90 versus 60 min of early skin-to-skin contact on exclusive breastfeeding rate in healthy infants' ≥35 weeks: A randomised controlled trial.

AIM: To compare the effect of 90 versus 60 min of early skin-to-skin contact (SSC) among vaginally born healthy infants ≥35 weeks of gestation on their exclusive breastfeeding rates and breastfeeding behaviour. METHODS: This parallel-group, open-label, randomised controlled trial enrolled healthy term and late preterm infants born vaginally. Infants in the intervention group received early SSC for 90 min compared to 60 min in the control group. The primary outcome was the proportion of infants on exclusive breastfeeding at 60 ± 12 h. RESULTS: One hundred ninety-eight mother-infant dyads were randomised (99 in each group). The infants in the 90-min SSC group were more likely to be exclusively breastfed at 60 ± 12 h as compared to the 60-min SSC group (RR, 95% CI-1.44, [1.15-1.79], p < 0.01). The modified infant breastfeeding assessment tool score at 60 ± 12 h was significantly higher in the 90-min SSC group (median [IQR]-9, [8, 10] versus 8 [7, 10], p = 0.03]. The proportion of infants on exclusive breastfeeding at 6, 10, and 14 weeks of age was also significantly higher in the 90-min SSC group (RR, 95% CI-1.39 [1.11-1.74], 1.36 [1.08-1.07], and 1.38 [1.08-1.75], respectively). CONCLUSION: Increasing the duration of early SSC showed a dose-response benefit on exclusive breastfeeding rates and breastfeeding behaviour. TRIAL REGISTRATION: CTRI/2018/09/015632, registered on 06/09/2018.

A cross-sectional study to assess the anxiety and coping mechanism among primary caregivers of children admitted in PICU.

Introduction: PICU admission of a child may cause anxiety and stress among the caregivers. The criteria for admission to a PICU are terrifying and may legitimately cause parents to fear that their child may pass away or suffer a serious disability. They may be overburdened with stress and anxiety of illness and compliment medical information while trying to maintain a balance with other family demands. They must learn coping mechanisms and use resources to stay stable when they face challenges. Evidence on the coping mechanisms used by primary caregivers to control their stress and anxiety is scarce so this study assessed the anxiety and coping mechanism among the primary caregivers of children admitted in PICU. Materials and Methods: A cross-sectional study was conducted among 143 primary caregivers by using convenience sampling technique at PICU, AIIMS, Jodhpur, from April 31, 2021, to January 20, 2022. The participants were enrolled after obtaining informed consent and were interviewed by the researcher. Results: Study findings revealed that primary caregivers had 38% severe anxiety, 54% moderate anxiety, and 8% mild anxiety. They used emotion-focused coping (43.5%) followed by problem focused coping (37.2%) and avoidant coping (19.3%). Also, there was a significant association found between anxiety of primary caregivers and gender of the child (P = 0.012). Conclusion: Anxiety and stress are one of the expected psychological problems faced by caregivers of children admitted in PICU. Healthcare workers must make concerted attempts to support caregivers adaptive coping mechanisms, so they can retain a sense of balance.

The Impact of the COVID-19 Outbreak on Lifestyle-Related Behavior Among the General Population.

INTRODUCTION: Coronavirus has affected more than 200 countries around the world. Due to lockdowns, people have limited outdoor activities and started adopting new and healthy lifestyle behaviors. METHOD: A cross-sectional study was conducted to explore the impact of COVID-19 on lifestyle-related behavior. Data were collected from different regions of North India using Google Forms (Google, Inc., Mountain View, CA, USA) with the help of a standardized questionnaire. Both descriptive and inferential statistics were used for analysis. The p-value was set at <0.05. RESULTS: A total of 468 responses were recorded (mean age: 28.51 years). A significant improvement was found in the intake of fruits and vegetables as well as pulses, eggs, or meat during the COVID-19 pandemic. Participation in household chores and screen time in watching mobile or television were significantly increased. The majority (44.4%) of participants had stable weight, and 37.8% gained weight during the COVID-19 pandemic. The anxiety they felt in a day also increased, which was predominantly due to fear of COVID-19. During the COVID-19 pandemic, a significant association was found between physical activity scores and gender, residence, nature of work, and hours of work of study subjects. CONCLUSION: There is an improvement in healthy eating behavior, quality of sleep, and participation in household chores during the COVID-19 pandemic. Further, domains of lifestyle can be explored to bring a positive style of living for the achievement of healthy lifestyle behavior by the general population.

Acceptance and Attitude of Parents Regarding COVID-19 Vaccine for Children: A Cross-Sectional Study.

Background The coronavirus disease 2019 (COVID-19) pandemic has claimed millions of lives worldwide. India also launched a COVID-19 vaccination drive, and clinical trials for a pediatric COVID-19 vaccine are in development. Objectives The study aims to assess the acceptance and attitude of parents regarding the COVID-19 vaccine for children in India. The study also aims to find the association between selected demographic variables and acceptance and attitudes in parents regarding the COVID-19 vaccine for children. Materials and methods We conducted a cross-sectional descriptive study with 204 participants, and data were collected online using Google Forms. The study participants were parents of children aged two to 15 years. A self-structured tool was used to assess parents' acceptance regarding vaccinating their children, and a modified vaccination attitudes examination scale was used to assess parents' attitudes toward pediatric vaccination against COVID-19. We used IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, New York) to analyze the data. Demographic data were represented as frequency and percentage. Binary logistic regression analysis was used to determine the associations between sociodemographic data and parents' levels of acceptance and attitude. For all the data, p<0.05 was considered significant. Results The majority of the participants (85%) reported acceptance of the COVID-19 vaccine for children. More than 80% of parents agree that vaccines are essential to halt the COVID-19 pandemic and are mandatory for children. Most parents (62%) also believed that complementary medicine is better than vaccines for children. While most parents (95%) reported trusting the vaccine, but more than half (59%) reported concerns regarding the unknown future effects of the vaccine. Mothers (odds ratio (OR), 2.963; p=0.015) and parents of children who received routine vaccination (OR, 0.175; p=0.039) were willing to vaccinate their children when a COVID-19 vaccine became available. Mothers (OR, 3.294; p=0.002) and respondents whose family member or close relative suffered from COVID-19 (OR, 0.420; p=0.029) accepted the COVID-19 vaccine irrespective of the child's age. Study participants who had previously tested positive for COVID-19 (OR, 0.275; p=0.012) believed vaccines for children were necessary to halt the COVID-19 pandemic. Conclusion We sought to assess parents' acceptance and attitudes regarding the COVID-19 vaccine for children in India. According to our results, while parents have a high acceptance of a pediatric COVID-19 vaccine, they also have a few apprehensions. Therefore, for a successful mass vaccination drive among the pediatric age group, there should be rigorous communication regarding the vaccine and staunch health campaigns to create more awareness and acceptance toward the COVID-19 vaccine for children.

Effectiveness of Flippits and Virtual Reality Therapy on Pain and Anxiety Among Children Undergoing Painful Procedures.

Introduction Pain experienced by children during painful procedures may cause stress, fear, and anxiety. Currently, a number of interventions are used to reduce pain perception during medical procedures and distraction therapy is one of the most commonly used interventions. Method A randomized control trial was conducted among 105 children aged between three years and 12 years undergoing painful procedures such as intravenous cannulation, blood sampling, and injections to evaluate the effect of flippits and virtual reality therapy (VRT) on pain and anxiety. Through a computerized random approach, 35 samples were allotted to each group. Experimental group -1 received VRT, experimental group -2 received flippit (distraction card) therapy during painful procedures, and the control group received the conventional intervention. Standard tools were used to assess the pain and anxiety. Result Total 128 children were admitted to the ward and 23 were not included in the study for various reasons. Total 105 children undergone randomization to three groups, 35 in each group. All were analyzed for primary and secondary outcomes. After adjusting for confounding factors using multiple logistic regression, it was found that pain scores of VRT and flippit groups were less than the control group (aOR, 95% CI 0.635, 0.504-0.799, P = 0.000 and aOR, 95% CI 0.705, 0.572-0.868, P = 0.001, respectively) and no difference was observed between VRT and Flippit group (aOR, 95% CI; 0.901, 0.723 - 1.123, P 0.353). Flippit group perceived less intensity of pain compared to control group (aOR, 95% CI 0.542, 0.322-0.912, P = 0.021) and children received VRT perceived less intensity of pain than both control and flippit groups of children (aOR, 95% CI 0.258, 0.132-0.503, P = 0.000 and aOR, 95% CI 0.476, 0.252-0.900, respectively). Children received VRT and flippit therapy perceived less anxiety compared to control group (aOR, 95% CI 0.589, 0.348-0.999, P = 0.050 and aOR, 95% CI 0.385, 0.217-0.682, P = 0.001, respectively). But, there was no difference between VRT and flippit groups (aOR, 95% CI 1.532, 0.940-2.498, P = 0.087). Conclusion Flippit therapy and virtual reality therapy were better than conventional therapy in reducing the perception of anxiety and pain in children, aged three to 12 years, undergone painful procedures. Virtual reality therapy had an edge over flippit therapy in reducing the worst hurt.