Effect of nonnutritive sucking and oral stimulation on feeding performance in preterm infants: a randomized controlled trial.

OBJECTIVES: To evaluate the effectiveness of nonnutritive sucking (NNS) and oral stimulation (OS), either applied alone or in combination, to reduce the transition time from tube feeding to independent oral feeding. DESIGN: Randomized controlled trial. SETTING: A 40-bed neonatal ICU in a university hospital in the People's Republic of China. PATIENTS: A total of 120 preterm infants were admitted to the neonatal ICU from December 2012 to July 2013. INTERVENTIONS: Oral motor interventions. MEASUREMENTS AND MAIN RESULTS: One hundred twelve preterm infants were assigned to three intervention groups (NNS, OS, and combined NNS + OS) and one control group. Primary outcome was the number of days needed from introduction of oral feeding to autonomous oral feeding (transition time). Secondary outcome measures were the rate of milk transfer (mL/min), proficiency (intake first 5 min/volume ordered), volume transfer (volume transferred during entire feeding/volume prescribed), weight, and hospital length of stay. Transition time was reduced in the three intervention groups compared with the control group (p < 0.001). The milk transfer rate in the three intervention groups was greater than in the control group (F3,363 = 15.37; p < 0.001). Proficiency in the NNS and OS groups did not exceed that in the control group while the proficiency in the NNS + OS group was greater than that in the control group at the stage when the infants initiated the oral feeding (p = 0.035). Among all groups, no significant difference was found on weight gain and length of stay. CONCLUSIONS: The combined NNS + OS intervention reduced the transition time from introduction to independent oral feeding and enhanced the milk transfer rate. The combined intervention seems to have a beneficial effect on oral feeding proficiency in preterm infants

Oropharyngeal Colostrum Administration in Very Low Birth Weight Infants

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Testing a Family Supportive End of Life Care Intervention in a Chinese Neonatal Intensive Care Unit: A Quasi-experimental Study With a Non-randomized Controlled Trial Design

Background: Neonatal death often occurs in tertiary Neonatal Intensive Care Units (NICUs). In China, end-of-life-care (EOLC) does not always involve parents. Aim: The aim of this study is to evaluate a parent support intervention to integrate parents at the end of life of their infant in the NICU. Methods: A quasi-experimental study using a non-randomized clinical trial design was conducted between May 2020 and September 2021. Participants were infants in an EOLC pathway in the NICU and their parents. Parents were allocated into a family supportive EOLC intervention group or a standard EOLC group based on their wishes. The primary outcomes depression (Edinburgh Postnatal Depression Scale for mothers; Hamilton Depression rating scale for fathers) and Satisfaction with Care were measured 1 week after infants' death. Student t-test for continuous variables and the Chi-square test categorical variables were used in the statistical analysis. Results: In the study period, 62 infants died and 45 infants and 90 parents were enrolled; intervention group 20 infants, standard EOLC group 25 infants. The most common causes of death in both groups were congenital abnormalities (n = 20, 44%). Mean gestational age of infants between the family supportive EOLC group and standard EOLC group was 31.45 vs. 33.8 weeks (p = 0.234). Parents between both groups did not differ in terms of age, delivery of infant, and economic status. In the family support group, higher education levels were observed among mother (p = 0.026) and fathers (p = 0.020). Both mothers and fathers in the family supportive EOLC group had less depression compared to the standard EOLC groups; mothers (mean 6.90 vs. 7.56; p = 0.017) and fathers (mean 20.7 vs. 23.1; p < 0.001). Parents reported higher satisfaction in the family supportive EOLC group (mean 88.9 vs. 86.6; p < 0.001). Conclusions: Supporting parents in EOLC in Chinese NICUs might decreased their depression and increase satisfaction after the death of their infant. Future research needs to focus on long-term effects and expand on larger populations with different cultural backgrounds. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT05270915

Effects of family-centered care interventions on preterm infants and parents in neonatal intensive care units: a systematic review and meta-analysis of randomized controlled trials

Objective: To review English and Chinese randomized controlled trials (RCTs) to determine the effects of family-centered care interventions on preterm infants’ and parental outcomes in Neonatal Intensive Care Units and to conduct a meta-analysis. Review method used: Systematic review and meta-analysis. Data sources: MEDLINE, CINAHL, EMBASE, PsycInfo, BNI, AMED and the Chinese databases CNKI and Wanfang were searched in April 2017 and updated in August 2018. Review methods: Only RCTs were included. Participants were preterm infants ≤ 37 weeks gestational age and parents. Interventions were related to family-centered care and outcome measures were infant and parent clinical outcomes. Included studies were assessed for risk of bias using Cochrane Manual 5.1.0. Meta-analyses used Mean Differences (MD), Standardized Mean Differences (SMD) or Odds Ratio (OR) followed by 95% Confidence Interval (CI). Heterogeneity was tested with Cochran’s Q chi-square, tau-squared and inconsistency index (I2). Results: Included were 19 studies (10 from English and 9 from Chinese databases); meta-analysis included 15 studies (7 English and 8 Chinese RCTs). Meta-analysis showed significant improvements in weight gain (7 studies: MD 4.57; 95%CI: 2.80;6.34; P<0.001; I2 94%); readmission (3 studies: OR=0.23; 95%CI: 0.10;0.52; P<0.001; I2=0%); parent satisfaction (5 studies: OR=11.20; 95%CI: 4.76;26.34; p<0.001; I2=0%); Skills of parents (4 studies: SMD=2.57; 95%CI: 2.19;2.96; P<0.001; I2=53%); Knowledge of parents (4 studies: SMD=2.74; 95%CI: 2.47;3.00; P<0.001; I2=0%); Parental anxiety at follow-up: (3 studies: SMD=-0.19; 95%CI: -0.28;-0.09; P<0.001; I2=0%); Parent depression at follow-up: (2 studies: SMD=0.37; 95%CI: -0.63;-0.12; P=0.004; I2=44%); Parental stress: (3 studies: MD=-0.20; 95%CI: -0.26;-0.13; P<0.001; I2=0%). No statistical differences were observed in neuro-behavioral-development (3 studies) and hospital-length-of-stay (7 studies). Conclusions: Family-centered care interventions can improve weight gain and readmission in preterm infants as well as parent satisfaction, knowledge and skills, and possibly long-term anxiety, depression and stress. Developing standardized outcome sets for testing family-centered care interventions is recommended

Social Interactions vs Revisions, What is important for Promotion in Wikipedia?

In epistemic community, people are said to be selected on their knowledge contribution to the project (articles, codes, etc.) However, the socialization process is an important factor for inclusion, sustainability as a contributor, and promotion. Finally, what does matter to be promoted? being a good contributor? being a good animator? knowing the boss? We explore this question looking at the process of election for administrator in the English Wikipedia community. We modeled the candidates according to their revisions and/or social attributes. These attributes are used to construct a predictive model of promotion success, based on the candidates's past behavior, computed thanks to a random forest algorithm. Our model combining knowledge contribution variables and social networking variables successfully explain 78% of the results which is better than the former models. It also helps to refine the criterion for election. If the number of knowledge contributions is the most important element, social interactions come close second to explain the election. But being connected with the future peers (the admins) can make the difference between success and failure, making this epistemic community a very social community too