Infant and baby feeding and the development of the maxillofacial complex based on own observations and the literature.

The method and technique of feeding a young child affect the shape of the maxillofacial complex. Breastfeeding is the recommended method of feeding in the first six months of life. It is encouraged to continue natural feeding in later months, simultaneously developing other food extraction techniques. The correct formation of the stomatognathic system is a result of the correct organization of the motor patterns during feeding.

[Lactation support and professional care in natural feeding for mothers of prenature infants and infants with anatomical disorders of facial skeleton - based on the literature and own experience].

According to the international and regional and european recommendations exclusive breast feeding for first 6 months of infant's life is the aim to achieve. Advantages of breast feeding and policy of breast feeding promotion were discussed in the article. Immaturity and/or functional disorders of sucking and anatomical disorders of oral cavity such as cleft lip, cleft palate, short frenulum of the tongue, were showed to be the most common causes of breast feeding problems. Proceedings promoting breast feeding in prenature infants according to lactation early stimulation programme for tertiary Neonatal and Obstetrical Units (2014) were also presented. Project of lactation support and help in feeding children with anatomical disorders of oral cavity with pumped mother's milk as well as scheme of introducing supplementary food were proposed.

Patient-Level Factors Influencing Palliative Care Consultation at a Safety-Net Urban Hospital.

The influence of patient-level factors on palliative and hospice care is unclear. We conducted a retrospective review of 2321 patients aged ≥18 that died within 6 months of admission to our institution between 2012 and 2017. Patients were included for analysis if their chart was complete, their length of stay was ≥48 hours, and if based on their diagnoses, they would have benefited from palliative care consultation (PCC). Bayesian regression with a weakly informative prior was used to find the odds ratio (OR) and 99% credible interval (CrI) of receiving PCC based on race/ethnicity, education, language, insurance status, and income. 730 patients fit our inclusion criteria and 30% (n = 211) received PCC. The OR of receiving PCC was 1.26 (99% CrI, 0.73-2.12) for Blacks, 0.81 (99% CrI, 0.31-1.86) for Hispanics, and 0.69 (99% CrI, 0.19-2.46) for other minorities. Less than high school education was associated with greater odds of PCC (OR 2.28, 99% CrI, 1.09-4.93) compared to no schooling. Compared to English speakers, non-English speakers had higher odds of receiving PCC when cared for by medical services (OR 3.01 [99% CrI, 1.44-5.32]) but lower odds of PCC when cared for by surgical services (0.22 [99% CrI, <0.01-3.42]). Insurance status and income were not associated with differences in PCC. At our institution, we found no evidence of racial/ethnic, insurance, or income status affecting PCC while primary language spoken and educational status did. Further investigation is warranted to examine the system and provider-level factors influencing PCC's low utilization by medical and surgical specialties.

Analysis of the Sound Environment and the Sound Level in the Delivery Room in the First Hour of a Newborn's Life.

OBJECTIVE: The aim of the study was to analyse the sound environment and the range of sound levels recorded in the delivery room immediately after the birth of a newborn. MATERIALS AND METHODS: The research method was open observation combined with recording measurements of the sound intensity levels. The material was collected by means of an observation questionnaire. The research was conducted in 11 maternity hospitals in Warsaw. A total of 304 vaginal labours were analysed. RESULTS: The average sound level in the delivery room after the birth of a newborn was 58.03 ± 7.66 dB, and the sound intensity ranged from 40.30 dB to 78.0 dB. Staff conversations were the most common sources of noise. A statistically significant relationship between the number of people in the delivery room and sound intensity was observed. The number of people positively correlated with the average sound level (R=0.520, p<0.001). CONCLUSIONS: Based on the tests, it was found that the average sound level in the delivery room exceeded the recommended standards. The noise was mainly caused by the activity of staff. The present study indicates the need for staff education and the use of noise reduction procedures.

Differential Utilization of Palliative Care Consultation Between Medical and Surgical Services.

There is a paucity of data regarding the utilization of palliative care consultation (PCC) in surgical specialties. We conducted a retrospective review of 2321 adult patients (age ≥18) who died within 6 months of admission to Boston Medical Center from 2012 to 2017. Patients were included for analysis if their length of stay was more than 48 hours and if, based on their diagnoses as determined by literature review and expert consensus, they would have benefited from PCC. Bayesian regression was used to estimate the odds ratio (OR) and 99% credible intervals (CrI) of receiving PCC adjusted for age, sex, race, insurance status, median income, and comorbidity status. Among the 739 patients who fit the inclusion criteria, only 30% (n = 222) received PCC even though 664 (90%) and 75 (10%) of these patients were identified as warranting PCC on medical and surgical services, respectively. Of the 222 patients who received PCC, 214 (96%) were cared for by medical services and 8 (4%) were cared for by surgical services. Patients cared for primarily by surgical were significantly less likely to receive PCC than primary patients of medical service providers (OR, 0.19, 99% CrI, 0.056-0.48). At our institution, many surgical patients appropriate for PCC are unable to benefit from this service due to low consultation numbers. Further investigation is warranted to examine if this phenomenon is observed at other institutions, elucidate the reasons for this disparity, and develop interventions to increase the appropriate use of PCC throughout all medical specialties.

The influence of structured prenatal education on the use of specialist lactation counseling in case of difficulties.

OBJECTIVE: Introduction: Breastfeeding is the optimal way to nourish newborns and infants. According to the PTGHiZDz, ESPGHAN and AAP, exclusive breastfeeding should be sought for the first 6 months of life. Aim: To analyse the relationship between participation in prenatal education and the frequency to intend and then continue breastfeeding in the first 6 months of a child's life. To assess the impact of participation in prenatal education on women's use of specialist lactation counselling. PATIENTS AND METHODS: Material and methods: The study was conducted in the period from May 2013 to June 2014 at the Specialist Hospital of St. Sophia in Warsaw. It included 333 women in the maternity ward. The study group consisted of 244 women who participated in structured prenatal education classes in group form. The control group numbered 89 women who did not participate in prenatal education either in one-to-one or group form. The first stage of the study was carried out among women 48 hours after childbirth. In the second stage of the study, a questionnaire was sent to women in electronic form, not earlier than one day after the child was 6 months old. RESULTS: Results: The variables that differentiated the groups studied were: education, place of residence, professional activity before pregnancy and professional activity during pregnancy longer than 27 weeks. The intention to take up exclusive breastfeeding expressed 48 hours after childbirth was declared by 94.7% of the women from the study group and 86.5% of the women from the control group (p=0.024). Breastfeeding was the most common difficulty reported by women during their stay in hospital (39.3% vs. 38.2% p=0.85) and during the first 6 months after childbirth (19.8% vs. 7.1% p=0.11). In case of difficulties in the course of childbirth, the women from the study group who used specialised lactation counselling accounted for 12.7%. No woman from the control group benefited from this type of care. CONCLUSION: Conclusions: Participation in structured prenatal education is a factor influencing the frequency of intending to breastfeed. Women after a cycle of structured prenatal education classes are more likely to take advantage of lactation counselling at a specialist level. Structured prenatal education has no influence on the subjective assessment of women concerning the practical application of the knowledge concerning breastfeeding.

Implementation of the first breastfeeding in Warsaw's maternity hospitals.

OBJECTIVE: Introduction: Birth is associated with the loss of the comfortable intrauterine environment and the beginning of life in the external environment. The newborn undertakes basic life functions in an environment of stimuli to which his nervous system is particularly sensitive. Some fundamental methods that facilitate adaptation to extrauterine life are skin-to-skin contact and the first breastfeeding. Aim: The aim of the study was to assess the provision of the first breastfeeding after natural delivery in Warsaw's medical facilities. PATIENTS AND METHODS: Material and method: The method of direct observation was used in the study. The research material was collected using the authored observation sheet designed for the purposes of the study. The tests were carried out in 11 Warsaw obstetric facilities with varying degrees of referentiality, in which the management agreed to conduct the study. It was ensured that the data collected would be presented anonymously. The research began in January 2016 and was completed in December 2017. RESULTS: Results: During the direct contact of the mother with the child, in 97.37% of the cases the newborn was attached to the mother's breast. In 25.01% of the cases, the duration of the first breastfeeding was over 30 minutes, and in the same number of feedings it ranged from 21-30 minutes. The shortest duration of feeding from 1-5 minutes was observed in 5.58% of the cases. CONCLUSION: Conclusions: In most cases, the first breastfeeding took place within 2 hours of birth. The initiation of breastfeeding after natural delivery took place during the mother's first contact with the child. In more than half of the cases, the first feeding lasted as long as the specialists recommend - over 20 minutes.

The effect of aging and muscle type on the quality characteristics and lipid oxidation of lamb meat.

The research carried out on meat from 45 ram lambs of the Polish merino breed allowed to determine the effect of meat aging and muscle type on physicochemical characteristics and oxidative stability of lipids. Analysis of physicochemical traits (pH, meat color, expressed juice, cooking loss, shear force, moisture, protein, fat and total collagen content) was performed on fresh and meat aged for 14 d in the longissimus lumborum (LL) and gluteus medius (GM) muscles. The meat aging determined all physicochemical characteristics except protein and fat content. More changes in pH and meat color parameters were defined in the GM muscle compared to the LL muscle. The increase in the tenderness of meat expressed as a reduction ( P < 0.05 ) of shear force values was observed in both muscles aged for 14 d. A lower value ( P < 0.05 ) of the shear force, despite the higher content of collagen, was determined in the GM muscle compared to LL. The investigated muscles differed in the degree of lipid peroxidation expressed as thiobarbituric acid-reactive substances (TBARS) in both fresh and aged meat. The TBARS value was lower ( P < 0.05 ) in the LL muscle than in GM. In the longissimus lumborum muscle, the significantly lower content of polyunsaturated fatty acids (PUFAs) and PUFA n-6 has been recorded. The oxidation stability was not influenced by the meat aging.