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transitional care neonates

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https://www.readbyqxmd.com/read/28334973/analysis-of-dropout-across-the-continuum-of-maternal-health-care-in-tanzania-findings-from-a-cross-sectional-household-survey
#1
Diwakar Mohan, Amnesty E LeFevre, Asha George, Rose Mpembeni, Eva Bazant, Neema Rusibamayila, Japhet Killewo, Peter J Winch, Abdullah H Baqui
The 'continuum of care' is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC).We analyzed data from 1931 women who delivered in the preceding 2-14 months, from a two-stage cluster sampling household survey in four districts of Tanzania's Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program...
March 16, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28324899/infant-guided-co-regulated-feeding-in-the-neonatal-intensive-care-unit-part-i-theoretical-underpinnings-for-neuroprotection-and-safety
#2
Catherine S Shaker
The rapid progress in medical and technical innovations in the neonatal intensive care unit (NICU) has been accompanied by concern for outcomes of NICU graduates. Although advances in neonatal care have led to significant changes in survival rates of very small and extremely preterm neonates, early feeding difficulties with the transition from tube feeding to oral feeding are prominent and often persist beyond discharge to home. Progress in learning to feed in the NICU and continued growth in feeding skills after the NICU may be closely tied to fostering neuroprotection and safety...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28304316/perspectives-and-attitudes-of-pediatricians-concerning-post-discharge-care-practice-of-premature-infants
#3
A Gad, E Parkinson, N Khawar, A Elmeki, P Narula, D Hoang
OBJECTIVE: Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. METHODS: An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28301894/transitions-in-care-for-infants-with-trisomy-13-or-18
#4
Jacquelyn Patterson, Genevieve Taylor, Melissa Smith, Sarah Dotters-Katz, Arlene M Davis, Wayne Price
Background and Objectives The scope of interventions offered to infants with trisomy 13 (T13) or trisomy 18 (T18) is increasing. We describe the spectrum of care provided, highlighting transitions in care for individual patients. Patients and Methods This is a single-center, retrospective cohort of infants with T13 or T18 born between 2004 and 2015. Initial care was classified as comfort care or intervention using prenatal counseling notes. Transitions in care were identified in the medical record. Results In this study, 25 infants were divided into two groups based on their care: neonates who experienced no transition in care and neonates who experienced at least one transition...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28292963/electrical-activity-of-the-diaphragm-during-ncpap-and-high-flow-nasal-cannula
#5
C G de Waal, G J Hutten, J V Kraaijenga, F H de Jongh, A H van Kaam
OBJECTIVE: To determine if the electrical activity of the diaphragm, as measure of neural respiratory drive and breathing effort, changes over time in preterm infants transitioned from nasal continuous positive airway pressure (nCPAP) to high flow nasal cannula (HFNC). DESIGN: Prospective observational study. SETTING: Neonatal intensive care unit. PATIENTS: Stable preterm infants transitioned from nCPAP to HFNC using a 1:1 pressure to flow ratio...
March 14, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28286665/parents-experiences-of-discharge-readiness-from-a-swedish-neonatal-intensive-care-unit
#6
Christina Larsson, Ulrika Wågström, Erik Normann, Ylva Thernström Blomqvist
AIM: The aim of this study was to describe how parents experienced the support at, and preparation for discharge from, the NICU and how they experienced the first time at home. DESIGN: A qualitative design with quantitative elements was applied. METHODS: A questionnaire study. Data were analysed using qualitative content analysis with quantitative elements. RESULTS: The majority of included parents felt adequately prepared for going home and sufficiently supported during the first period home...
April 2017: Nursing Open
https://www.readbyqxmd.com/read/28285280/effect-of-delayed-cord-clamping-on-hematocrit-and-thermal-and-hemodynamic-stability-in-preterm-neonates-a-randomized-controlled-trial
#7
Niraj Kumar Dipak, Ruchi Nimish Nanavat, Nand Kishore Kabra, Anita Srinivasan, Anitha Ananthan
OBJECTIVE: To evaluate the short term clinical effects of delayed cord clamping in preterm neonates. DESIGN: Randomized controlled trial. SETTING: A tertiary care neonatal unit from October 2013 to September 2014. PARTICIPANTS: 78 mothers with preterm labor between 27 to 316/7 weeks gestation. INTERVENTION: Early cord clamping (10 s), delayed cord clamping (60 s) or delayed cord clamping (60 s) along with intramuscular ergometrine (500 µg) administered to the mother...
February 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28279994/multicentre-randomised-study-of-the-effect-and-experience-of-an-early-inhome-programme-prehomecare-for-preterm-infants-using-video-consultation-and-smartphone-applications-compared-with-inhospital-consultations-protocol-of-the-prehomecare-study
#8
Mai-Britt Hägi-Pedersen, Annelise Norlyk, Ram Dessau, Hristo Stanchev, Hanne Kronborg
INTRODUCTION: Although premature infants and their parents are discharged earlier to inhomecare programmes, how to optimally support parents during this transition remains unknown. The aim of this study is to compare the effects of early inhomecare (PreHomeCare) including video consultations and mobile applications with those of inhospital consultations regarding breast feeding, parental confidence and parent-infant interactions. METHODS AND ANALYSIS: A randomised controlled intervention study will be conducted in four neonatal departments offering PreHomeCare (ie, premature infant inhomecare) in Denmark...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28252522/homecare-and-healthcare-utilization-errors-post-neonatal-intensive-care-unit-discharge
#9
Rupalee Patel, Matthew Nudelman, Adebola Olarewaju, Sunshine Weiss Pooley, Priya Jegatheesan, Dongli Song, Balaji Govindaswami
BACKGROUND: High-risk infants transitioning from the neonatal intensive care unit (NICU) to home represent a vulnerable population, given their complex care requirements. Little is known about errors during this period. PURPOSE: Identify and describe homecare and healthcare utilization errors in high-risk infants following NICU discharge. METHODS: This was a prospective observational cohort study of homecare (feeding, medication, and equipment) and healthcare utilization (appointment) errors in infants discharged from a regional NICU between 2011 and 2015...
March 1, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28237375/maternal-mental-health-and-neonatal-intensive-care-unit-discharge-readiness-in-mothers-of-preterm-infants
#10
Elisabeth C McGowan, Nan Du, Katheleen Hawes, Richard Tucker, Melissa O'Donnell, Betty Vohr
OBJECTIVE: To evaluate associations between maternal mental health disorders (MHDs) and discharge readiness for mothers of infants born preterm (<37 weeks). We hypothesized that mothers with a history of MHDs would report decreased perceptions of neonatal intensive care unit (NICU) discharge readiness compared with mothers without a history. STUDY DESIGN: Mothers of infants born preterm in the NICU >5 days between 2012 and 2015 and participating in a transition home program completed a discharge readiness questionnaire measuring perceptions of staff support, infant well-being (medical stability), maternal well-being (emotional readiness/competency), and maternal comfort (worry about infant)...
February 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28187839/understanding-the-implications-of-birth-weight
#11
Stephanie F McGuire
Neonatal growth parameters include birth weight, length, and head circumference. Weight, as it relates to gestational age, is monitored closely during pregnancy to assess the appropriate growth of the fetus. At birth, it becomes an important parameter to assess the health and well-being of the newborn. Birth weight carries implications for nursing care and monitoring of the newborn's transition to extrauterine life. The importance of birth weight assessment and its interpretation will be reviewed, along with the implications for immediate neonatal care and potential long-term effects on an infant's health outcomes...
February 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/28154744/environmental-factors-influencing-biological-rhythms-in-newborns-from-neonatal-intensive-care-units-to-home
#12
Clarissa Bueno, Luiz Menna-Barreto
Photic and non-photic environmental factors are suggested to modulate the development of circadian rhythms in infants. Our aim is to evaluate the development of biological rhythms (circadian or ultradian) in newborns in transition from Neonatal Intensive Care Units (NICU) to home and along the first 6 months of life, to identify masking and entraining environment factors along development. Ten newborns were evaluated in their last week inside the NICU and in the first week after being delivered home; 6 babies were also followed until 6 months of corrected age...
October 2016: Sleep Science
https://www.readbyqxmd.com/read/28153467/water-balance-in-the-fetus-and-neonate
#13
REVIEW
Julie B Lindower
Fetal water balance is dependent prenatally on the placental transfer of water from maternal to fetal circulation. Adequate amniotic fluid volume is one indicator of stable fetal status and development. Excessive or less than expected amniotic fluid volume may be a precursor to postnatal morbidity and mortality. Postnatal transition is marked by predictable changes in body water including contraction of extracellular volume and insensible fluid loss, primarily across the skin barrier. The degree to which these occur is determined by gestational and postnatal age...
January 30, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28151495/greater-brain-response-to-emotional-expressions-of-their-own-children-in-mothers-of-preterm-infants-an-fmri-study
#14
R Montirosso, F Arrigoni, E Casini, A Nordio, P De Carli, F Di Salle, S Moriconi, M Re, G Reni, R Borgatti
OBJECTIVE: The birth of a preterm infant and Neonatal Intensive Care Unit hospitalization constitute a potentially traumatic experience for mothers. Although behavioral studies investigated the parenting stress in preterm mothers, no study focused on the underlying neural mechanisms. We examined the effect of preterm births in mothers, by comparing brain activation in mothers of preterm and full-term infants. STUDY DESIGN: We used functional magnetic resonance imaging to measure the cerebral response of 10 first-time mothers of preterm infants (gestational age <32 weeks and/or birth weight <1500) and 11 mothers of full-term infants, viewing happy-, neutral- and distress-face images of their own infant, along with a matched unknown infant...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28121762/transition-to-a-new-neonatal-intensive-care-unit-positive-effects-on-staff-working-environment-and-how-the-physical-environment-facilitates-family-centered-care
#15
Johannes van den Berg, Frida Bäck, Zara Hed, David Edvardsson
To optimize family-centered care and the staff working environment, the physical care environment should be designed to meet the needs of the infants, their families, and staff. It is important to evaluate the effects of a purpose-built neonatal ward on staff perceptions of job strain, the psychosocial climate, and the appropriateness of the physical environment. This study collected information from staff at a neonatal intensive care unit (NICU), before and after the ward was relocated to a new NICU. Effects were measured using the following variables: job strain, person-centered climate and appropriateness-of-the-physical-environment questionnaires...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#16
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28009334/challenges-successes-and-opportunities-for-reducing-readmissions-in-a%C3%A2-referral-based-children-s-hospital-nicu
#17
R Bapat, R McClead, E Shepherd, G Ryshen, T Bartman
AIM: To evaluate readmission data in a level IV neonatal intensive care unit (NICU) to identify patient characteristics and process failures which serve as drivers for readmission. METHODS: Our center is a primary referral center in Central and Southeast Ohio, providing us a unique opportunity to evaluate readmissions. We studied our current discharge process, caregiver perception of discharge readiness, parental comfort and the pre-discharge and post-discharge characteristics of infants...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28008218/objective-assessment-of-a-preterm-infant-s-nutritive-sucking-from-initiation-of-feeding-through-hospitalization-and-discharge
#18
Gilson J Capilouto, Tommy J Cunningham
INTRODUCTION: In 2008, the American Academy of Pediatrics recommended that an infant's ability to feed independently be considered a primary consideration for discharge home. To date, NICU healthcare teams have relied on clinical experience as well as descriptive scales to determine a high risk infant's ability to transition safely from tube feeding to oral feeding. The aim of the current case study was to illustrate the clinical utility of nfant(®) Feeding Solution as a noninvasive and objective instrument for determining a neonate's readiness to begin and advance oral feeding...
2016: Neonatal Intensive Care: the Journal of Perinatology-neonatology
https://www.readbyqxmd.com/read/28002310/committee-opinion-no-684-delayed-umbilical-cord-clamping-after-birth
#19
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28002305/committee-opinion-no-684-summary-delayed-umbilical-cord-clamping-after-birth
#20
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
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