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Harm reduction child

Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
Kelton Tremellen, Dominic Wilkinson, Julian Savulescu
Obesity is associated with a reduction in fertility treatment success and increased risks to mother and child. Therefore guidelines of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) suggest that a body mass index exceeding 35 kg/m(2) should be an absolute contraindication to assisted fertility treatment such as in vitro fertilisation IVF. In this paper we challenge the ethical and scientific basis for such a ban. Livebirth rates for severely obese women are reduced by up to 30%, but this result is still far better than that observed for many older women who are allowed access to IVF...
March 16, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Bradley N Collins, Stephen J Lepore
BACKGROUND: Addressing children's tobacco smoke exposure (TSE) remains a public health priority. However, there is low uptake and ineffectiveness of treatment, particularly in low-income populations that face numerous challenges to smoking behavior change. A multilevel intervention combining system-level health messaging and advice about TSE delivered at community clinics that disseminate the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), combined with nicotine replacement and intensive multimodal, individual-level behavioral intervention may improve TSE control efforts in such high-risk populations...
March 14, 2017: BMC Public Health
Anju Dhawan, Raman Deep Pattanayak, Anita Chopra, Vinod Kumar Tikoo, Rajesh Kumar
INTRODUCTION: Injection drug use (IDU) is intricately linked to preventive aspects for human immunodeficiency virus from a public health perspective. No large-scale data are yet available for injectable drug use among children and adolescents in India, apart from few anecdotal reports. AIMS AND METHODS: The present paper reports on the profile and substance use pattern of 509 child IDU users, among a total sample of over 4000 children using substances across 100 sites from 27 states and 2 UTs in India...
October 2016: Indian Journal of Psychiatry
Sarah Munro, Amber Hui, Vanessa Salmons, Carolyn Solomon, Emily Gemmell, Nahal Torabi, Patricia A Janssen
BACKGROUND: We engaged Canadian women in the development of a prenatal education program delivered via one-way text messaging called SmartMom. SmartMom is the first peer-reviewed, evidence-based mHealth program for prenatal education in Canada and the first to be endorsed by the Society of Obstetricians and Gynaecologists of Canada. OBJECTIVE: To explore women's preferences for a prenatal education program by text messaging. METHODS: We conducted a qualitative focus group study in three Canadian communities in the Northern Health Authority...
February 7, 2017: JMIR Public Health and Surveillance
Lucie Cluver, Franziska Meinck, Alexa Yakubovich, Jenny Doubt, Alice Redfern, Catherine Ward, Nasteha Salah, Sachin De Stone, Tshiamo Petersen, Phelisa Mpimpilashe, Rocio Herrero Romero, Lulu Ncobo, Jamie Lachman, Sibongile Tsoanyane, Yulia Shenderovich, Heidi Loening, Jasmina Byrne, Lorraine Sherr, Lauren Kaplan, Frances Gardner
BACKGROUND: No known studies have tested the effectiveness of child abuse prevention programmes for adolescents in low- or middle-income countries. 'Parenting for Lifelong Health' ( ) is a collaborative project to develop and rigorously test abuse-prevention parenting programmes for free use in low-resource contexts. Research aims of this first pre-post trial in South Africa were: i) to identify indicative effects of the programme on child abuse and related outcomes; ii) to investigate programme safety for testing in a future randomised trial, and iii) to identify potential adaptations...
July 13, 2016: BMC Public Health
Dorte Vesterholm Lind, Katharina M Main, Henriette Boye Kyhl, David Møbjerg Kristensen, Jorma Toppari, Helle Raun Andersen, Marianne Skovsager Andersen, Niels E Skakkebæk, Tina Kold Jensen
STUDY QUESTION: Is maternal use of mild analgesics in pregnancy associated with anogenital distance (AGD)-the distance from the anus to the genitals-in the offspring? SUMMARY ANSWER: Maternal use of mild analgesics [especially simultaneous use of paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)] during pregnancy was associated with a shorter AGD in boys whereas no effect was found in girls. WHAT IS KNOWN ALREADY: Mild analgesics including paracetamol (acetaminophen) and NSAIDs (e...
January 2017: Human Reproduction
Geraldine Macdonald, Nuala Livingstone, Jennifer Hanratty, Claire McCartan, Richard Cotmore, Maria Cary, Danya Glaser, Sarah Byford, Nicky J Welton, Tania Bosqui, Lucy Bowes, Suzanne Audrey, Gill Mezey, Helen L Fisher, Wendy Riches, Rachel Churchill
BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study...
September 2016: Health Technology Assessment: HTA
Caitlin Gerdts, Inna Hudaya
OBJECTIVES: To examine services offered by safe-abortion hotlines in contexts in which abortion is legally restricted and to document the experiences of women contacting a safe-abortion hotline in Indonesia. METHODS: We analyzed 1829 first-time contacts to a safe-abortion hotline in Indonesia as a part of routine service provision between January 1, 2012 and December 31, 2014. RESULTS: Nearly one third (29.9%) of initial contacts reported their age as between 18 and 24 years, and most (51...
November 2016: American Journal of Public Health
Leonel Briozzo, Rodolfo Gómez Ponce de León, Giselle Tomasso, Anibal Faúndes
OBJECTIVE: To evaluate changes in maternal mortality rates in Uruguay over the past 25years, as well as their distribution by cause, and their temporal relationship with social changes and Human Development Index (HDI) indicators. METHODS: Data on maternal mortality obtained directly from the Uruguayan Ministry of Public Health for the 2001 to 2015 period were analyzed together with data from the United Nations Inter-Agency Group for Child Mortality Estimation for the 1990 to 2015 period...
August 2016: International Journal of Gynaecology and Obstetrics
Abbey Alkon, Sahar Nouredini, Alicia Swartz, Andrew Mason Sutherland, Michelle Stephens, Nita A Davidson, Roberta Rose
INTRODUCTION: To reduce young children's exposure to pests and pesticides, an integrated pest management (IPM) intervention was provided for child care center staff. METHODS: The 7-month IPM education and consultation intervention was conducted by trained nurse child care health consultants in 44 child care centers in California. IPM knowledge surveys were completed by child care staff, objective IPM assessments were completed by research assistants pre- and postintervention, and activity logs were completed by the nurses...
November 2016: Journal of Pediatric Health Care
Liz Webb, Jum Skingle
AIM: COPPS is a computerised outpatient prescription printing system for WP10 prescriptions. It aims to improve the quality and safety of service, as patients will be provided with a legible, complete prescription to take to a community pharmacy of their choice. Patients requiring specialist medicines will have their medicines dispensed more promptly by the hospital pharmacy or medicines home care provider. The software ensures prescriptions contain all the required information to allow safe dispensing, reducing frequency of delays...
September 2016: Archives of Disease in Childhood
Niphattra Haritavorn
Mothers who use drugs face much discriminatory action as society in general finds female drug users' modes of caring for their children unacceptable. In this article, I explore the ways in which Thai women's injecting practices revolve around the role of mother 'maae' and the ways they employ tactics to challenge the motherhood discourse. This article draws on in-depth interviews with 30 Thai mothers injecting drugs. Thai mothers injecting drugs struggled with stigma and self-blame. They internalise the values of the mother 'maae', that is, what the mother is supposed to be; attempting to combine their drug use with their parental responsibilities...
September 2016: Sociology of Health & Illness
Sumona Chaudhury, Felicity L Brown, Catherine M Kirk, Sylvere Mukunzi, Beatha Nyirandagijimana, Josee Mukandanga, Christian Ukundineza, Kalisa Godfrey, Lauren C Ng, Robert T Brennan, Theresa S Betancourt
HIV-affected families report higher rates of harmful alcohol use, intimate partner violence (IPV) and family conflict, which can have detrimental effects on children. Few evidence-based interventions exist to address these complex issues in Sub-Saharan Africa. This mixed methods study explores the potential of a family-based intervention to reduce IPV, family conflict and problems related to alcohol use to promote child mental health and family functioning within HIV-affected families in post-genocide Rwanda...
March 2016: AIDS Care
E C Grilo, W F Medeiros, A G A Silva, C S S Gurgel, H M M Ramalho, R Dimenstein
BACKGROUND: Maternal supplementation with vitamin A is one of the strategies for controlling its deficiency in the mother-child dyad, although studies with animals showed that supplementation with high doses of vitamin A reduces the levels of α-tocopherol (vitamin E) in the mother's serum and milk. The objective of the present study was to assess the influence of maternal supplementation with vitamin A on the concentration of retinol and α-tocopherol in human milk. METHODS: Healthy puerperal women were randomly distributed into a control group (n = 44) and a supplemented group (n = 44)...
October 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
E Melinda Mahabee-Gittens, Judith W Dexheimer, Jane C Khoury, Julie A Miller, Judith S Gordon
BACKGROUND: Tobacco smoke exposure (TSE) is unequivocally harmful to children's health, yet up to 48% of children who visit the pediatric emergency department (PED) and urgent care setting are exposed to tobacco smoke. The incorporation of clinical decision support systems (CDSS) into the electronic health records (EHR) of PED patients may improve the rates of screening and brief TSE intervention of caregivers and result in decreased TSE in children. OBJECTIVE: We propose a study that will be the first to develop and evaluate the integration of a CDSS for Registered Nurses (RNs) into the EHR of pediatric patients to facilitate the identification of caregivers who smoke and the delivery of TSE interventions to caregivers in the urgent care setting...
April 20, 2016: JMIR Research Protocols
Lars Mehlum, Maria Ramberg, Anita J Tørmoen, Egil Haga, Lien M Diep, Barbara H Stanley, Alec L Miller, Anne M Sund, Berit Grøholt
OBJECTIVE: We conducted a 1-year prospective follow-up study of posttreatment clinical outcomes in adolescents with recent and repetitive self-harm who had been randomly allocated to receive 19 weeks of either dialectical behavior therapy adapted for adolescents (DBT-A) or enhanced usual care (EUC) at community child and adolescent psychiatric outpatient clinics. METHOD: Assessments of self-harm, suicidal ideation, depression, hopelessness, borderline symptoms, and global level of functioning were made at the end of the 19-week treatment period and at follow-up 1 year later...
April 2016: Journal of the American Academy of Child and Adolescent Psychiatry
I H Caspersen, M Haugen, S Schjølberg, K Vejrup, H K Knutsen, A L Brantsæter, H M Meltzer, J Alexander, P Magnus, H E Kvalem
BACKGROUND: Prenatal exposure to dioxins and PCBs is potentially harmful to the developing fetus and may increase the risk of delayed or impaired neurodevelopment. Several studies have reported negative associations between prenatal exposure to these compounds and aspects of cognition related to language in early childhood. OBJECTIVES: The aim was to examine the association between maternal low level dietary exposure to dioxins and PCB during pregnancy and language development in 3year old children in a large group of mother-child pairs participating in the Norwegian Mother and Child Cohort Study (MoBa)...
May 2016: Environment International
Rachel M Amiya, Linda B Mlunde, Erika Ota, Toshiyuki Swa, Olufemi T Oladapo, Rintaro Mori
BACKGROUND: This study synthesizes available evidence on antenatal corticosteroids (ACS) use among special subgroups of women at risk of imminent preterm birth, including those (1) with pregestational and gestational diabetes mellitus, (2) undergoing elective caesarean section (CS) in late preterm (34 to<37 weeks), (3) with chorioamnionitis, and (4) with growth-restricted fetuses. METHODS: A systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Library, POPLINE, and World Health Organization Regional Databases was conducted for all comparative studies...
2016: PloS One
Howard J A Carp
Progestational agents are often prescribed to prevent threatened miscarriage progressing to miscarriage, and subsequent miscarriages in recurrent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. A recent Cochrane review reported that progestogens were effective for treating threatened miscarriage with no harmful effects on mother or fetus. The results were not statistically different when vaginal progesterone was compared to placebo, (RR=0...
August 1, 2016: Hormone Molecular Biology and Clinical Investigation
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