Cup versus bottle feeding for hospitalized late preterm infants in Egypt: A quasi-experimental study

<p>Abstract</p> <p>Background</p> <p>Although previous studies have demonstrated beneficial breastfeeding outcomes when cup feeding rather than bottle feeding was used for feeding preterm infants, cup feeding has not been implemented in Egypt. The aim of the current study was to examine the effect of using cup feeding as an exclusive method of feeding preterm infants during hospitalization on breastfeeding outcomes after discharge.</p> <p>Methods</p> <p>A quasi-experimental design, with the control group studied first, was used to examine the effect of cup feeding for preterm infants on breastfeeding outcomes after discharge. Sixty preterm infants (mean gestational age was 35.13 weeks and mean birth weight was 2150 grams) were recruited during Neonatal Intensive Care Unit (NICU) stay. Control group infants (n = 30) received only bottle feedings during hospitalization and the experimental group (n = 30) received only cup feedings during hospitalization. Both groups were followed up after discharge for six weeks to evaluate infant's breastfeeding behavior and mother's breastfeeding practices. Data were analyzed using descriptive statistics and repeated measures ANOVA for testing the differences between the cup feeding and bottle feeding groups over six weeks after discharge.</p> <p>Results</p> <p>Cup fed infants demonstrated significantly more mature breastfeeding behaviors when compared to bottle fed infants (p < 0.01) over six weeks, and had a significantly higher proportion of breast feedings one week after discharge (p = 0.03).</p> <p>Conclusion</p> <p>Cup fed infants were more exclusively breast fed one week after discharge, supporting the Baby Friendly Hospital Initiative recommendations for using cup feeding and avoiding bottle feeding when providing supplementation for preterm infants. The current study provides initial evidence for the implementation of cup feeding as a method of supplementation for late preterm infants during hospitalization.</p> <p>Trial Registration</p> <p>Clinical Trial NCT00756587.</p

The effect of auditory stimulation on pain response of preterm infants

This study aimed to evaluate the effect of auditory stimulation on preterm infants' pain responses. A quasi-experimental design was utilized in this study. Thirty preterm infants were recruited for the study. They were one group used for three days as day one (routine care), day two (music intervention) and day three (recorded mother voice intervention) before, during and after blood sample procedure (heel prick) from Cairo University hospitals (El Monira and Kasar Aini). A tool containing two parts was used for data collection: 1) socio-demographic data for the preterm infants and the mothers, 2) Premature Infant Pain Profile (PIPP) tool for physiological responses (heart rate, oxygen saturation) behavioral state, brow bulge, eye squeeze, nasolabial furrow and respiratory rate was determined. Results of the study showed that during heel prick the majority of preterm infants (96.7%) who were exposed to recorded mother voice had highly statistical significant no or minimal pain followed by music groups (66.7%). On the other hand, nearly half of the cases (46.7%) had moderate pain and (30%) had severe pain among control group. There were significant differences between the three groups in the behavioral state, brow bulge, eye squeeze and nasolabial furrow (P≤0.001) and improved oxygen saturation (P≤0.05). After heel prick, the preterm infants (100%) who were exposed to recorded mother voice had highly statistically significant no or minimal pain in the items of behavioral state, eye squeeze and nasolabial furrow (P≤0.001), brow bulge was significantly lower (P≤0.05) when comparing by control or music group. In Conclusion, exposure to recorded mother voice during heel prick of preterm infants is better than exposure to music or no intervention and this was manifested by lower pain level, decrease heart rate, improved oxygen saturation and respiration. Key words: Auditory stimulation; recorded mother voice; music; pain response; physiological responses; behavioral stat

Efecto de la técnica de energía muscular versus la técnica de Graston sobre el dolor de cuello inespecífico

Antecedentes: Numerosas investigaciones se han llevado a cabo con el fin de determinar la estrategia de fisioterapia más eficaz para el tratamiento del dolor de cuello inespecífico (NSNP). Propósito: contrastar los resultados de la Técnica de Graston (GT) y la Técnica de Energía Muscular (MET) tanto en la intensidad del dolor como en la discapacidad funcional en pacientes con NSNP. Métodos: Cuarenta y dos (30 hombres y 12 mujeres) pacientes con NSNP divididos aleatoriamente en tres grupos: Grupo A: recibieron técnica de Graston y tratamiento de fisioterapia tradicional (TPT), Grupo B: recibieron técnica de energía muscular y TPT, y Grupo C: recibieron TPT solamente. La intervención tuvo una duración de 12 sesiones (3 por semana). Al inicio y al final de la cuarta semana, se utilizó una escala analógica visual para cuantificar la intensidad del dolor y un cuestionario de índice de discapacidad del cuello (NDI) para medir la discapacidad funcional. Resultados: Hubo efectos significativos de tiempo (pre/post) y grupo de intervención (Graston, MET, convencional) e interacción significativa sobre el dolor y la discapacidad (p<0,05). El grupo MET tuvo mayores cambios en el dolor que los grupos Graston y control (p<0,05). Sin embargo, no hubo diferencias significativas entre grupos en el cambio funcional. Conclusión: GT y MET tuvieron efectos similares sobre la función en pacientes con NSNP, pero MET tuvo efectos más altos sobre la reducción del dolor.Background: Numerous researches have been carried out in order to determine the most effective physical therapy strategy for treating nonspecific neck pain (NSNP). Purpose: To contrast between the outcomes of Graston Technique (GT)and Muscle Energy Technique (MET)on both pain intensity and functional disability in patients with NSNP. Methods: Forty-two(30 males and 12 females) patients with NSNP divided randomly into three groups: Group A: received Graston Technique and traditional physiotherapy treatment (TPT), Group B: received muscle energy technique and TPT, and Group C: received TPT only. Intervention lasted for 12 sessions (3per week). At the start and finish of the fourth week, a visual analogue scale was used to quantify pain intensity and a neck disability index (NDI) questionnaire was used to measure functional disability. Results: There were significant mean effects of time (pre/post) and intervention group (Graston, MET, conventional) and significant interaction on pain and disability (p<0.05). MET group had higher changes in the pain than both Graston and control groups (p<0.05). However, no significant differences among groups in the functional change. Conclusion: GT and MET had similar effects on the function in patients with NSNP, but MET had highereffects on reducing pain

Effect of Muscle Energy Technique versus Graston Technique on non-specific neck pain

Article accepted. The article will be published here soon. Pending final quality checks

Medium and long-term adherence to postabortion contraception among women having experienced unsafe abortion in Dar es Salaam, Tanzania

<p>Abstract</p> <p>Background</p> <p>Postabortion contraceptive service is considered an effective means in addressing the problem of unsafe abortion; in spite this fact this component remains one of the weakest parts of postabortion care. In this context, the paper aims to describe the impact of a postabortion contraceptive service intervention among women admitted with complications from unsafe abortions and to explore the women's long-term contraceptive adherence.</p> <p>Methods</p> <p>392 women having experienced unsafe abortion were identified by an empathetic approach and offered postabortion contraceptive service, which included counselling on HIV and condom use. Questionnaire interviews about contraceptive use were conducted at the time of inclusion and 12 months after the abortion. Additionally, in-depth interviews were performed 6–12 months after the abortion.</p> <p>Results</p> <p>Eighty-nine percent of the women accepted postabortion contraception. Follow-up information was obtained 12 months after the abortion among 59 percent of the women. Among these, 79 percent of the married women and 84 percent of the single women stated they were using contraception at 12 months. Condom use among the single women increased significantly during the 12 months follow up.</p> <p>Conclusion</p> <p>Postabortion contraceptive services appear to be well accepted by women who are admitted with complications after an unsafe abortion and should thus be recognized as an important means in addressing the problem of unsafe abortion. In addition, counselling about HIV and condom use should be considered an essential aspect of postabortion care.</p

A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

BACKGROUND: Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. METHODS: Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions) to assess the perspectives of women, providers, policy makers and community members. RESULTS: There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears) were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services available to women in their communities. CONCLUSION: To address gaps in services and unmet needs, state policies and integrated interventions have the potential to improve the quality of services for prevention of cervical cancer in Uttar Pradesh

Upgrading locally-regulated green buildings to LEED standards: a Dubai case study

Abstract With Dubai aiming to be one of the greenest cities in the world, the local government has set various requirements and regulations to achieve this goal. The Dubai Municipality has already established and implemented its own locally-developed green building regulation, Green Building Regulations &amp; Specifications (GBR&amp;S), to address major concerns associated with buildings’ resource efficiency. This study proposes a comparison between the GBR&amp;S system with USGBC’s LEED v4 rating to identify where GBR&amp;S falls short and how much it would cost to upgrade to the various levels of LEED certification. The authors also hypothesize that access to efficient, mass public transportation systems is a major factor when determining the cost of LEED certification. With this in mind, proximity to a public transportation network and its effect on the cost of a LEED upgrade were investigated.</jats:p