Demographic profile of 266 mother-infant dyads presenting to a multidisciplinary breast-feeding clinic: a descriptive study

Worldwide, sustained breastfeeding rates are lower than optimal. Mothers and infants with suboptimal breastfeeding present to a wide variety of practitioners to assist their goal of total breastfeeding. To support these mother-infant dyads, a multi-disciplinary chiropractic and midwifery feeding clinic was opened alongside a chiropractic teaching clinic in England. To improve understanding of the presentation and clinical needs of these nursing dyads, a descriptive study was developed. This paper provides an overview of the cases that presented to this clinic over nine months, with a focus on feeding difficulties, birth and musculoskeletal problems in the infant. Mothers frequently reported more than one type of feeding problem, which most commonly included difficulty attaching, painful feeding, and a one sided feeding preference. Birth intervention was more common in this population than the national averages, particularly forceps deliveries. Musculoskeletal problems were prevalent in the babies presented to the feeding clinic, most commonly of the thoracic spine, cervical spine and sternocleidomastoid. Although causation cannot be established from this type of study, intervention at birth, feeding difficulties and musculoskeletal problems frequently coexisted in these infants. Therefore, including musculoskeletal care for infants as part of support for suboptimal breastfeeding may be appropriate

Discover Mojave Outdoor World Activity Unit Curriculum

This document provides suggested activity outlines for each recreational unit as well as available resources, pertinent contacts, checklists, and activity assessments. Each unit is correlated with the themes identified by the Southern Nevada Agency Partnership Conservation Education and Interpretation Team. The Discover Mojave Outdoor World program introduces urban youth, ages 8-12, to outdoor recreation and environmental education. The program promotes the belief that outdoor recreation plays an important and positive role in the health and fitness of America’s youth. The program is patterned after the national Wonderful Outdoor World (WOW) program. WOW introduces urban youth and families to the outdoors and outdoor recreation through overnight camping experiences within the heart of their own community. With this approach, the program seeks to bring the excitement of camping and the environment directly into the neighborhoods and communities of the children most in need

Supporting breastfeeding: it takes a whole community

In collaboration with the Anglo-European Chiropractic College (AECC), the Faculty of Health and Social Sciences at Bournemouth University hosted a conference in July 2015 to raise awareness of the Joint Chiropractic and Midwifery Newborn Feeding Clinic. The interprofessional approach to facilitating a student-led, newborn infant feeding clinic is an innovative and unique opportunity to provide a positive learning environment for students as well as improve sustained breastfeeding rates for women; a current public health challenge. Learning from skilled, qualified practitioners in a real time practice environment has the ability to enrich the student educational experience. It was felt that a one day interprofessional conference to share good practice from the clinic and listen to the views of women and students would provide a springboard to ensure the clinic continued to meet the needs of those using the facilities

Explorations in Off-Higway Vehicle (OHV) Recreation: a High School Driver Education Extension

The lessons within this curriculum have been designed to meet the following goals: ● To increase knowledge about the natural world OHV recreationists will encounter in their exploration of Southern Nevada; ● To increase knowledge of responsible use of OHVs and principles of Tread Lightly! and Leave No Trace (both are nonprofit organizations dedicated to increasing awareness about how to minimize impacts while enjoying public and private lands); ● To increase awareness, knowledge, and understanding of land ethics; ● To allow youth to analyze personal values regarding recreational experiences, including OHV use

Parent report of exclusive breastfeeding after attending a combined midwifery and chiropractic feeding clinic in the UK: A cross-sectional service evaluation

This service evaluation investigated an interdisciplinary allied professional health care strategy to address the problem of suboptimal breastfeeding. A clinic of midwives and chiropractors was developed in a university-affiliated clinic in the UK to care for suboptimal feeding through a multidisciplinary approach. No studies have previously investigated the effect of such an approach. The aim was to assess any impact to the breastfeeding dyad and maternal satisfaction after attending the multidisciplinary clinic through a service evaluation. Eighty-five initial questionnaires were completed and 72 (85%) follow-up questionnaires were returned. On follow-up, 93% of mothers reported an improvement in feeding as well as satisfaction with the care provided. Prior to treatment, 26% of the infants were exclusively breastfed. At the followup survey 86% of mothers reported exclusive breastfeeding. The relative risk ratio for exclusive breastfeeding after attending the multidisciplinary clinic was 3.6 (95%CI 2.4-5.4)

Discover Mojave Forever Earth Curriculum

The Discover Mojave Forever Earth program is more than a field trip to Lake Mead National Recreation Area (NRA). The program takes place aboard the Forever Earth, a floating environmental learning center. It is designed to give students the rare opportunity to study different facets of water in the desert—such as its characteristics and quality, the species that rely on it, its ability to change a landscape, and much more. This educational experience complements traditional classroom studies with engaging, participatory, on-site activities and support lessons based upon a solid framework for inquiry and discovery. On-site activities and the supporting lessons described herein align with Clark County School District curriculum and are correlated to Nevada State Science Standards and Clark County School District Curriculum Essentials Framework and Science Objectives. Pre-visit lessons prepare students for their trip, introducing important background concepts, key questions, and themes. Post-visit lessons follow up on and reinforce the on-site learning, and more importantly, encourage “big-picture” synthesis and options for stewardship

Are Hospital Quality Characteristics Consistent Over Time?

We conduct a study of a large sample collected from hospitals to extend the knowledge of quality indicators in the healthcare profession and to determine if results are consistent over time. Findings show that, over time, the hospital size and teaching status were consistent indicators of higher rates of error as shown by several patient safety variables. This is contrary to conventional wisdom, which holds that the best care is provided by large teaching hospitals. As a result, context variables are shown to influence quality indicators in a healthcare setting that could also offer implications for quality in other industries

The Relationship Between Patient Safety Outcomes and Hospital Characteristics

To augment the discussion of the extent to which quality is universal, this study presents the results of an analysis of 13.5 million inpatient discharges from 1,640 general hospitals from 16 states. Factor analysis was performed on 588 general U.S. hospitals and 18 PSIs were reduced to seven factors. Hospital tiers were profiled utilizing demographic variables. Contrary to expectations the best quality hospitals tended to be smaller, non-teaching hospitals whereas larger, teaching hospitals tended to be poor quality performers. This analysis provided evidence patient safety quality rates may not be universal and organizational context may be an important influencing factor

A case of recurrent giant cell tumor of bone with malignant transformation and benign pulmonary metastases

Giant cell tumor (GCT) of bone is a locally destructive tumor that occurs predominantly in long bones of post-pubertal adolescents and young adults, where it occurs in the epiphysis. The majority are treated by aggressive curettage or resection. Vascular invasion outside the boundary of the tumor can be seen. Metastasis, with identical morphology to the primary tumor, occurs in a few percent of cases, usually to the lung. On occasion GCTs of bone undergo frank malignant transformation to undifferentiated sarcomas. Here we report a case of GCT of bone that at the time of recurrence was found to have undergone malignant transformation. Concurrent metastases were found in the lung, but these were non-transformed GCT