PubMed Baby Friendly

Beyond BFHI: The Spatz 10-Step and Breastfeeding Resource Nurse Model to Improve Human Milk and Breastfeeding Outcomes.

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Beyond BFHI: The Spatz 10-Step and Breastfeeding Resource Nurse Model to Improve Human Milk and Breastfeeding Outcomes.

J Perinat Neonatal Nurs. 2018 Apr/Jun;32(2):164-174

Authors: Spatz DL

Abstract
A report released by the World Health Organization states that worldwide less than 10% of birth occur in hospitals certified through the Baby-Friendly Hospital Initiative. Furthermore, the Baby-Friendly Hospital Initiative's primary focus is on breastfeeding for healthy, mother-infant dyads. This article provides alternative models for implementing evidence-based care during maternal-infant separation so that mothers can achieve their personal breastfeeding goals. These include the Spatz 10-step model for human milk and breastfeeding in vulnerable infants and the Breastfeeding Resource Nurse model. Clinical outcome data are provided to demonstrate the effectiveness of the models as well as a road map of strategies to implement the models and measure outcomes.

PMID: 29689018 [PubMed - in process]

Baby-Friendly as a Regional Collaborative Quality Improvement Project in an Academic Medical Center Environment.

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Baby-Friendly as a Regional Collaborative Quality Improvement Project in an Academic Medical Center Environment.

J Perinat Neonatal Nurs. 2018 Apr/Jun;32(2):136-143

Authors: Krauss MJ, Sharp M

Abstract
In 2012, the state of South Carolina lacked any Baby-Friendly designated hospitals. The Medical University of South Carolina had a strong lactation service since 2002 but continued to struggle with improving breastfeeding rates. The Baby-Friendly Hospital Initiative was the catalyst to increase breastfeeding rates at this academic medical center. In 2012, membership in the Best Fed Beginnings Learning Collaborative heightened awareness of the importance of interdisciplinary collaboration. Participation in the regional collaborative provided evidence-based breastfeeding education and best clinical practices that supported the maternal-infant dyad. These improved practices are achieved by implementation of the Ten Steps to Successful Breastfeeding. The collaborative model accelerated change, and the goals to reach 80% of each metric were met. The exclusive breastfeeding rate increased by 30%. As a result of swiftly achieving designation, the institution was then able to focus on sustainability issues and efforts to expand breastfeeding support into the community. The purpose of this article is to review one hospital's journey while providing guidance to other organizations undergoing the process of becoming Baby-Friendly. The invaluable membership in the Best Fed Beginnings Learning Collaborative quality improvement initiative proved to be a major incentive and source of support in efficiently achieving Baby-Friendly status.

PMID: 29689014 [PubMed - in process]

Incorporating "Father-Friendly" Breastfeeding Language in Maternity Settings.

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Incorporating "Father-Friendly" Breastfeeding Language in Maternity Settings.

J Perinat Neonatal Nurs. 2018 Apr/Jun;32(2):112-115

Authors: Johnston JT

Abstract
The purpose of this commentary is to provide perinatal providers with the tools they need to incorporate fathers into the breastfeeding relationship. Research shows that engaged fathers increase initiation rates, decrease the rate of breastfeeding complications that lead to premature cessation, and increase the duration and exclusivity of a mother's breastfeeding efforts. Despite this evidence, studies frequently show that fathers report being ignored or excluded from breastfeeding education. This is likely an oversight on the behalf of perinatal providers rather than a conscious effort. Ultimately, however, perinatal providers need to be prepared to address the concerns of all parents who will provide care to the infant and not the mother alone. This commentary discusses the value of fathers as breastfeeding supporters and offers evidence-based teaching strategies requested by fathers. This commentary also identifies and describes 4 father-friendly breastfeeding promotion resources and highlights the techniques used to draw fathers into the mother's breastfeeding efforts.

PMID: 29689012 [PubMed - in process]

Live Birth after Rescue In vitro Maturation-intracytoplasmic Sperm Injection in Type 1 Diabetes, Polycystic Ovary Syndrome Patient Using Clomiphene-antagonist Protocol.

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Live Birth after Rescue In vitro Maturation-intracytoplasmic Sperm Injection in Type 1 Diabetes, Polycystic Ovary Syndrome Patient Using Clomiphene-antagonist Protocol.

J Hum Reprod Sci. 2018 Jan-Mar;11(1):75-78

Authors: Sankari S, Elanchezhian M, Selvamani D, Nagarajan M, Gopikrishnan D

Abstract
Infertility in patients with polycystic ovary syndrome (PCOS) associated with diabetes leads to challenging situations seeking alternative treatments. In vitro maturation (IVM) followed by intracytoplasmic sperm injection (ICSI) could overcome the challenges with promising pregnancies in such patients. In the treatment of a 32-year-old diabetic woman who also had PCOS, single immature oocyte was retrieved. Rescue IVM followed by ICSI yielded a grade 1 day 3 embryo which on transferring resulted in pregnancy and a healthy infant was delivered. Rescue IVM-ICSI could help in achieving pregnancy and live birth. Stimulation involving clomiphene and gonadotropin-releasing hormone antagonist is an effective and patient-friendly protocol for women with PCOS and diabetes and also for poor responders.

PMID: 29681720 [PubMed]

Retrieval and clinical analysis of distraction-based dual growing rod constructs for early-onset scoliosis.

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Retrieval and clinical analysis of distraction-based dual growing rod constructs for early-onset scoliosis.

Spine J. 2017 Oct;17(10):1506-1518

Authors: Hill G, Nagaraja S, Akbarnia BA, Pawelek J, Sponseller P, Sturm P, Emans J, Growing Spine Study Group, Bonangelino P, Cockrum J, Kane W, Dreher M

Abstract
BACKGROUND CONTEXT: Growing rod constructs are an important contribution for treating patients with early-onset scoliosis. These devices experience high failure rates, including rod fractures.
PURPOSE: The objective of this study was to identify the failure mechanism of retrieved growing rods, and to identify differences between patients with failed and intact constructs.
STUDY DESIGN/SETTING: Growing rod patients who had implant removal and were previously enrolled in a multicenter registry were eligible for this study.
PATIENT SAMPLE: Forty dual-rod constructs were retrieved from 36 patients across four centers, and 34 of those constructs met the inclusion criteria. Eighteen constructs failed due to rod fracture. Sixteen intact constructs were removed due to final fusion (n=7), implant exchange (n=5), infection (n=2), or implant prominence (n=2).
OUTCOME MEASURES: Analyses of clinical registry data, radiographs, and retrievals were the outcome measures.
METHODS: Retrievals were analyzed with microscopic imaging (optical and scanning electron microscopy) for areas of mechanical failure, damage, and corrosion. Failure analyses were conducted on the fracture surfaces to identify failure mechanism(s). Statistical analyses were performed to determine significant differences between the failed and intact groups.
RESULTS: The failed rods fractured due to bending fatigue under flexion motion. Construct configuration and loading dictate high bending stresses at three distinct locations along the construct: (1) mid-construct, (2) adjacent to the tandem connector, or (3) adjacent to the distal anchor foundation. In addition, high torques used to insert set screws may create an initiation point for fatigue. Syndromic scoliosis, prior rod fractures, increase in patient weight, and rigid constructs consisting of tandem connectors and multiple crosslinks were associated with failure.
CONCLUSION: This is the first study to examine retrieved, failed growing rod implants across multiple centers. Our analysis found that rod fractures are due to bending fatigue, and that stress concentrations play an important role in rod fractures. Recommendations are made on surgical techniques, such as the use of torque-limiting wrenches or not exceeding the prescribed torques. Additional recommendations include frequent rod replacement in select patients during scheduled surgeries.

PMID: 28456673 [PubMed - indexed for MEDLINE]

Breastfeeding during infancy and neurocognitive function in adolescence: 16-year follow-up of the PROBIT cluster-randomized trial.

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Breastfeeding during infancy and neurocognitive function in adolescence: 16-year follow-up of the PROBIT cluster-randomized trial.

PLoS Med. 2018 Apr;15(4):e1002554

Authors: Yang S, Martin RM, Oken E, Hameza M, Doniger G, Amit S, Patel R, Thompson J, Rifas-Shiman SL, Vilchuck K, Bogdanovich N, Kramer MS

Abstract
BACKGROUND: Evidence on the long-term effect of breastfeeding on neurocognitive development is based almost exclusively on observational studies. In the 16-year follow-up study of a large, cluster-randomized trial of a breastfeeding promotion intervention, we evaluated the long-term persistence of the neurocognitive benefits of the breastfeeding promotion intervention previously observed at early school age.
METHODS AND FINDINGS: A total of 13,557 participants (79.5% of the 17,046 randomized) of the Promotion of Breastfeeding Intervention Trial (PROBIT) were followed up at age 16 from September 2012 to July 2015. At the follow-up, neurocognitive function was assessed in 7 verbal and nonverbal cognitive domains using a computerized, self-administered test battery among 13,427 participants. Using an intention-to-treat (ITT) analysis as our prespecified primary analysis, we estimated cluster- and baseline characteristic-adjusted mean differences between the intervention (prolonged and exclusive breastfeeding promotion modelled on the Baby-Friendly Hospital Initiative) and control (usual care) groups in 7 cognitive domains and a global cognitive score. In our prespecified secondary analysis, we estimated mean differences by instrumental variable (IV) analysis to account for noncompliance with the randomly assigned intervention and estimate causal effects of breastfeeding. The 16-year follow-up rates were similar in the intervention (79.7%) and control groups (79.3%), and baseline characteristics were comparable between the two. In the cluster-adjusted ITT analyses, children in the intervention group did not show statistically significant differences in the scores from children in the control group. Prespecified additional adjustment for baseline characteristics improved statistical precision and resulted in slightly higher scores among children in the intervention for verbal function (1.4 [95% CI 0.3-2.5]) and memory (1.2 [95% CI 0.01-2.4]). IV analysis showed that children who were exclusively breastfed for ≥3 (versus <3) months had a 3.5-point (95% CI 0.9-6.1) higher verbal function, but no differences were observed in other domains. While our computerized, self-administered cognitive testing reduced the cluster-level variability in the scores, it may have increased individual-level measurement errors in adolescents.
CONCLUSIONS: We observed no benefit of a breastfeeding promotion intervention on overall neurocognitive function. The only beneficial effect was on verbal function at age 16. The higher verbal ability is consistent with results observed at early school age; however, the effect size was substantially smaller in adolescence.
PROBIT TRIAL REGISTRATION: ClinicalTrials.gov NCT01561612.

PMID: 29677187 [PubMed - in process]

A novel sandwich enzyme-linked immunosorbent assay with covalently bound monoclonal antibody and gold probe for sensitive and rapid detection of bovine β-lactoglobulin.

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A novel sandwich enzyme-linked immunosorbent assay with covalently bound monoclonal antibody and gold probe for sensitive and rapid detection of bovine β-lactoglobulin.

Anal Bioanal Chem. 2018 Apr 14;:

Authors: He S, Li X, Wu Y, Wu S, Wu Z, Yang A, Tong P, Yuan J, Gao J, Chen H

Abstract
Bovine milk is a recognized allergenic food source with β-lactoglobulin (BLG) as its major allergen. Reliable detection of BLG epitopes can, therefore, be a useful marker for the presence of milk in processed food products, and for potential allergenicity. At the present, enzyme-linked immunosorbent assays (ELISA) for the detection of BLG are time-consuming and generally not specific to BLG IgE epitopes. In this study, the 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide-activated anti-BLG IgE epitope monoclonal antibody (mAb 1G9) was covalently bound onto the KOH-treated microtiter plate surface. Using this mAb-bound plate in sandwich combination with biotinylated anti-BLG polyclonal antibody-labeled gold nanoparticles, a linear dynamic range between 31.25 and 64 × 103 ng mL-1 with a limit of detection for BLG of 0.49 ng mL-1 was obtained, which is 32 times wider and 16 times more sensitive than conventional sandwich ELISA (sELISA). Total recovery of BLG in spiked food samples was found, without matrix effects. Also in partially hydrolyzed infant formulas, the allergenic BLG residues were detected quantitatively. Compared with conventional and commercial BLG detection sELISAs, our sELISA is reliable, highly BLG epitope-specific, user-friendly, and time-saving and allows accurate detection of potentially allergenic residues in different types of processed foods. This improved sELISA protocol can be easily extended to detect other well-identified and characterized food allergens. Graphical abstract IgE epitope mAb-bound plate in sandwich combination with gold probe for sensitive and rapid detection of bovine β-lactoglobulin and its potentially allergenic residues.

PMID: 29654339 [PubMed - as supplied by publisher]

A novel method for examining corneal endothelial cell morphology in infants.

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A novel method for examining corneal endothelial cell morphology in infants.

J AAPOS. 2017 Jun;21(3):241-243.e1

Authors: Rufai SR, Tan NY, Barbara R, Hartrey R, Self JE

Abstract
Previous studies have suggested that central corneal endothelial cell density (ECD) decreases from 6,100 cells/mm2 in neonates to 3,100 cells/mm2 in 10-year-olds. Currently data on ECD in young children as well as the trend for ECD decrease during childhood is sparse because of the difficulty of examination using existing clinic-based specular microscopes. We developed a novel method of imaging young children intraoperatively with the goal of beginning to establish age-specific normative data for ECD and hexagonality of cells (%HEX). Children were imaged using our novel technique under general anesthesia or awake in clinic using a child-friendly technique. A total of 58 children were recruited (mean age, 5.50; range, 0.44-10.36). Our cohort displayed a significant linear decrease in ECD with age (r = -0.56, P < 0.001). No correlation was found between %HEX and age (r = -0.10, P = 0.48).

PMID: 28347727 [PubMed - indexed for MEDLINE]

Stomach frame-count-based attenuation correction of dynamic posterior view gastric emptying scintigraphy with continuous acquisition in children.

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Stomach frame-count-based attenuation correction of dynamic posterior view gastric emptying scintigraphy with continuous acquisition in children.

Pediatr Radiol. 2017 Nov;47(12):1599-1607

Authors: Cao X, Xu X, Drubach L, Fahey FH

Abstract
BACKGROUND: When performing dynamic gastric emptying scintigraphy with continuous acquisition in children, a single posterior view acquisition is preferred because it allows the young patient to more easily interact with a parent or technologist even though this method tends toward overestimating gastric emptying.
OBJECTIVES: The objective of our study was to develop a new attenuation correction (AC) method to improve the accuracy of the time activity curve and the measurement of residual gastric emptying from 1-h posterior images of gastric emptying scintigraphy with continuous acquisition.
MATERIALS AND METHODS: We developed a frame-count-based AC for gastric emptying scintigraphy from the posterior view (posterior AC method). We retrospectively reviewed 122 gastric emptying studies performed in children using conjugated posterior and anterior views, and evaluated the statistical differences between posterior only (without AC) and posterior AC using the geometric mean method as a reference standard.
RESULTS: The residual values obtained using posterior AC were not significantly different (P=0.813) compared to those using the geometric mean while the values using the posterior only were significantly different (P<0.001) from the geometric mean.
CONCLUSION: The proposed method can replace the geometric mean method to estimate gastric emptying residual fraction using patient-friendly posterior view without a significant difference in 1-h gastric emptying scintigraphy with continuous acquisition.

PMID: 28685191 [PubMed - indexed for MEDLINE]

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