zweben, A
This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Longitudinal study with pre- and post-treatment initiation. The total medical care costs for inpatient and outpatient treatment for patients participating over a span of 3 years post-treatment. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Two hundred and seventy-nine patients. Patients were randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment.
Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio
Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Lee, Teresa; Schiller, Jennifer
In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions.
Babies and the flu; Your infant and the flu; Your toddler and the flu ... FLU SYMPTOMS IN INFANTS AND TODDLERS The flu is an infection of the nose, throat, and (sometimes) lungs. Call your baby's provider if ...
Loeslie, Vicki; Abcejo, Ma Sunnimpha; Anderson, Claudia; Leibenguth, Emily; Mielke, Cathy; Rabatin, Jeffrey
Substantial evidence in critical care literature identifies a lack of quality and quantity of communication between patients, families, and clinicians while in the intensive care unit. Barriers include time, multiple caregivers, communication skills, culture, language, stress, and optimal meeting space. For patients who are chronically critically ill, the need for a structured method of communication is paramount for discussion of goals of care. The objective of this quality improvement project was to identify barriers to communication, then develop, implement, and evaluate a process for semistructured family meetings in a 9-bed respiratory care unit. Using set dates and times, family meetings were offered to patients and families admitted to the respiratory care unit. Multiple avenues of communication were utilized to facilitate attendance. Utilizing evidence-based family meeting literature, a guide for family meetings was developed. Templates were developed for documentation of the family meeting in the electronic medical record. Multiple communication barriers were identified. Frequency of family meeting occurrence rose from 31% to 88%. Staff satisfaction with meeting frequency, meeting length, and discussion of congruent goals of care between patient/family and health care providers improved. Patient/family satisfaction with consistency of message between team members; understanding of medications, tests, and dismissal plan; and efficacy to address their concerns with the medical team improved. This quality improvement project was implemented to address the communication gap in the care of complex patients who require prolonged hospitalizations. By identifying this need, engaging stakeholders, and developing a family meeting plan to meet to address these needs, communication between all members of the patient's care team has improved.
Full Text Available ... mail was sent. Save to my dashboard Sign in or Sign up to save this page. Saving Just a moment, please. You've saved this page It's been added to your dashboard . Time to eat! Feeding your baby helps her grow ...
Dr. Stacey Bosch, a veterinarian with CDC, discusses her article on Salmonella infections associated with baby turtles. Created: 1/9/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 1/9/2017.
... be done. If your baby’s reflux is causing health problems, your doctor may prescribe medicine. This medicine is the same ... Is my baby at risk for any health problems? Last Updated: February 8, 2018 ... of Family Physicians This information provides a general overview and may ...
Full Text Available ... Product Catalog Volunteer Volunteer leaders Team Youth National service partners ... strong. It’s also a great time for you and your partner to bond with her. Breast milk is the best food for your baby during the first year of ...
Bachleda, Amelia R.; Thompson, Ross A.
Babies think differently than adults, and understanding how they think can help us see their explosive brain growth in everyday behavior. Infants learn language faster than adults do, use statistics to understand how the world works, and even reason about the minds of others. But these achievements can be hidden by their poor self-regulatory…
... wipes within your reach, but out of your baby’s reach. Car seat: The law requires drivers to place a child in a car seat designed for the child’s age, weight, and height. These requirements can vary by state and include: Rear-facing car seats for babies up to age 2. Forward-facing car seats ...
Executive leaders of an acute care hospital performed a market and financial analysis, and created a business plan to establish an inpatient hemodialysis unit operated by the hospital to provide safe, high-quality, evidence-based care to the population of individuals experiencing end stage renal disease (ESRD) within the community. The business plan included a SWOT (Strengths - Weaknesses - Opportunities - Threats) analysis to assess advantages of the hospital providing inpatient hemodialysis services versus outsourcing the services with a contracted agency. The results of the project were a newly constructed tandem hemodialysis room and an operational plan with clearly defined key performance indicators, process improvement initiatives, and financial goals. This article provides an overview of essential components of a business plan to guide the establishment of an inpatient hemodialysis unit. Copyright© by the American Nephrology Nurses Association.
To live well is a universal human aspiration as well as the ultimate goal of the services that take care of people's health. In this paper, two different ideas are discussed about how to achieve it: health care and life project. Part I begins with a detailed account of human degradation and the social inequities responsible for the unprecedented social and cultural breakdown of the actual society. Under this interpretative framework, the medicalization of human life as result of the alienating consumerism is analyzed as well as the excesses it entails from both health care institutions and health services users. By exploring the reasons of medicalization, it becomes clear that its influence in our actual lifestyles has driven us to be obsessed with being healthy and horrified of diseases; this works as a very effective mean of social control from the powers that maintain and deepen inequality. As such, the first to benefit from it is the health industry. This constant concern for health takes us away from our goal of living well since it causes anxiety, insecurity and disquietude. In conclusion, different considerations about the inconveniences of devoting all our energies towards health care are offered and it is suggested that instead we all have the responsibility of creating a more hospitable and inclusive world. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.
Engel-Smothers, Holly; Heim, Susan M.
With more than 100 billion neurons that would stretch more than 60,000 miles, a newborn baby's brain is quite phenomenal! These neurons must generally form connections within the first eight months of a baby's life to foster optimal brain growth and lifelong learning. Mommies, daddies, and caregivers are extremely vital to ensuring babies reach…
... won't harm your baby. It's common for babies to cry when put down for sleep, but most will quiet themselves if left alone for a few minutes. If the crying lasts longer than a few minutes, check on your baby and offer comforting words. Then give him or ...
Weaning should start when the baby turns 4 months old. At this stage (4 to 6 months), milk is no longer enough. Parents should introduce new foods which can meet the fast-increasing nutrition needs of the child. Among the latest materials produced by the Video Radio Production Division of the Nutrition Center of the Philippines is a VTR training module entitled "Karagdagang Pagkain ni Baby" (Weaning Foods for Baby), designed to strengthen this important aspect of child care. Specifically, the module seeks to encourage parents to introduce foods in addition to breastmilk to their 4 to 6 month old children and to start giving them "complete" meals from 6 months onward. It provides suggestions on the kinds of foods or food combinations to give to the baby and encourages home food production (backyard gardening, poultry-raising etc) to supply food requirements of growing children. Contents of the module include how-to's on weaning food preparation (mashing, straining, flaking, chopping, scraping, etc), prescriptions on the kinds and amounts of foods for babies; and food combinations (porridge or rice and a viand from the 3 basic food groups: energy-giving, body building and regulating). For instance, at 4 months old, the baby may be given lugao (porridge), soup and fruits; at 5 months, eggs, vegetables and beans; at 6 months, fish/meat, oil or gata (coconut oil). With a running time of 18 minutes, the module uses computer graphics to highlight food items, recommended amounts, and age group requirements in the text, and applies digital multi-effects to ensure smooth traditions. full text
Reith, W.; Ahlhelm, F.; Papanagiotou, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)
Shaken baby syndrome (SBS) describes the coincidence of subdural hematoma, retinal bleeding and, disadvantageous for the prognosis, diffuse brain damage caused by powerful shaking of the infant. The clinical symptoms include irritability, difficulty with drinking, somnolence, apathy, cerebral cramp attacks, apnoea, temperature regulation disorders and vomiting due to cranial pressure. Milder symptoms of SBS are often not diagnosed and the number of unregistered cases is probably much greater. The diagnosis of SBS is made through the typical symptom constellation, but the lack of retinal bleeding does not exclude the diagnosis. Normally the infants are held by the thorax or upper arms and shaken in a sagittal direction during which the head falls backwards and forwards and is stopped abruptly at each extreme position. The injurious mechanism is considered to be caused by rotational forces which force tissue layers in the brain against each other and also lead to rupture of bridging veins between the skull and the brain. The prognosis is poor and approximately 25% of infants die of SBS within days or weeks. Approximately 75% of survivors suffer from long term damage with physical handicaps, limitations in hearing, visual disturbances up to blindness and mental disorders or combinations of these conditions. Prevention is therefore the most important aspect. (orig.) [German] Das Shaken-baby-Syndrom (SBS) oder Schuetteltrauma des Saeuglings beschreibt die Koinzidenz subduraler Haematome, retinaler Blutungen und prognostisch unguenstiger, diffuser Hirnschaeden durch heftiges Schuetteln eines Saeuglings. Die klinischen Symptome umfassen Irritabilitaet, Trinkschwierigkeiten, Somnolenz, Apathie, zerebrale Krampfanfaelle, Apnoe, Temperaturregulationsstoerungen und Erbrechen durch Hirndruck. Leichtere Symptome des SBS werden haeufig nicht diagnostiziert, die Dunkelziffer ist wahrscheinlich viel hoeher. Die Diagnose des SBS wird durch die typische Symptomkonstellation gestellt
Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy
This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.
Nielsen, H.B.; Ninomiya, Masao
We give an elementary review of the so called 'the theory of baby universes' which is a series of ideas or speculations about some effects in quantum gravity, viz. the effect of a certain type of wormholes, representing the exchange of small 3-space universes called baby universes. We consider this 'theory' as being physically and scientifically a very promising candidate for a theory of everything. It is, however, mathematically lacking any strong foundation at all. It solves several fine-tuning problems: First of all the cosmological constant problem, and also the strong CP-problem and the hierarchy problem. We also speculate that it might predict the possibility of influencing the probability distributions of the outcome of quantum mechanical measurements at one time by acts at a later time. (orig.)
The Center for Remote Sensing of Ice Sheets (CReSIS) has developed an outreach program based on hands-on activities called "Ice, Ice, Baby". These lessons are designed to teach the science principles of displacement, forces of motion, density, and states of matter. These properties are easily taught through the interesting topics of glaciers, icebergs, and sea level rise in K-8 classrooms. The activities are fun, engaging, and simple enough to be used at science fairs and family science nights. Students who have participated in "Ice, Ice, Baby" have successfully taught these to adults and students at informal events. The lessons are based on education standards which are available on our website www.cresis.ku.edu. This presentation will provide information on the activities, survey results from teachers who have used the material, and other suggested material that can be used before and after the activities.
Rita V Vora
Full Text Available Michelin tire baby syndrome (MTBS, is a rare genodermatosis, characterized by generalized folding of excess skin and may be associated with various phenotypic abnormalities. The pathogenesis of this condition is unclear. Various congenital anomalies can be associated with it. It may be a clinical finding associated with various syndromes. Diagnosis is mainly clinical, and skin folds gradually diminish and disappear with age without any intervention. Here, we report a case of MTBS associated with convergent squint and hydrocephaly.
Full Text Available The ichthyosis are a heterogeneous group of hereditary and acquired disorder of keratinization which affected the epidermis characterized by presence of visible scales on the skin surface in the absence of inflammation. It can occur as a disease limited to the skin or in association with abnormalities of other organ systems. Lamelar ihthyosis (LI is one of two mayor autosomal recessive ichthyosis with an incidence of approximately one in 300,000. The diagnosis is based on clinical and pathologic finding. Infection is the most common complication, while prognosis of LI is depends on severity and complication of the disease. A case of lamellar ichthyosis in 0 day Balinese female baby was reported. The skin of the body was thick, plate-like appearance, scaling on the entire body, some of the thick skin was ruptured on chest and extremities. There were eclabium on the mouth and ectropion on the eyes. Histopathology examination showed hyperkeratosis without perivascular infiltration lymphocyte. The baby was given breast feeding, antibiotic, hydrocortisone cream and olium olivarum. The prognosis of the baby is good.
Uduman, S A; Farrukh, A S; Nath, K N R; Zuhair, M Y H; Ifrah, A; Khawla, A D; Sunita, P
We report an outbreak of Serratia marcescens infection in a special-care baby unit (SCBU) of a university-affiliated community hospital in the United Arab Emirates. The outbreak involved 36 infants and lasted for 20 weeks. Seven of the colonized infants developed invasive illnesses in the form of bacteraemia (four cases), bacteraemic meningitis (two) and clinical sepsis (one). Three other term infants had purulent conjunctivitis. There were five deaths with an overall mortality of 14%. S. marcescens was cultured from airflow samples from the air conditioning (AC) which was the reservoir of infection in this outbreak. Elimination of the nosocomial source and outbreak containment were eventually achieved by specialized robotic cleaning of the entire AC duct system of the SCBU. Strict adherence to the infection control policies was reinforced to prevent transmission of cross-infection. Copyright 2002 The Hospital Infection Society
Mackinson, Lynn G; Corey, Juliann; Kelly, Veronica; O'Reilly, Kristin P; Stevens, Jennifer P; Desanto-Madeya, Susan; Williams, Donna; O'Donoghue, Sharon C; Foley, Jane
A nurse project consultant role empowered 3 critical care nurses to expand their scope of practice beyond the bedside and engage within complex health care delivery systems to reduce harms in the intensive care unit. As members of an interdisciplinary team, the nurse project consultants contributed their clinical expertise and systems knowledge to develop innovations that optimize care provided in the intensive care unit. This article discusses the formal development of and institutional support for the nurse project consultant role. The nurse project consultants' responsibilities within a group of quality improvement initiatives are described and their challenges and lessons learned discussed. The nurse project consultant role is a new model of engaging critical care nurses as leaders in health care redesign. ©2018 American Association of Critical-Care Nurses.
Khan, M.; Akram, D.S.
To determine changes in the breastfeeding practices of mothers after receiving counseling on Ten Steps to Successful Breastfeeding as defined by the Baby Friendly Hospital Initiative comparing baby friendly hospitals (BFHs) and non-baby-friendly hospitals in Sindh, Pakistan. Methods: The observational study was conducted from June 2007 to June 2009 in randomly selected baby-friendly and non-baby-friendly hospitals of Sindh, Pakistan. Non-probability purposive sampling was employed. The maternity staff was trained on Ten Steps to Successful Breastfeeding. The changes in breastfeeding practices were analysed by SPSS version 15. Results: A total of 236 women were included in the study. Of them, 196 (83.05%) were from baby-friendly hospitals and 40 (16.94%) from non-baby-friendly hospitals. Besides, 174 (88.7%) mothers in baby-friendly hospitals and 5 (12.5%) in non-baby-friendly hospitals during antenatal care received counseling by healthcare providers. There was an increase in breastfeeding practice up to 194 (98.97%) in the first category compared to 12 (30%) in the other category. Conclusion: Counseling under the Baby Friendly Hospital Initiative improved breastfeeding practices up to 98.97% in baby-friendly compared to non-baby-friendly hospitals. (author)
Bertholf, L; Loveless, S
Health care staffing challenges for the next few years necessitate the need to develop strategies to integrate the Generation Xer into a predominantly Baby Boomer work force. Strategies to assist Baby Boomers and Generation Xers to engage one another in constructive relationships are discussed. Misunderstanding and stereotyping create barriers that focus on differences and perceived limitations rather than identification of common thinking and focusing on strengths of each generation.
A one-day presentation of the project will take place on Monday February 10th in the CERN Council Chamber. The meeting will start a 9am and is expected to end at 4:30pm. The meeting, which is open to the whole community, will present an initiative on accelerator R&D in Europe, supported by ECFA, with the aim to bid for European Union support through the Framework 6 scheme. This initiative is coordinated by a steering group (ESGARD - European Steering Group on Accelerator Research and Development), which has been set up to coordinate European efforts on accelerator R&D and the submission of such bids. The initial bids have to be submitted by April 15th. All those interested in accelerator R&D are welcome to attend. Presentation of the CARE project (Coordinated Accelerator Research in Europe) to be submitted within FP6 February 10th, at CERN in the council room Agenda Chair : C. Wyss 9:00 General presentation of FP6 and introduction of IA proposal (R. Aleksan) 9:45 Networking activities on e ...
Full Text Available Colloidon baby is a rare congenital disorder characterized clinical-ly by parchment like taught membrane covering the whole body at the time of birth, which subsequently develops Non bullous ichthyosiform erythroderma or Lamellar ichthyiosis in most cases and in few cases other ichthyosiform disorders. The colloidon membrane spontaneously desquamates within 2 weeks or up to 3 months in few cases. Herein, we present 2 cases of colloidon babies born to consanguineously married couples of which the first baby was born at term by normal vaginal delivery and second baby born prematurely by caesarean section. Both 1st & 2nd baby were delivered in different private hospitals in villages of Nizamabad district, Telangana state and reported to tertiary level children’s hospital in Hyderabad city on 4nd and 6th day of life respectively with complaints of colloidon membrane and macera-tion of skin in diaper area, was admitted in Neonatal intensive care unit (NICU in humidified incubator, treated with emollients, intra-venous fluids and prophylactic antibiotics to avoid complications. Nursing care is of prime importance. This presentation was aimed at stressing not only the importance of early recognition by pedia-trician & timely referral to dermatologist and ophthalmologist for saving life of affected baby but also equal importance to proper nursing care.
Fraser, W; Hatem-Asmar, M; Krauss, I; Maillard, F; Bréart, G; Blais, R
The purpose of this study was to compare indicators of process and outcome of midwifery services provided in the Quebec pilot projects to those associated with standard hospital-based medical services. Women receiving each type of care (961 per group) were matched on the basis of socio-demographic characteristics and level of obstetrical risk. We found midwifery care to be associated with less obstetrical intervention and a reduction in selected indicators of maternal morbidity (caesarean section and severe perineal injury). For neonatal outcome indicators, midwifery care was associated with a mixture of benefits and risks: fewer babies with preterm birth and low birthweight, but a trend toward a higher stillbirth ratio and more frequent requirement for neonatal resuscitation. The study design does not permit to conclude that the associations were causal in nature. However, the high stillbirth rate observed in the group of women who were selected for midwife care raises concerns both regarding the appropriateness of the screening procedures for admission to such care and regarding the quality of care itself.
Martins, Tiago; de Magalhães, Sérgio Tenreiro
The baby's crying is his most important mean of communication. The crying monitoring performed by devices that have been developed doesn't ensure the complete safety of the child. It is necessary to join, to these technological resources, means of communicating the results to the responsible, which would involve the digital processing of information available from crying. The survey carried out, enabled to understand the level of adoption, in the continental territory of Portugal, of a technology that will be able to do such a digital processing. It was used the TAM as the theoretical referential. The statistical analysis showed that there is a good probability of acceptance of such a system.
Kim, Heejung; Lee, Sangeun; Cheon, Jooyoung; Hong, Soyun; Chang, Mido
Baby boomers' position in the caregiving context is shifting from caregiver to care recipient as the population ages. While the unique characteristics of baby boomer caregivers are well established in caregiving literature, there is limited information about the next caregiving group after the baby boomers. In this study, the sociodemographic and caregiving-related characteristics of the two generations are compared and specific factors contributing to caregiver burden between baby boomer and post baby boomer caregivers are identified. This cross-sectional and correlational study used secondary analysis of data from the National Alliance for Caregiving and the American Association of Retired Persons. A structured online survey was conducted in 2014 with randomly selected samples (n = 1069) in the United States focusing on sociodemographics, caregiving-related characteristics, and burden of care. Descriptive statistics, multivariate linear regression analyses, and Steiger's Z-test were used to identify group differences in multivariate factors related to caregiver burden in two generational groups. Baby boomers and post baby boomers experienced caregiver burden to a similar degree. Caregiving-related factors are more likely to increase burden of care than sociodemographics in both groups. Caregiving without choice and spending longer hours on caregiving tasks were common factors that increased the burden in both generational groups (all p values baby boomer caregivers reported additional challenges, such as unemployment during caregiving, the dual responsibility of both adult and child care, and a family relationship with the care recipient. Due to the aging population of baby boomers, post baby boomers encounter different challenges related to caregiving burden, which is often considered an additional workload in their life course. Current policy and program tailored to baby boomers should be re-designed to meet the different needs of emerging caregivers
Toda, Y.; Kaneda, Y.; Satoh, Y.; Suzukawa, I.; Yamada, T.
Designed by The Japan Steel Works, Ltd., specially for installation in a hospital's medical department and nuclear research laboratory, '' JSW BABY CYCLOTRON '' has been developed to produce short-lived radioisotopes such as 11C, 13N, 15O and 18F. JSW's Baby Cyclotron has some design features. 1) Fixed energy and four sector azimuthally varying field. 2) Compact figure desired for hospital's nuclear medical department 3) A bitter type magnet yoke shielding activity 4) Simple control and operation 5) Easy maintenance without skilled personnel. Type BC105 (P:10MeV, d:5MeV), BC107 (P:10MeV, d:7MeV), BC168 (P:16MeV, d:8MeV) and BC1710 (P:17MeV, d:10MeV) are available according to required amount of radioisotopes. In our radioisotope production test, yield and purity of 11C, 13N, 15O and 18F are usable to clinical diagnosis
although typically unaccounted for in the calculus of risks of VBAC versus repeat cesarean, the literature documents heightened risk of many short and...cessation and other behav- ioral interventions, aI!d dental care. • Within hospitals and health sys\\ ems, use person- nel policies to remove incentives...Cruel calculus : why saving premature babies is better business than helping them thrive. Health Aff (Millwood), 29(11), 2114-2117. Lawrence, P. R
... range). As your baby develops, take advantage of every opportunity to help stimulate her mind and body. From the earliest weeks of life, walk around the house while holding and interacting with your baby and say aloud the names of the objects that the ...
Mefodiev, A. V.; Kudenko, Yu. G.; Mineev, O. V.; Khotjantsev, A. N.
The main objective of the Baby-MIND detector (Magnetized Iron Neutrino Detector) is the study of muon charge identification efficiency for muon momenta from 0.3 to 5 GeV/ c. This paper presents the results of measurement of the Baby-MIND parameters.
Gao Yihong; Gao Hongbo
In this paper some quantum effects of baby universes with induced gravity are discussed. It is proved that the interactions between the baby-parent universes are non-local, and argue that the induced low-energy cosmological constant is zero. This argument does not depend on the detail of the induced potential
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Akhtar, Jamshed; Shaikh, Muhammad Ali; Saleem, Nasir; Taqvi, Syed Raees; Jehan, Yaqoot; Batool, Tayyaba; Zameer, Naima; Mirza, Farhat
Sirenomelia is a rare anomaly that rarely occurs as an isolated lesion. Several theories have been proposed regarding the etiopathogenesis. In this communication, we report a case of sirenomelia. Our patient was referred to hospital at the age of four hours. On examination, fusion of both lower limbs with hook shaped appendage, attached distally, absent genitalia and absent anal orifice was found. Spine was deficient in sacral region. Upper torso looked normal. Baby also had frothing from mouth. Abdomen was non-distended. Feeding tube no.10 was tried to pass through mouth, which got obstructed at the level of upper esophagus that suggested oesophageal atresia. The skeletogram revealed absence of pelvic bones, sacral agenesis, absent fibulae and fracture of both femora. The patient died at the age of 12 hours.
Mortari, Luigina; Ubbiali, Marco
The educative project MelArete proposes an interpretation of ethical education: a form of Education to Virtue Ethics in the light of the philosophy of care. Starting from the ontological assumption that care is prime in life and without it the human being cannot flourish in his/her humanity, the project is based on an interpretation of the…
van Mil, J.W F
The evolving concept of Pharmaceutical Care knows different interpretations in a different countries. In the Netherlands community pharmacists already perform several functions which may be part of the Pharmaceutical Care concept. The Dutch concept of Pharmaceutical care is tested in the TOM and
Mansfield, Elizabeth; Bhattacharyya, Onil; Christian, Jennifer; Naglie, Gary; Steriopoulos, Vicky; Webster, Fiona
Purpose Canada's primary care system has been described as "a culture of pilot projects" with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.
Jennings, Fiona L; Mitchell, Marion
Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement. The project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients' care. The rounds were evaluated to assess the nurse's perception of improvement. There were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues. Inter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.
P.J.M. van den Burg
Full Text Available The Donor Health Care project is a EU granted project to develop a learning programme for professionals working in the field of Donor Health Care. The innovation of this curriculum is the focus on all donors, irrespective of whether they donate blood, cells, tissues or organs. This article describes the background of the project and the current possibilities and limitations of European accreditation, distance learning and Master degrees.
Full Text Available ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...
Full Text Available ... Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care ... Preterm labor & premature birth The newborn intensive care unit (NICU) Birth defects & other health ...
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... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...
... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...
Full Text Available ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...
Nielsen, H.B.; Ninomiya, Masao.
We review the recently popular 'theory of baby universes' put forward by Banks, Coleman and Hawking. We then derive the strong CP breaking coefficient θ-bar to be very small, in a similar manner to the derivation of the cosmological constant being zero. A solution for an old controversy concerning the entropy creation in black holes is also discussed. We finally confront the baby universe theory with random dynamics. We conclude that the theory of baby universes is so successful that the essential features are likely true and might have to go into a right theory even if with some troubles at first. (author)
Yamamoto, Shota; Yoshitomi, Yasunari; Tabuse, Masayoshi; Kushida, Kou; Asada, Taro
We developed a method for pattern recognition of baby's emotions (discomfortable, hungry, or sleepy) expressed in the baby's cries. A 32-dimensional fast Fourier transform is performed for sound form clips, detected by our reported method and used as training data. The power of the sound form judged as a silent region is subtracted from each power of the frequency element. The power of each frequency element after the subtraction is treated as one of the elements of the feature vector. We per...
ARÉVALO SÁNCHEZ ELIZABETH
The purposeofthisresearch istovalue thecarepractices that mothers perform on themselves and on the baby to whom she is going to give birth. 150 pregnant women that go to the Centro Operativo Local Engativá medical facility, registered on project 7317: "Preganant Families: healthy and desired babies of the Administrative DepartmentofSocialWellbeing", using a quantitative and descriptive methodology. We applied the "Instrument to value those care practices that are performed on themselves and o...
Thomas, R E; Spragins, W; Mazloum, G; Cronkhite, M; Maru, G
Early and regular developmental screening can improve children's development through early intervention but is insufficiently used. Most developmental problems are readily evident at the 18-month well-baby visit. This trial's purpose is to: (1) compare identification rates of developmental problems by GPs/family physicians using four evidence-based tools with non-evidence based screening, and (2) ascertain whether the four tools can be completed in 10-min pre-visit on a computer. We compared two approaches to early identification via random assignment of 54 families to either: 'usual care' (informal judgment including ad-hoc milestones, n = 25); or (2) 'Evidence-based' care (use of four validated, accurate screening tools, n = 29), including: the Parents' Evaluation of Developmental Status (PEDS), the PEDS-Developmental Milestones (PEDS-DM), the Modified Checklist for Autism in Toddlers (M-CHAT) and PHQ9 (maternal depression). In the 'usual care' group four (16%) and in the evidence-based tools group 18 (62%) were identified as having a possible developmental problem. In the evidence-based tools group three infants were to be recalled at 24 months for language checks (no specialist referrals made). In the 'usual care' group four problems were identified: one child was referred for speech therapy, two to return to check language at 24 months and a mother to discuss depression. All forms were completed on-line within 10 min. Despite higher early detection rates in the evidence-based care group, there were no differences in referral rates between evidence-based and usual-care groups. This suggests that clinicians: (1) override evidence-based screening results with informal judgment; and/or (2) need assistance understanding test results and making referrals. Possible solutions are improve the quality of information obtained from the screening process, improved training of physicians, improved support for individual practices and acceptance by the regional
Chen, Mei-Ju; Lu, Yu-Hua; Chen, Chiu-Chun; Li, Ai-Cheng
Foreign health aides are the main providers of care for the elderly and the physically disabled in Taiwan. Correct care skills improve patient safety. In 2010, the incidence of mistakes among foreign health aides in our hospital unit was 58% for nasogastric tube care and 57% for tracheostomy tube care. A survey of foreign health aides and nurses in the unit identified the main causes of these mistakes as: communication difficulties, inaccurate instructions given to patients, and a lack of standard operating procedures given to the foreign health aides. This project was designed to reduce the rates of improper nasogastric tube care and improper tracheostomy tube care to 20%, respectively. This project implemented several appropriate measures. We produced patient instruction hand-outs in Bahasa Indonesia, established a dedicated file holder for Bahasa Indonesian tube care reference information, produced Bahasa Indonesian tube-care-related posters, produced a short film about tube care in Bahasa Indonesian, and established a standardized operating procedure for tube care in our unit. Between December 15th and 31st, 2011, we audited the performance of a total of 32 foreign health aides for proper execution of nasogastric tube care (21 aides) and of proper execution of tracheostomy tube care (11 aides). Patients with concurrent nasogastric and tracheostomy tubes were inspected separately for each care group. The incidence of improper care decreased from 58% to 18% nasogastric intubation and 57% to 18% for tracheostomy intubation. This project decreased significantly the incidence of improper tube care by the foreign health aides in our unit. Furthermore, the foreign health aides improved their tube nursing care skills. Therefore, this project improved the quality of patient care.
Trosman, Julia R; Carlos, Ruth C; Simon, Melissa A; Madden, Debra L; Gradishar, William J; Benson, Al B; Rapkin, Bruce D; Weiss, Elisa S; Gareen, Ilana F; Wagner, Lynne I; Khan, Seema A; Bunce, Mikele M; Small, Art; Weldon, Christine B
Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. We examined challenges faced by a patient with early-stage breast cancer that resulted from difficulties in understanding and managing task interdependence across clinical domains involved in this patient's care. We used team science supported by the project management discipline to discuss how various task interdependence aspects can be recognized, deliberately designed, and systematically managed to prevent care breakdowns. This case highlights how effective task interdependence management facilitated by project management methods could markedly improve the course of a patient's care. This work informs efforts of cancer centers and practices to redesign cancer care delivery through innovative, practical, and patient-centered approaches to management of task interdependence in cancer care. Future patient-reported outcomes research will help to determine optimal ways to engage patients, including those who are medically underserved, in managing task interdependence in their own care.
... they leave the hospital for home. Retinopathy of Prematurity (ROP) What It Is: ROP is an eye ... sometimes seen in preterm babies include anemia of prematurity (a low red blood cell count) and heart ...
Full Text Available Colloidon baby describes a highly characteristic clinical entity in newborns encased in a yellowish translucent membrane resembling collodion. In most cases the condition either precedes the development of one of a variety of ichthyoses, the commonest of which are lamellar ichthyosis and non-bullous ichthyosiform erythroderma, or occasionally represents an initial phase of other ichthyoses such as ichthyosis vulgaris. In at least 10% of all cases of collodion baby, the condition is followed by a mild ichthyosis of lamellar type, so mild as to be considered more or less normal, so-called self-healing collodion baby or ‘lamellar ichthyosis of the newborn’. In this report we present a rare case of collodion baby in whom, after collodion membrane peeled-off, the skin retained normal appearance.
Bürki, Lukas; Yersin, Bertrand
This article evaluates 3 controversial subjects of pre-hospital emergency care : 1) The concept of the « Golden hour » predicates an increased morbidity and mortality for injured patients, if pre-hospital care exceeds 1 hour. In the subgroup of patients presenting with severe hemorrhagic injuries or penetrating trauma to the torso, a transport of 60 minutes or less decreases mortality ; 2) The Sellick manoeuvre is used to decrease the risk of bronchoaspiration in patients undergoing an emergency intubation. In view of the low incidence of bronchoaspiration and the inherent risks of cricoid pressure, it should be used only in selected patients ; 3) Improvised cricothyroidotomy using non-medical devices may be feasible if a knife to perform an incision in the cricothyroid membrane and an endotracheal tube of sufficient diameter are available.
Conclusions: Holistic palliative care can reduce the desperate poverty driven by life-limiting illness, and can do so systematically, on a large-scale, in-depth, especially if started early in the illness. Home-based care also frees up hospitals to serve more patients with treatable conditions.
Ethel Cukierkorn Battikha
Full Text Available Objective: To analyze and to interpret the psychological repercussions generated by the presence of parents in the Neonatal Intensive Care Unit for residents in Neonatology. Methods: Study based on the psychoanalytic theory, involving a methodological interface with qualitative surveys in Health Sciences. Twenty resident physicians in Neonatology, from five public institutions of São Paulo state, responded to a single semi-structured interview. Based on several readings of the material, achieving the core of emergent meanings that would be significant to the object of the survey, six categories were elected for analysis and interpretation: parents' staying at the Neonatal Intensive Care Unit and its effects on the neonatologists' professional practice; communication of the diagnosis and what parents should know; impasses between parents and doctors when the diagnosis is being communicated; doctor's identification with parents; communication of the child's death and their participation in the interview. Results: The interpretation of the categories provided an understanding of the psychic mechanisms mobilized in doctors in their relationships with the children's parents, showing that the residents experience anguish and suffering when they provide medical care and during their training process, and also that they lack psychological support to handle these feelings. Conclusions: There is a need of intervention in neonatologists training and education, which may favor the elaboration of daily experiences in the Unit, providing a less anguishing and defensive way out for young doctors, especially in their relationship with patients and parents.
Jäykkä, Juha; Speight, Martin
The baby Skyrme model is studied with a novel choice of potential, V=(1)/(2)ϕ32. This “easy plane” potential vanishes at the equator of the target two-sphere. Hence, in contrast to previously studied cases, the boundary value of the field breaks the residual SO(2) internal symmetry of the model. Consequently, even the unit charge Skyrmion has only discrete symmetry and consists of a bound state of two half lumps. A model of long-range inter-Skyrmion forces is developed wherein a unit Skyrmion is pictured as a single scalar dipole inducing a massless scalar field tangential to the vacuum manifold. This model has the interesting feature that the two-Skyrmion interaction energy depends only on the average orientation of the dipoles relative to the line joining them. Its qualitative predictions are confirmed by numerical simulations. Global energy minimizers of charges B=1,…,14,18,32 are found numerically. Up to charge B=6, the minimizers have 2B half lumps positioned at the vertices of a regular 2B-gon. For charges B≥7, rectangular or distorted rectangular arrays of 2B half lumps are preferred, as close to square as possible.
With the machine restart and first collisions at 3.5 TeV, 2009 and 2010 were two action-packed years at the LHC. The events were a real media success, but one important result that remained well hidden was the ten births in the LHC team over the same period. The mothers – engineers, cryogenics experts and administrative assistants working for the LHC – confirm that it is possible to maintain a reasonable work-life balance. Two of them tell us more… Verena Kain (left) and Reyes Alemany (right) in the CERN Control Centre. With the LHC running around the clock, LHC operations engineers have high-pressure jobs with unsociable working hours. These past two years, which will undoubtedly go down in the annals of CERN history, the LHC team had their work cut out, but despite their high-octane professional lives, several female members of the team took up no less of a challenge in their private lives, creating a mini-baby-boom by which the LHC start-up will also be remembe...
Vadim Aleksandrovich Lomazov
Full Text Available Purpose: analysis of key indicators and creation of evaluation criteria of innovative socio-economic investment projects in healthcare, implemented on the basis of public-private partnerships.Methodology: there has been performed comprehensive assessment of specialized socio-economic projects in health sector taking into consideration interests of participants in the project (public and private, main aspects (medical, social, economic, scientific and innovative, and assessment components (presumable effectiveness or risk during implementation of the project. The degree of relative importance of the factors considered in each level, and the levels themselves are determined by experts with the help of paired comparisons method. The values of the project indicators are estimated against nonuniform grading scale, both the results of direct measurements and expert information being used.Results: There has been suggested an approach and a procedure for evaluating projects based on the allocation of interests, issues and evaluation components of the project as sub-criteria levels of the hierarchy analysis method; there has been developed research prototype of information analysis system for assessment of projects on the basis of the proposed approach.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-48
Full Text Available ... Global Map Premature Birth Report Cards Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...
LeRouge, Cynthia; Van Slyke, Craig; Seale, Deborah; Wright, Kevin
Background As they age, baby boomers (born 1946-1964) will have increasing medical needs and are likely to place large demand on health care resources. Consumer health technologies may help stem rising health care needs and costs by improving provider-to-patient communication, health monitoring, and information access and enabling self-care. Research has not explored the degree to which baby boomers are ready for, or are currently embracing, specific consumer health technologies This study ex...
Kizawa, Yoshiyuki; Yamamoto, Ryo
Although palliative care is assuming an increasingly important role in patient care, most physicians did not learn to provide palliative care during their medical training. To address these serious deficiencies in physician training in palliative care, government decided to provide basic palliative education program for all practicing cancer doctors as a national policy namely Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education(PEACE). The program was 2-days workshop based on adult learning theory and focusing on symptom management and communication. In this 9 years, 4,888 educational workshop has been held, and 93,250 physicians were trained. In prospective observational study, both knowledges and difficulties practicing palliative care were significantly improved. In 2017, the new palliative care education program will be launched including combined program of e-learning and workshop to provide tailor made education based on learner's readiness and educational needs in palliative care.
Kennerley, Dorothy; Bolas, Robert; Bourne, Jennifer; Branson, Kathy; Cavenagh, Penny; Chappell, Pam; Collins, Gwen; Coveney, Nick; Day, Nicole; Hardman, Mary; Hayter, Sue; Fenner, Pam; Jones, Jennifer; Jordan, Siobhan; Noble, Brendon; Osbourne, Sarah; Smith, Carol; Wigens, Lynn
Health leaders from across Suffolk joined together in a collaborative action-learning project to identify ways of offering more productive and personalised care for patients with dementia and their carers. The project revealed a range of factors necessary for success, notably professional collaboration and effective facilitation. The outcome was a range of evidenced-based recommendations to improve care and efficiency, as well as ensuring that the quality, innovation, productivity and prevention (QIPP) agenda was met. The lessons can be applied not just in dementia care, but to other long-term and complex care situations.
Ncube, Rosinah K; Barlow, Hilary; Mayers, Pat M
Preterm and low-birth weight infants are often separated from their mothers when admitted to neonatal units for stabilisation of body temperature and technological support. The aim of the study was to explore and describe the lived experiences of mothers regarding care of their hospitalised preterm infants in a neonatal unit in a public hospital in Gaborone, Botswana. This study utilised a qualitative exploratory and descriptive phenomenological study design. Mothers of hospitalised preterm infants were purposefully selected, with whom there was extensive engagement. Two in-depth interviews were conducted with each participant (P). Mothers were shocked by the sudden birth of a preterm infant and found the neonatal environment intimidating. This increased their fear and anxiety and delayed development of a relationship with their infants. Support from staff, other mothers in the neonatal unit and family members enabled the mothers to overcome their fear and to develop an emotional connection with their infants. On-going supportive communication with the mothers by healthcare professionals promotes their confidence and competence in caring for their preterm infants, which in turn promotes mother-infant attachment.
Larsen, Anna; Cheyip, Mireille; Aynalem, Getahun; Dinh, Thu-Ha; Jackson, Debra; Ngandu, Nobubelo; Chirinda, Witness; Mogashoa, Mary; Kindra, Gupreet; Lombard, Carl; Goga, Ameena
Achieving World Health Organization (WHO) recommendations for postnatal care (PNC) within the first few weeks of life is vital to eliminating early mother-to-child transmission of HIV (MTCT) and improving infant health. Almost half of the annual global deaths among children under five occur during the first six weeks of life. This study aims to identify uptake of three PNC visits within the first six weeks of life as recommended by WHO among South African mother-infant pairs, and factors associated with uptake. We analyzed data from three facility-based, nationally representative surveys (2010, 2011/12 and 2012/13) primarily designed to determine the effectiveness of the South African program to prevent MTCT. This analysis describes the proportion of infants achieving the WHO recommendation of at least 3 PNC visits. Interviews from 27 699 HIV-negative and HIV-positive mothers of infants aged 4-8 weeks receiving their six week immunization were included in analysis. Data were analyzed using STATA 13.0 and weighted for sample ascertainment and South African live births. We fitted a multivariable logistic regression model to estimate factors associated with early PNC uptake. Over half (59.6%, 95% confidence interval (CI) = 59.0-60.3) of mother-infant pairs received the recommended three PNC visits during the first 6 weeks; uptake was 63.1% (95% CI = 61.9-64.3) amongst HIV exposed infants and 58.1% (95% CI = 57.3-58.9) amongst HIV unexposed infants. Uptake of early PNC improved significantly with each survey, but varied significantly by province. Multivariable analysis of the pooled data, controlling for survey year, demonstrated that number of antenatal visits (4+ vs 12 weeks, aOR = 1.13, 95% CI = 1.04-1.23), place of delivery (clinic vs hospital aOR = 1.5, 1.3-1.6), and infant HIV exposure (exposed vs unexposed aOR = 1.2, 95% CI = 1.1-1.2) were the key factors associated with receiving recommended PNC visits. Approximately 40% of
... for Educators Search English Español Medical Care During Pregnancy KidsHealth / For Parents / Medical Care During Pregnancy What's ... and their babies. What Is Prenatal Care Before Pregnancy? Prenatal care should start before you get pregnant. ...
Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap
The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.
RESEARCH. Background. Several factors, including gestational age (GA), gender, race and geographical/regional area, contribute to variations in the ... While the impact of GA and gender are clearly established, the influences of region and ethnicity vary ... in the lying-in ward and babies in the Newborn Special Care Unit.
This article reports an aspect of a life historical study which investigated the part that "love" played in mothers' decision-making about returning to work and placing their babies in day care. The article begins with a brief discussion of the context, including 21st-century policies in England to encourage mothers to return to the…
Histopathological Study of Placentae in Low Birth Weight Babies in India. JS Nigam, V Misra, P Singh, PA Singh, S Chauhan, B Thakur. Abstract. Background: The antenatal health-care given to pregnant women has great influence on the rates of perinatal death and morbidity. Amongst the different causes of perinatal ...
Viniegra Velázquez, Leonardo
On the basis that life project as the driving force behind the life experience, the quest for human dignity is the way for true progress and the improvement of human condition. It's pointed out the need to be aware of the meaning of life understanding the motives behind our will to live that is the antecedent of life project. The proposed life project is a cognitive adventure, capable of transcending consumerism, individualism and passivity, toward the creation of a more inclusive world where the improvement spiritual, intellectual and moral can be viable. Said life project entails: a) A primary need: to link oneself with like-minded people that synergize against the prevailing order b) A core: The everlasting struggle for sublimated dignity c) A desideratum: The well-being of the majority d) An unavoidable purpose: The creation of a suitable world build on different ethical, political, lawful, cognitive and ecological foundations. In conclusion, this paper analyzes the influence of projects with an alternate proposal to the endeavors centered in healthcare that favor individualism, passivity and the current status quo. The best example of said alternate proposals is the commonly called "good death". Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.
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Hall, Pippa; Weaver, Lynda; Gravelle, Debbie; Thibault, Hélène
Maximizing interprofessional collaborative patient-centred practice holds promise for improving patient care and creating satisfying work roles. In Canada's evolving health care system, there are demands for increased efficiency, cost-effectiveness, and quality improvement. Interprofessional collaboration warrants re-examination because maximizing interprofessional collaboration, especially nurse-physician collaboration, holds promise for improving patient care and creating satisfying work roles. A palliative care team seized the opportunity to pilot a different approach to patient and family care when faced with a reduction in medical staff. Grounded in a collaborative patient-centred practice approach, the Canadian Hospice Palliative Care Association's National Model to Guide Hospice Palliative Care (2002), and outcomes from program retreats and workgroups, a collaborative person-centred model of care was developed for a 12-bed pilot project. Preliminary findings show that the pilot project team perceived some specific benefits in continuity of care and interprofessional collaboration, while the presence of the physician was reduced to an average of 3.82 hours on the pilot wing, compared with 8 hours on the non-pilot wings. This pilot study suggests that a person-centred model, when focused on the physician-nurse dyad, may offer improved efficiency, job satisfaction and continuity of care on a palliative care unit. Incorporating all team members and developing strategies to successfully expand the model across the whole unit are the next challenges. Further research into the impact of these changes on the health care professionals, management and patients and families is essential.
Aganagic, Mina; Okuda, Takuya; Ooguri, Hirosi
We study quantum entanglements of baby universes which appear in non-perturbative corrections to the OSV formula for the entropy of extremal black holes in type IIA string theory compactified on the local Calabi-Yau manifold defined as a rank 2 vector bundle over an arbitrary genus G Riemann surface. This generalizes the result for G=1 in hep-th/0504221. Non-perturbative terms can be organized into a sum over contributions from baby universes, and the total wave-function is their coherent superposition in the third quantized Hilbert space. We find that half of the universes preserve one set of supercharges while the other half preserve a different set, making the total universe stable but non-BPS. The parent universe generates baby universes by brane/anti-brane pair creation, and baby universes are correlated by conservation of non-normalizable D-brane charges under the process. There are no other source of entanglement of baby universes, and all possible states are superposed with the equal weight
Essman, Eric P.; Aganagic, Mina; Okuda, Takuya; Ooguri, Hirosi
We study quantum entanglements of baby universes which appear in non-perturbative corrections to the OSV formula for the entropy of extremal black holes in type IIA string theory compactified on the local Calabi-Yau manifold defined as a rank 2 vector bundle over an arbitrary genus G Riemann surface. This generalizes the result for G=1 in hep-th/0504221. Non-perturbative terms can be organized into a sum over contributions from baby universes, and the total wave-function is their coherent superposition in the third quantized Hilbert space. We find that half of the universes preserve one set of supercharges while the other half preserve a different set, making the total universe stable but non-BPS. The parent universe generates baby universes by brane/anti-brane pair creation, and baby universes are correlated by conservation of non-normalizable D-brane charges under the process. There are no other source of entanglement of baby universes, and all possible states are superposed with the equal weight
Currie, Thayne; Grady, Carol
What did our solar system look like in its infancy,...... when the planets were forming? We cannot travel back in time to take an image of the early solar system, but in principle we can have the next best thing: images of infant planetary systems around Sun-like stars with ages of 1 to 5 million years, the time we think it took for the giant planets to form. Infant exoplanetary systems are critically important because they can help us understand how our solar system fits within the context of planet formation in general. More than 80% of stars are born with gas- and dust-rich disks, and thus have the potential to form planets. Through many methods we have identified more than 760 planetary systems around middle-aged stars like the Sun, but many of these have architectures that look nothing like our solar system. Young planetary systems are important missing links between various endpoints and may help us understand how and when these differences emerge. Well-known star-forming regions in Taurus, Scorpius. and Orion contain stars that could have infant planetary systems. But these stars are much more distant than our nearest neighbors such as Alpha Centauri or Sirius, making it extremely challenging to produce clear images of systems that can reveal signs of recent planet formation, let alone reveal the planets themselves. Recently, a star with the unassuming name LkCa 15 may have given us our first detailed "baby picture" of a young planetary system similar to our solar system. Located about 450 light-years away in the Taurus starforming region. LkCa 15 has a mass comparable to the Sun (0.97 solar mass) and an age of l to 5 million years, comparable to the time at which Saturn and perhaps Jupiter formed. The star is surrounded by a gas-rich disk similar in structure to the one in our solar system from which the planets formed. With new technologies and observing strategies, we have confirmed suspicions that LkCa 15's disk harbors a young planetary system.
... parties of a Military Health System (MHS) Demonstration project under the authority of Title 10, U.S. Code... of Service (POS) deductibles and cost shares shall apply to these four unmanaged visits. Additionally... TRICARE authorized provider or UCC without incurring POS deductibles and cost shares. The ADSM and family...
Gábor, Katalin; Csanádi, Lajosné; Helembai, Kornélia; Szögi, Zoltánné; Tulkán, Ibolya; Unginé, Kántor Katalin
The aim of the present paper is to inform physicians about the work completed by nurses and professors of baccalaureat nurses in the framework of Leonardo da Vinci project, organised and sponsored by the European Union. The goal of the project was to increase the effectiveness of chief nurses throughout their further training programme in the field of management. The team of Szeged chose the human resource management, since in this field is possible to achieve the greatest improvement with the smallest financial investment. We measured the fluctuations and the absentees of the nurses, the changes in the degree of education, the nurse' and patient' satisfaction at the beginning and at the end of the period studied. Except the patient's satisfaction all the other parameters improved by the end of tested period. The project provided a unique possibility to compare the state of the Hungarian nursing with that of the countries belonging to the European Union, to exchange the experience and to learn some new methods. In the framework of this project a book of two volumes was prepared containing the suggestions of EU. This book is widely available in English and in French.
... DEPARTMENT OF DEFENSE Office of the Secretary Autism Services Demonstration Project for TRICARE... Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department implemented a...
Niemeijer, G.C.; Does, R.J.M.M.; de Mast, J.; Trip, A.; van den Heuvel, J.
Background: The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. Methods: This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning
Though many objections can be levelled against the idea of the practice of genetic intervention to produce 'designer babies', upon examination they are shown to hinge on features which concern parental intentions towards their children, rather than features specific to the means involved. These intentions may be pursued by a variety of social practices which may, though need not, involve a measure of 'traditional' genetic selection (i.e. in terms of the identity and characteristics of the reproducing partners). This paper reviews a number of these objections and, by parity of reasoning, rejects their claim to count specifically or decisively against genetic intervention in pursuit of 'designer babies'. Rejecting these objections does not lead to the endorsement of 'designing babies, but it shows that any unease must be grounded elsewhere and defended by other arguments.
Siren, Anu; Haustein, Sonja
Baby boomers will comprise a considerable share of tomorrow's older population. Previous research has indicated higher travel activity and car use amongst baby boomers than amongst older cohorts. However, little evidence exists on the effects of boomers' ageing on the transportation system....... To analyse how retirement affects baby boomers' travel and the related future travel demand, we compared three groups, distinguished by employment status as ‘still working’, ‘early retirees’ and ‘recent retirees’, in a longitudinal setting. Data for 864 individuals were collected via standardised telephone...... working had a high car reliance that did not decline over time. This study suggests that retirement is a transition point associated with decreasing car use. Hence, the ageing of the population is likely to have a decreasing effect on transportation demand. However, informal care-giving, prolonged careers...
Cummings Greta G
Full Text Available Abstract Background While there is a growing awareness of the importance of organizational context (or the work environment/setting to successful knowledge translation, and successful knowledge translation to better patient, provider (staff, and system outcomes, little empirical evidence supports these assumptions. Further, little is known about the factors that enhance knowledge translation and better outcomes in residential long-term care facilities, where care has been shown to be suboptimal. The project described in this protocol is one of the two main projects of the larger five-year Translating Research in Elder Care (TREC program. Aims The purpose of this project is to establish the magnitude of the effect of organizational context on knowledge translation, and subsequently on resident, staff (unregulated, regulated, and managerial and system outcomes in long-term care facilities in the three Canadian Prairie Provinces (Alberta, Saskatchewan, Manitoba. Methods/Design This study protocol describes the details of a multi-level – including provinces, regions, facilities, units within facilities, and individuals who receive care (residents or work (staff in facilities – and longitudinal (five-year research project. A stratified random sample of 36 residential long-term care facilities (30 urban and 6 rural from the Canadian Prairie Provinces will comprise the sample. Caregivers and care managers within these facilities will be asked to complete the TREC survey – a suite of survey instruments designed to assess organizational context and related factors hypothesized to be important to successful knowledge translation and to achieving better resident, staff, and system outcomes. Facility and unit level data will be collected using standardized data collection forms, and resident outcomes using the Resident Assessment Instrument-Minimum Data Set version 2.0 instrument. A variety of analytic techniques will be employed including descriptive
Arnold, Robert M; Back, Anthony L; Barnato, Amber E; Prendergast, Thomas J; Emlet, Lillian L; Karpov, Irina; White, Patrick H; Nelson, Judith E
The aim of this study was to develop an evidence-based communication skills training workshop to improve the communication skills of critical care fellows. Pulmonary and critical care fellows (N = 38) participated in a 3-day communication skills workshop between 2008 and 2010 involving brief didactic talks, faculty demonstration of skills, and faculty-supervised small group skills practice sessions with simulated families. Skills included the following: giving bad news, achieving consensus on goals of therapy, and discussing the limitations of life-sustaining treatment. Participants rated their skill levels in a pre-post survey in 11 core communication tasks using a 5-point Likert scale. Of 38 fellows, 36 (95%) completed all 3 days of the workshop. We compared pre and post scores using the Wilcoxon signed rank test. Overall, self-rated skills increased for all 11 tasks. In analyses by participant, 95% reported improvement in at least 1 skill; with improvement in a median of 10 of 11 skills. Ninety-two percent rated the course as either very good/excellent, and 80% recommended that it be mandatory for future fellows. This 3-day communication skills training program increased critical care fellows' self-reported family meeting communication skills. Copyright © 2014 Elsevier Inc. All rights reserved.
Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S
To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Ambulatory-based general internists in 13 states participated in the assessment. We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Performance on the individual and composite measures varied substantially within (range 5-86 percent compliance on 46 measures) and between physicians (ICC range 0.12-0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; pmeasures and by sampling feasible numbers of patients for each condition. © Health Research and Educational Trust.
Full Text Available According to the World Health Organization, the incidence of hearing impairment in newborn population is 1-3 per 1000 (WHO, 2012. Apart from that, many authors have found that the incidence of hearing impairment is twenty times higher, 2-4%, in neonatal intensive care unit (NICU. Thus, a congenital hearing loss is the most frequent sensory or motor deficit that could be diagnosed immediately upon birth. The objective of this study was to determine the incidence of risk factors for hearing impairment in the population of preterm babies. We were especially interested in the impact of gestational age at birth on the incidence of risk factors for hearing loss. A cohort of 150 preterm babies was enrolled in the study. They were hospitalized in the Institute for Neonatology in Belgrade during 2014 and 2015 and the data were obtained from their medical files. The results of this study indicate high incidence of risk factors for hearing impairment in this population of babies. Gestational age at birth had a strong, statistically significant, correlation with risk factor incidence in lower gestational age and vice versa. High incidence of risk factors and their interaction could account for twenty times higher occurrence of congenital and early acquired hearing loss in population of preterm babies compared to term neonates. These results imply the need for systematic audiological surveillance of prematurely born babies at least until 12 months of corrected age.
Walters, Bethany Hipple; Adams, Samantha A; Nieboer, Anna P; Bal, Roland
Disease management programs, especially those based on the Chronic Care Model (CCM), are increasingly common in The Netherlands. While disease management programs have been well-researched quantitatively and economically, less qualitative research has been done. The overall aim of the study is to explore how disease management programs are implemented within primary care settings in The Netherlands; this paper focuses on the early development and implementation stages of five disease management programs in the primary care setting, based on interviews with project leadership teams. Eleven semi-structured interviews were conducted at the five selected sites with sixteen professionals interviewed; all project directors and managers were interviewed. The interviews focused on each project's chosen chronic illness (diabetes, eating disorders, COPD, multi-morbidity, CVRM) and project plan, barriers to development and implementation, the project leaders' action and reactions, as well as their roles and responsibilities, and disease management strategies. Analysis was inductive and interpretive, based on the content of the interviews. After analysis, the results of this research on disease management programs and the Chronic Care Model are viewed from a traveling technology framework. This analysis uncovered four themes that can be mapped to disease management and the Chronic Care Model: (1) changing the health care system, (2) patient-centered care, (3) technological systems and barriers, and (4) integrating projects into the larger system. Project leaders discussed the paths, both direct and indirect, for transforming the health care system to one that addresses chronic illness. Patient-centered care was highlighted as needed and a paradigm shift for many. Challenges with technological systems were pervasive. Project leaders managed the expenses of a traveling technology, including the social, financial, and administration involved. At the sites, project leaders served
Congenital heart defects are the most common type of birth defect in the U.S. This podcast discusses the importance of pregnant women talking with their health care providers about ways to increase chances of having a healthy baby.
Antonova, M.; et al.
Baby MIND is a magnetized iron neutrino detector, with novel design features, and is planned to serve as a downstream magnetized muon spectrometer for the WAGASCI experiment on the T2K neutrino beam line in Japan. One of the main goals of this experiment is to reduce systematic uncertainties relevant to CP-violation searches, by measuring the neutrino contamination in the anti-neutrino beam mode of T2K. Baby MIND is currently being constructed at CERN, and is planned to be operational in Japan in October 2017.
room for a conducive environment for child rights and social protection. ... new dimensions to include the worst of all forms of human trafficking issues ... of strict penalties for offenders in the bid to give every child born the benefit of ..... vein, the study conducted by Onuoha (2014) listed the causes of baby factory incidences to.
Full Text Available Efforts are underway in many European countries to channel efforts into creating improved integrated health and social care services. But most countries lack a strategic plan that is sustainable over time, and that reflects a comprehensive systems perspective. The Policy Guide on Integrated Care (PGIC as presented in this paper resulted from experiences with the EU Project INTEGRATE and our own work with healthcare reform for patients with chronic conditions at the national and international level. This project is one of the largest EU funded projects on Integrated Care, conducted over a four-year period (2012–2016 and included partners from nine European countries. Project Integrate aimed to gain insights into the leadership, management and delivery of integrated care to support European care systems to respond to the challenges of ageing populations and the rise of people living with long-term conditions. The objective of this paper is to describe the PGIC as both a tool and a reasoning flow that aims at supporting policy makers at the national and international level with the development and implementation of integrated care. Any Policy Guide on Integrated should build upon three building blocks, being a mission, vision and a strategy that aim at capturing the large amount of factors that directly or indirectly influence the successful development of integrated care.
Borgermans, Liesbeth; Devroey, Dirk
Efforts are underway in many European countries to channel efforts into creating improved integrated health and social care services. But most countries lack a strategic plan that is sustainable over time, and that reflects a comprehensive systems perspective. The Policy Guide on Integrated Care (PGIC) as presented in this paper resulted from experiences with the EU Project INTEGRATE and our own work with healthcare reform for patients with chronic conditions at the national and international level. This project is one of the largest EU funded projects on Integrated Care, conducted over a four-year period (2012-2016) and included partners from nine European countries. Project Integrate aimed to gain insights into the leadership, management and delivery of integrated care to support European care systems to respond to the challenges of ageing populations and the rise of people living with long-term conditions. The objective of this paper is to describe the PGIC as both a tool and a reasoning flow that aims at supporting policy makers at the national and international level with the development and implementation of integrated care. Any Policy Guide on Integrated should build upon three building blocks, being a mission, vision and a strategy that aim at capturing the large amount of factors that directly or indirectly influence the successful development of integrated care.
Penn State University (PSU) is the recipient of a Level II CARE cooperative agreement targeting environmental risks in Philadelphia communities. PSU is involved in developing IPM management practices recommendations and policies.
Wanka, Anna; Kolland, Franz; Psihoda, Sophie
Research indicates that the so-called baby boomer generation (the population born after World War II) exhibits worrying health trends. Taking age-cohort effects into account, it is still unclear how the mechanisms concerning stress and health function and how the distribution of stressors, stress mediators and stress effects on health differ between generations. The article approaches stress from a generational perspective asking: which are the stressors the baby boomer generation is facing? Under which conditions and with which resources is exposure to stressors harmful to health? Is there an accumulation of stress in later working life? In the course of the project "Wellbeing", a quantitative online survey was carried out in selected commercial enterprises and public institutions in four project partner countries. The results for Austrian participants are presented in this article. Employees of the baby boomer generation are exposed to both time-related and social stressors at the workplace and a high percentage of respondents expressed symptoms of physical and psychological stress. Stress mediators, such as agency-based coping strategies and social resources at the workplace could buffer these stressors; however, stressors and stress mediators are significantly correlated creating a "triple whammy" effect (i.e. exposure to stressors, lack of social resources and restricted coping), which particularly affects older male baby boomers. Social support buffers the negative effects of a limited health and lower education for female baby boomers, which supports the buffering hypothesis of social convoy theory, whereas male baby boomers lack the resources to effectively cope with work stress.
This project intends to demonstrate the possibilities for using smartphones to obtain highly : resolved behavioral information for older adults, especially leading edge baby boomers. : Towards this end, we are implementing a pilot study which will he...
Background Disease management programs, especially those based on the Chronic Care Model (CCM), are increasingly common in the Netherlands. While disease management programs have been well-researched quantitatively and economically, less qualitative research has been done. The overall aim of the study is to explore how disease management programs are implemented within primary care settings in the Netherlands; this paper focuses on the early development and implementation stages of five disease management programs in the primary care setting, based on interviews with project leadership teams. Methods Eleven semi-structured interviews were conducted at the five selected sites with sixteen professionals interviewed; all project directors and managers were interviewed. The interviews focused on each project’s chosen chronic illness (diabetes, eating disorders, COPD, multi-morbidity, CVRM) and project plan, barriers to development and implementation, the project leaders’ action and reactions, as well as their roles and responsibilities, and disease management strategies. Analysis was inductive and interpretive, based on the content of the interviews. After analysis, the results of this research on disease management programs and the Chronic Care Model are viewed from a traveling technology framework. Results This analysis uncovered four themes that can be mapped to disease management and the Chronic Care Model: (1) changing the health care system, (2) patient-centered care, (3) technological systems and barriers, and (4) integrating projects into the larger system. Project leaders discussed the paths, both direct and indirect, for transforming the health care system to one that addresses chronic illness. Patient-centered care was highlighted as needed and a paradigm shift for many. Challenges with technological systems were pervasive. Project leaders managed the expenses of a traveling technology, including the social, financial, and administration involved
Cuidados com os bebês: o conhecimento das primíparas adolescentes Cuidados con los bebés: el conocimiento de las primíparas adolescentes The care with babies: the knowledge of the teenagers primiparas
Dayane Cristina de Sousa Rocha
Salud. Se hube como resultado el bajo déficit de orientación de las primíparas adolescentes acerca de como cuidar del bebé, estas esperan contar con la ayuda de los padres y familiares. Seconstató aunque, a pesar de que realicen el prenatal, faltó interés en participar de las charlas ofrecidas.The well-being of babies born from adolescent mothers was the motivation to carry out this research that aimed to investigate if primipara pregnant adolescents are receiving orientations about the care with their babies. Descriptive study with quantitative approach, in which one used as technique for data collection the semi-structured interview, in the months of September and October, 2004. Had as a scenario the shared accommodation of a public maternity ward in the city of Fortaleza, considered as a tertiary reference in the state of Ceará. The sample was composed of thirty primipara adolescents between 13 and 19 years of age, low education and school evasion; low family income; stable union and that did not carry out the number of prenatal consultations recommended by the Ministry of Health.We had as a result the low deficit of orientation of the primipara adolescents about how to take care of the baby and what they hope to count on the help of parents and relatives. We still found out that, in spite of doing the pre-natal, they did not show interest in participating in the lectures offered.
... Artery Disease Venous Thromboembolism Aortic Aneurysm More Fetal Echocardiography / Your Unborn Baby's Heart Updated:Oct 6,2016 ... Your Risk • Symptoms & Diagnosis Introduction Common Tests Fetal Echocardiography/Your Unborn Baby's Heart - Fetal Echocardiogram Test - Detection ...
... child's state of development Can help prevent childhood obesity Recommendations During the first 6 months of life, your baby needs only breast milk or formula for proper nutrition. Your baby will ...
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Full Text Available My work is inspired by the intricacies of family life and of familial relationships. In my painting, I gravitate irresistibly toward representing the domestic, in particular the lives of mother and children. My paintings use the human figure to express the vulnerability of motherhood and my own obsession not only with the dilemma of raising boys in a violently media-driven culture, but in its midst, caring for a son with a fatal genetic disease.
Kortekaas, Marlous F; van de Pol, Alma C; van der Horst, Henriëtte E; Burgers, Jako S; Slort, Willemjan; de Wit, Niek J
PURPOSE. Although in the last decades primary care research has evolved with great success, there is a growing need to prioritize the topics given the limited resources available. Therefore, we constructed a nationwide database of ongoing primary care research projects in the Netherlands, and we assessed if the distribution of research topics matched with primary care practice. We conducted a survey among the main primary care research centres in the Netherlands and gathered details of all ongoing primary care research projects. We classified the projects according to research topic, relation to professional guidelines and knowledge deficits, collaborative partners and funding source. Subsequently, we compared the frequency distribution of clinical topics of research projects to the prevalence of problems in primary care practice. We identified 296 ongoing primary care research projects from 11 research centres. Most projects were designed as randomized controlled trial (35%) or observational cohort (34%), and government funded mostly (60%). Thematically, most research projects addressed chronic diseases, mainly cardiovascular risk management (8%), depressive disorders (8%) and diabetes mellitus (7%). One-fifth of the projects was related to defined knowledge deficits in primary care guidelines. From a clinical primary care perspective, research projects on dermatological problems were significantly underrepresented (P = 0.01). This survey of ongoing projects demonstrates that primary care research has a firm basis in the Netherlands, with a strong focus on chronic disease. The fit with primary care practice can improve, and future research should address knowledge deficits in professional guidelines more.
Karliner, Marek; Hen, Itay
We discuss one of the most interesting phenomena exhibited by baby skyrmions - breaking of rotational symmetry. The topics we will deal with here include the appearance of rotational symmetry breaking in the static solutions of baby Skyrme models, both in flat as well as in curved spaces, the zero-temperature crystalline structure of baby skyrmions, and finally, the appearance of spontaneous breaking of rotational symmetry in rotating baby skyrmions.
Cook, Deborah; Swinton, Marilyn; Toledo, Feli; Clarke, France; Rose, Trudy; Hand-Breckenridge, Tracey; Boyle, Anne; Woods, Anne; Zytaruk, Nicole; Heels-Ansdell, Diane; Sheppard, Robert
Dying in the complex, efficiency-driven environment of the intensive care unit can be dehumanizing for the patient and have profound, long-lasting consequences for all persons attendant to that death. To bring peace to the final days of a patient's life and to ease the grieving process. Mixed-methods study. 21-bed medical-surgical intensive care unit. Dying patients and their families and clinicians. To honor each patient, a set of wishes was generated by patients, family members, or clinicians. The wishes were implemented before or after death by patients, families, clinicians (6 of whom were project team members), or the project team. Quantitative data included demographic characteristics, processes of care, and scores on the Quality of End-of-Life Care-10 instrument. Semistructured interviews of family members and clinicians were transcribed verbatim, and qualitative description was used to analyze them. Participants included 40 decedents, at least 1 family member per patient, and 3 clinicians per patient. The 159 wishes were implemented and classified into 5 categories: humanizing the environment, tributes, family reconnections, observances, and "paying it forward." Scores on the Quality of End-of-Life Care-10 instrument were high. The central theme from 160 interviews of 170 persons was how the 3 Wishes Project personalized the dying process. For patients, eliciting and customizing the wishes honored them by celebrating their lives and dignifying their deaths. For families, it created positive memories and individualized end-of-life care for their loved ones. For clinicians, it promoted interprofessional care and humanism in practice. Impaired consciousness limited understanding of patients' viewpoints. The 3 Wishes Project facilitated personalization of the dying process through explicit integration of palliative and spiritual care into critical care practice. Hamilton Academy of Health Science Research Organization, Canadian Intensive Care Foundation.
Fingerman, Karen L.; Pillemer, Karl A.; Silverstein, Merril; Suitor, J. Jill
Purpose: As Baby Boomers enter late life, relationships with family members gain importance. This review article highlights two aspects of their intergenerational relationships: (a) caregiving for aging parents and (b) interactions with adult children in the context of changing marital dynamics. Design and Methods: The researchers describe three…
Best-feeding the baby. Human infants should be fed their own mothers' breast- milk. Where this is unavailable, replacement feeding becomes necessary. Through the ages and right up to the present, human milk has been supplied by other lactating women within or from outside the family. Donated breast-milk has been ...
Fenichel, Emily, Ed.
"Zero to Three" is a single-focus bulletin of the National Center for Infants, Toddlers, and Families providing insight from multiple disciplines on the development of infants, toddlers, and their families. Noting that America's babies and toddlers live in a world full of television sets, VCRs, computers, videogames, and interactive…
A Bangor University led research team partnered with the Gwynedd Local authority to explore the Governance Issues and practicalities of providing an anonymised dataset to the SAIL databank at Swansea. Two third sector agencies were also approached. With the various required Service Level Agreements in place, data were put through the tried and trusted SAIL process for analysis. Results Data relating to well over 20,000 referrals generated by 17,000+ social services clients in Gwynedd Local Authority from the period 2008 to 2015 were anonymised into the SAIL databank in Swansea, and linked to records from primary and secondary care. We will present results on the success of this process and on the emerging findings from the linked datasets.
Jagger, Carol; Collerton, Joanna C; Davies, Karen; Kingston, Andrew; Robinson, Louise A; Eccles, Martin P; von Zglinicki, Thomas; Martin-Ruiz, Carmen; James, Oliver F W; Kirkwood, Tom B L; Bond, John
Little is known of the capabilities of the oldest old, the fastest growing age group in the population. We aimed to estimate capability and dependency in a cohort of 85 year olds and to project future demand for care. Structured interviews at age 85 with 841 people born in 1921 and living in Newcastle and North Tyneside, UK who were permanently registered with participating general practices. Measures of capability included were self-reported activities of daily living (ADL), timed up and go test (TUG), standardised mini-mental state examination (SMMSE), and assessment of urinary continence in order to classify interval-need dependency. To project future demand for care the proportion needing 24-hour care was applied to the 2008 England and Wales population projections of those aged 80 years and over by gender. Of participants, 62% (522/841) were women, 77% (651/841) lived in standard housing, 13% (106/841) in sheltered housing and 10% (84/841) in a care home. Overall, 20% (165/841) reported no difficulty with any of the ADLs. Men were more capable in performing ADLs and more independent than women. TUG validated self-reported ADLs. When classified by 'interval of need' 41% (332/810) were independent, 39% (317/810) required help less often than daily, 12% (94/810) required help at regular times of the day and 8% (67/810) required 24-hour care. Of care-home residents, 94% (77/82) required daily help or 24-hour care. Future need for 24-hour care for people aged 80 years or over in England and Wales is projected to increase by 82% from 2010 to 2030 with a demand for 630,000 care-home places by 2030. This analysis highlights the diversity of capability and levels of dependency in this cohort. A remarkably high proportion remain independent, particularly men. However a significant proportion of this population require 24-hour care at home or in care homes. Projections for the next 20 years suggest substantial increases in the number requiring 24-hour care due to
Finance Project, Washington, DC.
The quality of child care in the United States has important implications for school preparedness, welfare reform, economic vitality, and the quality of family life. In this 8-minute videotape, business leaders describe why child care makes good business sense. Visuals explain the importance of early childhood for school and life success, and the…
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A one-day presentation of the project will take place on Monday February 10th in the CERN Council Chamber. The meeting will start a 9am and is expected to end at 4:30pm. The meeting, which is open to the whole community, will present an initiative on accelerator R&D in Europe, supported by ECFA, with the aim to bid for European Union support through the Framework 6 scheme. This initiative is coordinated by a steering group (ESGARD - European Steering Group on Accelerator Research and Development), which has been set up to coordinate European efforts on accelerator R&D and the submission of such bids. The initial bids have to be submitted by April 15th. All those interested in accelerator R&D are welcome to attend.
... a clean pacifier. Do not dip it in honey or another substance that has sugar. When to ... Healthy Living Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food ...
Lina María Granados Oliveros, Enf
.______________________________________________________________________Aim: In 2008 a cross-over survey among 150 pregnant teenager was made to evaluate attending self care practices, as well as care for unborn babies, attending on “Hospital Local del Norte” at Bucaramanga, Colombia. Methods: A validated instrument named: “Self-carepractices among pregnant teenagers and their unborn babies” was used; it was developed by the Maternal and Perinatal Team from Universidad National de Colombia. Results: Average age of participants was 17.2 years of age; 68% were unmarried girls and 59.3% lack school;70.7% were housewives and 64.7% were husband depended. Prenatal stimulation was not good as well as we expected: only 52.6% did a hearing stimulation and 72.3% tactile stimulation. Only 52% of the study pregnant teenagers did appropriated resting and exercise.Regarding hygiene and personal care practices, only 48% did daily brushing after meals, 51.3% had a good nutritional habits, and 40% took calcium on daily basis; 65.3% were seeking financial support from their families and 65.3% of the pregnant girls did not take any drugs, at all. Conclusion: We concluded that it is a good practice toinform pregnant teenagers about a gym, self care, stimulations, dietary habits, as well as to seek, early in their pregnancy medical and family support. The medical community should make an emphasis about these recommendations. All of these will be of a great benefit for both, the pregnant teenager girls and their unborned babies.
Andreassen, Hege K; Kjekshus, Lars Erik; Tjora, Aksel
From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success. Our empirical material is based on Norwegian telemedicine. Through a case study, we take an in-depth look into the history of one particular telemedical initiative and highlight how ICT projects matter on a managerial level. Our analysis reveals how management tasks were delegated to the ICT project, which thus contributed to four processes of organisational control: allocating resources, generating and managing enthusiasm, system correction and aligning local practice and national policies. We argue that the innovation project in itself can be considered an innovation that has become normalised in health care, not in clinical, but in management work. In everyday management, the ICT project appears to be a convenient tool suited to ease the tensions between state regulatory practices and claims of professional autonomy that arise in the wake of new public management reforms. Separating project management and funding from routine practice handles the conceptualised heterogeneity between innovation and routine within contemporary health care delivery. Whilst this separation eases the execution of both normal routines and innovative projects, it also delays expected diffusion of technology. Copyright © 2015 Elsevier Ltd. All rights reserved.
Lavoie-Tremblay, Mélanie; Aubry, Monique; Cyr, Guylaine; Richer, Marie-Claire; Fortin-Verreault, Jean-François; Fortin, Claude; Marchionni, Caroline
To explore the characteristics that influence project management offices acceptance and adoption in healthcare sector. The creation of project management offices has been suggested as a promising avenue to promote successful organisational change and facilitate evidence-based practice. However, little is known about the characteristics that promote their initial adoption and acceptance in health care sector. This knowledge is important in the context where many organisations are considering implementing project management offices with nurse managers as leaders. A descriptive multiple case study design was used. The unit of analysis was the project management offices. The study was conducted in three university-affiliated teaching hospitals in 2013-14 (Canada). Individual interviews (n = 34) were conducted with senior managers. Results reveal that project management offices dedicated to project and change management constitute an innovation and an added value that addresses tangible needs in the field. Project management offices are an innovation highly compatible with health care managers and their approach has parallels to the process of clinical problem solving and reasoning well-known to adopters. This knowledge is important in a context where many nurses hold various roles in project management offices, such as Director, project manager, clinical expert and knowledge broker. © 2017 John Wiley & Sons Ltd.
Daniel, C; Mora, B
The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain
Chang, David C; Anderson, Jamie E; Kobayashi, Leslie; Coimbra, Raul; Bickler, Stephen W
The lifetime risk and expected cost of trauma care would be valuable for health policy planners, but this information is currently unavailable. The cumulative incidence rates methodology, based on a cross-sectional population analysis, offers an alternative approach to prohibitively costly prospective cohort studies. Retrospective analysis of the California Office of Statewide Health Planning and Development (OSHPD) database was performed for 2008. Trauma admissions were identified by ICD-9 primary diagnosis codes 800-959, with certain exclusions. Cumulative incidence rates were calculated as the cumulative summation of incidence risks sequentially across age groups. A total of 2.2 million admissions were identified, with mean age of 63.8 y, 49.6% men, 82.8% Whites, 5.7% Blacks, 11.3% Hispanics, and 3.1% Asians. The cumulative incidence rate for patients older than age 85 y was 1119 per 10,000 people, with the majority of risk in the elderly, compared with 24,325 per 10,000 people for all-cause hospitalizations. The rates were 946 for men, 1079 for women, 999 for non-Hispanic Whites, 568 for Blacks, 577 for Hispanics, and 395 for Asians, per 10,000 population. The cumulative expected hospital charge was $6538, compared with $81,257 for all-cause hospitalizations. The cumulative lifetime risk of trauma/injury requiring hospitalization for a person living to age 85 y in California is 11.2%, accounting for 4.6% of expected lifetime hospitalizations, but accounting for 8.0% of expected lifetime hospital expenditures. Risk of trauma is significant in the elderly. The total expenditure for all trauma hospitalizations in California was $7.62 billion in 2008. Copyright © 2012 Elsevier Inc. All rights reserved.
Aguiar, Lívia; Mendes, Ana; Pereira, Cristiana; Neves, Paula; Mendes, Diana; Teixeira, João Paulo
Indoor air quality (IAQ) affects health particularly in susceptible individuals such as the elderly. It has been estimated that the older population spends approximately 19-20 h/d indoors, and the majority of the elderly spend all of their time indoors in elderly care centers (ECC). Older individuals may be particularly at risk of exposure to detrimental effects from pollutants, even at low concentrations, due to common and multiple underlying chronic diseases that increase susceptibility. This study, aimed to assess the impact of indoor biological agents in 22 ECC located in Porto, was conducted during summer and winter from November 2011 to August 2013 at a total of 141 areas within dining rooms, drawing rooms, medical offices, and bedrooms (including the bedridden). Air sampling was carried out with a microbiological air sampler (Merck MAS-100) and using tryptic soy agar for bacteria and malt extract agar for fungi. The results obtained were compared with the recently revised Portuguese standards. In winter, mean fungi concentration exceeded reference values, while bacteria concentrations were within the new standards in both seasons. The main fungi species found indoors were Cladosporium (73%) in summer and Penicillium (67%) in winter. Aspergillus fumigatus, Aspergillus niger, and Aspergillus flavus, known potential pathogenic/toxigenic species, were also identified. Although the overall rate and mean values of bacteria and fungi found in ECC indoor air met Portuguese legislation, some concern is raised by the presence of pathogenic microorganisms. Simple measures, like opening windows and doors to promote air exchange and renewal, may improve effectiveness in enhancing IAQ.
Stoop, Annerieke; Billings, Jenny; Leichsenring, Kai; Ruppe, Georg; Tram, Nhu; Barbaglia, María Gabriela; Ambugo, Eliva A.; Zonneveld, Nick; Paat-Ahi, Gerli; Hoffmann, Henrik; Khan, Usman; Stein, Viktoria; Wistow, Gerald; Lette, Manon; Jansen, Aaltje P.D.; Nijpels, Giel; Baan, Caroline A.
Introduction: Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project. Methods: SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap. Discussion: SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home. PMID:29632456
... 7 Agriculture 5 2010-01-01 2010-01-01 false Conditions governing the entry of baby squash and baby... Fruits and Vegetables § 319.56-48 Conditions governing the entry of baby squash and baby courgettes from Zambia. Baby squash (Curcurbita maxima Duchesne) and baby courgettes (C. pepo. L.) measuring 10 to 25...
Mankiw, N G; Weil, D N
This paper explores the impact of demographic changes on the housing market in the US, 1st by reviewing the facts about the Baby Boom, 2nd by linking age and housing demand using census data for 1970 and 1980, 3rd by computing the effect of demand on price of housing and on the quantity of residential capital, and last by constructing a theoretical model to plot the predictability of the jump in demand caused by the Baby Boom. The Baby Boom in the U.S. lasted from 1946-1964, with a peak in 1957 when 4.3 million babies were born. In 1980 19.7% of the population were aged 20-30, compared to 13.3% in 1960. Demand for housing was modeled for a given household from census data, resulting in the finding that demand rises sharply at age 20-30, then declines after age 40 by 1% per year. Thus between 1970 and 1980 the real value of housing for an adult at any given age jumped 50%, while the real disposable personal income per capita rose 22%. The structure of demand is such that the swelling in the rate of growth in housing demand peaked in 1980, with a rate of 1.66% per year. Housing demand and real price of housing were highly correlated and inelastic. If this relationship holds in the future, the real price of housing should fall about 3% per year, or 47% by 2007. The theoretical model, a variation of the Poterba model, ignoring inflation and taxation, suggests that fluctuations in prices caused by changes in demand are not foreseen by the market, even though they are predictable in principle 20 years in advance. As the effects of falling housing prices become apparent, there may be a potential for economic instability, but people may be induced to save more because their homes will no longer provide the funds for retirement.
Wajid, Abdul; White, Franklin; Karim, Mehtab S
As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a national and global challenge that remains
Full Text Available BACKGROUND: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH services in two areas with different levels of service in Punjab, Pakistan. METHODS: A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA. Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. RESULTS: The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. CONCLUSIONS: Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an
Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly; Dismuke, Clara; Janjua, Rabeea; Lynch, Mary G
Veterans are at high risk for eye disease because of age and comorbid conditions. Access to eye care is challenging within the entire Veterans Hospital Administration's network of hospitals and clinics in the USA because it is the third busiest outpatient clinical service and growing at a rate of 9% per year. Rural and highly rural veterans face many more barriers to accessing eye care because of distance, cost to travel, and difficulty finding care in the community as many live in medically underserved areas. Also, rural veterans may be diagnosed in later stages of eye disease than their non-rural counterparts due to lack of access to specialty care. In March 2015, Technology-based Eye Care Services (TECS) was launched from the Atlanta Veterans Affairs (VA) as a quality improvement project to provide eye screening services for rural veterans. By tracking multiple measures including demographic and access to care metrics, data shows that TECS significantly improved access to care, with 33% of veterans receiving same-day access and >98% of veterans receiving an appointment within 30 days of request. TECS also provided care to a significant percentage of homeless veterans, 10.6% of the patients screened. Finally, TECS reduced healthcare costs, saving the VA up to US$148 per visit and approximately US$52 per patient in round trip travel reimbursements when compared to completing a face-to-face exam at the medical center. Overall savings to the VA system in this early phase of TECS totaled US$288,400, about US$41,200 per month. Other healthcare facilities may be able to use a similar protocol to extend care to at-risk patients.
Shah, Parag K; Narendran, Venkatapathy; Kalpana, Narendran
To describe aggressive posterior retinopathy of prematurity (APROP) in a subset of premature babies, having gestational age (GA) of ≥28 weeks and birth weight (BW) of ≥1000 g. Retrospective observational case series. Case records of 99 babies, who were diagnosed to have APROP between July 2002 and October 2010 were reviewed. Fundus fluorescein angiography (FFA) was carried out in 19 babies. The mean GA was 31.7 weeks (range 28-35 weeks) and mean BW was 1572 g (range 1000-2310 g). All these babies received supplemental unblended oxygen 3 days or longer after birth. Of the 52 babies who had an eye exam in the neonatal intensive care unit prior to discharge, 35 babies had loss of vascularised retina from zone II to zone I and four babies from zone III to zone I, when examined as an outpatient. FFA revealed large geographic areas of vaso-obliteration (more than 30 disc areas) posterior to the shunt vessels within vascularised retina. Features of severe capillary bed loss in the vascularised retina were seen in our cases. Oxygen could be a precipitating factor in causing this retinopathy of prematurity in large babies.
Fagniez, P-L; Loriau, J; Tayar, C
Scientific advances during the last decades regarding potential intervention on embryos arouse many questions in society to prepare the ground concerning the limits that should be set for these practices. For the first time in 1994, a parliamentary proceeding allowed the definition of a French model of bioethics through laws of the same name. These laws, among others, authorized in a well and strictly defined setting the practice of preimplantation genetic diagnosis (PGD). Because of technical progress concerning PGD, new questions arose, especially concerning the accomplishment of designer babies. The French Chamber of Representatives came in with a new law that banishes the concept of designer babies and replaces it with another concept: double hope babies, in French "bébé du double espoir". A first hope of a pregnancy giving birth to a healthy child and the second being that this child conceived with the aid of PGD could help treat an elder brother. Because of the issuing of two specific laws in a ten years interval, France occupies a privileged place in a Europe where bioethical issues continue to be debated, particularly PGD.
Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen
In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.
Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.
The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, i...
Full Text Available Abstract Background Due to technological progress and improvements in medical care and health policy the average age of patients in primary care is continuously growing. In equal measure, an increasing proportion of mostly elderly primary care patients presents with multiple coexisting medical conditions. To properly assess the current situation of co- and multimorbidity, valid scientific data based on an appropriate data structure are indispensable. CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork is an ambitious project in Germany to establish a system for adequate record keeping and analysis in primary care based on episodes of care. An episode is defined as health problem from its first presentation by a patient to a doctor until the completion of the last encounter for it. The study aims to describe co- and multimorbidity as well as health care utilization based on episodes of care for the study population of the first participating general practices. Methods The analyses were based on a total of 39,699 patients in a yearly contact group (YCG out of 17 general practices in Germany for which data entry based on episodes of care using the International Classification of Primary Care (ICPC was performed between 1.1.2006 and 31.12.2006. In order to model the relationship between the explanatory variables (age, gender, number of chronic conditions and the response variables of interest (number of different prescriptions, number of referrals, number of encounters that were applied to measure health care utilization, we used multiple linear regression. Results In comparison to gender, patients' age had a manifestly stronger impact on the number of different prescriptions, the number of referrals and number of encounters. In comparison to age (β = 0.043, p Conclusion Documentation in primary care on the basis of episodes of care facilitates an insight to concurrently existing health problems and related medical procedures
Full Text Available The Risk Drinking Project was a national implementation endeavour in Sweden, carried out from 2004 to 2010, based on a government initiative to give alcohol issues a more prominent place in routine primary, child, maternity and occupational health care. The article describes and analyses the project. Critical factors that were important for the results are identified. The magnitude of the project contributed to its reach and impact in terms of providers’ awareness of the project goals and key messages. The timing of the project was appropriate. The increase in alcohol consumption in Sweden and diminished opportunities for primary prevention strategies since entry to the European Union in 1995 have led to increased expectations for health care providers to become more actively involved in alcohol prevention. This awareness provided favourable conditions for this project. A multifaceted approach was used in the project. Most educational courses were held in workshops and seminars to encourage learning-by-doing. Motivational interviewing was an integral aspect. The concept of risk drinking was promoted in all the activities. Subprojects were tailored to the specific conditions of each respective setting, building on the skills the providers already had to modify existing work practices. Nurses were afforded a key role in the project.
DeMattei, Ronda R; Allen, Jessica; Goss, Breanna
Children with special health care needs face many barriers to oral care and are at high risk for oral disease. School nurses are in a unique position to promote oral wellness in this vulnerable population. Collaboration between school nurses and dental hygiene faculty resulted in the formation of a partnership between a university-based dental hygiene program and two special education districts in rural southern Illinois. Senior dental hygiene students participated in a school-based service-learning project that provided dental examinations, preventive services, and education to children with special health care needs. Evidence-based behavioral interventions were used to teach children to comply with oral procedures. School nurses mentored dental hygiene students in behavior management of children. Dental exams were provided to 234 children from four special education schools with the majority receiving cleanings and fluoride.
A ''baby cyclotron'' has been developed by the Japan Steel Works, Ltd. Its No. 1 model (proton 9.4 MeV) was delivered to the Nakano Hospital of National Sanatorium in March, 1979. It is being used successfully for the production of 11 C, 13 N and 15 O and labeled compounds. The proton or deuteron particles accelerated in the cyclotron collide on target materials. The target box, which is automatically changeable, is directly installed to the accelerating box, thereby taking the safety measures for any leaking radiation. The following matters are described: the production of short-lived radioisotopes (RI yields and treatment); the processes of production in the Nakano Hospital, with No. 1 baby cyclotron, including the photosynthesis of labeled compounds such as 11 C-labeled glucose; the research on the automation in the synthesis of organic labeled compounds like 11 C-palmitic acid. (J.P.N.)
Full Text Available BACKGROUND: Injection drug users (IDU remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of ‘outreach nurses’ was piloted by All Ukrainian Harm Reduction Association (UHRA with support from ICF “International HIV/AIDS Alliance in Ukraine”. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average. For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93 during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of ‘outreach nurses’ to the package of services they provide.
Full Text Available We report a 3-year-old girl born with fair complexion which became darker. The color change was insidious in onset at the age of 5 months, asymptomatic and progressive involving the entire body surface. Histopathology revealed increased pigmentation of the epidermal basal layer. Universal acquired melanosis is a rare form of hypermelanosis which was synonymously referred to as "Carbon baby". This is a rare presentation with only one earlier case report.
Shaib , M.; Rashid , M.; Hamawy , L.; Arnout , M.; Majzoub , I. ,; Zaylaa , A. ,
International audience; Nearly 20 million premature and Low Birth Weight infants are born each year in developing countries, 4 million die within their first month. These deaths occur due to the unavailability or unreliability of traditional incubators. Moreover, although Telemedicine is helpful in rural areas, the shortage of healthcare providers have made it inaccessible in both basic healthcare. Thereby, traditional preterm baby and low-birth weight incubators and therapeutic techniques la...
Schwedler, Anna; Konopik, Nadine; Heber, Lukas; Wellenhofer, Marina; Oswald, Frank; Zenz, Gisela; Salgo, Ludwig
Most elderly people wish to remain and be cared for in their own home. Approximately 1.38 million people in Germany are cared for without professional support. However, domestic care by relatives can be a risk factor for violence against the elderly. This research project deals with the issue from a legal and social sciences perspective. The aim of the project is to develop a regulatory framework providing aid-oriented prevention and intervention in the family care of vulnerable elderly people by public agencies and courts. Firstly, empirical data on the situation in family care will be analyzed; secondly, the existing legal framework will be examined. In a third step, recommendations for legislation and administration will be developed in collaboration with practitioners. Initial findings show that, although various support, advice, and training services exist, the situation at home is not always safe. There is a lack of legal regulation on the issue of abuse in the family care setting, especially compared with German legislation on child protection. Thus, the legal framework should reinforce the prevention of care problems by giving more efficient support to carers and permitting legal intervention in the case of abuse. However, at the same time, the proposed legislation should take into account the importance of the individual's right to self-determination.
Dijkgraaf, Robbert; Gopakumar, Rajesh; Ooguri, Hirosi; Vafa, Cumrun
We argue that the holographic description of four-dimensional Bogomol'nyi-Prasad-Sommerfield black holes naturally includes multicenter solutions. This suggests that the holographic dual to the gauge theory is not a single AdS 2 xS 2 but a coherent ensemble of them. We verify this in a particular class of examples, where the two-dimensional Yang-Mills theory gives a holographic description of the black holes obtained by branes wrapping Calabi-Yau cycles. Using the free fermionic formulation, we show that O(e -N ) nonperturbative effects entangle the two Fermi surfaces. In an Euclidean description, the wave function of the multicenter black holes gets mapped to the Hartle-Hawking wave function of baby universes. This provides a concrete realization, within string theory, of effects that can be interpreted as the creation of baby universes. We find that, at least in the case we study, the baby universes do not lead to a loss of quantum coherence, in accord with general arguments
Smith, Kylie M; Crookes, Patrick A
To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research. It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required. In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants. The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing. The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a national scheme. The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century. © 2012 Blackwell Publishing Ltd.
Hugo, Cherie; Dwonczyk, Marcia; Skinner, Jan; Isenring, Liz
Mealtimes directly impact the quality of life of residents in aged care. The objective of The Lantern Project is to improve the dining experience of aged care residents to reduce malnutrition risk through improving dietary intake, meal. A transdisciplinary team of aged care professionals and resident advocates was formed as a collaboration collectively known as The Lantern Project. This paper outlines the journey and timeline of The Lantern Project collaboration since its inception and the interplay between the monthly stakeholder meetings and inter-related research projects demonstrating improved outcomes. Transdisciplinary collaboration offers well-grounded benefits and realistic strategies sensitive to the complexity of the aged care setting. © 2018 AJA Inc.
Suhonen, Marjo; Paasivaara, Leena
To explore factors of human capital related to project success that employees expect from nurse managers. Human capital refers to those resources that managers working with projects possess, such as abilities, knowledge and qualities of character. The data were collected by open interviews (n=14) with nurses, public health nurses and nurse managers working in primary health care and a hospital. Data analysis was carried out using qualitative content analysis. The main factors of human capital related to project success proved to be as follows: (1) management of enthusiastic project culture, (2) management of regeneration and (3) management of emotional intelligence. Future research is needed on the kind of means nurse managers use in human capital management in projects and how they see their possibilities in managing human capital. Human capital management skills should be underlined as an important competence area when recruiting a nurse manager. The success of health care projects cannot be improved only through education or by training of nurse managers; in addition, projects need nurse managers who understand workplace spirituality and have high emotional intelligence. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Jeannette, Crenshaw; Klaus, Phyllis H.; Klaus, Marshall H.
In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the value of keeping mothers and their babies together from the moment of birth is discussed and presented as an evidenced-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Babies held skin-to-skin with their mothers cry less often, breathe easier, and stay warmer than babies who are sepa...
Milgrom, Peter; Riedy, Christine A; Weinstein, Philip; Mancl, Lloyd A; Garson, Gayle; Huebner, Colleen E; Smolen, Darlene; Sutherland, Marilynn
Background Rural, low-income pregnant women and their children are at high risk for poor oral health and have low utilization rates of dental care. The Baby Smiles study was designed to increase low-income pregnant women?s utilization of dental care, increase young children?s dental care utilization, and improve home oral health care practices. Methods/design Baby Smiles was a five-year, four-site randomized intervention trial with a 2 ? 2 factorial design. Four hundred participants were rand...
Foote, Frederick O; Benson, Herbert; Berger, Ann; Berman, Brian; DeLeo, James; Deuster, Patricia A.; Lary, David J; Silverman, Marni N.; Sternberg, Esther M
In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the “Epidaurus 2” Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and “Star Glyphs.” This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine. PMID:29497586
Evans William Douglas
Full Text Available Abstract Background Mobile phone technologies for health promotion and disease prevention have evolved rapidly, but few studies have tested the efficacy of mobile health in full-fledged programs. Text4baby is an example of mobile health based on behavioral theory, and it delivers text messages to traditionally underserved pregnant women and new mothers to change their health, health care beliefs, practices, and behaviors in order to improve clinical outcomes. The purpose of this pilot evaluation study is to assess the efficacy of this text messaging campaign. Methods We conducted a randomized pilot evaluation study. All participants were pregnant women first presenting for care at the Fairfax County, Virginia Health Department. We randomized participants to enroll in text4baby and receive usual health care (intervention, or continue simply to receive usual care (control. We then conducted a 24-item survey by telephone of attitudes and behaviors related to text4baby. We surveyed participants at baseline, before text4baby was delivered to the intervention group, and at follow-up at approximately 28 weeks of baby’s gestational age. Results We completed 123 baseline interviews in English and in Spanish. Overall, the sample was predominantly of Hispanic origin (79.7% with an average age of 27.6 years. We completed 90 follow-up interviews, and achieved a 73% retention rate. We used a logistic generalized estimating equation model to evaluate intervention effects on measured outcomes. We found a significant effect of text4baby intervention exposure on increased agreement with the attitude statement “I am prepared to be a new mother” (OR = 2.73, CI = 1.04, 7.18, p = 0.042 between baseline and follow-up. For those who had attained a high school education or greater, we observed a significantly higher overall agreement to attitudes against alcohol consumption during pregnancy (OR = 2.80, CI = 1.13, 6.90, p = 0.026. We also observed a
Lavoie-Tremblay, Mélanie; Aubry, Monique; Richer, Marie-Claire; Cyr, Guylaine
Health care organizations need project and change management support in order to achieve successful transformations. A project management office (PMO) helps support the organizations through their transformations along with increasing their capabilities in project and change management. The aim of the present study was to extend understanding of the continuous improvement mechanisms used by PMOs and to describe PMO's strategies for continual change and continuous improvement in the context of major transformation in health care. This study is a descriptive case study design with interviews conducted from October to December 2015 with PMO's members (3 managers and 1 director) and 3 clients working with the PMO after a major redevelopment project ended (transition to the new facility). Participants suggested a number of elements including carefully selecting the members of the PMO, having a clear mandate for the PMO, having a method and a discipline at the same time as allowing openness and flexibility, clearly prioritizing projects, optimizing collaboration, planning for everything the PMO will need, not overlooking organizational culture, and retaining the existing support model. This study presents a number of factors ensuring the sustainability of changes.
Poling, Devereaux A.; Hupp, Julie M.
The authors designed an active learning project for a child development course in which students apply core concepts to a hypothetical baby they "raise" during the term. Students applied developmental topics to their unique, developing child. The project fostered student learning and enthusiasm for the material. The project's versatility makes it…
Gunter, Katherine B.; Rice, Kelly R.; Trost, Stewart G.
Baseline findings from the Healthy Home Child Care Project include data from Family Child Care Providers (FCCPs) in Oregon (n=53) who completed assessments of nutrition and physical activity policies and practices and BMI data for children in the care of FCCPs (n=205). Results show that a significant percentage of FCCPs failed to meet child care…
Downs, J A; Edwards, A D; McCormick, D C; Roth, S C; Stewart, A L
Preterm babies are physiologically hypotonic, which causes their posture to be flattened when lying in the prone position. This flattened posture may persist beyond term. In a prospective, randomised, controlled, double blind trial of postural support carried out on 45 babies born at less than 33 weeks of gestation, we showed that infants positioned with specific hip support during the period of intensive care had significantly fewer features of flattened posture at the age equivalent to term.
Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna
Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.
Balbale, Salva N; Locatelli, Sara M; LaVela, Sherri L
In this methodological article, we examine participatory methods in depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers, and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. © The Author(s) 2015.
Hernández, Carme; Alonso, Albert; Garcia-Aymerich, Judith; Grimsmo, Anders; Vontetsianos, Theodore; García Cuyàs, Francesc; Altes, Anna Garcia; Vogiatzis, Ioannis; Garåsen, Helge; Pellise, Laura; Wienhofen, Leendert; Cano, Isaac; Meya, Montserrat; Moharra, Montserrat; Martinez, Joan Ignasi; Escarrabill, Juan; Roca, Josep
To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. The project demonstrated: (i) Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.
Adam, C.; Romanczukiewicz, T.; Wereszczynski, A.; Sanchez-Guillen, J.
A restriction of the baby Skyrme model consisting of the quartic and potential terms only is investigated in detail for a wide range of potentials. Further, its properties are compared with those of the corresponding full baby Skyrme models. We find that topological (charge) as well as geometrical (nucleus/shell shape) features of baby Skyrmions are captured already by the soliton solutions of the restricted model. Further, we find a coincidence between the compact or noncompact nature of solitons in the restricted model, on the one hand, and the existence or nonexistence of multi-Skyrmions in the full baby Skyrme model, on the other hand.
Beluffi, Giampiero; Alberici, Elisa
A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)
Barley, Elizabeth A; Robinson, Susan; Sikorski, Jim
Participation in horticulture and arts may improve wellbeing in those with mental and physical illness. To conduct an in-depth exploration of the views and experience of participants of a primary-care-based horticultural and participatory arts rehabilitation project (Sydenham Garden). Qualitative interview study of a primary-care-based horticultural and participatory arts rehabilitation project in South London. Semi-structured interviews were conducted with 16 participants (referred to as 'coworkers') of Sydenham Garden. Seven were female. Participants were aged between 38 and 91 years and had a range of severe mental and physical health problems; most had depression. The interviews were analysed using constant comparison and thematic analysis. Data were overwhelmingly positive concerning participation. Coworkers considered participation in the project to promote wellbeing by providing purposeful and enjoyable activity and interest, improving mood and self-perceptions, and providing an escape from life's pressures. Being outdoors was considered therapeutic. The most-valued aspect of participation was the social contact derived as a result of it. Many of the coworkers who were interviewed developed transferable skills, including nationally recognised qualifications, which they valued highly. Delivery of horticultural therapy and participatory arts is a feasible model for improving wellbeing in patients in primary care who have serious illness. Longer-term studies are needed to address what happens to people after leaving such projects.
Barley, Elizabeth A; Robinson, Susan; Sikorski, Jim
Background Participation in horticulture and arts may improve wellbeing in those with mental and physical illness. Aim To conduct an in-depth exploration of the views and experience of participants of a primary-care-based horticultural and participatory arts rehabilitation project (Sydenham Garden). Design and setting Qualitative interview study of a primary-care-based horticultural and participatory arts rehabilitation project in South London. Method Semi-structured interviews were conducted with 16 participants (referred to as ‘coworkers’) of Sydenham Garden. Seven were female. Participants were aged between 38 and 91 years and had a range of severe mental and physical health problems; most had depression. The interviews were analysed using constant comparison and thematic analysis. Results Data were overwhelmingly positive concerning participation. Coworkers considered participation in the project to promote wellbeing by providing purposeful and enjoyable activity and interest, improving mood and self-perceptions, and providing an escape from life’s pressures. Being outdoors was considered therapeutic. The most-valued aspect of participation was the social contact derived as a result of it. Many of the coworkers who were interviewed developed transferable skills, including nationally recognised qualifications, which they valued highly. Conclusion Delivery of horticultural therapy and participatory arts is a feasible model for improving wellbeing in patients in primary care who have serious illness. Longer-term studies are needed to address what happens to people after leaving such projects. PMID:22520790
Barchitta, M; Fragapane, S; Consoli, M T; Pennisi, C; Agodi, A
The growing needs of people with disabilities require to integrate this issue into public health in order to improve political feasibility and to ensure that disability will not be left off from any strategic table. The main aim of the "Care for Work" project was to provide training contents to help workers and unemployed people to adapt their knowledge, skills and competencies to the care services sector in order to facilitate their insertion in a new employment source. The partners participating in the project are Organizations from 5 European countries. The project has been divided into seven Work Packages (WPs): three transversal WPs and four specific WPs, each addressing specific activities necessary to achieve the final objectives of the project. The "Care for Work" learning environment contains specific information and training on the techniques for caring people with acquired physical disabilities, as text documents and short training films. The project combines e-learning (Web 2.0) and mobile learning providing a flexible training platform for workers of care services sector. The "Care for Work" project offers specific training addressed to meet the new existing needs of workers of the care services sector and/or unemployed people. All the information and results of the project are available on the web page: www.careforwork.eu, and the present article is part of the WP "Valorization".
Full Text Available Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. Setting: One health care sector in Spain (Barcelona (n = 11.382; six municipalities in Norway (Trondheim (n = 450; and one hospital in Greece (Athens (n = 388. Method: The four services were: (i Home-based long-term maintenance of rehabilitation effects (n = 337; (ii Enhanced Care for frail patients, n = 1340; (iii Home Hospitalization and Early Discharge (n = 2404; and Support for remote diagnosis (forced spirometry testing in primary care (Support (n = 8139. Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. Results: The project demonstrated: (i Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01; (ii Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05; (iii Reduced in-hospital days for all types of patients (p < 0.001 in Home Hospitalization/Early Discharge; and (iv Increased quality of testing (p < 0.01 for patients with respiratory symptoms in Support, with marked differences among sites. Conclusions: The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.
Full Text Available Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus.Setting: One health care sector in Spain (Barcelona (n = 11.382; six municipalities in Norway (Trondheim (n = 450; and one hospital in Greece (Athens (n = 388.Method: The four services were: (i Home-based long-term maintenance of rehabilitation effects (n = 337; (ii Enhanced Care for frail patients, n = 1340; (iii Home Hospitalization and Early Discharge (n = 2404; and Support for remote diagnosis (forced spirometry testing in primary care (Support (n = 8139. Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted.Results: The project demonstrated: (i Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01; (ii Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05; (iii Reduced in-hospital days for all types of patients (p < 0.001 in Home Hospitalization/Early Discharge; and (iv Increased quality of testing (p < 0.01 for patients with respiratory symptoms in Support, with marked differences among sites.Conclusions: The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.
Full Text Available Patients with acute stroke have better outcomes in terms of survival or regaining independence if they receive organized inpatient care in a specific setting (Stroke Unit, SU where a coordinated multidisciplinary team can ensure the best level of care. The clinical governance of an SU requires a systematic monitoring of diagnostic, clinical and therapeutic processes through a structured audit. The entire project and set up of a new SU in Bentivoglio, Italy, were based on a model that focused on multidisciplinary teamwork and clinical governance. An audit based on the Benjamin audit cycle followed every step of the set up of the new SU. Markers from national and international guidelines and from the Italian Regional Audit, together with a specific database were used. The audit showed a high level of care and a significant improvement in the majority of clinical, diagnostic and therapeutic parameters. Only a few markers (i.e. waiting times for ultrasound tomography and prescription of oral anticoagulation therapy required specific projects in order to improve the results. Our experience confirmed that a structured audit can support clinical governance of an SU by monitoring clinical processes and quality of care. Such an audit involves the whole professional team and shows the effects of any single actions. It also helps integration and co-operation among staff. Furthermore, a structured audit is a useful instrument for professional accountability for both qualitative and quantitative aspects of care.
Full Text Available Abstract Background By measuring the quality of the organisation of palliative care with process and structure quality indicators (QIs, patients, caregivers and policy makers are able to monitor to what extent recommendations are met, like those of the council of the WHO on palliative care and guidelines. This will support the implementation of public programmes, and will enable comparisons between organisations or countries. Methods As no European set of indicators for the organisation of palliative care existed, such a set of QIs was developed. An update of a previous systematic review was made and extended with more databases and grey literature. In two project meetings with practitioners and experts in palliative care the development process of a QI set was finalised and the QIs were categorized in a framework, covering the recommendations of the Council of Europe. Results The searches resulted in 151 structure and process indicators, which were discussed in steering group meetings. Of those QIs, 110 were eligible for the final framework. Conclusions We developed the first set of QIs for the organisation of palliative care. This article is the first step in a multi step project to identify, validate and pilot QIs.
Full Text Available Umbilical catheters are frequently required in the management of severely ill premature babies. The risk of complications may increase with duration of UVC use. Objective: To determine whether the risk of central line-associated bloodstream infections (CLA-BSIs and sepsis remained constant over the duration of umbilical vein catheters (UVCs in high-risk premature neonates. Methods:retrospective analysis. The data were collected from the medical record of high risk premature neonates who had a UVC placed in neonatal care unit of Husada Utama Hospital between April 1st 2008 to April 30th 2011 with purposive sampling. Catheter duration was observed before and after 14 days on placement. Blood and UVC culture was performed to establish the risk of CLA-BSIs and sepsis. Chi-square and logistic regression analysis were performed in the laboratorium data. Result: A total 44 high risk premature babies with UVCs were enrolled (sepsis group: n = 23 and non sepsis group: n = 21. Baseline demographics were similar between the groups. 15 babies in sepsis group have UVCs duration > 14 days, and 8 babies have UVCs 14 days show blood culture performance in 11 babies with positive evidence, UVCs culture performance is negative in 18 babies (p = 0.456. Burkholderia cepacia and Klebsiella pneumonia mostly appeared in blood culture performance. 25% of UVC culture performance shows Pseudomonas aeroginosa. Conclusions: The catheter duration have no significant difference in risk of sepsis in premature babies with Umbilical Vein Catheters.
Neuman, Susan B.; Kaefer, Tanya; Pinkham, Ashley; Strouse, Gabrielle
Targeted to children as young as 3 months old, there is a growing number of baby media products that claim to teach babies to read. This randomized controlled trial was designed to examine this claim by investigating the effects of a best-selling baby media product on reading development. One hundred and seventeen infants, ages 9 to 18 months,…
Leach, Matthew J; Segal, Leonie; Esterman, Adrian; Armour, Caroline; McDermott, Robyn; Fountaine, Tim
Diabetes mellitus is an increasingly prevalent metabolic disorder that is associated with substantial disease burden. Australia has an opportunity to improve ways of caring for the growing number of people with diabetes, but this may require changes to the way care is funded, organised and delivered. To inform how best to care for people with diabetes, and to identify the extent of change that is required to achieve this, the Diabetes Care Project (DCP) will evaluate the impact of two different, evidence-based models of care (compared to usual care) on clinical quality, patient and provider experience, and cost. The DCP uses a pragmatic, cluster randomised controlled trial design. Accredited general practices that are situated within any of the seven Australian Medicare Locals/Divisions of General Practice that have agreed to take part in the study were invited to participate. Consenting practices will be randomly assigned to one of three treatment groups for approximately 18 to 22 months: (a) control group (usual care); (b) Intervention 1 (which tests improvements that could be made within the current funding model, facilitated through the use of an online chronic disease management network); or (c) Intervention 2 (which includes the same components as Intervention 1, as well as altered funding to support voluntary patient registration with their practice, incentive payments and a care facilitator). Adult patients who attend the enrolled practices and have established (≥12 month's duration) type 1 diabetes mellitus or newly diagnosed or established type 2 diabetes mellitus are invited to participate. Multiple outcomes will be studied, including changes in glycosylated haemoglobin (primary outcome), changes in other biochemical and clinical metrics, incidence of diabetes-related complications, quality of life, clinical depression, success of tailored care, patient and practitioner satisfaction, and budget sustainability. This project responds to a need for robust
Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.
This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…
Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P
This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.
Report outlining progress by the Baby MIND collaboration since the October 2015 SPSC committee meeting. The Baby-MIND proposal was approved as NP05 with a clear recommendation to focus the project on the timely delivery of the magnetized downstream muon spectrometer for the Wagasci project. The measures taken to fullfill these recommendations are summarized. The status of the magnet design and procurement; of the detector modules, procurement of scintillator and module mechanics design; the status of the electronics and DAQ; and finally simulations and analysis are desctribed. The project schedule and milestones, the plans for test beam and the request for the use of the T9 test area are presented.
Scales, Charles D; Moul, Judd W; Curtis, Lesley H; Elkin, Eric P; Hughes, M E; Carroll, Peter R
Baby Boomers (those born in 1946 to 1964) are thought to place a high value on quality of life, and have a higher propensity to consume healthcare services than previous generations. We sought to characterize prostate cancer (CaP) presentation among this group, and determine whether treatment patterns differ between Baby Boomers and the preceding generation. We defined two birth cohorts: men born in 1927 to 1945 (pre-Boomers) and Baby Boomers. Our study cohort included men less than 65 years old, diagnosed with CaP between 1999 and 2003 (Baby Boomers, n = 812; pre-Boomers, n = 1843). We compared the two groups for clinical presentation, sociodemographics, and primary treatment, controlling for age effects. The primary endpoint was selection of radical prostatectomy as primary treatment. Most Baby Boomers were diagnosed with stage T1 disease (466, 61%), biopsy Gleason sums less than 7 (572, 73%), and prostate-specific antigen levels of 4.1 to 10.0 (509, 66%). This presentation was not clinically different from pre-Boomers. Baby Boomers had higher socioeconomic status than pre-Boomers. On multivariate analysis, Baby Boomers were more likely to undergo radical prostatectomy as primary therapy (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.13 to 2.35). Controlling for age effects, however, there were no significant differences in treatment choice (OR 0.86, 95% CI 0.40 to 1.87) or sociodemographics between these groups. Differences in CaP presentation and treatment between Baby Boomers and pre-Boomers may be related to age at diagnosis rather than innate differences in behavior. As more Baby Boomers are diagnosed with CaP, further research will be required to characterize this generation's impact on CaP care.
Dorsey, Shannon; Kerns, Suzanne E U; Trupin, Eric W; Conover, Kate L; Berliner, Lucy
Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of "brokers" or "gateway providers" of services. For youth in foster care, child welfare caseworkers often play this role. This study examines caseworker-level outcomes of Project Focus, a caseworker training and consultation model designed to improve emotional and behavioral outcomes for youth in foster care through increased linkages with EBPs. Project Focus was tested through a small, randomized trial involving four child welfare offices. Caseworkers in the Project Focus intervention group demonstrated an increased awareness of EBPs and a trend toward increased ability to identify appropriate EBP referrals for particular mental health problems but did not have significantly different rates of actual referral to EBPs. Dose of consultation was associated with general awareness of EBPs. Implications for practice and outcomes for youth are discussed.
‘Baby Blues’ is a new highbush blueberry from the U.S. Department of Agriculture-Agricultural Research Service (USDA-ARS) breeding program in Corvallis, OR, released in cooperation with Oregon State University’s Agricultural Experiment Station. ‘Baby Blues’ is a vigorous, high-yielding, very small-f...
This 60 second public service announcement is based on the January 2018 CDC Vital Signs report. Every year, there are about 3,500 sleep-related deaths among U.S. babies. Learn how to create a safe sleep environment for babies.
Sanz, Teresa; Menendez, Javier; Rosique, Teresa
The present study contributes to the understanding of gross motor development in babies with Down's syndrome. Also, it facilitates the comprehension of the efficiency of the early motor stimulation as well as of beginning it as early as possible. We worked with two groups of babies with Down's syndrome, beginning the early motor training in each…
Baird, Stephen L.
"Designer babies" is a term used by journalists and commentators--not by scientists--to describe several different reproductive technologies. These technologies have one thing in common: they give parents more control over what their offspring will be like. Designer babies are made possible by progress in three fields: (1) Advanced…
Dahiya, Neha; Garg, Suneela
The UK was the first country to legalise mitochondrial donation in October 2015 (1). In 2016, the first three-parent baby was born in Mexico (2) and the US Food and Drug Administration declared that further research on mitochondrial donation is ethically permissible (3). It has now become an important issue, raising as it does, the spectre of "genetically modified designer babies".
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Ary Sulistyo Utomo
180m. Pengujian suhu ruang baby incubator menggunakan termometer sebagai perbandingan dengan nilai suhu yang dibaca pada alat. Dari pengukuran diperoleh tingkat perbedaan 0% pada suhu 30oC dan 2,8% pada suhu 37oC. Kata kunci: baby incubator, sistem monitoring sentral, microsoft visual studio, arduino.
... first hour. After that, or when the mother needs to sleep or cannot do skin-to-skin, babies should ... Back is Best New Crib Standards: What Parents Need to Know Safe Sleep for Babies (Video) The Healthy Children Show: Sleep ( ...
Mukhlis Mokhtar; Abu Bakar Ghazali; Muhammad Zahidee Taat
This paper explains the works being done to develop an interface system for Baby-Electron Beam Machine (EBM). The function of the system is for the safety, controlling and monitoring the Baby-EBM. The integration for the system is using data acquisition (DAQ) hardware and LabVIEW to develop the software. (author)
Mokhtar, Mukhlis; Ghazali, Abu Bakar; Taat, Muhammad Zahidee [Accelerator Development Center, Malaysian Nuclear Agency, Bangi, Kajang, Selangor (Malaysia), Technical Support Div.
This paper explains the works being done to develop an interface system for Baby-Electron Beam Machine (EBM). The function of the system is for the safety, controlling and monitoring the Baby-EBM. The integration for the system is using data acquisition (DAQ) hardware and LabVIEW to develop the software. (author)
Goode, Marsha; Broesamle, Barbara
Describes nine-day residential camp for Michigan teenage mothers/babies to enhance personal growth and develop responsible social skills. Outlines goals, pre-camp planning, staff, activities, evaluation. Reports 31 teen moms (ages 13-21) and 35 babies attended in 1986. Indicates participants were in therapy, experienced abuse, had low self-esteem,…
Davim, Rejane Marie Barbosa; Enders, Bertha Cruz; da Silva, Richardson Augusto Rosendo
This study aimed at learning about the feelings experienced by mothers while breastfeeding their premature babies in a rooming-in facility, by means of individual interviews with 33 mothers during the period of February to April 2006, at a maternity hospital in Natal/RN/Brazil. The main feelings referred by the mothers regarding their inability to breastfeed their premature babies immediately after delivery were: sorrow, guilt, disappointment, frustration, insecurity, and fear of touching, holding or harming the delicate babies while breastfeeding. However, the mother-child bond that was formed when the baby was discharged from the Neonatal Intensive Care Unit and taken to the rooming-in facility was reflected by feelings of fulfillment, pride, and satisfaction at experiencing the first breastfeeding.
Simon, Ross W; Canacari, Elena G
Manufacturing organizations have used Lean management principles for years to help eliminate waste, streamline processes, and cut costs. This pragmatic approach to structured problem solving can be applied to health care process improvement projects. Health care leaders can use a step-by-step approach to document processes and then identify problems and opportunities for improvement using a value stream process map. Leaders can help a team identify problems and root causes and consider additional problems associated with methods, materials, manpower, machinery, and the environment by using a cause-and-effect diagram. The team then can organize the problems identified into logical groups and prioritize the groups by impact and difficulty. Leaders must manage action items carefully to instill a sense of accountability in those tasked to complete the work. Finally, the team leaders must ensure that a plan is in place to hold the gains. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Full Text Available Adolescents and young adults (AYA with cancer form a particular group of patients with unique characteristics, who inhabit a so-called no man’s land between pediatric and adult services. In the last ten years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed towards patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients’ needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to adolescents and young adults with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes.
Full Text Available Abstract Background Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036. Methods We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions. Results Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure. Conclusion The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning.
Parkes, Jacqueline H; Pyer, Michelle; Wray, Paula; Taylor, Jane
In recent years, several UK and, international funders of health and social care related research have adopted the policy of requiring explicit evidence of the 'public' voice in all aspects of project design. For many academic researchers engaged within research, evaluations or audit projects, this formal requirement to actively engage members of the public will present them with both benefits and challenges to securing knowledgeable, skilled, and confident lay representation onto project teams. This could potentially lead to the exploitation of those individuals who are available, appropriately informed, and adequately prepared for such activities. Currently, much of the preparation of patients or members of the public for research involvement tends to be aligned to specific projects; however, with the call for greater active and meaningful involvement of lay representatives in future national and international funding applications, there is clearly a growing need to 'train' sufficient numbers of confident and competent representatives to meet this growing demand. This paper describes the development of a specifically designed research awareness training programme and underpinning theoretical model, which has been specifically designed to support active and meaningful lay involvement in research, evaluations and audit projects. Developed over a four year period, the course is a culmination of learning extracted from a series of four completed research projects, which have incorporated an element of public and patient involvement (PPI) training in their overall design. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.
Ida Bagus Ngurah Swacita
Full Text Available Sistiserkosis merupakan penyakit yang bersifat zoonosis yang disebabkan oleh larva cacing pita Taenia solium yang disebut Cysticercus cellulosae. Di Indonesia terdapat tiga provinsi yang berstatus endemik penyakit sistiserkosis, salah satunya adalah provinsi Bali. Penelitian ini bertujuan untuk mendeteksi antibodi terhadap C. cellulosae pada babi lokal yang dipotong di tempat pemotongan babi Panjer, Denpasar. Sampel penelitian adalah 270 sampel serum babi lokal yang dipotong di tempat pemotongan babi Panjer, Denpasar Selatan. Babi lokal ini berasal dari Nusa Penida, Karangasem dan Negara. Sampel serum diuji dengan metode ELISA (Enzyme Linked Immunosorbent Assay indirect. Hasil penelitian menunjukkan bahwa antibodi C. cellulosae terdeteksi pada 33 sampel. Disimpulkan bahwa terdeteksi antibodi C. cellulosae pada 33 sampel dari 270 sampel serum babi lokal yang dipotong di tempat pemotongan babi Panjer, Denpasar.
Full Text Available Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1 the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2 the neonatal resuscitators give volume much sooner.
Auger, Anamarie; Reich, Stephanie M.; Penner, Emily K.
The impact of a baby book intervention on promoting positive reading beliefs and increasing reading frequency for low-income, new mothers (n = 167) was examined. The Baby Books Project randomly assigned low-income, first-time mothers to one of three study conditions, receiving educational books, non-educational books, or no books, during pregnancy and over the first year of parenthood. Home-based data collection occurred through pregnancy until 18 months post-partum. Mothers who received free baby books had higher beliefs about the importance of reading, the value of having resources to support reading, and the importance of verbal participation during reading. The results showed that providing any type of baby books to mothers positively influenced maternal reading beliefs, but did not increase infant-mother reading practices. Maternal reading beliefs across all three groups were significantly associated with self-reported reading frequency when children were at least 12 months of age. PMID:25264394
Full Text Available Objective. To explore how the perceptions and experiences of working with risky drinkers change over time among primary health care staff during a systematic implementation project. Methods. Qualitative focus group interviews took place before and after the implementation of the project. Results. The staff displayed a positive change during the implementation period with regard to awareness, knowledge, and confidence that led to a change in routine practice. Throughout the project, staff were committed to engaging with risky drinkers and appeared to have been learning-by-doing. Conclusions. The results indicated a positive attitude to alcohol prevention work but staff lack knowledge and confidence in the area. The more practical experience during the study is, the more confidence seems to have been gained. This adds new knowledge to the science of implementation studies concerning alcohol prevention measures, which have otherwise shown disappointing results, emphasizing the importance of learning in practice.
Schmidt, Kayna Trombini; Terassi, Mariélli; Marcon, Sonia Silva; Higarashi, Ieda Harumi
The objective of this study was to identify the strategies used by the nursing team in the neonatal unity care of a school-hospital during the preparation of the family for the premature baby discharge. It is a descriptive study with qualitative approach. The data was collected between March and June 2011, by means of observation and semi-structured interviews. From the discourse analysis two categories appeared: Orientations and professional strategies in preparing the family for the premature baby hospital discharge and Difficulties and potentialities in the neonatal attention space. The main strategy mentioned was the family early insertion in the caring process and the stressed difficulty was the parents' absence during the child's hospital staying. The potentialities and limitations pointed out in this study revealed that the assistance process is dynamic, asking for constant correction and adequacies to effectively and wholly care for the premature baby and its family.
Full Text Available Prebiotics play significant role in life support of microorganisms of human gastrointestinal tract, and normal functional state of intestinal biocenosis is sufficient condition for human health. Intestinal microbiocenosis is a component of regulation of proteins and lipids metabolism, vitamins synthesis, detoxication process in intestine, etc. prebiotics include a number of disaccharides (lactulose, oligosaccharides and polysaccharides (inulin, cellulose, etc.. Fructose polymer — inulin — provides growth of bifido- and lactobacteria, improves metabolism and has immunomodulating activity. Formation of intestinal micro biocenosis in infant is provided by prebiotics of breast milk. Further state of micro biocenosis, which is necessary for growth and development of child, is determined by adequate intake of prebiotics from fruits, vegetables and cereals. It is reasonable to use special baby foods fortified with prebiotics (for example, inulin.Key words: prebiotics, intestinal microflora, inulin.(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(3:121-125
Schepman, Sanneke; Valentijn, Pim; Bruijnzeels, Marc; Maaijen, Marlies; de Bakker, Dinny; Batenburg, Ronald; de Bont, Antoinette
The need for organisational development in primary care has increased as it is accepted as a means of curbing rising costs and responding to demographic transitions. It is only within such inter-organisational networks that small-scale practices can offer treatment to complex patients and continuity of care. The aim of this paper is to explore, through the experience of professionals and patients, whether, and how, project management and network governance can improve the outcomes of projects which promote inter-organisational collaboration in primary care. This paper describes a study of projects aimed at improving inter-organisational collaboration in Dutch primary care. The projects' success in project management and network governance was monitored by interviewing project leaders and board members on the one hand, and improvement in the collaboration by surveying professionals and patients on the other. Both qualitative and quantitative methods were applied to assess the projects. These were analysed, finally, using multi-level models in order to account for the variation in the projects, professionals and patients. Successful network governance was associated positively with the professionals' satisfaction with the collaboration; but not with improvements in the quality of care as experienced by patients. Neither patients nor professionals perceived successful project management as associated with the outcomes of the collaboration projects. This study shows that network governance in particular makes a difference to the outcomes of inter-organisational collaboration in primary care. However, project management is not a predictor for successful inter-organisational collaboration in primary care.
McManus, Margaret; White, Patience; Pirtle, Robin; Hancock, Catina; Ablan, Michael; Corona-Parra, Raquel
This pediatric-to-adult health care transition pilot project describes the process and results of incorporating the "Six Core Elements of Health Care Transition (2.0)" into a Medicaid managed care plan with a group of 35 18-23 year olds who have chronic mental health, developmental, and complex medical conditions. The pilot project demonstrated an effective approach for customizing and delivering recommended transition services. At the start of the 18-month project, the Medicaid plan was at the basic level (1) of transition implementation of the Six Core Elements with no transition policy, member transition readiness assessment results, health care transition plans of care, updated medical summaries, transfer package for the adult-focused provider, and assurance of transfer completion and consumer feedback. At the conclusion of the pilot project, the plan scored at level 3 on each core element. The primary reason for not scoring at the highest level (4) was because the transition elements have not been incorporated into services for all enrollees within the plan. Future efforts in managed care will benefit from starting the transition process much earlier (ages 12-14), expanding the role of nurse care managers and participating pediatric and adult-focused clinicians in transition, and offering payment incentives to clinicians to implement the Six Core Elements of Health Care Transition. Copyright © 2015 Elsevier Inc. All rights reserved.
Powers, Christina; Comfort, Megan; Lopez, Andrea M; Kral, Alex H; Murdoch, Owen; Lorvick, Jennifer
People who are "triply diagnosed" with HIV, mental health issues, and substance-related disorders face tremendous barriers connecting to and remaining in HIV care. Authors of this article implemented Project Bridge Oakland (PBO), an intervention based on harm reduction and trauma-informed care, to help maintain continuity of care for triply diagnosed adults through cycles of criminal justice involvement. From August 2011 to December 2014, a clinical social worker and an HIV physician provided intensive case management for 19 clients living in Oakland, California. By working with clients across a multitude of community, clinic, and correctional spaces while maintaining a low threshold for services, the social worker was able to engage a severely marginalized population in HIV care. This article details the PBO strategies for assisting with a wide range of services needed for community stabilization, navigating criminal justice involvement, and establishing a therapeutic relationship through mundane practices such as eating and waiting for appointments. This article illustrates how programs aimed at stabilizing triply diagnosed clients in the community and connecting them to HIV care require coordination among providers, outreach to engage clients, ample time to work with them, and flexibility to account for the complexities of their day-to-day lives and experiences. © 2017 National Association of Social Workers.
Elg, Mattias; Kollberg, Beata; Lindmark, Jan; Olsson, Jesper
In this article we present parts of a larger research study, which aims at explaining how a process-oriented innovation unfolds and develops over time in Swedish health care. Through a longitudinal field study of a national and a local development project, we analyze how the flow model--a process-oriented innovation that emphasizes the sequence of activities a patient undertakes through the health care system--has been developed in Swedish health care. We propose to explain how the development projects unfold over time through the use of process theories of organizational development and change. The national project is best understood as a process of evolution from the phase of selection of projects and teleological (goal-oriented, socially constructed development) and dialectic theory (development via conflict of 2 opposing ideas from different organizational entities) through the process in which national ideas face real-world practice. We also propose a synthesis of dialectics and teleological motors for explaining local development. This synthesis proposes that local development teams have a rather broad notion of what it takes to implement the flow model. The team knows the goal, procedures, and activities from a broad perspective. Through a search-and-interact process, in which other organizational entities such as IT consultants, medical units and politicians have a heavy influence, the group sets and implements goals. Details of how to proceed are, however, constructed in the process of acting. This occurs as ideas are developed and tested in real settings. We conclude the article by presenting managerial implications for understanding these process patterns.
DiPietro Mager, Natalie A; Bright, David R; Markus, Dani; Weis, Lindsey; Hartzell, David M; Gartner, James
To demonstrate the ability of a statewide network of community pharmacists to provide preconception care services with the use of targeted medication reviews (TMRs). Community pharmacists are well qualified and well positioned to assist in this public health priority; however, there are no documented case studies of pharmacists providing preconception care with the use of TMRs. Through the demonstration project, pharmacists provided educational TMRs focused on 3 elements of preconception care to women aged 15 to 45 years enrolled in a nonprofit managed care plan: (1) medications that may cause fetal harm (category D/X); (2) folic acid use; and (3) immunizations. TMRs were generated and released to the individual pharmacy where that patient had prescriptions filled. Any practicing pharmacist in Ohio participating in the medication therapy management platform with a patient in the sample received a TMR notification. The pharmacists documented and billed for the service through this commercially available platform. Nineteen weeks after implementation of the TMRs, 1149 individual pharmacists from 818 different pharmacies had completed at least 1 TMR. Pharmacists completed 33% of all TMR opportunities with a 65% success rate. Establishing new services that were focused on preconception care resulted in rapid integration into existing medication therapy management processes in hundreds of pharmacies across Ohio. These results may help to provide justification for additional payers to reimburse for similar services. Through demonstrating the impact on preconception care, the role of the community pharmacist may continue to expand to include provision of additional preventive care services following the model developed in this initiative. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Vergara, Lizandra Garcia Lupi; Ribet, Lucie Elisa
A study in the educators' work station at baby nursery of NDI/UFSC, located in Florianópolis, was conducted using the Work Ergonomic Analysis methodological tool. The demand considered was the educators' physical exhaustion caused by the weight carried when taking care of the babies, the postures assumed during the labor activity and the spatial arrangement of the baby nursery. Thinking ergonomically, the spatial arrangement is directly associated to three factors: the formal aspect of the environment, the esthetic aspect including colors and finish quality and the ease of understanding involved in the baby nursery labor. By the ergonomic adequacy it is possible to assert that if were established better conditions of posture and comfort for the educators, as well as satisfactory technical and operational information to carry out the activities, greater safety and welfare would be provided to the babies, the main focus of the work.
Nau, Katja; Krug, Harald F.
Nanotechnology is increasingly considered to be the future technology. It will enable science and industry to provide new and better product solutions for the society. NanoCare is a German project, funded by the German Federal Ministry of Education and Research (BMBF), which aims to broaden knowledge about synthetic nanomaterials with regard to the potential impacts of nanomaterials on human health. 13 partners from industry, universities and research institutes are contributing their expertise to this partnership. The work plan of the NanoCare project is composed of three different parts: (1) the generation, (2) the management, and (3) the transfer of knowledge. The production of synthetic nanoparticles, the subsequent analysis of primary particles, aggregates and agglomerates, as well as the behaviour in biological media and effects on biological systems are focused in the generation of knowledge. In addition to the production and characterization of new synthetic nanoparticles (metal oxides like zirconium dioxide or zinc oxide), titanium dioxide and Carbon Black will be established as reference materials. This enables the comparison of the results of all partners of our project. Various analytical methods for characterization will be applied, for example: transmission and scanning electron microscopy, inductive coupled plasma mass spectroscopy (ICP-MS), atomic absorption spectroscopy (AAS) and the Brunner-Edward-Teller method (BET). In vitro studies will systematically investigate biological mechanisms of action of nanoparticles and the dependency on their size, shape, zeta potential and other important properties. In vitro data will be complemented by in vivo studies. Another work package deals with the measurement of working place exposure and agglomerate stabilities. Established measurement devices and methods will be developed further in order to determine aerosols and nanoparticles directly at the workplace during ongoing work processes. The stabilities of
Wegleitner, Klaus; Schuchter, Patrick
By now, the public health end-of-life care approach is well established and has induced diverse initiatives-subsumed under the concept of compassionate or caring communities-to engage the community in supporting vulnerable, dying people and their beloved ones. In the light of a participatory research project our paper examines the question: what are the deeper ideas behind caring communities and what constitutes a caring community? A multi-level analysis based on (I) qualitative research with focus groups and interviews with community members within the project; (II) the reflection of the role of participatory research in caring community initiatives, and (III) the meta-analysis of an international expert workshop, which allowed to discuss our experiences and insights in the light of international caring community models and expertise. Our analysis of qualities ("ingredients") of a caring community, from the perspective of community members, highlighted the importance of the co-creation of supportive care relationships in the local care web, through everyday life solidarity in the neighbourhood, appreciating and exchanging the wisdom of care, and also marked the role of professionals as enablers. Participatory research in caring community developments has the potential to engage and empower citizens, and to interlink existential care-stories with questions about the structural and political environments of appropriate end-of-life care. The caring community movement and public health end-of-life care has to maintain their critical potential against the commercialization and fragmentation of care (services), but also without "romanticizing" communities. Prospective caring community progresses need (I) an ecological health-promotion framework for action and (II) social learning processes along the existential experiences and the wisdom of community members, complementing each other. Organizing existential-political care dialogues can contribute to an ethic of caring
Full Text Available Background: The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions occur at the different levels of care and often without a clear link between the interventions (new and/or existing and their impact on outcomes (in terms of patients health, both patient and professional satisfaction and cost-effectiveness. Still, integrated care is seen as a core strategy in the sustainability of health and care provision in most societies in Europe and beyond. More specifically, at present, there is neither clear evidence on transferable factors of integrated care success nor a method for determining how to establish these specific success factors. The drawback of case methodology in this case, however, is that the in-depth results or lessons generated are usually highly context-specific and thus brings the challenge of transferability of findings to other settings, as different health care systems and different indications are often not comparable. Project INTEGRATE, a European Commission-funded project, has been designed to overcome these problems; it looks into four chronic conditions in different European settings, under a common methodology framework (taking a mixed-methods approach to try to overcome the issue of context specificity and limited transferability. The common methodological framework described in this paper seeks to bring together the different case study findings in a way that key lessons may be derived and transferred between countries, contexts and patient-groups, where integrated care is delivered in order to provide insight into generalisability and build on existing evidence in this field.Methodology: To compare the different integrated care experiences, a mixed-methods approach has
Ngapeth-Etoundi, M; Ekoto, E
The objective of this work is to analyse the situation of the Oral Health Care (OHC) of the population of operational district health unit in Primary Health Care (PHC) and finally integrate the component of OHC. Indeed in many countries in Africa, the World Health Organisation (WHO), in accord with the countries, have set up the policy of PHC. The agreement is that the component of OHC was neglected for quite sometimes in Cameroon. It's for this reason that a pilot project was initiated as a model so that it would be extended to all districts in this country. The method consist in investigation into the prevalence by means of questionnaire and clinical examination of the population of varied age; 900 persons were examined in the Sangmelina health district in order to master the situation of OHC. Oral dental hygiene: 70.5% of the population had a tooth brush, 79% declared they brush their teeth, The state of periodontal tissue: 75% had debris, 70% calculus, 60.7% gingivitis, The prevalence of caries: 66.9% (91.9% had between 21 and 32 teeth), 44.8% follon teeth, 50.8% of this population needed artificial teeth. The situation of the OHC in the health district of Sangmelina requires an effective prevention, consequently the importance of including this situation in PHC program of the said district.
Dighe, Manjiri P; Muckaden, Maryann A; Manerkar, Swati A; Duraisamy, Balaji P
Recent advances in medical care have improved the survival of newborn babies born with various problems. Despite this death in the neonatal intensive care unit (NICU) is an inevitable reality. For babies who are not going to "get better," the health care team still has a duty to alleviate the physical suffering of the baby and to support the family. Palliative care is a multidisciplinary approach to relieve the physical, psycho social, and spiritual suffering of patients and their families. P...
NASA's Phoenix Mars Lander's Surface Stereo Imager took this image on Sol 14 (June 8, 2008), the 14th Martian day after landing. It shows two trenches dug by Phoenix's Robotic Arm. Soil from the right trench, informally called 'Baby Bear,' was delivered to Phoenix's Thermal and Evolved-Gas Analyzer, or TEGA, on Sol 12 (June 6). The following several sols included repeated attempts to shake the screen over TEGA's oven number 4 to get fine soil particles through the screen and into the oven for analysis. The trench on the left is informally called 'Dodo' and was dug as a test. Each of the trenches is about 9 centimeters (3 inches) wide. This view is presented in approximately true color by combining separate exposures taken through different filters of the Surface Stereo Imager. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.
Nubia Castiblanco López
e analisada segundo a entrevista e análises etnográficos de James Spradley. Participantes: oito mães de recém nascidos prematuros que compareceram para controle no Programa Mãe Canguru Integral, Hospital Universitário São Ignácio, entre novembro de 2007 e maio de 2008. Resultados: surgem duas questões: cuidados diretos ao recém nascido prematuro e o caminho até a adaptação. O cuidado direto ao recém nascido prematuro em casa implica para a mãe carregar, massagear, proteger do frio, alimentar à criança, manter a higiene, conservar a proteção do médio, dar amor, suprir oxigeno suplementar ao bebê quando o precisar e saber sobre os sinais da criança. O caminho para a adaptação materna está dirigido a um objetivo para as mães: "criar a criança". Elas expressam que as noites são muito difíceis e expressam seus sentimentos e finalmente descrevem a adaptação materna ao hábito. Conclusão: a visão das mães sobre o cuidado do recém nascido prematuro é universal: "cuidar muito da criança" e ficar sempre atenta; por outro lado, a conotação de cuidado é diversa porque cada mãe o cataloga, desde sua própria percepção, como cuidado extremo, básico, essencial e especial. Também as mães compartilharam crenças, valores, tradições e mitos.Purpose: To describe the significance of taking care of premature babies at home for mothers, from their cultural context. Design: qualitative ethnographic study based on Madeleine Leininger's theory. Sample: Information obtained from observation and 23 interviews to mothers at home was collected and analyzed in accordance to the interview and James Spradley ethnographic analysis. Participants: eight mothers of premature newborns attending control at the Integral Kangaroo Mother Program (Programa Madre Canguro Integral, Hospital Universitario San Ignacio, between November 2007 and May 2008. Results: Two subjects arise: premature newborn care and the way to adaptation. Direct care to premature
Lisa M. Shook
Full Text Available Background: Approximately 100,000 persons with sickle cell disease (SCD live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. Methods: STORM investigators hypothesized that Project ECHO® methodology could be replicated to create a low-cost, high-impact intervention to train PCPs in evidence-based care for pediatric and young adult patients with SCD in the Midwest, called STORM TeleECHO. This approach utilizes video technology for monthly telementoring clinics consisting of didactic and case-based presentations focused on the National Heart, Lung and Blood Institute (NHLBI evidence-based guidelines for SCD. Results: Network leads in each of the STORM states assisted with developing the curriculum and are recruiting providers for monthly clinics. To assess STORM TeleECHO feasibility and acceptability, monthly attendance and satisfaction data are collected. Changes in self-reported knowledge, comfort, and practice patterns will be compared with pre-participation, and 6 and 12 months after participation. Conclusions: STORM TeleECHO has the potential to increase implementation of the NHLBI evidence-based guidelines, especially increased use of hydroxyurea, resulting in improvements in the quality of care and outcomes for children and young adults with SCD. This model could be replicated in other pediatric chronic illness conditions to improve PCP knowledge and confidence in delivering evidence-based care.
Golden, Janet; Weiner, Lynn
This article examines American baby books from the late nineteenth through the twentieth century. Baby books are ephemeral publications—formatted with one or more printed pages for recording developmental, health, and social information about infants and often including personal observations, artifacts such as photographs or palm prints, medical and other prescriptive advice, and advertisements. For historians they serve as records of the changing social and cultural worlds of infancy, offering insights into the interplay of childrearing practices and larger social movements.Baby books are a significant historical source both challenging and supporting current historiography, and they illustrate how medical, market and cultural forces shaped the ways babies were cared for and in turn how their won behavior shaped family lives. A typology of baby books includes the lavishly illustrated keepsake books of the late nineteenth century, commercial and public health books of the twentieth century, and on-line records of the present day. Themes that emerge over time include those of scientific medicine and infant psychology, religion and consumerism. The article relies on secondary literature and on archival sources including the collections of the UCLA Louise M. Darling Biomedical Library as well as privately held baby books.
Sauseng, W; Kerbl, R; Thaller, S; Hanzer, M; Zotter, H
Thermal stress is a risk factor for sudden infant death syndrome (SIDS). Recently, baby sleeping bags have been recommended as a preventive measure against SIDS. The aim of this study was to describe in which way the use of baby sleeping bags might influence thermoregulation of sleeping infants and maybe the incidence of SIDS. Body surface temperature was recorded by use of infrared thermography in 15 infants (median age 49 days). Recordings were done twice: after sleeping for 60 min under a blanket and after sleeping for 60 min in a baby sleeping bag. Temperature was recorded and compared for defined sites of body surface. Infants' mean body surface temperature as well as core temperature after sleeping in a baby sleeping bag did not show significant differences when compared to infants sleeping under a conventional blanket. Under controlled conditions, core temperature and mean body surface temperature are comparable, equally if using a baby sleeping bag or conventional bedding. However, under the more uncontrolled conditions of baby care at home, sleeping bags might provide a more constant temperature profile, while other bedding conditions may lead to significant variations of temperature pattern. © Georg Thieme Verlag KG Stuttgart · New York.
Elder, W G; Amundson, B A
The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.
McCarley, Renay Marie; Dowling, Donna A; Dolansky, Mary A; Bieda, Amy
The global aim of this quality improvement project was to develop and implement a systematic process to assign and maintain consistent bedside nurses for infants and families. A systematic process based on a primary care nursing model was implemented to assign consistent care for a 48-bed, single-family room NICU. Four PDSA cycles were necessary to obtain agreement from the nursing staff as to the best process for assigning primary nurses. Post-intervention data revealed a 9.5 percent decrease of consistent caregivers for infants in the NICU ≤ 28 days and a 2.3 percent increase of consistent caregivers for infants in the NICU ≥ 29 days. Although these findings did not meet the goal of the specific aim, a systematic process was created to assign bedside nurses to infants. Further PDSAs will be needed to refine the process to reach the aim.
Débora Barbosa e Alcântara
Full Text Available This paper reports the experience of a “storytelling and playing” group that took place in a FamilyHealth Unit in Sao Carlos, State of Sao Paulo. The group was formed as from the evaluation of the occupationaltherapist in the context of Primary Health Care, which broadly considers the daily lives of the actors involved:children, one user of the system, and the health team. From the viewpoint of Occupational Therapy, with focuson the problems of the territory, interventions linking the following matters were proposed: individual care,collective care, and co-responsibility of the community and staff in pursuit of the resignificance of the everydaylives of the actors involved. This is a concrete example of paradigm shift from the existing health model to theprecepts of the Family Health Strategy, with the involvement of users and professionals from various areas.The occupational therapist identified different demands of the territory: the need for transformation of dailylife and routine of a user; the need for children’s leisure; and the desire of the health team to build this spacethrough a playroom. The possible combination of the user, children and the team’s everyday realities composedan intervention project based on the vision of the clinic expanded. The “playing and storytelling” was able toactually transform the health care model.
Horne-Thompson, Anne; Daveson, Barbara; Hogan, Bridgit
The purpose of this project is to analyze music therapy (MT) referral trends from palliative care team members across nine Australian inpatient and community-based palliative care settings. For each referral 6 items were collected: referral source, reason and type; time from Palliative Care Program (PCP) admission to MT referral; time from MT referral to death/discharge; and profile of referred patient. Participants (196 female, 158 male) were referred ranging in age from 4-98 years and most were diagnosed with cancer (91%, n = 323). Nurses (47%, n = 167) referred most frequently to music therapy. The mean average time in days for all referrals from PCP admission to MT referral was 11.47 and then 5.19 days to time of death. Differences in length of time to referral ranged from 8.19 days (allied health staff) to 43.75 days (families). Forty-eight percent of referrals (48.5%, n = 172) were completed when the patient was rated at an Eastern Cooperative Oncology Group Performance (ECOG) of three. Sixty-nine percent (n = 244) were living with others at the time of referral and most were Australian born. Thirty-six percent (36.7%, n = 130) were referred for symptom-based reasons, and 24.5% (n = 87) for support and coping. Implications for service delivery of music therapy practice, interdisciplinary care and benchmarking of music therapy services shall be discussed.
Schonberger, Robert B; Barash, Paul G; Lagasse, Robert S
Since 2006, the Surgical Care Improvement Project (SCIP) has promoted 3 perioperative antibiotic recommendations designed to reduce the incidence of surgical site infections. Despite good evidence for the efficacy of these recommendations, the efforts of SCIP have not measurably improved the rates of surgical site infections. We offer 3 arguments as to why SCIP has fallen short of expectations. We then suggest a reorientation of quality improvement efforts to focus less on reporting, and incentivizing adherence to imperfect metrics, and more on creating local and regional quality collaboratives to educate clinicians about how to improve practice. Ultimately, successful quality improvement projects are behavioral interventions that will only succeed to the degree that they motivate individual clinicians, practicing within a particular context, to do the difficult work of identifying failures and iteratively working toward excellence.
Hess, Rosanna F
This case report describes the phases of an Amish Burn Care Project and the lessons learned throughout the process. Data sources to construct the case report included participant observation, interviews, archival documents, and a focus group. The narrative is organized into five phases of a participatory research approach: engagement, formalization, mobilization, maintenance, and expansion. Community-initiated research led to legitimate change, working together for change took time, team members grew in mutual trust and respect for each other, cultural humility brought personal and professional growth, and capacity building took place through mutually supported efforts.
Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices\\/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups\\' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland. Methods\\/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices\\/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals\\' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices\\/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may
Full Text Available Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a community related public health nurses; (b school public health nurses; (c GPs and practice nurses (primary care; and (d occupational health nurses (workplace from both Northern Ireland and the Republic of Ireland. Methods/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may
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Schwartz, Lita Linzer
Discusses the "Baby M" surrogate motherhood case which has produced heated debate in popular media, legal publications, and other professional journals. Summarizes arguments offered and reasoning behind actions of judiciary. (Author/ABL)
... Digital Press Kit Read the MMWR Science Clips Zika Virus Protecting Pregnant Women and Babies Language: English (US) ... Spanish) Recommend on Facebook Tweet Share Compartir Overview Zika virus infection (Zika) during pregnancy can cause damage to ...
Rachels reviews the social and legal facts of the celebrated "Baby M" case, in which surrogate Mary Beth Whitehead attempted to keep the daughter she had borne under contract to William Stern. The first phase of the legal battle between the parents ended in March 1988, when New Jersey Superior Court Judge Harvey R. Sorkow upheld the validity of the surrogacy contract, terminated Whitehead's parental rights, and awarded custody of the child to Stern. Rachels comments on public reaction to "Baby M," on Sorkow's decision, and on the impact the case may have on legislative attempts to regulate surrogacy. He also uses the example of "Baby M," as well as that of California heart transplant patient "Baby Jesse," to discuss how the media sensationalize controversial issues.
When an angry lion roars, the sounds it emits can terrify anyone within earshot. But, as Ingo Titze explains, the properties of a lion's roar have some surprising similarities with those of a crying baby.
... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Co-Pay Waiver at Captain James A. Lovell.... ACTION: Notice of TRICARE Co-Pay waiver at Captain James A. Lovell Federal Health Care Center... ``TRICARE Co-Pay Waiver at Captain James A. Lovell Federal Health Care (FHCC) Demonstration Project.'' Under...
Rourke, Leslie; Godwin, Marshall; Rourke, James; Pearce, Sarah; Bean, Joyce
The Rourke Baby Record (RBR) - http://www.rourkebabyrecord.ca - is a freely available evidence-based structured form for child health surveillance from zero to five years. Family physicians/general practitioners (FP/GPs) doing office based well-baby care in three Ontario Canada cities (London, Ottawa, and Toronto) were randomly sampled to study the prevalence and utility of the RBR and documentation of well-baby visits. Database with telephone confirmation was conducted to assess the prevalence of use of the RBR. Study Part 1: Questionnaire mailed to a random sample of 100 RBR users. Outcome measures were utility of, helpfulness of, and suggestions for the RBR. Descriptive analysis was employed. Study Part 2: Retrospective chart review of well-baby visits by 38 FP/GPs using student t-tests and factor analysis. Outcome measures were well-baby visit documentation of growth, nutrition, safety issues, developmental milestones, physical examination, and overall comprehensiveness. The RBR was used by 78.5% (402/512) of successfully contacted FP/GPs who did well-baby care in these 3 cities. Study Part 1: Questionnaire respondents (N = 41/100) used the RBR in several ways, and found it most helpful for assessing healthy child development, charting/recording the visits, managing time effectively, addressing parent concerns, identifying health problems, and identifying high risk situations. The RBR was seen to be least helpful as a tool for managing or for referring identified health problems. Study Part 2: Charts from a total of 1,378 well-baby visits on 176 children were audited. Well-baby care provided by the 20 FP/GPs who used the RBR compared to that by the 18 non-users was statistically more likely to include documentation of type of feeding (p = 0.023), discussion of safety issues (p baby care provided by the RBR users compared to that by the non-users was not more likely to include documentation of measurement of growth (p = 0.097), or physical examination (p = 0
The contributed papers presented to the workshop on ''Quantum Cosmology and Baby Universes'' have demonstrated the great interest in, and rapid development of, the field of quantum cosmology. In my view, there are at least three areas of active research at present. The first area can be defined as that of practical calculations. Here researchers are dealing with the basic quantum cosmological equation, which is the Wheeler-DeWitt equation. They try to classify all possible solutions to the Wheeler-DeWitt equation or seek a specific integration contour in order to select one particular wave function or generalize the simple minisuperspace models to more complicated cases, including various inhomogeneities, anisotropies, etc. The second area of research deals with the interpretational issues of quantum cosmology. There are still many questions about how to extract the observational consequences from a given cosmological wave function, the role of time in quantum cosmology, and how to reformulate the rules of quantum mechanics in such a way that they could be applicable to the single system which is our Universe. The third area of research is concerned with the so-called ''third quantization'' of gravity. In this approach a wave function satisfying the Wheeler-DeWitt equation becomes an operator acting on a Wave Function of the many-universes system. Within this approach one operates with Euclidean worm-holes joining different Lorentzian universes. (author)
Yoshida, Hyogo; Tanaka, Teruaki; Ito, Takashi; Toda, Yohjiro; Wakasa, Hideichiro
The Japan Steel Works, Ltd. has been supplying a very small sized cyclotron (Baby Cyclotron) to hospitals and research facilities. The cyclotron is designed to produce short-lived radioisotopes for medical use. In the present study, this cyclotron is modified so that it can serve for PIXE analysis. The PIXE (particle induced X-ray emission) technique has the following features: (1) Down to 1 ng of trace material in a sample (mg - μg) can be detected, (2) An analysis run is completed in one to ten minutes, permitting economical analysis for a large number of samples, (3) Several elements can be analyzed simultaneously, with an almost constant sensitivity for a variety of elements ranging from aluminum to heavy metals, (4) Analysis can be performed nondestructively without a chemical process, and (5) The use of microbeam can provide data on the distribution of elements with a resolution of several μm. Software for analysis is developed to allow the modified equipment to perform peak search, background fitting, and identification and determination of peaks. A study is now being conducted to examine the performance of the equipment for PIXE analysis of thin samples. Satisfactory results have been obtained. The analysis time, excluding the background correction, is 5-10 min. (Nogami, K.)
New legislation can be oppressive for a significant population depending upon the politics of its drafters. The current upsurge of the surrogacy trade in India, and the label of a "win-win" situation that it has acquired, points towards an unfettered commercialisation of assisted reproductive technology and the practice of surrogacy that is blinding its middle class users as well as providers, policy makers and law makers, and charging an imagination that is already caught up in spiralling consumerism. This paper analyses the Draft Assisted Reproductive Technology (Regulation) Bill and Rules, 2008, in the Indian socioeconomic context. It identifies the interests of the affected women, and examines the contradictions of the proposed Bill with their interests, as well as with current health and population policies, confining itself to the handling of surrogacy and not the entire content of the Bill. The bases of the analytical perspective used are: the context of poverty and the health needs of the Indian population; the need to locate surrogacy services within the overall public health service context and its epidemiological basis; the need to restrain direct human experimentation for the advancement of any technology; the use of safer methods; and, finally, the rights of surrogate mothers and their babies, in India, as opposed to the compulsion or dynamics of the medical market and reproductive tourism.
This 60 second public service announcement is based on the January 2018 CDC Vital Signs report. Every year, there are about 3,500 sleep-related deaths among U.S. babies. Learn how to create a safe sleep environment for babies. Created: 1/9/2018 by Centers for Disease Control and Prevention (CDC). Date Released: 1/9/2018.
Domrin, Andrei; Lechtenfeld, Olaf; Linares, Román; Maceda, Marco
The noncommutative baby Skyrme model is a Moyal deformation of the two-dimensional sigma model plus a Skyrme term, with a group-valued or Grassmannian target. Exact abelian solitonic solutions have been identified analytically in this model, with a singular commutative limit. Inside any given Grassmannian, we establish a BPS bound for the energy functional, which is saturated by these baby Skyrmions. This asserts their stability for unit charge, as we also test in second-order perturbation theory
Dodge, Diane Trister; Heroman, Cate
Noting that all parents can help their baby's brain to grow, this guide, in English- and Spanish-language versions, explores what science has learned about infant brain development and how parents and caregivers can influence cognitive development. Topics covered include: prenatal care, touching your baby, teaching about feelings and self-control,…
Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii
The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next...
Full Text Available The purpose of this study was to explore and describe the experiences of mothers who lost a baby during pregnancy and care given by doctors and midwives during this period. Opsomming Die doel van die studie was om die ervaring van moeders met betrekking tot die dood van ‘n baba tydens swangerskap te verken en te beskryf, asook die versorging wat hulle van vroedvroue en dokters gedurende die periode ontvang het. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
Song, Zirui; Ferris, Timothy G
The United States is facing a significant demographic transition, with about 10,000 baby boomers turning age 65 each day. At the same time, the nation is experiencing a similarly striking transition in hospital capacity, as the supply of hospital beds has declined in recent decades. The juxtaposition of population aging and hospital capacity portends a potentially widening divergence between supply and demand for hospital care. We provide a closer look at current hospital capacity and a rethinking of the future role of hospital beds in meeting the needs of an aging population.
Ciccone, Marco Matteo; Aquilino, Ambrogio; Cortese, Francesca; Scicchitano, Pietro; Sassara, Marco; Mola, Ernesto; Rollo, Rodolfo; Caldarola, Pasquale; Giorgino, Francesco; Pomo, Vincenzo; Bux, Francesco
Project Leonardo represented a feasibility study to evaluate the impact of a disease and care management (D&CM) model and of the introduction of "care manager" nurses, trained in this specialized role, into the primary health care system. Thirty care managers were placed into the offices of 83 general practitioners and family physicians in the Apulia Region of Italy with the purpose of creating a strong cooperative and collaborative "team" consisting of physicians, care managers, specialists, and patients. The central aim of the health team collaboration was to empower 1,160 patients living with cardiovascular disease (CVD), diabetes, heart failure, and/or at risk of cardiovascular disease (CVD risk) to take a more active role in their health. With the support of dedicated software for data collection and care management decision making, Project Leonardo implemented guidelines and recommendations for each condition aimed to improve patient health outcomes and promote appropriate resource utilization. Results show that Leonardo was feasible and highly effective in increasing patient health knowledge, self-management skills, and readiness to make changes in health behaviors. Patient skill-building and ongoing monitoring by the health care team of diagnostic tests and services as well as treatment paths helped promote confidence and enhance safety of chronic patient management at home. Physicians, care managers, and patients showed unanimous agreement regarding the positive impact on patient health and self-management, and attributed the outcomes to the strong "partnership" between the care manager and the patient and the collaboration between the physician and the care manager. Future studies should consider the possibility of incorporating a patient empowerment model which considers the patient as the most important member of the health team and care managers as key health care collaborators able to enhance and support services to patients provided by physicians in
Rice, Neil E; Lang, Iain A; Henley, William; Melzer, David
The baby-boom generation is entering retirement. Having experienced unprecedented prosperity and improved medical technology, they should be the healthiest generation ever. We compared prevalence of disease and risk factors at ages 50-61 years in baby boomers with the preceding generation and attributed differences to period or cohort effects. Data were from the Health Survey for England (HSE) from 1994 to 2007 (n = 48,563). Logistic regression models compared health status between birth cohorts. Age-period-cohort models identified cohort and period effects separately. Compared to the wartime generation, the baby-boomer group was heavier (3.02 kg; 95% confidence interval [CI], 2.42-3.63; p Baby boomers reported fewer heart attacks (OR = 0.61; CI, 0.47-0.79; p baby boomers are moving toward retirement with improved cardiovascular health. However, the baby-boomer cohort has a higher prevalence of mental illness diagnoses and shows no improvement in self-rated health compared to the wartime birth cohort. There remains substantial scope to reduce health risks and future disability.
...-Size Baby Cribs and Non-Full- Size Baby Cribs AGENCY: Consumer Product Safety Commission. ACTION: Final... Safety Specification for Full-Size Baby Cribs,'' and ASTM F 406-10a, ``Standard Consumer Safety Specification for Non-Full-Size Baby Cribs/Play Yards.'' The crib standards that the CPSC is publishing...
...] Revocation of Requirements for Full-Size Baby Cribs and Non-Full- Size Baby Cribs AGENCY: Consumer Product... standards, and include ASTM F 1169-10, ``Standard Consumer Safety Specification for Full-Size Baby Cribs,'' and ASTM F 406-10, ``Standard Consumer Safety Specification for Non-Full-Size Baby Cribs/Play Yards...
Liddy, Clare; Rowan, Margo; Valiquette-Tessier, Sophie-Claire; Drosinis, Paul; Crowe, Lois; Hogg, William
To examine the barriers to and facilitators of practice facilitation experienced by participants in the Improving Delivery of Cardiovascular Care (IDOCC) project. Case studies of practice facilitators' narrative reports. Eastern Ontario. Primary care practices that participated in the IDOCC project. Cases were identified by calculating sum scores in order to determine practices' performance relative to their peers. Two case exemplars were selected that scored within ± 1 SD of the total mean score, and a qualitative analysis of practice facilitators' narrative reports was conducted using a 5-factor implementation framework to identify barriers and facilitators. Narratives were divided into 3 phases: planning, implementation, and sustainability. Barriers and facilitators fluctuated over the intervention's 3 phases. Site A reported more barriers (n = 47) than facilitators (n = 38), while site B reported a roughly equal number of barriers (n = 144) and facilitators (n = 136). In both sites, the most common barriers involved organizational and provider factors and the most common facilitators were associated with innovation and structural factors. Both practices encountered various barriers and facilitators throughout the IDOCC's 3 phases. The case studies reveal the complex interactions of these factors over time, and provide insight into the implementation of practice facilitation programs. Copyright© the College of Family Physicians of Canada.
Liu, Yu-Chieh; Wang, Hui-Yu; Huang, Hui-Ling; Chen, Min-Li
Over half (57.14%) of patients in our ward suffer from abdominal obesity. This rate is on a continuing upward trend. Reasons for such obesity include lack of physical activity classes, inadequate physical activity, high calorie diets and unhealthy eating habits, chronic diseases and drug side effects, poor motivation to reduce weight, and lack of crisis awareness of abdominal obesity. This project was designed to lessen the problem of abdominal obesity among psychiatric day care inpatients. Resolution measures implemented included: (1) arranging aerobic exercise classes; (2) scheduling classes to teach patients healthy diet habits and knowledge regarding diseases and drugs; (3) holding a waistline reduction competition; (4) displaying health education bulletin boards; (5) holding a quiz contest with prizes for correct answers. The eight abdominally obese patients in the ward achieved an average waist circumference reduction of 2.9 cm and the overall abdominal obesity rate in the ward fell to 35.7%. BMI, eating habits, and awareness of weight loss importance and motivation all improved. The outcome achieved targeted project objectives. We recommend the integration of obesity prevention into routine ward activities and quality control indicators. Nurses should provide patients with weight loss concepts, regularly monitor risk factors, and encourage patient family cooperation to maintain medical care quality.
Full Text Available Aim. To describe 7 years of activity of “CROMa” (Coordination of Research on Osteonecrosis of the Jaws project of “Sapienza” University of Rome. Materials and Methods. A preventive and therapeutic care pathway was created for patients with bisphosphonates (BPs exposure. Demographic, social, behavioural, pharmacological, and clinical variables were registered in a dedicated database. Results. In the project, 502 patients, 403 females and 99 males, were observed. Bone pathologies were 79% osteometabolic diseases (OMD and 21% metastatic cancer (CA. Females were 90% in OMD group and 41% in CA. BP administration was 54% oral, 31% IV, and 11% IM; 89% of BPs were amino-BP and 11% non-amino-BP. Consistently with bone pathology (OMD/CA, alendronate appears to be prevalent for OMD (40% relative, while zoledronate was indicated in 92% of CA patients. Out of 502 cases collected, 28 BRONJ were detected: 17 of them were related to IV BP treatment. Preventive oral assessment was required for 50% of CA patients and by 4% of OMD patients. Conclusions. The proposed care pathway protocols for BP exposed patients appeared to be useful to meet treatment and preventive needs, in both oncological and osteometabolic diseases patients. Patients’ and physicians’ prevention awareness can be the starting point of a multilevel prevention system.
Keijser, W; de Manuel-Keenoy, E; d'Angelantonio, M; Stafylas, P; Hobson, P; Apuzzo, G; Hurtado, M; Oates, J; Bousquet, J; Senn, A
Information and communication technologies (ICT) are promising for the long-term care of older and frequently frail people. These innovations can improve health outcomes, quality of life and efficiency of care processes, while supporting independent living. However, they may be disruptive innovations. As all European member states are facing an increasing complexity of health and social care, good practices in ICT should be identified and evaluated. Three projects funded by DG CNECT are related to Active and Healthy Ageing (AHA) and frailty: (i) BeyondSilos, dealing with independent living and integrated services, (ii) CareWell, providing integrated care coordination, patient empowerment and home support and (iii) SmartCare, proposing a common set of standard functional specifications for an ICT platform enabling the delivery of integrated care to older patients. The three projects described in this paper provide a unique pan-European research field to further study implementation efforts and outcomes of new technologies. Below, based on a description of the projects, the authors display four domains that are in their views fundamental for in-depth exploration of heterogeneity in the European context: 1. Definition of easily transferable, high level pathways with solid evidence-base; 2. Change management in implementing ICT enabled integrated care; 3. Evaluation and data collection methodologies based on existing experience with MAST and MEDAL methodologies; and 4. Construction of new models for delivery of health and social care. Understanding complementarity, synergies and differences between the three unique projects can help to identify a more effective roll out of best practices within a varying European context.
Valentijn, Pim P; Ruwaard, Dirk; Vrijhoef, Hubertus J M; de Bont, Antoinette; Arends, Rosa Y; Bruijnzeels, Marc A
Collaborative partnerships are considered an essential strategy for integrating local disjointed health and social services. Currently, little evidence is available on how integrated care arrangements between professionals and organisations are achieved through the evolution of collaboration processes over time. The first aim was to develop a typology of integrated care projects (ICPs) based on the final degree of integration as perceived by multiple stakeholders. The second aim was to study how types of integration differ in changes of collaboration processes over time and final perceived effectiveness. A longitudinal mixed-methods study design based on two data sources (surveys and interviews) was used to identify the perceived degree of integration and patterns in collaboration among 42 ICPs in primary care in The Netherlands. We used cluster analysis to identify distinct subgroups of ICPs based on the final perceived degree of integration from a professional, organisational and system perspective. With the use of ANOVAs, the subgroups were contrasted based on: 1) changes in collaboration processes over time (shared ambition, interests and mutual gains, relationship dynamics, organisational dynamics and process management) and 2) final perceived effectiveness (i.e. rated success) at the professional, organisational and system levels. The ICPs were classified into three subgroups with: 'United Integration Perspectives (UIP)', 'Disunited Integration Perspectives (DIP)' and 'Professional-oriented Integration Perspectives (PIP)'. ICPs within the UIP subgroup made the strongest increase in trust-based (mutual gains and relationship dynamics) as well as control-based (organisational dynamics and process management) collaboration processes and had the highest overall effectiveness rates. On the other hand, ICPs with the DIP subgroup decreased on collaboration processes and had the lowest overall effectiveness rates. ICPs within the PIP subgroup increased in control
Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony
Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.
Boxer, Rebecca S; Dolansky, Mary A; Frantz, Megan A; Prosser, Regina; Hitch, Jeanne A; Piña, Ileana L
Rehospitalization rates and transitions of care for patients with heart failure (HF) continue to be of prominent importance for hospital systems around the United States. Skilled nursing facilities (SNF) are pivotal sites for transition especially for older adults. The purpose of this study was to evaluate in SNF both the (1) current state of HF management (HF admissions, protocols, and staff knowledge) and (2) the acceptability and effect of a HF staff educational program. Four SNF participated in the project, 2 the first year and 2 the second year. SNF were surveyed by discipline as to HF disease management techniques. Staff were evaluated on HF knowledge and confidence in pre- and post-HF disease management training. All-cause rehospitalization rates ranged from 18% to 43% in the 2 SNF evaluated. Overall, there was a lack of identification and tracking of HF patients in all the SNF. There were no HF-specific disease management protocols at any SNF and staff had limited knowledge of HF care. Staff pre and post test scores indicated an improvement in both staff knowledge and confidence in HF management after receiving training. The lack of identification and tracking of patients with HF limits SNF ability to care for patients with HF. HF education for staff is likely important to effective HF management in the SNF. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
Jensen, Vibeke Myrup
Physician-induced demand, whereby physicians deviate from providing optimal health care in the pursuit of personal gain lies at the heart of concerns about publicly provided health care. However, little is known how payments systems affect the ultimate outcome—patient health. Exploiting unique po...
Lavender, Tina; Furber, Christine; Campbell, Malcolm; Victor, Suresh; Roberts, Ian; Bedwell, Carol; Cork, Michael J
Some national guidelines recommend the use of water alone for napkin cleansing. Yet, there is a readiness, amongst many parents, to use baby wipes. Evidence from randomised controlled trials, of the effect of baby wipes on newborn skin integrity is lacking. We conducted a study to examine the hypothesis that the use of a specifically formulated cleansing wipe on the napkin area of newborn infants (skin hydration when compared with using cotton wool and water (usual care). A prospective, assessor-blinded, randomised controlled equivalence trial was conducted during 2010. Healthy, term babies (n=280), recruited within 48 hours of birth, were randomly assigned to have their napkin area cleansed with an alcohol-free baby wipe (140 babies) or cotton wool and water (140 babies). Primary outcome was change in hydration from within 48 hours of birth to 4 weeks post-birth. Secondary outcomes comprised changes in trans-epidermal water loss, skin surface pH and erythema, presence of microbial skin contaminants/irritants at 4 weeks and napkin dermatitis reported by midwife at 4 weeks and mother during the 4 weeks. Complete hydration data were obtained for 254 (90.7 %) babies. Wipes were shown to be equivalent to water and cotton wool in terms of skin hydration (intention-to-treat analysis: wipes 65.4 (SD 12.4) vs. water 63.5 (14.2), p=0.47, 95% CI -2.5 to 4.2; per protocol analysis: wipes 64.6 (12.4) vs. water 63.6 (14.3), p=0.53, 95% CI -2.4 to 4.2). No significant differences were found in the secondary outcomes, except for maternal-reported napkin dermatitis, which was higher in the water group (p=0.025 for complete responses). Baby wipes had an equivalent effect on skin hydration when compared with cotton wool and water. We found no evidence of any adverse effects of using these wipes. These findings offer reassurance to parents who choose to use baby wipes and to health professionals who support their use. Current Controlled Trials ISRCTN86207019.
Kollée, L A A; Cuttini, M; Delmas, D
to Intensive Care for Very Preterm Babies in Europe' (MOSAIC) project. POPULATION: All births from 22 to 29 weeks of gestation (n = 4146) in 2003, excluding terminations of pregnancy. METHODS: Comparison of three obstetric interventions (antenatal corticosteroids, antenatal transfer and caesarean section...... as a composite score of these three interventions. Outcomes included stillbirth, in-hospital mortality and intraventricular haemorrhage (IVH) grades III and IV and/or periventricular leucomalacia (PVL) and bronchopulmonary dysplasia (BPD). RESULTS: There were large differences between regions in interventions...... the composite intervention score and mortality. No association was observed at 26-27 weeks. For survivors at 24-25 weeks, the intervention score was associated with higher rates of BPD, but not with IVH or PVL. CONCLUSIONS: There are large differences between European regions in obstetric practices at the lower...
Wiethege, J; Ommen, O; Ernstmann, N; Pfaff, H
Currently, elements of managed care are being implemented in the German health-care system. The legal basis for these innovations are § 140, § 73, § 137, and §§ 63 et seq. of the German Social Code - Part 5 (SGB V). For the model projects according to §§ 63 et seq. of the German Social Code a scientific evaluation and publication of the evaluation results is mandatory. The present study examines the status of evaluation of German model projects. The present study has a mixed method design: A mail and telephone survey with the German Federal Social Insurance Authority, the health insurance funds, and the regional Associations of Statutory Health Insurance Physicians has been conducted. Furthermore, an internet research on "Medpilot" and "Google" has been accomplished to search for model projects and their evaluation reports. 34 model projects met the inclusion criteria. 13 of these projects had been terminated up to 30/9/2008. 6 of them have published an evaluation report. 4 model projects have published substantial documents. One model project in progress has published a meaningful interim report. 12 model projects failed to give information concerning the evaluator or the duration of the model projects. The results show a significant deficit in the mandatory reporting of the evaluation of model projects in Germany. There is a need for action for the legislator and the health insurance funds in terms of promoting the evaluation and the publication of the results. The institutions evaluating the model projects should obligate themselves to publish the evaluation results. The publication is an essential precondition for the development of managed care structures in the health-care system and in the development of scientific evaluation methods. © Georg Thieme Verlag KG Stuttgart · New York.
Eibner, Christine; Krull, Heather; Brown, Kristine M; Cefalu, Matthew; Mulcahy, Andrew W; Pollard, Michael; Shetty, Kanaka; Adamson, David M; Amaral, Ernesto F L; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M; Weinick, Robin M; Woods, Dulani; Hosek, Susan D; Farmer, Carrie M
The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade.
Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M.; Weinick, Robin M.; Woods, Dulani; Hosek, Susan D.; Farmer, Carrie M.
Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade. PMID:28083423
... Pregnancy week by week During the second trimester, prenatal care includes routine lab tests and measurements of your ... too. By Mayo Clinic Staff The goal of prenatal care is to ensure that you and your baby ...
... Pregnancy week by week During the third trimester, prenatal care might include vaginal exams to check the baby's position. By Mayo Clinic Staff Prenatal care is an important part of a healthy pregnancy, ...
Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M
Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.
LeRouge, Cynthia M; Tao, Donghua; Ohs, Jennifer; Lach, Helen W; Jupka, Keri; Wray, Ricardo
"Baby Boomers" (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) . As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.
Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M
The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to
... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked “baby” sweet corn (Zea mays L... consignments only. (b) Immature “baby” carrots (Daucus carota L. ssp. sativus) for consumption measuring 10 to...
Full Text Available AimTo investigate if during the third trimester of pregnancy fantasies emerge in the baby representations based on the information that pregnant women have on their real babies through ultrasound techniques.MethodA qualitative, descriptive and exploratory research based on a sample of 30 pregnant Portuguese women, whose average age is 32 years old, was developed. A socio-demographic questionnaire and a semi-directive interview entitled "Interview of Maternal Representations During Pregnancy – Revised Version" (IRMAG-R, Ammaniti & Tambelli, 2010 were employed.ResultsBaby representations are immersed in a fantasy dimension, which means that the imaginary baby is quite present in this phase of pregnancy. Pregnant women mainly attribute psychological characteristics to the babies, rather than physical characteristics. Regardless of the type of characteristics analysed, the preference for these characteristics emerges based on their wishes. Secondly, characteristics of the parents may also emerge. Fetal movements and information from ultrasound have no significant influence on the characterization of the baby.ConclusionDespite the development of ultrasound techniques, the imaginary baby defines parents representations about the baby on the third trimester of pregnancy. Consequently, a new understanding of how pregnant women experience the transition to the postnatal phase has to be considered.
Congenital heart defects are the most common type of birth defect in the U.S. This podcast discusses the importance of pregnant women talking with their health care providers about ways to increase chances of having a healthy baby. Created: 2/4/2016 by MMWR. Date Released: 2/4/2016.
Heller, Sherryl Scott; Breuer, Anna
This article describes the components of the FAN model used in the Fussy Baby Network® intervention. Careful attunement and matching to the parents' experience help stressed parents feel understood and not alone and foster a sense of coherence during this difficult time. It is this attention to the parent's experience that allows flexibility in…
Ellsbury, Dan L; Clark, Reese H; Ursprung, Robert; Handler, Darren L; Dodd, Elizabeth D; Spitzer, Alan R
Despite advances in neonatal medicine, infants requiring neonatal intensive care continue to experience substantial morbidity and mortality. The purpose of this initiative was to generate large-scale simultaneous improvements in multiple domains of care in a large neonatal network through a program called the "100,000 Babies Campaign." Key drivers of neonatal morbidity and mortality were identified. A system for retrospective morbidity and mortality review was used to identify problem areas for project prioritization. NICU system analysis and staff surveys were used to facilitate reengineering of NICU systems in 5 key driver areas. Electronic health record-based automated data collection and reporting were used. A quality improvement infrastructure using the Kotter organizational change model was developed to support the program. From 2007 to 2013, data on 422 877 infants, including a subset with birth weight of 501 to 1500 g (n = 58 555) were analyzed. Key driver processes (human milk feeding, medication use, ventilator days, admission temperature) all improved (P < .0001). Mortality, necrotizing enterocolitis, retinopathy of prematurity, bacteremia after 3 days of life, and catheter-associated infection decreased. Survival without significant morbidity (necrotizing enterocolitis, severe intraventricular hemorrhage, severe retinopathy of prematurity, oxygen use at 36 weeks' gestation) improved. Implementation of a multifaceted quality improvement program that incorporated organizational change theory and automated electronic health record-based data collection and reporting program resulted in major simultaneous improvements in key neonatal processes and outcomes. Copyright © 2016 by the American Academy of Pediatrics.
Full Text Available After numerous teething problems (1974-1994, the Department of Nursing Education of WITS University took responsibility for the Muldersdrift Health and Development Programme (MHDP. The nursing science students explored and implemented an empowerment approach to community participation. The students worked with MHDP health workers to improve health through community participation, in combination with primary health care (PHC activities and the involvement of a variety of community groups. As the PHC projects evolved overtime, the need arose to evaluate the level of community participation and how much community ownership was present over decision-making and resources. This led to the question “What was the level of community participation in PHC projects of the MHDP?” Based on the question the following objectives were set, i.e. i to evaluate the community participation in PHC initiatives; ii to provide the project partners with motivational affirmation on the level of community participation criteria thus far achieved; iii to indicate to participants the mechanisms that should still be implemented if they wanted to advance to higher levels of community participation; iv to evaluate the MHDP’s implementation of a people-centred approach to community participation in PHC; and v the evaluation of the level of community participation in PHC projects in the MHDP. An evaluative, descriptive, contextual and quantitative research design was used. Ethical standards were adhered to throughout the study. The MHDP had a study population of twentythree (N=23 PHC projects. A purposive sample of seven PHC initiatives was chosen according to specific selection criteria and evaluated according to the “Criteria to evaluate community participation in PHC projects” instrument (a quantitative tool. Structured group interviews were done with PHC projects’ executive committee members. The Joint Management Committee’s data was collected through mailed
Hildebrandt, Helmut; Schmitt, Gwendolyn; Roth, Monika; Stunder, Brigitte
The regional integrated care model "Gesundes Kinzigtal" pursues the idea of integrated health care with special focus on increasing the health gain of the served population. Physicians (general practitioners) and psychotherapists, physiotherapists, hospitals, nursing services, non-profit associations, fitness centers, and health insurance companies work closely together with a regional management company and its programs on prevention and care coordination and enhancement. The 10 year-project is run by a company that was founded by the physician network "MQNK" and "OptiMedis AG", a corporation with public health background specialising in integrated health care. The aim of this project is to enhance prevention and quality of health care for a whole region in a sustainable way, and to decrease costs of care. The article describes the special funding model of the project, the engagement of patients, and the different health and prevention programmes. The programmes and projects are developed, implemented, and evaluated by multidisciplinary teams. Copyright © 2011. Published by Elsevier GmbH.
Trosman, Julia R.; Carlos, Ruth C.; Simon, Melissa A.; Madden, Debra L.; Gradishar, William J.; Benson, Al B.; Rapkin, Bruce D.; Weiss, Elisa S.; Gareen, Ilana F.; Wagner, Lynne I.; Khan, Seema A.; Bunce, Mikele M.; Small, Art; Weldon, Christine B.
Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. W...
Drs Miranda Snoeren; MSc Donna Frost
Background: On two Care Innovation Units in the Netherlands, staff, students and Lecturer Practitioners work intensively together to provide care, create a rich learning environment, and to foster innovation and research. In striving to advance the quality of care and to develop person centred
Laux, G.; Kuehlein, T.; Rosemann, T.J.; Szecsenyi, J.
BACKGROUND: Due to technological progress and improvements in medical care and health policy the average age of patients in primary care is continuously growing. In equal measure, an increasing proportion of mostly elderly primary care patients presents with multiple coexisting medical conditions.
Godtfredsen, Nina Skavlan; Grann, Ove; Larsen, Hanne Bormann
Background: Implementation of pulmonary rehabilitation in primary health care in Denmark is a new challenge in the management of patients with chronic obstructive pulmonary disease (COPD). Objectives: To assess the feasibility of introducing a nationwide web-based tool for data recording...... not meet the criteria for pulmonary rehabilitation in terms of dyspnoea upon exertion at the baseline visit. Furthermore, information on severity of COPD is missing for 18% of the attendants. The majority of the referred patients have moderate COPD, which is in accordance with the intentions...... and quality assurance in the rehabilitation programmes and to evaluate whether patients are referred correctly according to Danish guidelines for community based COPD rehabilitation. Methods: Participation in the KOALA project has been offered to the municipalities since October 2007. As of October 2010, 62...
The personalized care project (PCP) can manage allergic emergencies that may occur during school hours. Other objectives are to facilitate academic achievement, social and professional integration of children and adolescents with chronic illness such as food allergy, by promoting education through certain changes. The PCP is derived from official files including Circular N(o) 2003-135 of September 8 and the inter-ministerial circular of 25 June 2001. The family must request a protocol with the host school principal or school head. Then, the doctor of Education organizes the drafting of the document based on information provided by the physician (or allergist). Copyright © 2010 Elsevier Masson SAS. All rights reserved.
At present, JSW baby cyclotrons are mostly used for the production of the radioisotopes for medical use. The attempt to use this baby cyclotron for neutron radiography began already in 1981. The feasibility of the neutron radiography for the explosives in metallic cases which are used for H1 rockets was investigated. In 1983, it was shown that the neutron radiography by using the baby cyclotron in Muroran Works, Japan Steel Works, Ltd. was able to be carried out as a routine work. Since then, the nondestructive inspection by neutron radiography has been performed for rocket pyrotechnic articles, and contributed to heighten their reliability. Further, the radiography by using fast neutrons was developed and put to practical use for recent large H2 rockets. The JSW baby cyclotron BC 168 which has been used for neutron radiography can accelerate 16 MeV protons or 8 MeV deuterons up to 50 μA. The principle of thermal neutron radiography is the generation of fast neutrons by irradiating a Be target with the proton beam accelerated by a baby cyclotron, the moderation of the fast neutrons, the formation of the thermal neutron flux of uniform distribution with a collimator, the thermal neutron flux hitting the Gd plate in a film cassette through an object, and the exposure of an X-ray film to electrons from the Gd plate. Fast neutron radiography apparatus, and commercial neutron radiography are described. (K.I.)
Makinde, Olusesan Ayodeji; Makinde, Olufunmbi Olukemi; Olaleye, Olalekan; Brown, Brandon; Odimegwu, Clifford O
The practice of reproductive medicine in Nigeria is facing new challenges with the proliferation of 'baby factories'. Baby factories are buildings, hospitals or orphanages that have been converted into places for young girls and women to give birth to children for sale on the black market, often to infertile couples, or into trafficking rings. This practice illegally provides outcomes (children) similar to surrogacy. While surrogacy has not been well accepted in this environment, the proliferation of baby factories further threatens its acceptance. The involvement of medical and allied health workers in the operation of baby factories raises ethical concerns. The lack of a properly defined legal framework and code of practice for surrogacy makes it difficult to prosecute baby factory owners, especially when they are health workers claiming to be providing services to clients. In this environment, surrogacy and other assisted reproductive techniques urgently require regulation in order to define when ethico-legal lines have been crossed in providing surrogacy or surrogacy-like services. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Cano, Isaac; Alonso, Albert; Hernandez, Carme; Burgos, Felip; Barberan-Garcia, Anael; Roldan, Jim; Roca, Josep
Extensive deployment and sustainability of integrated care services (ICS) constitute an unmet need to reduce the burden of chronic conditions. The European Union project NEXES (2008-2013) assessed the deployment of four ICS encompassing the spectrum of severity of chronic patients. The current study aims to (i) describe the open source Adaptive Case Management (ACM) system (Linkcare®) developed to support the deployment of ICS at the level of healthcare district; (ii) to evaluate its performance; and, (iii) to identify key challenges for regional deployment of ICS. We first defined a conceptual model for ICS management and execution composed of five main stages. We then specified an associated logical model considering the dynamic runtime of ACM. Finally, we implemented the four ICS as a physical model with an ICS editor to allow professionals (case managers) to play active roles in adapting the system to their needs. Instances of ICS were then run in Linkcare®. Four ICS provided a framework for evaluating the system: Wellness and Rehabilitation (W&R) (number of patients enrolled in the study (n)=173); Enhanced Care (EC) in frail chronic patients to prevent hospital admissions, (n=848); Home Hospitalization and Early Discharge (HH/ED) (n=2314); and, Support to remote diagnosis (Support) (n=7793). The method for assessment of telemedicine applications (MAST) was used for iterative evaluation. Linkcare® supports ACM with shared-care plans across healthcare tiers and offers integration with provider-specific electronic health records. Linkcare® successfully contributed to the deployment of the four ICS: W&R facilitated long-term sustainability of training effects (p<0.01) and active life style (p<0.03); EC showed significant positive outcomes (p<0.05); HH/ED reduced on average 5 in-hospital days per patient with a 30-d re-admission rate of 10%; and, Support, enhanced community-based quality forced spirometry testing (p<0.01). Key challenges for regional deployment
During a 12-month period there were 17 baby falls on the maternity wards at Nottingham University Hospitals Trust; two of the babies who fell were injured. By collecting information about the baby falls and how they happened, we were able to compile a guideline for both preventing and managing baby falls. This formed part of the trust's patient safety programme. We then piloted and implemented risk-prevention strategies for baby falls. These involved a risk assessment to identify women needing closer observation and the installation of bedside cots. These strategies brought about a marked reduction of baby falls and are now being established across all the maternity units across the trust.
Thomson, Hilary; Ross, Sue; Wilson, Philip; McConnachie, Alex; Watson, Richard
A copy of BabyCheck was sent to 497 mothers shortly after the birth of their baby. Six months later they were sent a questionnaire asking about their use of and attitudes to, BabyCheck. Questionnaires were returned by 323 (65%) mothers; 215 (67%) of them reported reading BabyCheck, the majority found it easy to understand (74%) and agreed with the advice (67%). Eighty-four (26%) of the mothers who returned the questionnaires reported using BabyCheck when their baby was ill; of these, 71% agre...
Full Text Available Attention to the issue of children with ASD in our country is growing steadily. Since the release of the new Law «About the education in Russian Federation», where for the first time this category of children was secured by state guarantees, all normative acts and basic solutions are focused on the development of comprehensive care for children with ASD and their families. Official initiatives are in many ways supported with the activity of community organizations and parental associations, representing the interests of families. Experience of many years becomes the basis for efficient solutions and social problems analysis of the identification, education and support of people with autism. Also it becomes platform for social and psychological support of their families. Currently, in the Russian Federation, domestic model for providing comprehensive medical and social, psychological and educational assistance for children with autism just begin to develop. However, the policy, conducted by the government for individuals with disabilities, including children with ASD, confirms state structures readiness to take the main measures of comprehensive rehabilitation and habilitation. The article describes the experience of creating integrated care systems for children with ASD in Russia. The example of project real¬ization involving three of the Russian Federation states, which is aimed at ensuring high quality of life of children, is shown
Fung-Kee-Fung, M; Maziak, D E; Pantarotto, J R; Smylie, J; Taylor, L; Timlin, T; Cacciotti, T; Villeneuve, P J; Dennie, C; Bornais, C; Madore, S; Aquino, J; Wheatley-Price, P; Ozer, R S; Stewart, D J
The Ottawa Hospital (toh) defined delay to timely lung cancer care as a system design problem. Recognizing the patient need for an integrated journey and the need for dynamic alignment of providers, toh used a learning health system (lhs) vision to redesign regional diagnostic processes. A lhs is driven by feedback utilizing operational and clinical information to drive system optimization and innovation. An essential component of a lhs is a collaborative platform that provides connectivity across silos, organizations, and professions. To operationalize a lhs, we developed the Ottawa Health Transformation Model (ohtm) as a consensus approach that addresses process barriers, resistance to change, and conflicting priorities. A regional Community of Practice (cop) was established to engage stakeholders, and a dedicated transformation team supported process improvements and implementation. The project operationalized the lung cancer diagnostic pathway and optimized patient flow from referral to initiation of treatment. Twelve major processes in referral, review, diagnostics, assessment, triage, and consult were redesigned. The Ottawa Hospital now provides a diagnosis to 80% of referrals within the provincial target of 28 days. The median patient journey from referral to initial treatment decreased by 48% from 92 to 47 days. The initiative optimized regional integration from referral to initial treatment. Use of a lhs lens enabled the creation of a system that is standardized to best practice and open to ongoing innovation. Continued transformation initiatives across the continuum of care are needed to incorporate best practice and optimize delivery systems for regional populations.