Return to Play Following Shoulder Stabilization: A Systematic Review and Meta-analysis.

BackgroundAnterior shoulder instability can be a disabling condition for the young athlete; however, the best surgical treatment remains controversial. Traditionally, anterior shoulder instability was treated with open stabilization. More recently, arthroscopic repair of the Bankart injury with suture anchor fixation has become an accepted technique.HypothesisNo systematic reviews have compared the rate of return to play following arthroscopic Bankart repair with suture anchor fixation with the Bristow-Latarjet procedure and open stabilization. We hypothesized that the rate of return to play will be similar regardless of surgical technique.Study designSystematic review; Level of evidence, 4.MethodsWe performed a systematic review and meta-analysis focused on return to play following shoulder stabilization. Inclusion criteria included studies in English that reported on rate of return to play and clinical outcomes following primary arthroscopic Bankart repair with suture anchors, the Latarjet procedure, or open stabilization. Statistical analyses included Student t tests and analyses of variance.ResultsSixteen papers reporting on 1036 patients were included. A total of 545 patients underwent arthroscopic Bankart repair with suture anchors, 353 with the Latarjet procedure, and 138 with open repair. No significant difference was found in patient demographic data among the studies. Patients returned to sport at the same level of play (preinjury level) more consistently following arthroscopic Bankart repair (71%) or the Latarjet procedure (73%) than open stabilization (66%) (P < .05). Return to play at any level and postoperative Rowe scores were not significantly different among studies. Recurrent dislocation was significantly less following the Latarjet procedure (3.5%) than after arthroscopic Bankart repair (6.6%) or open stabilization (6.7%) (P < .05).ConclusionThis systematic review demonstrates a greater rate of return to play at the preinjury level following arthroscopic Bankart repair and the Latarjet procedure than open stabilization. Despite this difference, >65% of all treated athletes returned to sport at their preinjury levels, with other outcome measures being similar among the treatment groups. Therefore, arthroscopic Bankart repair, the Latarjet procedure, and open stabilization remain good surgical options in the treatment of the athlete with anterior shoulder instability

Parents and nurses balancing parent-infant closeness and separation: a qualitative study of NICU nurses' perceptions

Background: When a newborn requires neonatal intensive care unit (NICU) hospitalization, parent and infant experience an unusual often prolonged separation. This critical care environment poses challenges to parent-infant closeness. Parents desire physical contact and holding and touching are particularly important. Evidence shows that visitation, holding, talking, and skin to skin contact are associated with better outcomes for infants and parents during hospitalization and beyond. Thus, it would be important to understand closeness in this context. The purpose of this study was to explore from nurses' perspective, what do parents and nurses do to promote parent-infant closeness or provoke separation.Methods: Qualitative methods were utilized to attain an understanding of closeness and separation. Following ethics approval, purposive sampling was used to recruit nurses with varying experience working different shifts in NICUs in two countries. Nurses were loaned a smartphone over one work shift to record their thoughts and perceptions of events that occurred or experiences they had that they considered to be closeness or separation between parents and their hospitalized infant. Sample size was determined by saturation (18 Canada, 19 Finland). Audio recordings were subjected to inductive thematic analysis. Team meetings were held to discuss emerging codes, refine categories, and confirm these reflected data from both sites. One overarching theme was elaborated.Results: Balancing closeness and separation was the major theme. Both parents and nurses engaged in actions to optimize closeness. They sought closeness by acting autonomously in infant caregiving, assuming decision-making for their infant, seeking information or skills, and establishing a connection in the face of separation. Parents balanced their desire for closeness with other competing demands, such as their own needs. Nurses balanced infant care needs and ability to handle stimulation with the need for closeness with parents. Nurses undertook varied actions to facilitate closeness. Parent, infant and NICU-related factors influenced closeness. Consequences, both positive and negative, arose for parents, infants, and nurses.Conclusion: Findings point to actions that nurses undertake to promote closeness and help parents cope with separation including: promoting parent decision-making, organizing care to facilitate closeness, and supporting parent caregiving

Bostonia: The Boston University Alumni Magazine. Volume 32

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs

COVID-19 restrictions and fathers of infants in neonatal care.

This is a letter without an abstract

Compositional shifts of alpine plant communities across the high Andes.

Aim: Climate change is transforming mountain summit plant communities worldwide, but we know little about such changes in the High Andes. Understanding large-scale patterns of vegetation changes across the Andes, and the factors driving these changes, is fundamental to predicting the effects of global warming. We assessed trends in vegetation cover, species richness (SR) and community-level thermal niches (CTN) and tested whether they are explained by summits' climatic conditions and soil temperature trends. Location: High Andes. Time period: Between 2011/2012 and 2017/2019. Major taxa studied: Vascular plants. Methods: Using permanent vegetation plots placed on 45 mountain summits and soil temperature loggers situated along a ~6800 km N-S gradient, we measured species and their relative percentage cover and estimated CTN in two surveys (intervals between 5 and 8 years). We then estimated the annual rate of changes for the three variables and used generalized linear models to assess their relationship with annual precipitation, the minimum air temperatures of each summit and rates of change in the locally recorded soil temperatures. Results: Over time, there was an average loss of vegetation cover (mean = −0.26%/ yr), and a gain in SR across summits (mean = 0.38 species m2/yr), but most summits had significant increases in SR and vegetation cover. Changes in SR were positively related to minimum air temperature and soil temperature rate of change. Most plant communities experienced shifts in their composition by including greater abundances of species with broader thermal niches and higher optima. However, the measured changes in soil temperature did not explain the observed changes in CTN. Main conclusions: High Andean vegetation is changing in cover and SR and is shifting towards species with wider thermal niche breadths. The weak relationship with soil temperature trends could have resulted from the short study period that only marginally captures changes in vegetation through time.EEA Santa CruzFil: Cuesta, F. Universidad de las Américas. Grupo de Investigación en Biodiversidad Medio Ambiente y Salud – BIOMAS; Ecuador.Fil: Carilla, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Carilla, Julieta. Universidad Nacional de Tucumán. Instituto de Ecología Regional; Argentina.Fil: Llambí, L.D. Universidad de Los Andes. Instituto de Ciencias Ambientales y Ecológicas; Venezuela.Fil: Llambí, L.D. Consorcio para el Desarrollo Sostenible de la Ecorregión Andina (CONDESAN); Perú.Fil: Muriel, P. Pontificia Universidad Católica del Ecuador. Escuela de Ciencias Biológicas Laboratorio de Ecofisiología; Ecuador.Fil: Lencinas, María Vanessa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas (CADIC); Argentina.Fil: Meneses, R. I. Universidad Católica del Norte. Instituto de Investigaciones Arqueológicas y Museo; Chile.Fil: Feeley, K. J. University of Miami. Biology Department. Coral Gables; Estados UnidosFil: Pauli, H. Austrian Academy of Sciences. Institute for Interdisciplinary Mountain Research; Austria.Fil: Pauli, H. University of Natural Resources and Life Sciences. Department of Integrative Biology and Biodiversity Research; Austria.Fil: Aguirre, N. Universidad Nacional de Loja. Carrera de Ingeniería Forestal. Centro de Investigaciones Tropicales del Ambiente y Biodiversidad (CITAB); Ecuador.Fil: Beck, S. Museo Nacional de Historia Natural - Instituto de Ecología (UMSA). Herbario Nacional de Bolivia; Bolivia.Fil: Peri, Pablo Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz; Argentina.Fil: Peri, Pablo Luis. Universidad Nacional de la Patagonia Austral; Argentina.Fil: Peri, Pablo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Tovar, C. Royal Botanical Gardens Kew. Jodrell Laboratory; Reino Unid

Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father coparenting

The Family Initiative's International Neonatal Fathers Working Group, whose members are the authors of this paper, has reviewed the literature on engaging fathers in neonatal units, with the aim of making recommendations for improving experience of fathers as well as health outcomes in neonatal practice. We believe that supporting the father-baby bond and supporting co-parenting between the mother and the father benefits the health of the baby, for example, through improved weight gain and oxygen saturation and enhanced rates of breastfeeding. We find, however, that despite much interest in engaging with parents as full partners in the care of their baby, engaging fathers remains sub-optimal. Fathers typically describe the opportunity to bond with their babies, particularly skin-to-skin care, in glowing terms of gratitude, happiness and love. These sensations are underpinned by hormonal and neurobiological changes that take place in fathers when they care for their babies, as also happens with mothers. Fathers, however, are subject to different social expectations from mothers and this shapes how they respond to the situation and how neonatal staff treats them. Fathers are more likely to be considered responsible for earning, they are often considered to be less competent at caring than mothers and they are expected to be “the strong one”, providing support to mothers but not expecting it in return. Our review ends with 12 practical recommendations for neonatal teams to focus on: (1) assess the needs of mother and father individually, (2) consider individual needs and wants in family care plans, (3) ensure complete flexibility of access to the neonatal unit for fathers, (4) gear parenting education towards co-parenting, (5) actively promote father-baby bonding, (6) be attentive to fathers hiding their stress, (7) inform fathers directly not just via the mother, (8) facilitate peer-to-peer communication for fathers, (9) differentiate and analyse by gender in service evaluations, (10) train staff to work with fathers and to support co-parenting, (11) develop a father-friendly audit tool for neonatal units, and (12) organise an international consultation to update guidelines for neonatal care, including those of UNICEF