13,203 research outputs found

    Healthy Child Programme: pregnancy and the first five years of life

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    Healthy Child programme: pregnancy and the first five years of life

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    "You Know You Are Sick, Why Do You Carry A Pregnancy Again?" Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya.

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    ObjectiveThroughout most of sub-Saharan Africa (SSA), prevention of mother-to-child transmission (PMTCT) services are readily available. However, PMTCT programs in SSA have had suboptimal performance compared to other regions of the world. The main objective of this study is to explore the socio-ecological and individual factors influencing the utilization of PMTCT services among HIV-positive pregnant women in western Kenya using a social ecological model as our analytical lens.MethodsData were collected using in-depth interviews with 33 HIV-infected women attending government health facilities in rural western Kenya. Women with HIV-infected infants aged between 6 weeks to 6 months with a definitive diagnosis of HIV in the infant, as well as those with an HIV-negative test result in the infant were interviewed between November 2012 and June 2013. Coding and analysis of the transcripts followed grounded theory tenets. Coding reports were discussed in a series of meetings held among the authors. We then employed constant comparative analysis to discover dominant individual, family, society and structural determinants of PMTCT use.ResultsBarriers to women's utilization of PMTCT services fell within the broad constructs of the socio-ecological model of individual, family, society and structural determinants. Several themes cut across the different steps of PMTCT cascade and relate to different constructs of the socio-ecological model. These themes include: self-motivation, confidence and resilience, family support, absence or reduced stigma, right provider attitude and quality of health services provided. We also found out that these factors ensured enhanced maternal health and HIV negative children.ConclusionThe findings of this study suggest that a woman's social environment is an important determinant of MTCT. PMTCT Interventions must comprehensively address multiple factors across the different ecological levels. More research is however required for the development of multi-component interventions that combine strategies at different ecological levels

    Virtual Home Visits During COVID-19 Pandemic: Mothers\u27 and Home Visitors\u27 Perspectives

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    Background The experiences of mothers enrolled in Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with virtual home visiting (VHV) during the pandemic remain mostly unknown. This study aimed to describe in detail the experience of home visitors and mothers with VHV during COVID-19 pandemic. This is a prerequisite for guiding future efforts to optimize MIECHV services that are provided through virtual operation. Methods Focus groups discussion were conducted with home visitors (n = 13) and mothers (n = 30) who were enrolled in BabyCare program in Virginia from January 2019 to June 2022. This included mothers who received in-person home visiting (IPHV), VHV, or both (hybrid IPHV and VHV). Inductive analysis was used to identify emergent themes from the transcripts, then coding was conducted following a codebook that was developed by the research team. Results Both mothers and home visitors considered IPHV necessary for a proper assessment of developmental milestones of children, for the assessment of the growth of the child through measuring the weight and height/length of the child, for the mothers to open up and discuss sensitive issues like domestic violence, for building a relationship between home-visitor and the parents, and for other potential benefits (comprehensive assessment of the environment around the child inside and outside the house from home visitors\u27 perspective and detecting abnormal health conditions in children from mothers\u27 perspective). Both mothers and home visitors see that VHV has some role to play but not to be a replacement for IPHV. If VHV is to be used, video conference is preferred by both mothers and home visitors, as it allows for some assessment. Conclusion Mothers and nurses considered IPHV critical for proper and comprehensive assessment of the child and the family and also essential to build the nurse-client relationship. Both mothers and home visitors considered VHV supplementary to IPHV that can be used from time to time particularly with busy mothers. VHV may have little room with parents with intellectual disabilities and the difficulty in dealing with technology seems to be no longer a major issue

    Neuroplasticity in Young Age: Computer-Based Early Neurodevelopment Classifier

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    Neurodevelopmental syndromes, a continuously growing issue, are impairments in the growth and development of the brain and CNS which are pronounced in a variety of emotional, cognitive, motor and social skills. Early assessment and detection of typical, clinically correlated early signs of developmental abnormalities is crucial for early and effective intervention, supporting initiation of early treatment and minimizing neurological and functional deficits. Successful early interventions would then direct to early time windows of higher neural plasticity. Various syndromes are reflected in early vocal and motor characteristics, making them suitable indicators of an infant’s neural development. Performance of the computerized classifiers we developed shows approximately 90% accuracy on a database of diagnosed babies. The results demonstrate the potential of vocal and motor analysis for computer-assisted early detection of neurodevelopmental insults

    Parental influences on children's eating behaviour and characteristics of successful parent-focussed interventions

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    Parental reports suggest that difficulties related to child-feeding and children's eating behaviour are extremely common. While 'fussy eating' does not pose an immediate threat to health, over the long-term, consumption of a poor diet can contribute to the development of a range of otherwise preventable diseases. In addition, the stress and anxiety that can surround difficult mealtimes can have a detrimental impact upon both child and parental psychological wellbeing. Since parents have a great influence over what, when, and how much food is offered, feeding difficulties may be preventable by better parental awareness. The aim of this review is to describe how parental factors contribute to the development of common feeding problems, and to discuss the merits of existing interventions aimed at parents/primary caregivers to improve child-feeding and children's eating behaviour. The potential for different technologies to be harnessed in order to deliver interventions in new ways will also be discussed

    Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial

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    Background: This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP) program by investigating pre-conceptual health and risk behaviours, teen pregnancy and the resultant birth outcomes, early child health and maternal health. Methods and Design: Fifty-seven schools (86% of 66 eligible secondary schools) in Perth, Australia were recruited to the clustered (by school) randomised trial, with even randomisation to the intervention and control arms. Between 2003 and 2006, the VIP program was administered to 1,267 participants in the intervention schools, while 1,567 participants in the non-intervention schools received standard curriculum. Participants were all female and aged between 13-15 years upon recruitment. Pre and post-intervention questionnaires measured short-term impact and participants are now being followed through their teenage years via data linkage to hospital medical records, abortion clinics and education records. Participants who have a live birth are interviewed by face-to-face interview. Kaplan-Meier survival analysis and proportional hazards regression will test for differences in pregnancy, birth and abortion rates during the teenage years between the study arms.Discussion: This protocol paper provides a detailed overview of the trial design as well as initial results in the form of participant flow. The authors describe the intervention and its delivery within the natural school setting and discuss the practical issues in the conduct of the trial, including recruitment. The trial is pragmatic and will directly inform those who provide Infant Simulator based programs in school settings

    The Impact of Breastfeeding Education on Infant Feeding Outcome

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    Background: Breastfeeding (BF) is widely recognized as the ideal infant feeding method with a multitude of well-known infant and maternal benefits. However, current BF rates, particularly in the southeastern United States, fail to meet current BF recommendations. BF education interventions have shown to be successful at improving BF outcomes, as well as maternal knowledge and self-efficacy. The purpose of this study was to examine the association between BF education and infant BF outcomes based upon World Health Organization recommendations, with a secondary aim of determining the impact of BF education on maternal BF knowledge and self-efficacy. Methods: Sixty adult female clients of PeaPod Nutrition and Lactation Support in the Atlanta, Georgia area, being the primary caregiver of an infant (12 months of age or younger) completed a short, anonymous, electronic questionnaire about any BF education they received and infant feeding outcomes. Outcome measures include BF rates and exclusivity. Secondary outcome measures include maternal BF knowledge and self-efficacy. The chi-square statistic was used to evaluate any associations between BF education and outcome measures. Results: Study participants had a median age of 34 years, 70% self-reported as Caucasian with a median income between 100,000100,000 - 150,000, and all participants held a college degree. Fifty-five of the 60 participants that completed the survey received BF education either during their pregnancy or in the postnatal period. The education received occurred in a variety of settings and topics, and mainly consisted of in-person/hands-on instruction, with limited virtual/telephone education. Twenty-three of the 60 respondents (38.3%) are currently BF, of which, 65.2% are exclusively BF and 52.2% have been BF for more than 6 months. No statistically significant association was found between those that received BF education and BF duration (p = .838) nor rate of exclusive BF (Fisher’s Exact Test p = .350). Of participants that are currently exclusively BF, 50% reported receiving some form of BF education. Of individuals that previously breastfed for 6 months or more, approximately 74% reported receiving some form of BF education. All 55 participants that received BF education agreed that the BF education that they received increased their knowledge of BF, with 60% strongly agreeing and most participants (90.9%) agreed that their confidence in BF improved because of their BF education, 52.7% of which strongly agreed. Conclusion: Overall, high rates of BF and exclusive BF of infants 6 months of age and older were observed among study participants. All participants agreed that BF education improved their BF knowledge and the majority agreed that their self-efficacy improved as a result of the education that they received
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