Ambient noise and neonatal hemodynamics - An observational cross-sectional study

Background: Previous studies reported numerous adverse effects of noise in the newborns such as increase in the heart rate (HR) and respiratory frequency and drop in the oxygen saturation. Objective: The objective of this study was to study the effect of ambient noise levels in neonatal intensive care unit (NICU) on the hemodynamics of neonates. Materials and Methods: This was a hospital-based cross-sectional observational study which aimed at assessing the ambient noise levels in the NICU with a digital decibel meter and its effect on HR, respiratory rate (RR), and oxygen saturation. A total of 105 neonates (both preterm and term) having stable cardiorespiratory status were enrolled in the study. Results: The mean noise level recorded in the NICU was 56.2 dB. The lowest noise level was recorded at 8 am, that is, 46 dB while the highest recorded level was at 2 pm, that is, 65 dB in different areas of the NICU. There was a statistically significant increase in the HR in relation to the noise levels at all times (p<0.0001). The RR also showed a significant rise in relation to the increase in noise level (p<0.0001 at 2 pm with maximum noise level). The oxygen saturation showed a negative correlation and a statistically significant drop at 2 pm when maximum noise level was recorded (p<0.0001). Changing shifts and more number of healthcare personnel were important factors contributing to increased noise levels at 2 pm. Conclusion: Noise levels of >56 dB affected the hemodynamics of the newborn. The maximum increase in the mean HR, RR, and drop in saturation was observed at 2 pm. Staff sensitization and attitude change are needed to decrease the noise pollution in NICU

A conceptual approach to enhance the well-being of elderly people

The number of elderly people living alone is increasing. Consequently, a lot of research works have been addressing this issue in order to propose solutions that can enhance the quality of life of elderly people. Most of them have been concerned in dealing with objective issues such as forgetfulness or detecting falls. In this paper, we propose a conceptual approach of a system that intends to enhance the daily sense of user’s well-being. For that, our proposal consists in a system that works as a social network and a smartwatch application that works unobtrusively and collects the user’s physiological data. In addition, we debate how important features such as to detect user’s affective states and to potentiate user’s memory could be implemented. Our study shows that there are still some important limitations which affect the success of applications built in the context of elderly care and which are mostly related with accuracy and usability of this kind of system. However, we believe that with our approach we will be able to address some of those limitations and define a system that can enhance the well-being of elderly people and improve their cognitive capabilities.The work presented in this paper has been developed under the EUREKA - ITEA3 Project PHE (PHE-16040), and by National Funds through FCT (Fundação para a Ciência e a Tecnologia) under the projects UID/EEA/00760/2019 and UID/CEC/00319/2019 and by NORTE-01-0247-FEDER-033275 (AIRDOC - “Aplicação móvel Inteligente para suporte individualizado e monitorização da função e sons Respiratórios de Doentes Obstrutivos Crónicos ”) by NORTE 2020 (Programa Operacional Regional do Norte)

Home-versus hospital-based phototherapy for the treatment of non-haemolytic jaundice in infants at more than 37 weeks' gestation (Review)

Background: Phototherapy is commonly used for the treatment of neonatal jaundice, and home-based phototherapy is now being used in certain centres. Home-based phototherapy offers possible advantages by avoiding prolonged hospital admissions, promoting mother-infant bonding and reducing hospitalisation costs. Potential problems include increased duration of phototherapy, increased readmission to hospital and increased risk of bilirubin encephalopathy. Objectives: To compare exclusively home-based versus exclusively hospital-based phototherapy or a combination of home- and hospital-based phototherapy for the management of non-haemolytic jaundice in term infants up to 28 days of age. We planned to include specific subgroups for duration in hospital, method of phototherapy and criteria for readiness for discharge. Search methods: We searched the Cochrane Neonatal Review Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) January 2013, Issue 1, part of The Cochrane Library, MEDLINE (from 1966 to 15 February 2013), CINAHL (from 1982 to 15 February 2013) and EMBASE (from 1988 to 15 February 2013). We searched for abstracts from the Pediatric Academic Societies' Annual Meetings 2000 to 2013. We searched for ongoing trials on the following websites: ClinicalTrials.gov (http://clinicaltrials.gov/) and Current Controlled Trials (http://controlled-trials.com/). Selection criteria: Randomised and quasi-randomised studies comparing term infants who received phototherapy exclusively at home versus phototherapy exclusively in the hospital or a combination of the two for non-haemolytic jaundice. Data collection and analysis: Two review authors independently assessed trial quality and extracted data. Main results: No studies that met the predefined eligibility criteria were identified. Authors' conclusions: No high-quality evidence is currently available to support or refute the practice of home-based phototherapy for non-haemolytic jaundice in infants at more than 37 weeks' gestation

Applying Collective Intelligence in Health Recommender Systems for Smoking Cessation: A Comparison Trial

Background: Health recommender systems (HRSs) are intelligent systems that can be used to tailor digital health interventions. We compared two HRSs to assess their impact providing smoking cessation support messages. Methods: Smokers who downloaded a mobile app to support smoking abstinence were randomly assigned to two interventions. They received personalized, ratable motivational messages on the app. The first intervention had a knowledge-based HRS (n = 181): it selected random messages from a subset matching the users' demographics and smoking habits. The second intervention had a hybrid HRS using collective intelligence (n = 190): it selected messages applying the knowledge-based filter first, and then chose the ones with higher ratings provided by other similar users in the system. Both interventions were compared on: (a) message appreciation, (b) engagement with the system, and (c) one's own self-reported smoking cessation status, as indicated by the last seven-day point prevalence report in different time intervals during a period of six months. Results: Both interventions had similar message appreciation, number of rated messages, and abstinence results. The knowledge-based HRS achieved a significantly higher number of active days, number of abstinence reports, and better abstinence results. The hybrid algorithm led to more quitting attempts in participants who completed their user profiles

Accelerate progress—Sexual and reproductive health and rights for all: Report of the Guttmacher–Lancet Commission

Sexual and reproductive health and rights (SRHR) are fundamental to people\u27s health and survival, to economic development, and to the wellbeing of humanity. Several decades of research have shown—and continue to show—the profound and measurable benefits of investment in sexual and reproductive health. Through international agreements, governments have committed to such investment. Yet progress has been stymied because of weak political commitment, inadequate resources, persistent discrimination against women and girls, and an unwillingness to address issues related to sexuality openly and comprehensively