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Infant Care (infant + care)
Terms modified by Infant Care Selected AbstractsMothers' attachment representations and choice of infant care: center care vs. homeINFANT AND CHILD DEVELOPMENT, Issue 3 2001Nina Koren-KarieArticle first published online: 14 SEP 200 Abstract In the debate concerning the effects of day care on infant development, insufficient attention has been paid to the potential relationship between pre-existing emotional differences among mothers and the type of care they choose for their infants. To shed light on this issue, this study examines the attachment representations of mothers who choose day-care centres as opposed to mothers who choose to remain at home with their infants. Participants were 76 primiparous mothers. Mothers' attachment classifications were assessed by the Adult Attachment Interview [AAI; Main M, Kaplan N, Cassidy J. 1985. Security in infancy, childhood, and adulthood: a move to the level of representation. In Growing Points of Attachment Theory and Research. Monograph of the Society for Research in Child Development, 50, (1,2, serial no. 209), Bretherton I, Waters E (eds); 66,104]. Results indicate that more Day-care than Home-Care mothers are classified as insecurely attached. These results highlight the contribution of maternal emotional characteristics to the effects of diverse child care arrangements on infant development. Copyright © 2001 John Wiley & Sons, Ltd. [source] Association between pacifier use and breast-feeding, sudden infant death syndrome, infection and dental malocclusionINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 6 2005Ann Callaghan RN RM BNurs(Hons) Executive summary Objective, To critically review all literature related to pacifier use for full-term healthy infants and young children. The specific review questions addressed are: What is the evidence of adverse and/or positive outcomes of pacifier use in infancy and childhood in relation to each of the following subtopics: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Inclusion criteria, Specific criteria were used to determine which studies would be included in the review: (i) the types of participants; (ii) the types of research design; and (iii) the types of outcome measures. To be included a study has to meet all criteria. Types of participants,The participants included in the review were healthy term infants and healthy children up to the age of 16 years. Studies that focused on preterm infants, and infants and young children with serious illness or congenital malformations were excluded. However, some total population studies did include these children. Types of research design, It became evident early in the review process that very few randomised controlled trials had been conducted. A decision was made to include observational epidemiological designs, specifically prospective cohort studies and, in the case of sudden infant death syndrome research, case,control studies. Purely descriptive and cross-sectional studies were excluded, as were qualitative studies and all other forms of evidence. A number of criteria have been proposed to establish causation in the scientific and medical literature. These key criteria were applied in the review process and are described as follows: (i) consistency and unbiasedness of findings; (ii) strength of association; (iii) temporal sequence; (iv) dose,response relationship; (v) specificity; (vi) coherence with biological background and previous knowledge; (vii) biological plausibility; and (viii) experimental evidence. Studies that did not meet the requirement of appropriate temporal sequencing of events and studies that did not present an estimate of the strength of association were not included in the final review. Types of outcome measures,Our specific interest was pacifier use related to: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Studies that examined pacifier use related to procedural pain relief were excluded. Studies that examined the relationship between pacifier use and gastro-oesophageal reflux were also excluded as this information has been recently presented as a systematic review. Search strategy, The review comprised published and unpublished research literature. The search was restricted to reports published in English, Spanish and German. The time period covered research published from January 1960 to October 2003. A protocol developed by New Zealand Health Technology Assessment was used to guide the search process. The search comprised bibliographic databases, citation searching, other evidence-based and guidelines sites, government documents, books and reports, professional websites, national associations, hand search, contacting national/international experts and general internet searching. Assessment of quality, All studies identified during the database search were assessed for relevance to the review based on the information provided in the title, abstract and descriptor/MeSH terms, and a full report was retrieved for all studies that met the inclusion criteria. Studies identified from reference list searches were assessed for relevance based on the study title. Keywords included: dummy, dummies, pacifier(s), soother(s), comforter(s), non-nutritive sucking, infant, child, infant care. Initially, studies were reviewed for inclusion by pairs of principal investigators. Authorship of articles was not concealed from the reviewers. Next, the methodological quality of included articles was assessed independently by groups of three or more principal investigators and clinicians using a checklist. All 20 studies that were accepted met minimum set criteria, but few passed without some methodological concern. Data extraction, To meet the requirements of the Joanna Briggs Institute, reasons for acceptance and non-acceptance at each phase were clearly documented. An assessment protocol and report form was developed for each of the three phases of review. The first form was created to record investigators' evaluations of studies included in the initial review. Those studies that failed to meet strict inclusion criteria were excluded at this point. A second form was designed to facilitate an in-depth critique of epidemiological study methodology. The checklist was pilot tested and adjustments were made before reviewers were trained in its use. When reviewers could not agree on an assessment, it was passed to additional reviewers and discussed until a consensus was reached. At this stage, studies other than cohort, case,control and randomised controlled trials were excluded. Issues of clarification were also addressed at this point. The final phase was that of integration. This phase, undertaken by the principal investigators, was assisted by the production of data extraction tables. Through a process of trial and error, a framework was formulated that adequately summarised the key elements of the studies. This information was tabulated under the following headings: authors/setting, design, exposure/outcome, confounders controlled, analysis and main findings. Results, With regard to the breast-feeding outcome, 10 studies met the inclusion criteria, comprising two randomised controlled trials and eight cohort studies. The research was conducted between 1995 and 2003 in a wide variety of settings involving research participants from diverse socioeconomic and cultural backgrounds. Information regarding exposure and outcome status, and potential confounding factors was obtained from: antenatal and postnatal records; interviews before discharge from obstetric/midwifery care; post-discharge interviews; and post-discharge postal and telephone surveys. Both the level of contact and the frequency of contact with the informant, the child's mother, differed widely. Pacifier use was defined and measured inconsistently, possibly because few studies were initiated expressly to investigate its relationship with breast-feeding. Completeness of follow-up was addressed, but missing data were not uniformly identified and explained. When comparisons were made between participants and non-participants there was some evidence of differential loss and a bias towards families in higher socioeconomic groups. Multivariate analysis was undertaken in the majority of studies, with some including a large number of sociodemographic, obstetric and infant covariates and others including just maternal age and education. As might be expected given the inconsistency of definition and measurement, the relationship between pacifier use and breast-feeding was expressed in many different ways and a meta-analysis was not appropriate. In summary, only one study did not report a negative association between pacifier use and breast-feeding duration or exclusivity. Results indicate an increase in risk for a reduced overall duration of breast-feeding from 20% to almost threefold. The data suggest that very infrequent use may not have any overall negative impact on breast-feeding outcomes. Six sudden infant death syndrome case,control studies met the criteria for inclusion. The research was conducted with information gathered between 1984 and 1999 in Norway, UK, New Zealand, the Netherlands and USA. Exposure information was obtained from a variety of sources including: hospital and antenatal records, death scene investigation, and interview and questionnaire. Information for cases was sought within 2 days after death, within 2,4 weeks after death and in one study between 3 and 11 years after death. Information for controls was sought from as early as 4 days of a nominated sudden infant death syndrome case, to between 1 and 7 weeks from the case date, and again in one study some 3,11 years later. In the majority of the studies case ascertainment was determined by post-mortem. Pacifier use was again defined and measured somewhat inconsistently. All studies controlled for confounding factors by matching and/or using multivariate analysis. Generally, antenatal and postnatal factors, as well as infant care practices, and maternal, family and socioeconomic issues were considered. All five studies reporting multivariate results found significantly fewer sudden infant death syndrome cases used a pacifier compared with controls. That is, pacifier use was associated with a reduced incidence of sudden infant death syndrome. These results indicate that the risk of sudden infant death syndrome for infants who did not use a pacifier in the last or reference sleep was at least twice, and possibly five times, that of infants who did use a pacifier. Three studies reported a moderately sized positive association between pacifier use and a variety of infections. Conversely, one study found no positive association between pacifier use at 15 months of age and a range of infections experienced between the ages of 6 and 18 months. Given the limited number of studies available and the variability of results, no meaningful conclusions could be drawn. Five cohort studies and one case,control study focused on the relationship between pacifier use and dental malocclusion. Not one of these studies reported a measure of association, such as an estimate of relative risk. It was therefore not possible to include these studies in the final review. Implications for practice, It is intended that this review be used as the basis of a ,best practice guideline', to make health professionals aware of the research evidence concerning these health and developmental consequences of pacifier use, because parents need clear information on which they can base child care decisions. With regard to the association between pacifier use and infection and dental malocclusion it was found that, due to the paucity of epidemiological studies, no meaningful conclusion can be drawn. There is clearly a need for more epidemiological research with regard to these two outcomes. The evidence for a relationship between pacifier use and sudden infant death syndrome is consistent, while the exact mechanism of the effect is not well understood. As to breast-feeding, research evidence shows that pacifier use in infancy is associated with a shorter duration and non-exclusivity. It is plausible that pacifier use causes babies to breast-feed less, but a causal relationship has not been irrefutably proven. Because breast-feeding confers an important advantage on all children and the incidence of sudden infant death syndrome is very low, it is recommended that health professionals generally advise parents against pacifier use, while taking into account individual circumstances. [source] Turkish women's perceptions of antenatal educationINTERNATIONAL NURSING REVIEW, Issue 3 2010P. Serçeku Serçeku, P. & Mete S. (2010) Turkish women's perceptions of antenatal education. International Nursing Review57, 395,401 Background:, Antenatal education is considered essential for expectant women. Although there are a number of studies on the effects of antenatal education, there are few studies featuring substantial evidence in this area. For this reason, the benefits have not been clearly defined. Aim:, To describe women's perceptions of the effectiveness of antenatal education on pregnancy, childbirth and the post-partum period, and also to describe their impressions on the type of education received. Methods:, A qualitative approach was used. The study featured 15 primipara women who had attended antenatal education. Data were gathered through semi-structured interviews and analysed using the content analysis method. Findings:, The results of this study showed that education provided a basis of knowledge about pregnancy, childbirth and the post-partum period. It was found that education could have positive effects on pregnancy, childbirth, breastfeeding, motherhood and infant care, and that it could at the same time have a positive or negative effect on fear of childbirth. Although different advantages were found to be perceived in both individual and group education, it was discovered that the study participants were much more satisfied with attending group sessions. Key conclusions and implications for practice:, Antenatal education should be planned in such a way that its content and methodology do not increase fear. When the lower costs incurred and the higher satisfaction level attained are considered, group education appears to be the type of antenatal education that should be preferred. [source] Hand-rearing a Potto Perodicticus potto at Franklin Park Zoo, BostonINTERNATIONAL ZOO YEARBOOK, Issue 1 2006H. D. BUCKANOFF In August 2001 a Potto Perodicticus potto was born in the Tropical Forest building of Franklin Park Zoo, Boston. The neonate was removed the following day for hand-rearing because its mother, which had a history of providing poor infant care, appeared to be neglecting it. Historically, Pottos in captivity have high rates of neonatal mortality that are frequently associated with maternal neglect. This paper gives detailed information about the methods used to hand-rear this infant successfully. Notes on infant development are presented and the health issues encountered, and medical treatments given, during the first few months are described. [source] A Review of Nursing Interventions to Foster Becoming a MotherJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 5 2006Ramona T. Mercer Objective:, To determine the current state of knowledge of nursing interventions that foster the process of becoming a mother. Data Sources:, A literature search was conducted using CINAHL and PubMed electronic databases and other key references. Study Selection:, Reports on nursing intervention research published in English that focused on a facet of maternal behavior in the process of becoming a mother during pregnancy or during the first 4 months following birth, or both, were included. Twenty eight reports were found. Data Extraction:, Studies were reviewed, categorized, and analyzed and interventions synthesized to determine the current knowledge base for fostering becoming a mother. Categories included instructions for infant caregiving, building awareness of and responsiveness to infant interactive capabilities, promoting maternal-infant attachment, maternal/social role preparation, and interactive therapeutic nurse-client relationships. Data Synthesis:, Interactive therapeutic nurse-client relationships and maternal/social role preparation had greater impact on variables indicating progress in becoming a mother than formal teaching. Instructions without nurse input were ineffective. Conclusions:, Interactive reciprocal nursing interventions are the most effective in enhancing mother-infant interactions and maternal knowledge about infant care. Evidence is limited on how to foster the mother's feelings about herself in becoming a mother and attachment to her infant. JOGNN, 35, 568-582; 2006. DOI: 10.1111/J.1552-6909.2006.00080.x [source] Social support and symptoms of postpartum depression among new mothers in Eastern TurkeyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2008Emel Ege Abstract Aim:, The aim of the present study was to examine the relationship between symptoms of postpartum depression and social support in new mothers in a semi-rural province (Malatya) of Eastern Turkey. Methods:, This is a descriptive, cross-sectional study. The study was conducted with a 12-item Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire, a 10-item Edinburgh Postnatal Depression Scale (EPDS) questionnaire, and a 16-item demographic/obstetric questionnaire designed by the authors. 364 women who were between 6 to 48 weeks postpartum were included in the study. Results:, Symptoms of postpartum depression were negatively correlated with social support (,0.39, P = 0.000). The frequency of the prevalence of symptoms of postpartum depression was 33.2%. The study showed that EPDS mean score was related to several factors, including age, woman's education, woman's occupation, socioeconomic status of family, spouse's education, number of years married, parity, planned pregnancy, method of delivery, knowledge of infant care, sharing of problems with a close person, past psychiatric history and family support during the postnatal period in an Eastern province of Turkey. Conclusion:, Symptoms of postpartum depression were negatively correlated among Turkish women living in the Malatya province of Eastern Turkey and were associated with the level of social support. The prevalence of postpartum depression was higher than in the published reports regarding most regions of Turkey, with the exception of Northeastern Turkey. [source] Movement disorders and pregnancy: A review of the literature,,MOVEMENT DISORDERS, Issue 6 2010Sarah M. Kranick MD Abstract Pregnant patients are rarely encountered in the movement disorders clinic, but they present significant dilemmas regarding treatment and counseling for neurologists. While movement disorders in pregnancy once described those disorders arising de novo during pregnancy, such as chorea gravidarum or restless leg syndrome, advancing maternal age in Western countries will likely increase the number of women in whom pregnancy complicates a pre-existing movement disorder. Physicians treating these women must be aware of the impact of the movement disorder and its treatment on fertility, pregnancy, fetal development, lactation, and infant care. This review summarizes retrospective series and case reports to both guide clinicians and to stimulate and direct the design of prospective studies. © 2010 Movement Disorder Society [source] Self-perception levels of mothers dealing with infant care problems for babies 0,12 months oldPEDIATRICS INTERNATIONAL, Issue 5 2009nar Bayhan Abstract Background:, Babies need the presence of an adult, especially their mothers, from the moment they are born in order to have their needs fulfilled. The significance of the care, particularly during the newborn and the babyhood period, increases gradually as the children grow older. The adequate and efficient fulfillment of needs during the newborn and babyhood period are fundamental in terms of child development. On the other hand, many mothers don't know what to do about problematic situations related to infant care that they might encounter when they have a newborn baby. Methods:, The self-perception of 864 mothers, in various educational level groups, with 432 male and 432 female babies, was analyzed in regards to dealing with problems that arise related to infant care. A questionnaire, developed by Pridham and Chang (1991), was filled out during interviews with the mothers. The analyses of the data obtained as the result of the study were evaluated with the Kruskal,Wallis test while the statistically significant findings were dually compared using the Mann,Whitney test. Results:, At the conclusion of the study it was determined that the gender of the baby did not effect the mother's self-perception during problem solving, whereas their educational levels created remarkable differences amongst their responses. [source] Variations in male parenting behavior and physiology in the common marmosetAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2009Toni E. Ziegler Infant survival and wellbeing is dependent upon good parenting skills. In some species of primates, fathers are necessary to ensure both positive developmental and social outcomes for their offspring. Common marmosets and the related cotton-top tamarin monkeys provide extensive paternal care of multiple offspring and are essential for infant survival. However, we have found significant variation in a father's motivation to respond to infant stimuli. Additionally, marmoset males who are experienced fathers are significantly more motivated to respond to infants and infant stimuli than adult males who have yet to be fathers. Expectant fathers appear to be preparing for their energetic role in infant care by responding with increases in multiple reproductive hormones and showing weight gain during their mate's pregnancy. Male marmosets have been shown to be hormonally responsive to scent signals. Males show increased testosterone shortly after smelling periovulatory scents and lower levels of testosterone following presentation of their own infant's scent. These two inverse testosterone responses combined indicate that paternal males have a flexible system of responding to socially relevant odor cues. Thus males can be ready to mate when their mate is fertile while continuing to be responsive to their infants when these two events occur simultaneously. A male's hormonal and physical responsiveness to parenting may be due to pair bonding between the male and his mate. Examining the variability between males in their behavioral, physical, and hormonal responses to their mate's pregnancy, and infant stimuli provides the means for determining the mechanisms of good parenting in fathers. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Breastfeeding structure as a test of parental investment theory in Papua New Guinea,AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009David P. Tracer Evolutionary parental investment theory predicts that parents invest preferentially in offspring best able to translate investments into fitness payoffs. It has also been proposed that where the reproductive prospects of offspring are directly correlated with parental investment and variance in fertility is higher for males than females, parents in better condition should bias investment toward males while those in poorer condition should bias investment toward females. Lactation is arguably among the costliest forms of investment expended by mothers and is thus expected to be allocated in ways consistent with fitness payoffs. Quantitative data collected among 110 Papua New Guinean mother-infant pairs during 470 h of focal follows on nursing frequency and duration and responses to infant demands by maternal and offspring characteristics are presented to provide empirically-based descriptions of infant care and tests of evolutionary parental investment theory. Results indicate that mothers show very high levels of investment in offspring. However, although breastfeeding in developing countries is often characterized as on-demand, fussing and crying by infants were only attended to with breastfeeding about 30% of the time. Contrary to expectations of parental investment theory that parents should invest less in poorer quality offspring, mothers increased investment in offspring in poorer condition. The expectation that mothers in better condition would bias investment toward male offspring was also not supported; better nourished mothers biased investment toward female offspring. This study illustrates how infant feeding data may be used for testing larger evolutionary questions such as those derived from parental investment theory. Am. J. Hum. Biol. 2009. © 2009 Wiley-Liss, Inc. [source] The effects of lactation and infant care on adult energy budgets in wild siamangs (Symphalangus syndactylus)AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2009Susan Lappan Abstract In mammals with biparental care of offspring, males and females may bear substantial energetic costs of reproduction. Adult strategies to reduce energetic stress include changes in activity patterns, reduced basal metabolic rates, and storage of energy prior to a reproductive attempt. I quantified patterns of behavior in five groups of wild siamangs (Symphalangus syndactylus) to detect periods of high energetic investment by adults and to examine the relationships between infant care and adult activity patterns. For females, the estimated costs of lactation peaked at around infant age 4,6 months and were low by infant age 1 year, whereas the estimated costs of infant-carrying peaked between ages 7 and 12 months, and approached zero by age 16 months. There was a transition from primarily female to male care in the second year of life in some groups. Females spent significantly less time feeding during lactation than during the later stages of infant care, suggesting that female siamangs do not use increased food intake to offset the costs of lactation. Female feeding time was highest between infant ages 16 and 21 months, a period of relatively low female investment in the current offspring that coincided with the period of highest male investment in infant care. This suggests that male care may reduce the costs of infant care for females in the later stages of a reproductive attempt. The female energy gain resulting from male care was likely invested in somatic maintenance and future reproduction, rather than the current offspring. Am J Phys Anthropol, 2009. © 2009 Wiley-Liss, Inc. [source] Social dynamics and individual plasticity of infant care behavior in cooperatively breeding cotton-top tamarinsAMERICAN JOURNAL OF PRIMATOLOGY, Issue 4 2010Sofia Refetoff Zahed Abstract Individual variation in infant caretaking behavior is prevalent among marmoset and tamarin monkeys. Although most group members participate in infant care, the timing and amount provided differs greatly. In this study, we quantified general trends in infant carrying behavior by using a longitudinal database that included 11 years of instantaneous scan observations following 80 births of cotton-top tamarins. Using detailed focal observations on a subset of the same families (10 births) we identified influences that affected expression of infant care at the group and individual levels. Fathers were the primary carriers and paternal carry time gradually decreased with increasing infant age. Paternal carry time also decreased significantly with an increasing number of older sibling helpers. Most fathers began to carry on the first day postpartum. However, we report circumstances in which fathers delayed carrying until almost a month postpartum. Fathers retrieved infants the most, although adult brothers' rates of retrievals peaked and surpassed fathers' rates during week 4 postpartum. Fathers delayed rejection of infants until week 4, whereas mothers rejected infants immediately and throughout the eight weeks. Nonetheless, infants climbed onto their mothers more than onto any other family member. Mothers showed a high initial investment in carrying during the first two weeks, decreasing quickly thereafter. Maternal contributions to infant carrying remained low and relatively consistent regardless of group size. However, mothers dramatically increased their infant carrying behavior in families in which fathers were absent. Older siblings cared for infants more than did younger siblings, and brothers retrieved and carried infants more than did sisters. Individual expression of infant care changed to accommodate infant needs and changed according to varying social dynamics and circumstances across litters. Am. J. Primatol. 72:296,306, 2010. © 2009 Wiley-Liss, Inc. [source] Life history traits and parental care in Lepilemur ruficaudatusAMERICAN JOURNAL OF PRIMATOLOGY, Issue 1 2008Roland Hilgartner Abstract In this study we investigated the importance of biparental care for the evolution and/or maintenance of pair-living in red-tailed sportive lemurs (Lepilemur ruficaudatus), a nocturnal folivorous lemur. Between 2000 and 2005, we collected data on life history traits from a total of 14 radio-collared pairs of adults and their offspring in Kirindy forest, western Madagascar. Predation rate varied between years with a minimum of 0% and a maximum of 40% per year. Patterns of parental care were quantified during simultaneous focal observations of both pair-partners in 2003 and 2004. Mating activity was limited to the months of May and June, as indicated by conspicuous changes of vulval morphology and male mate guarding behavior. After a gestation length of about 5 months, which is much longer than expected for a lemur of this body mass, single infants were born in November. Lactation lasted for about 50 days. Apart from lactation, females provided infant care by warming, grooming and transporting infants orally. Infants were parked in dense vegetation while females foraged. Males were seen only rarely in proximity to infants and we found no evidence for direct infant care provided by social fathers. We conclude that the necessity of direct infant care cannot explain the evolution and/or maintenance of pair-living in Lepilemur ruficaudatus. Am. J. Primatol. 70:2,11, 2008. © 2007 Wiley-Liss, Inc. [source] Activity budgets and activity rhythms in red ruffed lemurs (Varecia rubra) on the Masoala Peninsula, Madagascar: seasonality and reproductive energeticsAMERICAN JOURNAL OF PRIMATOLOGY, Issue 1 2005Natalie Vasey Abstract The activity budgets and daily activity rhythms of Varecia rubra were examined over an annual cycle according to season and reproductive stage. Given the relatively high reproductive costs and patchy food resources of this species, I predicted that V. rubra would 1) travel less and feed more during seasonal resource scarcity in an attempt to maintain energy balance, and 2) show sex differences in activity budgets due to differing reproductive investment. Contrary to the first prediction, V. rubra does not increase feeding time during seasonal food scarcity; rather, females feed for a consistent amount of time in every season, whereas males feed most during the resource-rich, hot dry season. The results are consistent with other predictions: V. rubra travels less in the resource-scarce cold rainy season, and there are some pronounced sex differences, with females feeding more and resting less than males in every season and in every reproductive stage except gestation. However, there are also some provocative similarities between the sexes when activity budgets are examined by reproductive stage. During gestation, female and male activity budgets do not differ and appear geared toward energy accumulation: both sexes feed and rest extensively and travel least during this stage. During lactation, activity budgets are geared toward high energy expenditure: both sexes travel most and in equal measure, and rest least, although it remains the case that females feed more and rest less than males. These similarities between female and male activity budgets appear related to cooperative infant care. The high energetic costs of reproduction in V. rubra females may require that they allot more time to feeding year round, and that their overall activity budget be more directly responsive to seasonal climate change, seasonal food distribution, and reproductive schedules. Am. J. Primatol. 66:23,44, 2005. [source] Pragmatic indicators for remote Aboriginal maternal and infant health care: why it matters and where to startAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Malinda Steenkamp Abstract Objective: There are challenges in delivering maternal and infant health (MIH) care to remote Northern Territory (NT) communities. These include fragmented care with birthing in regional hospitals resulting in cultural and geographical dislocation for Aboriginal women. Many NT initiatives are aimed at improving care. Indicators for evaluating these for remote Aboriginal mothers and infants need to be clearer. We reviewed existing indicators to inform a set of pragmatic indicators for reporting improvement in remote MIH care. Methods: Scientific databases and grey literature (organisational websites and Google Scholar) were searched using the terms ,Aboriginal/maternal/infant/remote health/monitoring performance'. Key stakeholders identified omitted indicators sets. Relevant sets were reviewed and organised by indicator type, stage of patient journey, topic and theme. Results: Forty-two indicators sets were found. Seven focused on Aboriginal health, 23 on reproductive/maternal health, eight on child/infant health and four on other aspects, e.g. remote health. We identified more than 1,000 individual indicators. Of these, 656 were relevant for our purpose and were subsequently organised into 300 topics and 16 themes for antenatal, birth and postpartum, and infant care by indicator type. Conclusion: There are many measures for monitoring health care delivery to mothers and infants. Few are framed around remote MIH services, despite poorer health outcomes of remote mothers and infants and the specific challenges with providing care in this setting. Establishing relevant indicators is vital to support relevant data collection and the development of appropriate policy for remote Aboriginal maternal and infant care. [source] Transcutaneous bilirubinometry in very low birthweight infantsACTA PAEDIATRICA, Issue 7 2004L Karolyi Aim: To evaluate whether transcutaneous bilirubinometry (TcB) would be a reliable and efficient screening technique for hyperbilirubinaemia in very low birthweight (VLBW, ±1500 g) infants in an intensive care unit setting. Methods: TcB measurements (Minolta Airshield Jaundice Meter JM-102, Osaka, Japan) were obtained immediately before or within 10min following routine blood sampling for plasma bilirubin concentration measurements in 124 VLBW infants not receiving phototherapy. The relationship between the two techniques was analysed by linear regression analysis. A plasma bilirubin ±150 ,mol/1 was defined as hyperbilirubinaemia. The sensitivity and specificity of possible TcB cut-off readings to detect hyperbilirubinaemia was evaluated. Results: There was a significant correlation between the measurements of both techniques (p < 0.0001, r= 0.68). In the present study, a TcB cut-off reading of 14 would have reduced the need for plasma bilirubin measurements by 26% without missing true hyperbilirubinaemia. Conclusion: The data suggest that TcB will improve VLBW infant care in an intensive care unit setting by reducing the need for invasive bilirubin concentration measurements. [source] | |||||||||||||