• Alstrup Mooney posted an update 1 day, 6 hours ago

    Birth asphyxia is a global health burden, and effective neonatal resuscitation could reduce the burden of deaths. Providing a suitable newborn resuscitation care will depend on the availability of an effective skilled health worker, who is competent in neonatal resuscitation. The study explores and assesses the effect of neonatal resuscitation training and retention of knowledge and skills in the management of asphyxiated newborns in rural Nigeria. This study used a narrative analysis technique to analyze data from a semistructured, individual interview. Data were analyzed using ATLAS.ti 8 qualitative software and applying the principle of thematic analysis. There was a considerable retention of knowledge and ability to practice the procedure even though some equipment was not available. Proficiency in neonatal resuscitation is an essential intervention for the survival of newborns and infants. Therefore, execution of neonatal resuscitation training program in rural communities can further improve knowledge and skills of community birth attendants in Nigeria.Background. In low-income countries, preterm nutrition is often inadequately addressed. The aim of the study was to assess the patterns of feeding and associated clinical outcomes of preterm neonates admitted to neonatal intensive care units in Ethiopia. Method. This was a multicenter, prospective study. Infants’ clinical characteristics at birth, daily monitoring of feeding history, and weight measurements were collected. An outcome assessment was completed at 28 days. Result. For this analysis, 2560 infants (53% male) were eligible. selleck products The mean (SD) gestational age was 33.1 (2.2) weeks. During the hospital stay the proportion of infants on breast milk only, preterm formula, term formula, and mixed feeding was 58%, 27.4%, 1.6%, and 34.1%, respectively. Delay in enteral feeding was associated with increased risk of death (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.33-2.78; P less then .001) and (OR = 5.06, 95% CI = 3.23-7.87; P less then .001) for 1 to 3 and 4 to 6 days of delay in enteral feeding, respectively, after adjusting for possible confounders. The length of delay in enteral feeding was associated with increased risk of hypoglycemia (OR = 1.2, 95% CI = 1.1-1.2; P = .005). The mortality rate was lower in hospitals providing preterm formula more often (P = .04). Half of the infants continued losing weight at the time of discharge. Conclusion. Delayed enteral feeding significantly increases the risk of mortality before discharge and hypoglycemia in preterm infants in resource-limited settings. Ensuring adequate nutritional support of preterm infants is highly needed.Objective Cycling Without Age is a global initiative in which trained volunteers take adults living in care homes or supported housing environments out on specially designed trishaws. Despite its global success, there is limited research on the effect the initiative has on the older adults taking part. The current study therefore assessed changes in mood and wellbeing to determine whether there were short-term benefits of participation. Methods Forty-nine older adults (69% female; 67-100 years old (M = 84.1, SD = 7.6)) living in care homes and supported housing environments were recruited; 35 participants completed all measures and comprise the analytical sample. Participants completed the Warwick-Edinburgh Mental Wellbeing Scale and UWIST Mood Adjective Checklist immediately before a ride (baseline); they repeated the measures on completion of the ride (follow-up). Participants also completed baseline and follow-up measures on a day in which they did not go on a ride. Mixed ANOVA compared differences in baseline and follow-up mood and wellbeing scores on ride and no ride days. Results For all mood and wellbeing measures, there were significant interactions between day (ride or no ride) and measurement occasion (baseline or follow-up). Analyses revealed significant improvement in mood and wellbeing at follow-up on ride days versus no ride days. Conclusion Short-term positive changes in mood and wellbeing were reported as a result of participation in the Cycling Without Age initiative for older adults in care home and supported living environments. Further research is needed to explore the longevity of benefits and longer-term changes.

    To evaluate the impact of

    , 10th revision, Clinical Modification (

    ) implementation on pneumonia hospitalizations rates, which had declined following pneumococcal conjugate vaccine introduction for infants in 2000.

    We randomly selected records from a single hospital 1 year before (n = 500) and after (n = 500) October 2015 implementation of

    coding. We used a validated

    algorithm and translation of that algorithm to

    to identify pneumonia hospitalizations pre- and post-implementation, respectively. We recoded

    records to

    and vice versa. We calculated sensitivity and positive predictive value (PPV) of the

    algorithm using

    coding as the reference. We used sensitivity and PPV values to calculate an adjustment factor to apply to

    era rates to enable comparison with

    rates. We reviewed primary diagnoses of charts not meeting the pneumonia definition when recoded.

    Sensitivity and PPV of the

    algorithm were 94% and 92%, respectively, for young children and 74% and 79% for older adults. The estimated adjustment factor for

    period rates was -2.09% (95% credible region [CR], -7.71% to +3.0%) for children and +6.76% (95% CR, -3.06% to +16.7%) for older adults. We identified a change in coding adult charts that met the

    pneumonia definition that led to recoding in

    as chronic obstructive pulmonary disease (COPD) exacerbation.

    The

    algorithm derived from a validated

    algorithm should not introduce substantial bias for evaluating pneumonia trends in children. However, changes in coding of pneumonia associated with COPD in adults warrant further study.

    The ICD-10-CM algorithm derived from a validated ICD-9-CM algorithm should not introduce substantial bias for evaluating pneumonia trends in children. However, changes in coding of pneumonia associated with COPD in adults warrant further study.