Co-Development of Implementation Interventions to Support Parent-Led Infant Pain Care: A Collaborative, Theoretically Informed Study (Preprint)

2021 ◽  
Author(s):  
Britney University) ◽  
Christine Cassidy ◽  
Jacqueline van Wijlen ◽  
Quinn Correll ◽  
Marsha Campbell-Yeo ◽  
...  

BACKGROUND Untreated infant pain is associated with adverse health outcomes. Despite the strong evidence for accessible, effective, and low-cost parent-led pain-relieving interventions such as breast/chestfeeding and skin-to-skin contact, these interventions are not routinely used. OBJECTIVE The objective of this research is to support implementation of parent-led pain interventions by 1) identifying barriers and facilitators to parent-led, evidence-informed infant pain care during acute procedures, and 2) developing theory-informed, contextually relevant implementation interventions for supporting the use of parent-led infant pain care in hospital and community contexts. METHODS This study will consist of two phases that follow a systematic, theoretically informed approach guided by the Theoretical Domains Framework (TDF) and the Behaviour Change Wheel (BCW). In Phase 1, we will utilize a qualitative descriptive design to explore barriers and facilitators to use of parent-led infant pain care from the perspectives of hospital and community-based clinicians, clinical leaders, and families. In Phase 2, we will utilize the BCW to design tailored implementation interventions that have evidence for effectively addressing identified barriers in collaboration with an advisory committee of administrative, clinical, and family leaders. RESULTS Following completion of this study we will have co-designed, theoretically informed implementation interventions that can be pilot tested and experimentally applied. CONCLUSIONS Findings will be used to implement parent-led interventions that improve patient safety and health outcomes for diverse families.

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3948
Author(s):  
Francesco Capozzi ◽  
Faidon Magkos ◽  
Fabio Fava ◽  
Gregorio Paolo Milani ◽  
Carlo Agostoni ◽  
...  

Ultra-processed foods (UPFs) are negatively perceived by part of the scientific community, the public, and policymakers alike, to the extent they are sometimes referred to as not “real food”. Many observational surveys have linked consumption of UPFs to adverse health outcomes. This narrative synthesis and scientific reappraisal of available evidence aims to: (i) critically evaluate UPF-related scientific literature on diet and disease and identify possible research gaps or biases in the interpretation of data; (ii) emphasize the innovative potential of various processing technologies that can lead to modifications of the food matrix with beneficial health effects; (iii) highlight the possible links between processing, sustainability and circular economy through the valorisation of by-products; and (iv) delineate the conceptual parameters of new paradigms in food evaluation and classification systems. Although greater consumption of UPFs has been associated with obesity, unfavorable cardiometabolic risk factor profiles, and increased risk for non-communicable diseases, whether specific food processing techniques leading to ultra-processed formulations are responsible for the observed links between UPFs and various health outcomes remains elusive and far from being understood. Evolving technologies can be used in the context of sustainable valorisation of food processing by-products to create novel, low-cost UPFs with improved nutritional value and health potential. New paradigms of food evaluation and assessment should be funded and developed on several novel pillars—enginomics, signalling, and precision nutrition—taking advantage of available digital technologies and artificial intelligence. Research is needed to generate required scientific knowledge to either expand the current or create new food evaluation and classification systems, incorporating processing aspects that may have a significant impact on health and wellness, together with factors related to the personalization of foods and diets, while not neglecting recycling and sustainability aspects. The complexity and the predicted immense size of these tasks calls for open innovation mentality and a new mindset promoting multidisciplinary collaborations and partnerships between academia and industry.


2021 ◽  
Vol 9 ◽  
Author(s):  
Alexandra Ullsten ◽  
Matilda Andreasson ◽  
Mats Eriksson

Introduction: Parents' active involvement during painful procedures is considered a critical first step in improving neonatal pain practices. Of the non-pharmacological approaches in use, the biopsychosocial perspective supports parent-delivered interventions, in which parents themselves mediate pain relief, consistent with modern family-integrated care. This scoping review synthesizes the available research to provide an overview of the state of the art in parent-delivered pain-relieving interventions.Methods: A scoping review was performed to achieve a broad understanding of the current level of evidence and uptake of parent-driven pain- and stress-relieving interventions in neonatal care.Results: There is a strong evidence for the efficacy of skin-to-skin contact and breastfeeding, preferably in combination. These parent-delivered interventions are safe, valid, and ready for prompt introduction in infants' pain care globally. Research into parents' motivations for, and experiences of, alleviating infant pain is scarce. More research on combined parent-delivered pain alleviation, including relationship-based interventions such as the parent's musical presence, is needed to advance infant pain care. Guidelines need to be updated to include infant pain management, parent-delivered interventions, and the synergistic effects of combining these interventions and to address parent involvement in low-income and low-tech settings.Conclusions: A knowledge-to-practice gap currently remains in parent-delivered pain management for infants' procedure-related pain. This scoping review highlights the many advantages of involving parents in pain management for the benefit not only of the infant and parent but also of health care.


2019 ◽  
Vol 15 (1) ◽  
pp. 33-36
Author(s):  
Animesh Gupta ◽  
Soumya K. Inamadar ◽  
Ashish Goel

Geriatric syndromes consist of common clinical conditions affecting the elderly population. They lead to multiple, interacting medical and social deficits that increase the risk of adverse health outcomes, including dependence, institutionalization and also death. Research over the last few decades, in this area of medicine, has led to evolution of newer syndromes that pose a greater challenge to the physician. The present review aims to provide a synopsis of some of the newer syndromes like frailty, osteosarcopenia, sleep disorders and oropharyngeal dysphagia that have emerged in geriatric literature in recent times.


Author(s):  
Maria Florencia Heber ◽  
Grażyna Ewa Ptak

Abstract Background The increasing prevalence of metabolic diseases places a substantial burden on human health throughout the world. It is believed that predisposition to metabolic disease starts early in life, a period of great susceptibility to epigenetic reprogramming due to environmental insults. Assisted reproductive technologies (ART), i.e., treatments for infertility, may affect embryo development, resulting in multiple adverse health outcomes in postnatal life. The most frequently observed alteration in ART pregnancies is impaired placental nutrient transfer. Moreover, consequent intrauterine growth restriction and low birth weight followed by catch-up growth can all predict future obesity, insulin resistance, and chronic metabolic diseases. Scope of the review In this review, we have focused on evidence of adverse metabolic alterations associated with ART, which can contribute to the development of chronic adult-onset diseases, such as metabolic syndrome, type 2 diabetes, and cardiovascular disease. Due to high phenotypic plasticity, ART pregnancies can produce both offspring with adverse health outcomes, as well as healthy individuals. We further discuss the sex-specific and age-dependent metabolic alterations reflected in ART offspring, and how the degree of interference of a given ART procedure (from mild to more severe manipulation of the egg) affects the occurrence and degree of offspring alterations. Major conclusions Over the last few years, studies have reported signs of cardiometabolic alterations in ART offspring that are detectable at a young age but that do not appear to constitute a high risk of disease and morbidity per se. These abnormal phenotypes could be early indicators of the development of chronic diseases, including metabolic syndrome, in adulthood. The early detection of metabolic alterations could contribute to preventing the onset of disease in adulthood. Such early interventions may counteract the risk factors and improve the long-term health of the individual.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042212
Author(s):  
Hamish Foster ◽  
Peter Polz ◽  
Frances Mair ◽  
Jason Gill ◽  
Catherine A O'Donnell

IntroductionCombinations of unhealthy lifestyle factors are strongly associated with mortality, cardiovascular disease (CVD) and cancer. It is unclear how socioeconomic status (SES) affects those associations. Lower SES groups may be disproportionately vulnerable to the effects of unhealthy lifestyle factors compared with higher SES groups via interactions with other factors associated with low SES (eg, stress) or via accelerated biological ageing. This systematic review aims to synthesise studies that examine how SES moderates the association between lifestyle factor combinations and adverse health outcomes. Greater understanding of how lifestyle risk varies across socioeconomic spectra could reduce adverse health by (1) identifying novel high-risk groups or targets for future interventions and (2) informing research, policy and interventions that aim to support healthy lifestyles in socioeconomically deprived communities.Methods and analysisThree databases will be searched (PubMed, EMBASE, CINAHL) from inception to March 2020. Reference lists, citations and grey literature will also be searched. Inclusion criteria are: (1) prospective cohort studies; (2) investigations of two key exposures: (a) lifestyle factor combinations of at least three lifestyle factors (eg, smoking, physical activity and diet) and (b) SES (eg, income, education or poverty index); (3) an assessment of the impact of SES on the association between combinations of unhealthy lifestyle factors and health outcomes; (4) at least one outcome from—mortality (all cause, CVD and cancer), CVD or cancer incidence. Two independent reviewers will screen titles, abstracts and full texts of included studies. Data extraction will focus on cohort characteristics, exposures, direction and magnitude of SES effects, methods and quality (via Newcastle-Ottawa Scale). If appropriate, a meta-analysis, pooling the effects of SES, will be performed. Alternatively, a synthesis without meta-analysis will be conducted.Ethics and disseminationEthical approval is not required. Results will be disseminated via peer-reviewed publication, professional networks, social media and conference presentations.PROSPERO registration numberCRD42020172588.


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