scholarly journals Effects of Perinatal Testosterone on Infant Health, Mother–Infant Interactions, and Infant Development

2013 ◽  
Vol 16 (2) ◽  
pp. 228-236 ◽  
Author(s):  
June Cho ◽  
Diane Holditch-Davis
Keyword(s):  
Gender Differences ◽  
Conceptual Framework ◽  
Preterm Infants ◽  
Health Care Providers ◽  
Infant Development ◽  
Infant Health ◽  
Very Low Birth Weight ◽  
Nursing Interventions ◽  
Care Providers ◽  
Health And Development

Objective: Many researchers and health care providers have noticed male vulnerability in infant health, mother–infant interactions, and some infant cognitive development, especially among very low birth weight (VLBW) preterm infants. However, factors beyond gender that could explain these observed differences have not been clear. The purpose of this article is to review the literature on the subject and to introduce a conceptual framework relating these factors. Discussion: According to gender-difference theories, prenatal exposure to high levels of testosterone may influence infant health and mother–infant interactions by negatively affecting infant cognitive/motor/language development. We constructed a conceptual framework based on the associations among biological (perinatal testosterone), stress-related (perinatal and maternal cortisol), and developmental (infant cognitive/motor/language skills) factors. If research establishes these biological, environmental, and developmental associations in mother–VLBW preterm pairs, the results will highlight the importance of addressing gender differences in nursing research and encourage the development of nursing interventions designed to reduce stress among mothers of VLBW preterm infants, particularly male infants. Conclusion: From a psychobiosocial perspective, combining biophysiological factors such as perinatal testosterone and cortisol with socioenvironmental factors such as the quality of mother–infant interactions and infant temperament may provide a broader view of gender differences in infant health and development.

Nursing Assessment of Guaiac-Positive and Occult Blood in Preterm Infant Stools

2014 ◽  
Vol 33 (2) ◽  
pp. 101-105 ◽  
Author(s):  
Brigit M. Carter ◽  
Robin B. Knobel
Keyword(s):  
Preterm Infants ◽  
Health Care Providers ◽  
Very Low Birth Weight ◽  
Occult Blood ◽  
Tube Placement ◽  
Diagnostic Tools ◽  
Feeding Intolerance ◽  
Care Providers ◽  
Contributing Factors ◽  
Nursing Assessment

Guaiac testing the stool of very low birth weight (VLBW; <1,500 g) preterm infants has been a standard of care for many neonatal intensive care units (NICUs) and considered a diagnostic tool that could potentially provide early warning of gastrointestinal disturbances, feeding intolerance (FI), or necrotizing enterocolitis (NEC). Evidence to either support or eliminate testing stool for occult blood from standard care practices is lacking. Support to eliminate testing is often based on the knowledge that neonatal treatment interventions—such as gastric tube placement, intubation, and/or suctioning—may often result in occult blood in stools. However, there is also reasonable concern that occult blood may indicate a cascade of pathophysiological events, which may lead to FI and NEC, is in progress.Feeding intolerance remains one of the most consistent reasons VLBW preterm infants experience poor weight gain and extended hospital stays. Every nursing assessment is strategic to the early identification of contributing factors to either the development of FI or NEC. Including low-cost, noninvasive diagnostic tools to augment the findings of the nursing assessment can only help guide health care providers in appropriate decision making related to the feeding plan.

Insulin Infusion for the Treatment of Hyperglycemia in Low Birth Weight Infants: Examining the Evidence

2008 ◽  
Vol 27 (2) ◽  
pp. 127-140 ◽  
Author(s):  
Mary Raney ◽  
Ann Donze ◽  
Joan Renaud Smith
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Health Care Providers ◽  
Insulin Infusion ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Care Providers ◽  
Low Birth Weight Infants ◽  
Continuous Insulin Infusion

FORTY TO 80 PERCENT OF VERY LOW birth weight (VLBW) (infants <1,500 g) and extremely low birth weight (ELBW) (infants <1,000 g) infants will develop hyperglycemia when provided with glucose infusions adequate to meet basal metabolic needs.1,2 Avoiding hyperglycemia while providing adequate nutrition to promote growth and development is a major challenge for health care providers in the NICU. Some health care providers suggest that the judious use of continuous insulin infusion (CII) may provide the opportunity for increasing nutritional support while maintaining euglycemia. A systematic review of the literature is presented to evaluate the evidence supporting this practice.

Effect of an Educational Presentation about Extremely Preterm Infants on Knowledge and Attitudes of Health Care Providers

2017 ◽  
Vol 34 (10) ◽  
pp. 0982-0989 ◽  
Author(s):  
Stefani Doucette ◽  
Brigitte Lemyre ◽  
Thierry Daboval ◽  
Sandra Dunn ◽  
Salwa Akiki ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Survival Rates ◽  
Care Providers ◽  
Perinatal Medicine ◽  
Knowledge And Attitudes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Before And After

Objective To determine healthcare providers' knowledge (HCP) about survival rates of extremely preterm infants (EPI) and attitudes toward resuscitation before and after an educational presentation and, to examine the relationship between knowledge and attitudes toward resuscitation. Study Design Participants completed a survey before and after attending a presentation detailing evidence-based estimates of survival rates and surrounding ethical issues. Respondents included neonatologists, obstetricians, pediatricians, maternal-fetal medicine specialists, trainees in pediatrics, obstetrics, neonatal-perinatal medicine and neonatal and obstetrical nurses. Results In total, 166 participants attended an educational presentation and 130 participants completed both pre- and postsurveys (response rate 78%). Prepresentation, for all gestations, ≤ 50% of respondents correctly identified survival/intact survival rates. Postpresentation, correct responses regarding survival/intact survival rates ranged from 49 to 86% (p < 0.001) and attitudes shifted toward being more likely to resuscitate at all gestations regardless of parental wishes. There was a weak-to-modest relationship (Spearman's coefficient 0.24–0.40, p < 0.001–0.004) between knowledge responses and attitudes. Conclusion Attendance at an educational presentation did improve HCP knowledge about survival and long term outcomes for EPI, but HCP still underestimated survival and were not always willing to resuscitate in accordance with parental wishes. These findings may represent barriers to some experts' recommendation to use shared decision-making with parents when considering the resuscitation options for their EPI.

Early Enteral Feeding for the Very Low Birth Weight Infant: The Development and Impact of a Research-Based Guideline

2005 ◽  
Vol 24 (4) ◽  
pp. 9-19 ◽  
Author(s):  
Joan Renaud Smith
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Period ◽  
Evidence Based ◽  
Care Providers ◽  
Vlbw Infant ◽  
The Impact

Providing optimal nutrition for the very low birth weight (VLBW) infant is critical during the neonatal period. Evidence-based practice guidelines are essential in managing these fragile infants. Putting scientific research into daily clinical practice may be arduous at times, however. A multidisciplinary team of health care providers successfully established a practical feeding guideline for a 52-bed, teaching-affiliated, Level III neonatal intensive care unit in St. Louis. This guideline identifies human milk as the recommended source of nutrition for the VLBW infant, a suggestion that has significantly affected lactation services in the unit. This article describes the process of developing, implementing, and evaluating a feeding guideline based on current research and describes the impact on lactation rates of having such a guideline in place within the unit.

Gender Differences in Health Literacy Among Korean Adults

2014 ◽  
Vol 9 (5) ◽  
pp. 370-379 ◽  
Author(s):  
Hee Yun Lee ◽  
Jiwoo Lee ◽  
Nam Keol Kim
Keyword(s):  
Gender Differences ◽  
Health Literacy ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Future Research ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Men And Women ◽  
Korean Adults

The role of gender in determining the level of health literacy in Korean adults is unclear. This study aimed to investigate the level of health literacy in Korean adults and identify factors associated with health literacy by gender. This study employed a cross-sectional survey design with a convenient sample of 585 community-dwelling Korean adults age19 years and older. Health literacy was measured by using eight items selected from Chew et al.’s 16-question self-reported health literacy measure. In accordance with Andersen’s health behavior model, predisposing, enabling, and need factors were included in the multiple regression model. Women indicated a higher level of health literacy than men in understanding medical forms, directions on medication bottles, and written information offered by health care providers. Additionally, for Korean women, a higher level of health literacy was associated with attaining a higher education level and having a consistent place to receive care. Unmarried men and men who had higher self-rated health reported a higher level of health literacy compared with their counterparts. Lower level of depression and higher monthly income were significantly linked to a higher level of health literacy in both men and women. This study has established the importance of gender differences in health literacy and suggests gender-specific intervention may be warranted to reduce the existing gap in health literacy in both Korean men and women. Future research should replicate this study to confirm whether or not our finding is an international phenomenon.

scholarly journals Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Sarah Fredsted Villadsen ◽  
Britt Pinkowski Tersbøl ◽  
Dereje Negussie ◽  
Abebe GebreMariam ◽  
Abebech Tilahun ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health System ◽  
Health Care Providers ◽  
Infant Health ◽  
Care Providers ◽  
National Guidelines ◽  
Professional Students ◽  
Laboratory Facilities ◽  
Maternal And Infant Health ◽  
User Expectations

Objective.We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia.Methods.A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC.Results.There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals.Conclusions.Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.

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