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1.
Matern Child Health J ; 23(12): 1658-1669, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31584144

RESUMO

Objectives mHealth interventions for MNCH have been shown to improve uptake of antenatal and neonatal services in low- and middle-income countries (LMICs). However, little systematic analysis is available about their impact on infant health outcomes, such as reducing low birth weight or malnutrition among children under the age of five. The objective of this study is to determine if an age- and stage-based mobile phone voice messaging initiative for women, during pregnancy and up to 1 year after delivery, can reduce low birth weight and child malnutrition and improve women's infant care knowledge and practices. Methods We conducted a pseudo-randomized controlled trial among pregnant women from urban slums and low-income areas in Mumbai, India. Pregnant women, 18 years and older, speaking Hindi or Marathi were enrolled and assigned to receive mMitra messages (intervention group N = 1516) or not (Control group N = 500). Women in the intervention group received mMitra voice messages two times per week throughout their pregnancy and until their infant turned 1 year of age. Infant's birth weight, anthropometric data at 1 year of age, and status of immunization were obtained from Maternal Child Health (MCH) cards to assess impact on primary infant health outcomes. Women's infant health care practices and knowledge were assessed through interviews administered immediately after women enrolled in the study (Time 1), after they delivered their babies (Time 2), and after their babies turned 1 year old (Time 3). 15 infant care practices self-reported by women (Time 3) and knowledge on ten infant care topics (Time 2) were also compared between intervention and control arms. Results We observed a trend for increased odds of a baby being born at or above the ideal birth weight of 2.5 kg in the intervention group compared to controls (odds ratio (OR) 1.334, 95% confidence interval (CI) 0.983-1.839, p = 0.064). The intervention group performed significantly better on two infant care practice indicators: giving the infant supplementary feeding at 6 months of age (OR 1.4, 95% CI 1.08-1.82, p = 0.009) and fully immunizing the infant as prescribed under the Government of India's child immunization program (OR 1.531, 95% CI 1.141-2.055, p = 0.005). Women in the intervention group had increased odds of knowing that the baby should be given solid food by 6 months (OR 1.89, 95% CI 1.371-2.605, p < 0.01), that the baby needs to be given vaccines (OR 1.567, 95% CI 1.047-2.345, p = 0.028), and that the ideal birth weight is > 2.5 kg (OR 2.279, 95% CI 1.617-3.213, p < 0.01). Conclusions for Practice This study provides robust evidence that tailored mobile voice messages can significantly improve infant care practices and maternal knowledge that can positively impact infant child health. Furthermore, this is the first prospective study of a voice-based mHealth intervention to demonstrate a positive impact on infant birth weight, a health outcome of public health importance in many LMICs.


Assuntos
Telefone Celular , Transtornos da Nutrição Infantil/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/métodos , Desnutrição/prevenção & controle , Mães/psicologia , Voz , Adulto , Criança , Feminino , Humanos , Índia , Lactente , Saúde do Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Áreas de Pobreza , Gravidez , Estudos Prospectivos , Telemedicina , Adulto Jovem
2.
Neonatal Netw ; 38(2): 107-108, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470374

RESUMO

Babies in the NICU should be managed in a neurodevelopment-friendly environment. Frequent handling by multiple examiners potentially increases the risk of cross infection. Interruption in kangaroo care is not advisable unless urgent. A minimum of three-point exam should be done (chest, heart, and abdomen) using a stethoscope and gentle palpation. However, the infant should not be wakened from sleep and all handling should be synchronized with the touch time.


Assuntos
Cuidado do Lactente , Doenças do Recém-Nascido , Terapia Intensiva Neonatal , Administração dos Cuidados ao Paciente , Humanos , Cuidado do Lactente/ética , Cuidado do Lactente/métodos , Cuidado do Lactente/psicologia , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/terapia , Unidades de Terapia Intensiva Neonatal/organização & administração , Terapia Intensiva Neonatal/ética , Terapia Intensiva Neonatal/métodos , Terapia Intensiva Neonatal/psicologia , Administração dos Cuidados ao Paciente/ética , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/organização & administração , Conforto do Paciente , Exame Físico/métodos , Exame Físico/psicologia , Relações Profissional-Família , Fatores de Tempo
3.
Phys Ther ; 99(6): 771-785, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31155664

RESUMO

In response to the opioid crisis, the American Physical Therapy Association has strongly advocated for physical therapy as a safe alternative to pharmacological pain management through the "#ChoosePT" campaign and the dedication of a PTJ special issue to the nonpharmacological management of pain. Physical therapists not only play an important role in the rehabilitation of the nearly 2 million adolescents and adults addicted to prescription opioids but also provide care to infants born to mothers with various drug addictions. This Perspective article explores the incidence, pathophysiology, and risk factors for neonatal abstinence syndrome and describes the clinical presentations of withdrawal and neurotoxicity in infants. Discipline-specific recommendations for the physical therapist examination and plan of care, including pharmacological management considerations, are outlined. Nonpharmacological management, including supportive care, feeding, parent education, social aspects of care, and follow-up services, are discussed from a physical therapy perspective. Finally, this article reviews developmental outcomes in infants with neonatal abstinence syndrome and reflects on challenges and future directions of research in this area.


Assuntos
Analgésicos Opioides/efeitos adversos , Tratamento Conservador/métodos , Síndrome de Abstinência Neonatal/terapia , Tratamento de Substituição de Opiáceos/métodos , Modalidades de Fisioterapia/organização & administração , Feminino , Humanos , Lactente , Cuidado do Lactente/métodos , Recém-Nascido
4.
Compr Child Adolesc Nurs ; 42(sup1): 65-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192725

RESUMO

The aim of the paper is to examine the relationship between infant and young child feeding practices (aged 6-23 months) and stunting in East Jakarta. A cross-sectional study design is conducted with three main instruments: maternal and child characteristics, feeding practices, and health behaviors. Sampling is done by simple random sampling technique with a total of 143 respondent mothers in East Jakarta. The results of the analysis show no significant relation between infant and young child feeding practices and stunting (p = 0.147), and its relation with maternal and child characteristics, such as maternal age, maternal employment status, maternal educational level, low birthweight less than 2,500 g, sanitation and health behaviors, and household income (p > 0.05). Further longitudinal studies are required to identify risk factors associated with stunting among children.


Assuntos
Comportamento Alimentar , Transtornos do Crescimento/etiologia , Crescimento e Desenvolvimento/fisiologia , Cuidado do Lactente/normas , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Indonésia/epidemiologia , Lactente , Cuidado do Lactente/métodos , Recém-Nascido , Masculino
5.
Matern Child Health J ; 23(12): 1613-1620, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31250240

RESUMO

OBJECTIVE: Compare mothers' reports of injuries for infants and toddlers sleeping with crib-bumpers/mesh-liners/no-barriers and reasons for these sleep environment choices. METHODS: A cross-sectional survey of mothers subscribing to a parenting magazine and using crib bumpers (n = 224), mesh liners (n = 262), and no barriers (n = 842). Analyses of four possible injuries (face-covered, climb-out/fall, slat-entrapment, hit-head) including multivariate logistic regression adjusted for missing data/demographics and Chi squared analyses of reasons for mothers' choices. RESULTS: Maternal reports of finding infants/toddlers with face covered had 3.5 times higher adjusted odds (aOR) for crib bumper versus mesh liner use. Breathing difficulties and wedgings were reported for infants/toddlers using crib bumpers but not mesh liners. Climb-outs/falls showed no significant difference in aORs for crib bumpers versus no-barriers and mesh liners versus no barriers. Reports of slat-entrapment were less likely for mothers using crib bumpers and mesh liners than using no barrier (aOR = .28 and .32). Reports of hit-heads were less likely for crib bumpers vs no barrier (aOR = .38) with no significant difference between mesh liners versus no barrier use. Mothers using crib bumpers and mesh liners felt their choice prevented slat-entrapment (89%, 91%); 93.5% of crib bumper users felt their choice prevented hit-heads. Significantly more mesh liner than crib bumper users chose them because "There is no suffocation risk" (64.1% vs. 40.6%), while 83.6% of no-barrier users chose them because "I was concerned about suffocation risk." CONCLUSIONS FOR PRACTICE: Mothers appeared to be more concerned about preventing minor risks than suffocation. Understanding reasons for mothers' use of barriers/no-barriers is important in tailoring counseling for mothers with infants/toddlers.


Assuntos
Asfixia/prevenção & controle , Leitos , Comportamento de Escolha , Cuidado do Lactente/métodos , Equipamentos para Lactente , Mães/psicologia , Sono , Ferimentos e Lesões/prevenção & controle , Asfixia/epidemiologia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Inquéritos e Questionários , Ferimentos e Lesões/epidemiologia
6.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31213519

RESUMO

OBJECTIVES: Among very low birth weight infants born from January 2015 to December 2017, the Massachusetts statewide quality improvement collaborative aimed to increase provision of (1) any mother's milk at discharge or transfer from a baseline of 63% to ≥75%, (2) exclusive mother's milk at discharge or transfer from a baseline of 45% to ≥55%, and (3) to reduce racial and ethnic disparities in provision of mother's milk. METHODS: We used the Institute for Healthcare Improvement Breakthrough Series framework in which our main process measures were receipt of prenatal education regarding human milk education, first milk expression within 6 hours after birth, and any skin-to-skin care on 4 weekly audit days in the first month. We examined changes over time among all very low birth weight infants and for 3 racial and ethnic subgroups (non-Hispanic white, non-Hispanic black, and Hispanic) using control and run charts, respectively. RESULTS: Of 1670 infants eligible to receive mother's milk at 9 hospitals, 43% of their mothers were non-Hispanic white, 19% were non-Hispanic black, 19% were Hispanic, 11% were of other races or ethnicities, and 7% were unknown. Hospital teams conducted 69 interventions. We found improvement in all 3 process measures but not for our main outcomes. Improvements in process measures were similar among racial and ethnic subgroups. Hospitals varied substantially in the rate of any mother's milk at discharge or transfer according to race and ethnicity. CONCLUSIONS: Our collaborative achieved similar improvements in process measures focused within the first month of hospitalization among all racial and ethnic subgroups. Reduction in racial and ethnic disparities in mother's milk at discharge was not reached. Future efforts will focus on factors that occur later in the hospitalization.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Cuidado do Lactente/normas , Recém-Nascido de muito Baixo Peso , Terapia Intensiva Neonatal/normas , Melhoria de Qualidade , Aleitamento Materno/etnologia , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Grupos Étnicos , Feminino , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Humanos , Cuidado do Lactente/métodos , Cuidado do Lactente/estatística & dados numéricos , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Massachusetts
7.
Pediatrics ; 143(6)2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31053622

RESUMO

BACKGROUND: Discharge readiness is a key determinant of outcomes for families in the NICU. Since 2003, using a broad set of outcome and process measures, we have conducted an ongoing quality improvement initiative to improve the discharge preparation process in our NICU and readiness of families being discharged from the NICU. METHODS: Iterative improvements to the discharge preparation process were made by a multidisciplinary committee. Discharge readiness was measured by using a parental and nurse survey for all families discharged from our NICU. Primary outcome measures included parental self-assessment of discharge readiness and nurse assessment of the family's emotional and technical discharge readiness. Secondary outcome measures included assessment of specific technical skills and emotional factors. Process measures included nursing familiarity with family at discharge. Improvement over time was analyzed by using statistical process control charts. RESULTS: Significant improvement was seen in all primary outcome measures. Family self-assessment of discharge readiness increased from 85.1% to 89.1%; nurse assessment of the family's emotional discharge readiness increased from 81.2% to 90.5%, and technical discharge readiness increased from 81.4% to 87.7%. Several secondary outcome measures revealed significant improvement, whereas most remained stable. Nurse familiarity with the family at discharge increased over time. CONCLUSIONS: Quality improvement methodology can be used to measure and improve discharge readiness of families with an infant in the NICU. This model can provide the necessary framework for a structured approach to systematically evaluating and improving the discharge preparation process in a NICU.


Assuntos
Cuidado do Lactente/métodos , Cuidado do Lactente/normas , Unidades de Terapia Intensiva Neonatal/normas , Pais , Alta do Paciente/normas , Adulto , Feminino , Humanos , Cuidado do Lactente/psicologia , Recém-Nascido , Masculino , Pais/psicologia
8.
Dermatitis ; 30(3): 207-212, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31045936

RESUMO

BACKGROUND: Formaldehyde is a common preservative and strong sensitizer. OBJECTIVE: The aim of the study was to evaluate the release of formaldehyde from baby/toddler wet wipes using the chromotropic acid method (CAM). METHODS: An online search of best-selling baby wipes was conducted. None declared formaldehyde or formaldehyde-releasing preservatives. Standard CAM procedures were used: a 1 × 1-in square of fresh wipe was placed in a bottle with an open vial of 4 mg/1 mL of chromotropic acid and sulfuric acid solution, sealed, and stored for 48 hours. Formalin and water served as controls. A blinded investigator graded color change (negative, indeterminate, mild, moderate, or strong). For quality control, 20% of all samples as well as all positives were retested. RESULTS: Fifty-one popular and highly reviewed baby and toddler wet wipe products were tested using CAM. Twelve wipes (24%) released formaldehyde (8 mild, 4 moderate/strong). Chromotropic acid method testing of 9 wipes (18%) was indeterminate and 30 (59%) were negative. CONCLUSIONS: Almost one quarter of baby/toddler wet wipes released formaldehyde when evaluated with CAM. Patients and clinicians should be aware of this potentially undeclared source of this common allergen.


Assuntos
Formaldeído/análise , Produtos Domésticos/análise , Naftalenossulfonatos/análise , Conservantes Farmacêuticos/análise , Alérgenos/análise , Pré-Escolar , Cosméticos/análise , Formaldeído/efeitos adversos , Produtos Domésticos/efeitos adversos , Humanos , Lactente , Cuidado do Lactente/métodos , Recém-Nascido , Conservantes Farmacêuticos/efeitos adversos , Rotulagem de Produtos
9.
Glob Health Action ; 12(1): 1603491, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31062667

RESUMO

During the past decades innovative research has shown that exposure to harmful events during pregnancy and early infancy ('the first 1000 days') has an impact on health at subsequent stages of the life course and even across generations. Recently it has been shown that even the pre-conception period is of outmost importance, and other scholars have made the case that the 1000 days should be extended to a period of 8000 days post-conception. The present contribution aims to bridge further the gap between research evidence and public health policy by applying a holistic 'full-cycle' perspective. Thus, a conceptual framework is suggested for guiding public health prioritization, including the variables of 'impact on the next generation', 'plasticity' and 'available interventions with documented impact'. This framework could guide decision makers in selecting at which stages of the life course to invest (and not), and furthermore it points to some pertinent research priorities.


Assuntos
Promoção da Saúde/métodos , Estilo de Vida Saudável , Cuidado do Lactente/métodos , Pais/educação , Cuidado Pré-Natal/métodos , Saúde Pública/métodos , Política Pública , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
10.
Bull World Health Organ ; 97(3): 200-212, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30992633

RESUMO

Objective: To assess adoption of World Health Organization (WHO) guidance into national policies for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) and to monitor implementation of guidelines at facility level in rural Malawi, South Africa and the United Republic of Tanzania. Methods: We summarized national PMTCT policies and WHO guidance for 15 indicators across the cascades of maternal and infant care over 2013-2016. Two survey rounds were conducted (2013-2015 and 2015-2016) in 46 health facilities serving five health and demographic surveillance system populations. We administered structured questionnaires to facility managers to describe service delivery. We report the proportions of facilities implementing each indicator and the frequency and durations of stock-outs of supplies, by site and survey round. Findings: In all countries, national policies influencing the maternal and infant PMTCT cascade of care aligned with WHO guidelines by 2016; most inter-country policy variations concerned linkage to routine HIV care. The proportion of facilities delivering post-test counselling, same-day antiretroviral therapy (ART) initiation, antenatal care and ART provision in the same building, and Option B+ increased or remained at 100% in all sites. Progress in implementing policies on infant diagnosis and treatment varied across sites. Stock-outs of HIV test kits or antiretroviral drugs in the past year declined overall, but were reported by at least one facility per site in both rounds. Conclusion: Progress has been made in implementing PMTCT policy in these settings. However, persistent gaps across the infant cascade of care and supply-chain challenges, risk undermining infant HIV elimination goals.


Assuntos
Antirretrovirais/administração & dosagem , Aconselhamento/organização & administração , Infecções por HIV/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Organização Mundial da Saúde , África ao Sul do Saara/epidemiologia , Feminino , Saúde Global , Guias como Assunto , Humanos , Lactente , Cuidado do Lactente/métodos , Recém-Nascido , Cuidado Pré-Natal/organização & administração , Vigilância em Saúde Pública , Fatores Socioeconômicos
11.
J Clin Nurs ; 28(15-16): 2979-2989, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31013376

RESUMO

AIMS AND OBJECTIVES: This qualitative study explored the experiences of neonatal nurses with facilitating closeness between parents and babies with congenital abnormalities in the neonatal intensive care unit (NICU). BACKGROUND: Babies with congenital abnormalities often require admission to the neonatal intensive care unit. Parents may experience emotional distancing from their baby, due to their response to their baby's congenital abnormality, as well as physical separation due to their baby's hospitalisation in the NICU. NICU nurses can help facilitate the development of closeness between babies and parents in the NICU. METHOD: This qualitative interpretive description study involved face-to-face, semi-structured interviews with twelve neonatal nurses following which the data collected were thematically analysed. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in preparing this paper. RESULTS: Three major themes emerged from the analysis-"Everyone copes differently," "You have to focus on what is the normal thing" and "It's very much an individualised approach." Participants often felt unprepared to care for babies with congenital abnormalities and implemented coping mechanisms to overcome the emotional labour they experienced. Skin-to-skin cuddles were considered the most beneficial strategy for parents to develop closeness with their baby. Participants recognised that they sometimes "pushed" parents into engaging with their baby. Participants highlighted the importance of individualised, supportive care for these parents. CONCLUSIONS: Neonatal nurses require increased education about congenital abnormalities and individualised care to support them in caring for babies with congenital abnormalities. RELEVANCE TO CLINICAL PRACTICE: Further research is needed on parental experience of developing closeness with a baby with a congenital abnormality in the NICU.


Assuntos
Adaptação Psicológica , Cuidado do Lactente/métodos , Enfermeiras Neonatologistas , Apego ao Objeto , Pais/psicologia , Adulto , Anormalidades Congênitas/enfermagem , Feminino , Humanos , Lactente , Cuidado do Lactente/psicologia , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
12.
PLoS One ; 14(4): e0214548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31017930

RESUMO

BACKGROUND: Frequent infant crying is associated with parental exhaustion, depression, or even infant hospitalization and shaken baby syndrome. Effective prompt soothing methods are lacking for infants under 6 months. We examined whether swaddling, sound, and movement evoked an immediate calming response (CR) when parents soothed their infants and using a smart crib, and whether infant age affected the CR. METHODS: Infants' CR was assessed in a community sample of 69 infants (0-6 months) in a counterbalanced experiment with two conditions (parent, smart crib) each composed of three two-minute phases (baseline, supine, soothing). During baseline 1, parent and infant were sitting together; in supine 1, fussiness was elicited by putting the infant suddenly supine, followed by parental soothing (shushing and jiggling of the swaddled infant). Baseline 2, supine 2, and soothing by the crib followed. Fussiness was observed and infant heart rate (HR) and heart rate variability (HRV) were recorded. The CR was operationalized as decreased fussiness and HR, and increased HRV during soothing compared to lying supine. RESULTS: Infant fussiness and HR were lower in both soothing phases compared to the supine phases. Infant HRV tended to be higher during parental soothing than during supine, but did not significantly differ between mechanical soothing and supine. Younger infants responded with a stronger CR (decreased fussiness and increased HRV) to parental soothing, but not to mechanical soothing. For HR, infants' CR was stronger in the crib than in the parent condition, whereas for HRV, infants' CR was stronger in the parent condition. For fussiness, infants' CR tended to be stronger in the parent condition. CONCLUSION: Parental and mechanical soothing using swaddling, sound, and movement promptly induced a CR in infants. This has important clinical implications for soothing fussy and crying infants. Future studies should investigate the effects of parental versus mechanical soothing in the home setting.


Assuntos
Choro , Comportamento do Lactente , Cuidado do Lactente/métodos , Movimento , Pais , Adulto , Ansiedade , Eletrocardiografia , Emoções , Feminino , Idade Gestacional , Frequência Cardíaca , Humanos , Lactente , Recém-Nascido , Masculino , Países Baixos , Som
13.
Pediatrics ; 143(5)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31015374

RESUMO

OBJECTIVES: To determine mediators of improvements in infant safe-sleep (SS) practices in a mobile health intervention. METHODS: In a cluster-randomized controlled trial, mothers received SS intervention or breastfeeding control videos for 60 days. Maternal responses about infant sleep position and location (outcomes) and mediators (attitudes, perceived social norms, and perceived control) from the theory of planned behavior were assessed. Intervention effects on mediators and association between mediators and outcomes were examined. RESULTS: Of 1600 recruited, 1263 mothers participated. Mothers receiving SS videos were more likely to have positive attitudes and norms for supine sleep (attitudes: adjusted odds ratio [aOR] = 2.35 [95% confidence interval (CI) 1.72 to 3.20]; norms: aOR = 1.75 [95% CI 1.27 to 2.42]) and recommended sleep location (attitudes: aOR = 1.91 [95% CI 1.54 to 2.36]; norms: aOR = 1.37 [95% CI 1.13 to 1.66]). Positive attitudes and norms toward supine sleep and room-sharing without bed-sharing were associated with higher odds of both practices (supine: aOR = 8.25 [95% CI 4.72 to 14.43] for positive attitudes and aOR = 6.67 [95% CI 4.25 to 10.46] for norms; room-sharing: aOR = 7.14 [95% CI 5.35 to 9.53] for positive attitudes and aOR = 4.44 [95% CI 3.03 to 6.51] for norms). Both positive attitudes and positive norms mediated the effect of the intervention. CONCLUSIONS: The intervention achieved success in improving adherence to SS recommendations by changing maternal attitudes and norms about supine sleeping and room-sharing without bed-sharing. Recognition that these attitudes and norms appear to be the main drivers of mothers' choices regarding infant-sleep practices should inform health messaging strategies to promote SS.


Assuntos
Aleitamento Materno/psicologia , Fidelidade a Diretrizes/normas , Cuidado do Lactente/normas , Mães/psicologia , Morte Súbita do Lactente/prevenção & controle , Telemedicina/normas , Adulto , Análise por Conglomerados , Feminino , Humanos , Lactente , Cuidado do Lactente/métodos , Masculino , Mães/educação , Mídias Sociais , Decúbito Dorsal/fisiologia , Telemedicina/métodos
14.
Rev Esp Cir Ortop Traumatol ; 63(4): 289-294, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30928246

RESUMO

BACKGROUND AND OBJECTIVE: Hip dysplasia has been associated with risk factors such as breech presentation, female gender or family history. However, external factors, such as the use of baby carriers, seem to influence the development of the hip in the first months of life. The aim of this study is to evaluate the position of the hips of babies placed in different types of baby carriers by ultrasound image. METHOD: An ultrasound study of the hips of healthy babies between 1.5 and 3.5 months of age was carried out, when the children were carried in three different baby backpacks, which provide different degrees of support for the babies' thighs. All hips were typeI according to the Graf classification. Graf's alpha angle, acetabular coverage and distance to the pubis were assessed at baseline (examination table) and when the children were carried in the three different backpacks. RESULTS: In all cases, the babies showed normal values in the three studied parameters, without statistically significant differences between any of the situations. There were also no differences in the ultrasound parameters related to the sex, age or weight of the baby. CONCLUSIONS: The right hip of the babies shows normal ultrasound parameters when placed in any of the baby carriers studied.


Assuntos
Articulação do Quadril/diagnóstico por imagem , Equipamentos para Lactente , Acetábulo/diagnóstico por imagem , Fatores Etários , Feminino , Luxação Congênita de Quadril/etiologia , Articulação do Quadril/crescimento & desenvolvimento , Humanos , Lactente , Cuidado do Lactente/instrumentação , Cuidado do Lactente/métodos , Masculino , Estudos Prospectivos , Osso Púbico/diagnóstico por imagem , Fatores Sexuais , Ultrassonografia
15.
Health Care Women Int ; 40(5): 495-514, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30951439

RESUMO

There is little research on beliefs and practices regarding unsettled infant behavior and infant sleep in low and lower-middle income countries such as Vietnam. Here, researchers used a participatory qualitative visual method (photo-elicitation) to investigate how infant settling was perceived "through the eyes" of new mothers in Central Vietnam. Four qualitative themes emerged from the data: "loneliness in the midst of the crowd", "finding the right position", "protecting from cold", and "affection and exhaustion". Further research into how parenting programs and evidence based infant sleep guidelines can be modified to be socially acceptable in Vietnam is recommended.


Assuntos
Choro , Cuidado do Lactente/métodos , Mães/psicologia , Poder Familiar/psicologia , Fotografação , Sono , Adulto , Feminino , Humanos , Lactente , Comportamento do Lactente , Masculino , Poder Familiar/etnologia , Áreas de Pobreza , Pesquisa Qualitativa , Vietnã
16.
Gait Posture ; 70: 168-174, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30877855

RESUMO

BACKGROUND: The act of babywearing is recognizably a task of load carriage and has gained popularity among millennial caregivers. RESEARCH QUESTION: The implications of babywearing on lower extremity joint moments of the caregiver are still unknown during prolonged transport and a direct comparison of babywearing to carrying an infant in-arms has not been previously conducted. METHODS: Eighteen females participated in this study by performing 3 conditions: a) 3 min walking unloaded (UL), b) 15 min walking while carrying a mannequin infant in-arms (IA), and c) 15 min walking while wearing a mannequin infant in an anteriorly positioned baby carrier (BC). Two separate data analyses were conducted using a repeated measures ANOVA. First, UL compared to the initial minute of walking for IA and BC. Second, UL compared to the final minute of walking for IA and BC. RESULTS: During initial minute comparisons, both IA and BC conditions increased joint moments in the frontal and sagittal plane at the knee with no change at the ankle and hip. During final minute comparisons, IA maintained the increases in the knee frontal plane joint moments observed during initial minute comparisons but also increased at the hip; however, BC generally showed no statistical difference from UL. Carrying an infant in a baby carrier more closely resembles unloaded walking, while carrying an infant in-arms appears to increase the mechanical load placed on the knee and hip joints in the frontal plane through an increase in joint moments. SIGNIFICANCE: During prolonged transportation, caregivers might choose to employ a baby carrier as opposed to carrying an infant in-arms, as in-arm carriage increases the loading knee abduction moment by 8.7% and the loading knee extension moment by 16.7%.


Assuntos
Articulação do Tornozelo/fisiologia , Articulação do Quadril/fisiologia , Cuidado do Lactente/métodos , Articulação do Joelho/fisiologia , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Lactente , Suporte de Carga/fisiologia
17.
Midwifery ; 74: 57-67, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30927633

RESUMO

Postnatal depression (PND) has been a common depressive mental disorder among the mothers in a low-income country like Bangladesh where stunting, underweight and wasting are prevalent among infants. The present prospective cohort study was carried out among 297 non-depressed and 103 depressed mothers (ages 18-36 years) to find the association between post natal depression and growth of infants. Data were collected by face to face interview through semi-structured questionnaires and anthropometric measurements were taken with proper anthropometric techniques and calibrated instruments. Postnatal depression was assessed by the Edinburgh Postnatal Depression Scale and infants' physical growth was assessed by Z score of weight, length and Mid-Upper Arm Circumference (MUAC). The overall prevalence of post natal depression was found 22% [95% CI, 21.71-30.29]. Infants of depressed mothers were found iller in comparison with the infants of non-depressed mothers (p < 0.001) which could result in growth retardation of infants. According to the MUAC level, infants of depressed mothers were more at risk of malnutrition (p < 0.001). Early detection of postpartum depression, implementation of interventions, prevention or treatment of maternal depressive disorders and effective strategies will not only ameliorate the impact of PND among mothers but also facilitates infant growth.


Assuntos
Desenvolvimento Infantil/fisiologia , Depressão Pós-Parto/complicações , Mães/psicologia , Adolescente , Adulto , Bangladesh/epidemiologia , Peso Corporal , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Lactente , Cuidado do Lactente/métodos , Cuidado do Lactente/normas , Entrevistas como Assunto/métodos , Mães/estatística & dados numéricos , Prevalência , Psicometria/instrumentação , Psicometria/métodos , Psicometria/estatística & dados numéricos , Pesquisa Qualitativa , População Urbana/tendências
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