scholarly journals A Multifaceted Approach to Supporting Mothers of Premature Infants

2021 ◽  
Author(s):  
Parisa Mohagheghi ◽  
Afsaneh Keramat ◽  
Reza Chaman ◽  
Ahmad Khosravi ◽  
Seyed Abbas Mousavi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Premature Birth ◽  
Intervention Group ◽  
Information Support ◽  
Perceived Support ◽  
Control Group ◽  
Informational Support ◽  
Support Tool ◽  
Supportive Program

Abstract Background Premature birth exposes mothers to a strange experience for which they are not mentally ready. Premature birth exposes mothers to a strange experience for which they are not mentally ready. This study aimed to examine the effect of a multi-faceted supportive approach on the levels of perceived support in mothers. Methods The present experimental study was conducted on 143 mothers with preterm infants, (In the intervention group, 75 infants and mothers and 68 infants and mothers in the control group), in the NICUs of two educational and referral hospitals of Tehran, Iran; from Feb 14, 2016 to May 14, 2016. The inclusion criteria were: having a preterm infant with gestational age < 37 weeks, birth weight < 2500 gr, high probability of survival, Iranian nationality and ability to communicate verbally. Exclusion criteria were: preterm infants without abnormality or disabling conditions such as intra ventricular hemorrhage (IVH) grade 3 or 4. The designed intervention was conducted based on the support system pattern of mothers with premature infants. Different interventions in support (appraisal, instrumental, emotional, and informational support) of mothers in NICU were planned for the supportive program, which was gradually implemented within 3 months of the intervention. The Nurse Parent Support Tool (NPST) was used to assess the mothers' perceptions of the perceived support. The control group received routine care. The obtained data were analyzed by STATA software 13. Classified variables were analyzed using t-test, chi-square and Inverse Probability Treatment Weights (IPTW). Results After adjusted mean differences (95% confidence interval) of outcomes between two groups, results showed that the all support scores including total support, -1.83 (95% CI -1.6 to -2.06), Instrumental support, -1.23 (95% CI -1.04 to -1.43), Emotional support, -1.87 (95% CI -2.15 to 1.6) and Appraisal support, -2.01 (95% CI -1.73 to -2.29), and Informational support, -2.12 (95% CI -1.82 to -2.43), in the experimental group were significantly higher than in the control group (P<0.001). Conclusions The information, support and early intervention play important roles in the maternal empowerment to cope with her situation.

scholarly journals Effect of early versus standard central line removal on growth of very low birthweight premature infants: a protocol for a non-inferiority randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030167
Author(s):  
Justyna Romańska ◽  
Wojciech Margas ◽  
Renata Bokiniec ◽  
Paweł Krajewski ◽  
Joanna Seliga-Siwecka
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Low Birthweight ◽  
Intervention Group ◽  
Central Line ◽  
Optimal Time ◽  
Control Group ◽  
Very Low Birthweight ◽  
Central Lines ◽  
The Mean

IntroductionUncertainty exists regarding the optimal time for removal of central lines used to provide parenteral nutrition in preterm infants. The aim of this study is to determine whether earlier central line removal is non-inferior to its removal after reaching full enteral intake, in respect to growth outcome of preterm infants.Methods and analysisVery low birthweight premature infants will be recruited. Eligible infants will be randomised in equal proportions between two groups. In the intervention group central lines will be removed when infants reach 100 mL/kg/day of enteral intake. In the control group central lines will be removed when infants reach 140 mL/kg/day of enteral intake (full enteral intake). The primary outcome measure will be the difference between the two groups in weight at 36 weeks’ postmenstrual age. Non-inferiority will be declared if the mean weight of children in the intervention group will be no worse than the mean weight of children from the control group, by a margin of −210 g.Ethics and disseminationThe Bioethics Committee of the Medical University of Warsaw approved the study protocol prior to recruitment. The findings of this trial will be submitted to a peer-reviewed journal (neonatology, paediatrics or nutrition). Abstracts will be submitted to relevant national and international conferences.Trial registration numberNCT03730883.Protocol versionVersion 3. 14.08.2019.

scholarly journals Effect of Probiotics on Full Intestinal Feeding in Premature Infants: A Double Blind, Clinical Trial

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Seyedeh Zohreh Jalali ◽  
Mohammad Reza shiri ◽  
Morvarid Ghassab Shirazi
Keyword(s):  
Clinical Trial ◽  
Preterm Infants ◽  
Premature Infants ◽  
Statistical Tests ◽  
Mode Of Delivery ◽  
Intervention Group ◽  
Control Group ◽  
Double Blind ◽  
Adverse Health Outcomes ◽  
Saline Administration

Background: Premature infants suffer from many problems due to the lack of evolution of the digestive system, and early onset of intestinal feeding prevents these complications. Probiotics have been used to prevent intestinal disorders in preterm infants due to their many benefits. Objectives: This study was conducted to measure the efficacy of probiotics on time to reach full intestinal feeds (120 cc/kg/day) in premature newborns. Methods: This study was double-blind randomized clinical trial. Preterm infants born at < 36 weeks and birth weight of 1000 – 2500 gr (n = 58) in 17th Shahrivar Hospital, Rasht, Iran, were randomly assigned into intervention group (oral administration of probiotics) and control group (with normal saline administration). Data were collected using a data form that includes demographic characteristics, time to full intestinal feeding, and the incidence of complications. Data were analyzed by SPSS version 21 using descriptive and analytical statistical tests. Results: The results of the study showed that the mean and standard deviation time to full intestinal feeding in the probiotic group was 5.7 ± 1.06 days, while in the placebo group was 6.72 ± 1.98 days, which was statistically significant (P = 0.002). There were no significant correlation between study variables and time to full intestinal feeding except mode of delivery (P = 0.029). Conclusions: Feeding with probiotics is recognized as an effective way to prevent adverse health outcomes in preterm infants. The present study showed that administration of probiotics reduced the time to full feeding. Therefore, it is an effective and inexpensive method to prevent intestinal disorders in newborns.

ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

2020 ◽  
Author(s):  
Janet Elizabeth Berrington ◽  
William McGuire ◽  
NIcholas David Embleton
Keyword(s):  
United Kingdom ◽  
Preterm Infants ◽  
Late Onset ◽  
Disease Onset ◽  
Intervention Group ◽  
Control Group ◽  
Bovine Lactoferrin ◽  
The United Kingdom ◽  
Late Onset Sepsis ◽  
The Uk

Previous studies suggested that supplemental bovine lactoferrin (BLF) given to preterm infants (<32 weeks gestation) may reduce late onset sepsis (LOS) and necrotising enterocolitis (NEC), but have been underpowered. The Enteral Lactoferrin in Neonates (ELFIN) study, performed in the United Kingdom (UK), aimed to further address this issue with a well powered double blinded placebo controlled trial of >2200 preterm infants. ELFIN did not demonstrate a reduction in LOS or NEC, or several other clinically important measures. 316 (29%) of 1093 infants in the intervention group developed late-onset sepsis versus 334 (31%) of 1089 in the control group with an adjusted risk ratio of 0·95 (95% CI 0·86–1·04; p=0· 233). Reasons for the differences in ELFIN trial results and other studies may include population differences, the routine use of antifungals in the UK, timing of administration of the lactoferrin in relation to disease onset, or specific properties of the lactoferrin used in different trials. Further exploration is being undertaken in the UK NIHR funded Mechanisms Affecting the Guts of Preterm Infants in Enteral feeding trials (MAGPIE) study, for which results should be available soon.

Self-Care Training and Information Support of Patients With Mechanical Heart Valve on International Normalized Ratio and the Bleeding Complications

2020 ◽  
Author(s):  
Shirdel Zandi ◽  
Behzad Imani ◽  
GHolamreza Safarpor
Keyword(s):  
Heart Valve ◽  
Intervention Group ◽  
Mechanical Heart Valve ◽  
Self Care ◽  
International Normalized Ratio ◽  
Information Support ◽  
Bleeding Complications ◽  
Target Range ◽  
Control Group ◽  
Care Training

Abstract BackgroundPatients with mechanical heart valve due to the possibility of coagulation complications require lifelong use of anticoagulants and International Normalized Ratio (INR) control. But if not taken care of properly, anticoagulant therapy itself can put people at risk for bleeding and be life-threatening. ObjectivesThe aim of this study was to determine the effect of Self-care training and information support of patients with mechanical heart valve on INR and the bleeding complications.DesignA randomized double-blind controlled trial.Settings and MethodsParticipants were recruited via convenience sampling from Farshchian hospital in Hamadan, Iran; and were randomly divided into two groups control (n=80) and intervention (n=80). Participants in the control group received only routine training; in addition, the intervention group received 6 sessions of self-care training and 6 months of information support. Monthly the level of INR and incidence of bleeding were determined. Data were analyzed using independent t-test and chi-square in spss16 software at a significance level of 0.05.ResultsDuring 6 months of follow-up, except for the third month, the frequency of INR levels in therapeutic target range (2.5-3.5) in the intervention group was significantly higher than the control group (p<0.05). Also in the intervention group, the incidence of bleeding complications was relatively less than the control group, but this difference was not statistically significant (p>0.05).ConclusionProper self-care training and information support in patients with mechanical heart valve replacement have positive results. By doing self-care, the level of a therapeutic target range of INR maintained and the incidence of bleeding complications can be reduced.

scholarly journals Serial Assessment of Body Fat and Fat-Free Mass Accretion in Very Preterm Infants: A Randomized Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1067-1067
Author(s):  
Ariel Salas ◽  
Maggie Jerome ◽  
Paula Chandler-Laney ◽  
Namasivayam Ambalavanan
Keyword(s):  
Body Composition ◽  
Preterm Infants ◽  
Body Fat ◽  
Intervention Group ◽  
Feeding Practices ◽  
Control Group ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Study Participants ◽  
Serial Assessments

Abstract Objectives To incorporate assessment of body composition in the routine care of preterm infants to guide feeding practices before and after hospital discharge. Methods Very preterm infants with gestational ages between 29 and 32 weeks of gestation were included. Infants with gastrointestinal or neurologic malformations and terminal illness needing to limit or withhold support were excluded. All study participants were eligible for serial assessments of body composition between birth and 32 weeks PMA, at 36 weeks PMA or hospital discharge, and at 3 months of corrected age. Infants randomly assigned to the intervention group had the information about infant body composition available to the clinicians caring for them (including reference data). Infants randomly assigned to the control group also underwent serial assessments, but this information on infant body composition was not shown to the clinicians caring for them. The primary outcome was % body fat (%BF) estimated by air displacement plethysmography. Results Fifty very preterm infants were randomized. Mean birthweight of study participants was 1387 g +/– SD 283 and median gestational age at birth was 30 weeks (IQR: 30 – 31). Sociodemographic characteristics did not differ between groups. Mean %BF between birth and 32 weeks PMA (n = 45) was 6 +/– 4, mean %BF at 36 weeks PMA (n = 35) was 14 +/– 4, and mean %BF at 3 months of corrected age (n = 25) was 20 +/– 4. Mean differences in %BF between the intervention group and the control group were not statistically significant at 36 weeks PMA (−0.8) or 3 months corrected age (−1.2). Similarly, feeding practices during hospitalization did not differ between groups. Growth outcomes did not differ between groups. Conclusions Serial assessments of body composition at birth, 36 weeks PMA, and 3 months corrected age in very preterm infants show increased %BF in both intervention and control groups without an apparent influence of the intervention on feeding practices. While 36 weeks PMA has been a common assessment point for research purposes, body composition assessments may need to be done at earlier intervals in order to make meaningful clinical changes to the infant diet in order to affect body composition later in infancy. Funding Sources UAB OHDRC.

scholarly journals Assessment of the Effectiveness of a Computerised Decision-Support Tool for Health Professionals for the Prevention and Treatment of Childhood Obesity. Results from a Randomised Controlled Trial

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 706 ◽  
Author(s):  
George Moschonis ◽  
Maria Michalopoulou ◽  
Konstantina Tsoutsoulopoulou ◽  
Elpis Vlachopapadopoulou ◽  
Stefanos Michalacos ◽  
...  
Keyword(s):  
Decision Support ◽  
Childhood Obesity ◽  
Randomised Controlled Trial ◽  
Healthcare Professionals ◽  
Controlled Trial ◽  
Intervention Group ◽  
Decision Support Tool ◽  
Control Group ◽  
Support Tool ◽  
Randomised Controlled

We examined the effectiveness of a computerised decision-support tool (DST), designed for paediatric healthcare professionals, as a means to tackle childhood obesity. A randomised controlled trial was conducted with 65 families of 6–12-year old overweight or obese children. Paediatricians, paediatric endocrinologists and a dietitian in two children’s hospitals implemented the intervention. The intervention group (IG) received personalised meal plans and lifestyle optimisation recommendations via the DST, while families in the control group (CG) received general recommendations. After three months of intervention, the IG had a significant change in dietary fibre and sucrose intake by 4.1 and −4.6 g/day, respectively. In addition, the IG significantly reduced consumption of sweets (i.e., chocolates and cakes) and salty snacks (i.e., potato chips) by −0.1 and −0.3 portions/day, respectively. Furthermore, the CG had a significant increase of body weight and waist circumference by 1.4 kg and 2.1 cm, respectively, while Body Mass Index (BMI) decreased only in the IG by −0.4 kg/m2. However, the aforementioned findings did not differ significantly between study groups. In conclusion, these findings indicate the dynamics of the DST in supporting paediatric healthcare professionals to improve the effectiveness of care in modifying obesity-related behaviours. Further research is needed to confirm these findings.

scholarly journals Placental Vascular Obstructive Lesions: Risk Factor for Developing Necrotizing Enterocolitis

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Laure Dix ◽  
Matthias Roth-Kleiner ◽  
Maria-Chiara Osterheld
Keyword(s):  
Risk Factor ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Strong Association ◽  
Age Groups ◽  
Control Group ◽  
Age Group ◽  
Significant Difference ◽  
And Control

Necrotizing enterocolitis (NEC) is a severe neonatal disease affecting particularly preterm infants. Its exact pathogenesis still remains unknown. In this study, we have compared the prevalence of vascular obstructive lesions in placentae of premature newborns which developed NEC and of a control group. We further compared separately the findings of placentae of infants of less than 30 weeks of gestation, the age group in which NEC occurs most frequently. We found signs of fetal vascular obstructive lesions in 65% of the placentae of preterm patients developing NEC, compared to only 17% of the placentae of preterm patients in the control group. In the age groups below 30 weeks of gestation, 58.5% of placentae of later NEC patients presented such lesions compared to 24.5% in the control group. The significant difference between NEC and control group suggests a strong association between fetal vascular obstructive lesions and NEC. Therefore, we propose that fetal vascular obstructive lesions might be considered as a risk factor for the development of NEC in premature infants.

scholarly journals The effect of multisensory stimulation on weight gain in premature infants admitted to the intensive care unit: A clinical trial study

2021 ◽  
Vol 20 (1) ◽  
pp. 96-102
Author(s):  
Sari Mahdieh ◽  
◽  
Mozhgan Rahnama ◽  
Fereshteh Ghaljaei ◽  
Majid Reza Akbarizadeh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Weight Gain ◽  
Preterm Infants ◽  
Premature Infants ◽  
Infant Nutrition ◽  
Visual Stimulation ◽  
T Test ◽  
Control Group ◽  
Multisensory Stimulation

Introduction. Premature infants undergo a lot of stressful procedures during care and treatment procedure, which may lead to weight changes. Multisensory stimulation is a broad classification of interventions designed to improve the developmental and physiological outcomes of preterm infants admitted to the neonatal intensive care unit (NICU). The aim of this study was to evaluate the effect of multisensory stimuli on weight gain in preterm infants admitted to the NICU. Materials and methods. This study was a two-group randomized controlled trial (multisensory stimulation and control group). Forty preterm infants admitted to the NICU who met the inclusion criteria were selected. The intervention method was a multisensory stimulation program including auditory stimulation, tactile stimulation, visual stimulation and vestibular stimulation, which were performed by the researcher for 12 min (each stimulation lasting for 3 min). The infant nutrition was monitored and recorded during the intervention and the infant’s weight was measured after changing diapers every morning for a 7 days. It was conducted in the two groups using a calibrated scale of confirmed validity and reliability. Data were analyzed using SPSS 20 software, paired t-test and independent t-test. Results. Based on the findings of the present study, an upturn was observed in weight gain of preterm infants as a result of multisensory intervention. This indicates that the intervention improves weight gain in premature infants. Conclusions. Since premature infants are usually hospitalized in the NICU for a long time due to their low weight and poor physical condition, they are mostly cared by nurses. Hence, considering its positive outcomes, besides specialized care, this effective and very low cost method could be used by nurses to promote weight gain and early discharge of preterm infants.

scholarly journals Effect of a Multicomponent mHealth Intervention on the Composition of Diet in a Population with Overweight and Obesity—Randomized Clinical Trial EVIDENT 3

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 270
Author(s):  
Cristina Lugones-Sánchez ◽  
José I. Recio-Rodríguez ◽  
Marta Menéndez-Suárez ◽  
Alicia Saz-Lara ◽  
José I. Ramirez-Manent ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Overweight And Obesity ◽  
Control Group ◽  
Food Groups ◽  
Support Tool ◽  
Mhealth Intervention ◽  
Activity Tracker ◽  
Balanced Diet ◽  
Brief Advice

A balanced diet can help in the prevention of chronic diseases. The aim of this study was to evaluate the effect of an mHealth intervention on the distribution of macronutrients and the intake of food groups. A total of 650 participants were included in this multi-center, clinical, randomized, controlled trial (Evident 3 study). All participants were given brief advice about diet and exercise. The intervention group received, in addition, an app (Evident 3) for the self-recording of their diet and an activity tracker wristband for 3 months. Follow-up visits were performed at 3 and 12 months to collect the diet composition using the Food Frequency Questionnaire. There were decreases in the intake of total calories, fat, protein and carbohydrates in both groups throughout the study, without significant differences between them. The intervention group reduced the intake of cholesterol (−30.8; 95% CI −59.9, −1.7) and full-fat dairies (−23.3; 95% CI −42.8, −3.8) and increased the intake of wholemeal bread (3.3; 95% CI −6.7, 13.3) and whole-grain cereals (3.4; 95% CI −6.8, 13.7) with respect to the control group. No differences were found in the rest of the nutritional parameters. The brief advice is useful to promote a healthier diet, and the app can be a support tool to obtain changes in relevant foods, such as integral foods, and the intake of cholesterol. Trial registration: ClinicalTrials.gov with identifier NCT03175614.

scholarly journals Shared Decision-Making in Chronic Patients with Polypharmacy: An Interventional Study for Assessing Medication Appropriateness

2019 ◽  
Vol 8 (6) ◽  
pp. 904
Author(s):  
Valle Coronado-Vázquez ◽  
Juan Gómez-Salgado ◽  
Javier Cerezo-Espinosa de los Monteros ◽  
Diego Ayuso-Murillo ◽  
Carlos Ruiz-Frutos
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Intervention Group ◽  
Decision Support Tool ◽  
Control Group ◽  
Potentially Inappropriate Medications ◽  
Shared Decision ◽  
Support Tool ◽  
Inappropriate Medications ◽  
Medication Appropriateness

Potentially inappropriate medications are associated with polypharmacy and polypathology. Some interventions such as pharmacotherapy reviews have been designed to reduce the prescribing of inappropriate medications. The objective of this study is to evaluate how effective a decision-making support tool is for determining medication appropriateness in patients with one or more chronic diseases (hypertension, dyslipidaemia, and/or diabetes) and polypharmacy in the primary care setting. For this, a quasi-experimental study (randomised, controlled and multicentre) has been developed. The study compares an intervention group, which assesses medication appropriateness by applying a decision support tool, with a control group that follows the usual clinical practice. The intervention included a decision support tool in paper format, where participants were informed about polypharmacy, inappropriate medications, associated problems and available alternatives, as well as shared decision-making. This is an informative guide aimed at helping patients with decision-making by providing them with information about the secondary risks associated with inappropriate medications in their treatment, according to the Beers and START/STOPP criteria. The outcome measure was the proportion of medication appropriateness. The proportion of patients who confirmed medication appropriateness after six months of follow-up is greater in the intervention group (32.5%) than in the control group (27.9%) p = 0.008. The probability of medication appropriateness, which was calculated by the proportion of drugs withdrawn or replaced according to the STOPP/Beers criteria and those initiated according to the START criteria, was 2.8 times higher in the intervention group than in the control group (OR = 2.8; 95% CI 1.3–6.1) p = 0.008. In patients with good adherence to the treatment, the percentage of appropriateness was 62.1% in the shared decision-making group versus 37.9% in the control group (p = 0.005). The use of a decision-making support tool in patients with potentially inappropriate medications increases the percentage of medication appropriateness when compared to the usual clinical practice.

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