United Arab Emirates
People: The population in the United Arab Emirates is incredibly diverse. Only some 20% of the population of the Emirates are ‘real’ Emiratis; Most the rest come from the Indian Subcontinent: India, Pakistan, or Bangladesh (some 50%); other parts of Asia, particularly the Philippines, Malaysia, and Sri Lanka (another perhaps 15%); and “Western” countries (Europe, Australia, North America, South Africa; 5-6%), with the remainder from everywhere else. On any given day in, say, Dubai or Sharjah, you can see people from every continent and every social class. With this diversity, one of the few unifying factors is language, and consequently nearly everyone speaks some version of English. Nearly all road or other information signs are in English and Arabic, and English is widely spoken, particularly in the hospitality industry. On the other hand, there are elements that would be unsettling for overseas travelers, such as fully veiled women, but as this is “their way”, tourists should show respect and will be offered the same in turn.
Full Article: http://wikitravel.org/en/United_Arab_Emirates
UAE – The Smallest Lives Matter
University Hospital Sarjah (UHS) – NEWS – The smallest lives matter: World Prematurity Day 2016 at University Hospital Sharjah. On November 17, 2016 University Hospital Sharjah commemorated World Prematurity Day on November 17, 2016 focusing attention on infants born early and the need to alleviate the concerns of their families.
In this article, Prof Hakam Yaseen, Medical Director (CMO) Consultant Neonatologist, HOD Paediatric & NICU and Member of Board of Trustees, UHS, said, “The neonatal mortality rate at UHS is 4 babies per 1000 which is much less than the global average rate. We have the experience, expertise, tools, and technology. This is a day for us to align our actions and global efforts and in doing so, demonstrate our conviction that every newborn is worth saving.” HE Abdullah Ali Al Mahyan, Chairman of Board of Trustees, UHS, said, “A baby born less than 37 weeks of gestation risks suffering from complications after birth and could face a lifetime of disability. Preterm birth is of growing concern, but the lives of these infants can be saved as well as preventing negative impacts on their families. Today, we stand poised to end preventable deaths by recognizing preterm birth as a priority in alignment with global efforts. *10% of babies born in UAE are preterm births.
Sheikh Zayed Institute Doctors Children’s National Medical Center:
Per their website http://www.uaeusaunited.com/story/childrens-national-medical-center Children’s National Medical Center, located in Washington DC states “For decades, physicians at Children’s National Medical Center in Washington, DC have treated Emirati patients who require specialized pediatric care. A transformative $150 million grant from the United Arab Emirates in 2009 established the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National, spurring new research and groundbreaking developments that will improve the health of children in the US, the UAE, and around the world”. The partnership between the United Arab Emirates and Children’s National also supports education exchange opportunities. The Website states “UAE doctors are learning from some of the best pediatric physicians, nurses and technical professionals in the United States, on their journey to contribute to UAE’s growing reputation as a world-class medical care hub with state-of-the-art hospitals and research facilities”.
Preemie Family Partners-
In Dubai, UAE Preterm Birth families find support through Babies Born a little too soon.
Who they are: Our hope is to bring people together by offering support and care to those families currently in NICU or who have recently come home. We are not doctors, nurses or counsellors. We are mothers who have experienced first-hand the NICU journey and we hope to help you like we helped each other.
**** Please take a peak at this Neonatal Womb/Preterm Birth Community resource!http://www.smallandmightybabies.com/about/
“Music Therapy Helps Preemie Babies Thrive”-
Web MD By Amy Norton/ HealthDay Reporter THURSDAY, Aug. 25, 2016 (HealthDay News): “The soothing sound of mom singing may help premature newborns breathe easier, a new review finds.
Breathing rate during their time in the neonatal intensive care unit (NICU). For the most part, music therapy involved mothers singing to their babies (though some studies used recordings of mom’s voice). And that’s key, the researchers said. “Full-term infants can recognize the mother’s voice at birth,” explained researcher Lucja Bieleninik. “This connection is important to foster inpremature infants, whose last months of gestation are instead spent outside of the womb.”
Plus, when mom or dad sing, they can change their voices – getting quieter, for example, when the baby seems to be falling asleep, explained Bieleninik, a postdoctoral researcher at the Grieg Academy Music Therapy Research Center, in Bergen, Norway.
In essence, music therapy begins in the womb, said Joanne Loewy. She’sdirector of the Mount Sinai Health System’s Louis Armstrong Center forMusic and Medicine, in New York City.
“The first drummer you ever hear is your mother’s heart,” said Loewy, who wasn’t involved in the review. “You hear the ‘whoosh’ sounds of the womb.”
Loewy had some advice for parents who want to use music to soothe their infants: Sing a simple lullaby at bedtime, holding your baby over your heart, skin to skin. She said the “best” song is one that has meaning for parents — because it’s from their culture or because their parents sang it to them, for example. And it doesn’t have to be a traditional lullaby. “Parents can sing their favorite songs, modifying them into a lullaby style that is gentle, quiet, and ‘lulling,'” Bieleninik said. “Often,” she added, “a very simple, nurturing use of the voice serves as the best medicine between preterm infant and parent at this vulnerable time.” The study was published August 25 in the journal Pediatrics.
Enjoy the full article at – http://www.webmd.com/parenting/baby/news/20160825/music-therapy-helps-preemie-babies-thrive#1
Kathy: I played music (Yanni, Tangerine Dream, George Winston, Kitaro) for Kathryn and Cruz in 1991 by placing ear phones connected to a cassette player (yes, old technology) across my belly. We played the same cassette for Kathryn while she was in the NICU. In 1991 the NICU rooms were shared, and someone must have played a lot of “Carpenters” music because as a toddler, whenever Kathryn heard a Carpenter’s song, she sang all of the lyrics.
Preterm Birth Dads need support also! The Fatherhood Global website offers Preterm Dads food for thought! Because support for Dads is elusive, we are including the full article.
Fatherhood.Global reports the science of fatherhood. –
FATHERS ARE NEEDED IN THE NEONATAL INTENSIVE CARE UNIT
It is important for fathers to have physical contact with their babies in a neonatal intensive care unit.
Six different research articles published in 2016 have looked at fathers in neonatal care units. The researches come to three main conclusions:
- Babies need to have physical contact with their father.
- Mothers need fathers to be present.
- There are things that parents can do to make sure the intensive care unit helps fathers in the best way.
Things mothers and fathers can do-
Neonatal intensive care units are not always very good at involving fathers properly. A big study of 9,000 parents in 11 neonatal intensive care units in Finland, Sweden, Norway, Estonia, Spain and Italy found that units performed weakest in fathers’ participation in infant care, particularly in the view of fathers. The researchers top tips are:
- Make sure the father is really OK!
This is not selfish. Mother and baby need the father to be OK.
Whilst both parents experience the situation in similar ways – stress, fear, alienation and a sense of chaos and unreality – mothers and fathers can respond in different ways. Fathers can try to fit into the role of the “strong” person. Sometimes they have to cry alone and unseen. If the mother is also unwell, the father is concerned for her care as well as the baby’s, while the mother can focus more of her concern on the baby.
- Get father time alone with the baby
The research shows that fathers can be less intimate with the baby when the mother is present – they defer to the mother. Fathers tend to express less determination to be in control of the care of their babies than mothers do, so may let the mother take over. But mothers need a break and babies need their fathers.
- Stroke and carry the baby as much as possible
Nurses should be ready to teach fathers the practice of stroking the baby and carrying them skin-to-skin (often called “kangaroo care”).
- Don’t rely on second-hand information
Many fathers have to keep working and look after other family members too. There is a risk that they receive too much second-hand information because they are not present during working hours. Staff should be available in the evenings to communicate information directly to fathers.
- Get flexible access to the unit
Flexible access to the unit and longer visits are important for fathers. There is a risk of this not happening if the father is taking on the other family responsibilities.
- Connect with other fathers in the internet
This is what some fathers said to other fathers on social media groups in a US research study.
“I think that one thing I could have used was communication with other dads who had been through the NICU experience. The moms were able to bond in the pumping room but I had no place to meet or talk with other dads that had gone through what I was expecting.”
“The whole preemie thing is terrifying. Everybody around the situation is focused on mom/baby. Dads are left to worry about everything and everyone. As a dad, you may feel lonely. Hopefully, you will get some support by talking to people in here.”
“Because of our choice to speak up, [infant’s name] is receiving the support he so desperately needs. Feeling empowered and speaking up to advocate for your child is such an important aspect of helping your child whether it’s in the NICU or after you come home.”
“I don’t want to be weak in front of my wife. I don’t think she knows how bad I am hurting right now.”
“We guys like to fix things and this is something that cannot be fixed and there’s got to be some frustration about that. I wouldn’t want my wife asking me how I feel.”
Full Article: https://fatherhood.global/neonatal-intensive-care/
THE GOLDEN HOUR
What is the Golden Hour in the World of Neonatology?
A term borrowed from emergency and cardiovascular medicine, the phrase “Golden Hour” refers to the first hour of an infant’s life following delivery. Two articles approaching similar and alternative perspectives are provided.
We found this article to be unique and compelling! Please enjoy the feature, data and research and be sure to check out the Audit form for the First Golden Hour Practice and additional interesting forms on the website indicated below.:
The golden hour approach: Practical guidelines of the Saudi neonatology society on managing very low birth weight infants in the first hour of life.
Premature infants are at a high risk of morbidity and mortality. Furthermore, physiologic immaturity renders most very low birth weight infants (VLBWIs) in need of interventions and stabilization immediately following birth. Some of these may trigger deleterious processes that become significant precursors to acute and chronic morbidities. The Kingdom of Saudi Arabia is lacking guidelines that focus on VLBWI, especially on the first hour of life (golden hour). Therefore, the aim of these practice guidelines is to compliment rather than replace clinical judgment. In addition, golden hour approach will enable units to collaborate in providing comprehensive care to VLBWI and thus will improve their chances of survival without pulmonary, neurodevelopmental, and neurosensory morbidities.
This finding noted in the article really caught our attention: Care of the high-risk fetus and neonate demands close collaboration among medical (neonatologists/pediatricians, obstetricians, and perinatologists), nursing (Neonatal Intensive Care Unit [NICU] nurses, midwives, and transport nurses), and auxiliary (respiratory therapists and clinical pharmacists) personnel. Effective communication is vital to focusing such multidisciplinary efforts on the objective of ensuring complication-free survival of VLBWI, particularly as communication errors have been identified as the root cause of perinatal deaths and injuries.,
Journal of Pediatrics and Neonatal Care
The Golden Hour: Providing Very Premature Infants a Favorable Beginning
Abstract: The first hour of life in a very premature neonate is a critical period of transition requiring extra-uterine adaptation of multiple organ systems for which the vulnerable neonate is ill prepared. Medical interventions provided to the neonate during this golden first hour of life can have significant implications on immediate survival and long term morbidities. Delayed cord clamping, delivery room temperature stabilization, strategies to establish functional residual capacity and gentle ventilation, early administration of dextrose and amino acid infusions, antibiotics when indicated and timely successful placement of peripheral or umbilical venous catheters are areas of focus during golden hour care. Premature infants born and resuscitated at tertiary and quaternary care centers have improved survival chances and outcomes when compared to similar “outborn” infants which highlight the role of experienced and skilled resuscitation teams in the golden hour. Strategies to standardize the various elements used in the resuscitation and stabilization of the very premature neonate that utilize quality improvement measures such as a golden hour protocol may help improve timeliness and efficacy of care provided in the first hour of life.
Conclusion: An increasing body of evidence substantiates that medical interventions done during resuscitation and stabilization of a very premature infant may have a direct impact on immediate survival and long term morbidities. A multitude of complex decisions and tasks need to be completed in a brief time period following birth of a very premature infant to provide the best chances for a smooth transition to postnatal life and ensure positive outcomes. A standardized evidence based approach of team development, effective communication and enhanced performance by utilization of a ‘golden hour for neonate’ protocol by interdisciplinary teams caring for high risk newborns may improve timeliness of interventions and advance outcomes.
Full Article: http://medcraveonline.com/JPNC/JPNC-05-00182.pdf
The Golden Hour … Family-Centered Care and Innovation-
Health Care Partners-
At its 2016 Interim Meeting, in Orlando, Fla., the AMA House of Delegates adopted policies aimed at expanding access to spiritual care, mental health services, protecting newborns from harm, improving access to care for prisoners and ex-convicts, and supporting physicians’ efforts to highlight shortfalls in care. A summary of a few of the policies that were addressed follows:
AMA News – 11/17/16 Timothy M. Smith
Physicians see positive role for spirituality in medicine –
Appreciating patients’ spiritual side:
With research suggesting that patient satisfaction is lower and cost of care is higher in the absence of spiritual support from care teams, the AMA adopted policy recognizing the importance of individual patient spirituality and its effect on health. Delegates also encouraged giving patients access to spiritual care services.
In addition, the AMA adopted policy “supporting mental health and faith community partnerships that foster improved education and understanding regarding culturally competent, medically accepted and scientifically proven methods of care for psychiatric and substance use disorders.” The policy says mental health professionals should better understand the role faith can play in mental health and addiction recovery for some patients. The AMA will support the efforts of mental health professionals to “create respectful, collaborative relationships with local religious leaders to improve access to scientifically sound mental health services.”
Better mental health services for undergrads and grad students:
A rising number of college students are experiencing disorders such as depression, anxiety, suicidal ideation, alcohol misuse, eating disorders and self-injury. According to a 2014 National Survey of College Counseling Centers, 94 percent of surveyed college counseling directors reported that the number of students with significant mental health problems is a growing concern.
The AMA adopted policy supporting strategies to destigmatize mental illness and enable timely and affordable access to mental health services for undergraduate and graduate students. The Association will support college and university efforts to stress to undergraduate and graduate students and their parents the importance, availability and efficacy of mental health resources. Lastly, the policy supports collaborations among university mental health specialists and local public or private practices to provide a larger pool of resources, “such that any student is able to access care in a timely and affordable manner.”
“Many physicians-in-training do not seek out treatment for physical, mental health or addiction issues because they are concerned about confidentiality, the possible negative impact that receiving treatment could have on their future career in medicine, or burdening colleagues with extra work,” AMA Board Member and medical student Omar Z. Maniya said in a statement. “With a high number of medical students and residents experiencing depression, burnout and suicide, and too many physicians overlooking their own health needs, we must do everything we can to reduce the barriers and stigmas that keep them from receiving care.”
Latifa Women and Children Hospital- Dubai Health Authority (DHA) cordially invites you to the “3rd Latifa Hospital International Pediatric and Neonatal Conference” (LHPNC 2017) to be held from 23rd – 25th March 2017 in Dubai – UAE.
Preterm births result from many diverse environmental, medical, physical, psychological, economical, situational, nutritional, and multidimensional factors and are unique to each of us. However, there are also known factors that impact our Neonatal Womb Community as a whole which once recognized and understood may allow us to decrease preterm birth and preterm mortality rates over time. This article approaches an issue that is not often discussed as a factor in preterm birth, and the research is compelling. As we become protectors and keepers of our planet and as we embrace our social and global responsibilities, some of us may be called to serve in capacities that support an environmentally health and life-sustaining planet.
Science News reported on February 16, 2017 (University of New York): Outdoor air pollution tied to millions of preterm births. In Summary, the article states: Outdoor air pollution has been linked to 2.7 million preterm births per year, a major study has concluded. When a baby is born preterm (at less than 37 weeks of gestation), there is an increased risk of death or long-term physical and neurological disabilities. The annual economic cost of the nearly 16,000 premature births linked to air pollution in the United States has reached $4.33 billion, according to a report by scientists at NYU Langone Medical Center. The sum includes $760 million spent on prolonged hospital stays and long-term use of medications, as well as $3.57 billion in lost economic productivity due to physical and mental disabilities associated with preterm birth. For the study, Trasande and his colleagues examined data from the Environmental Protection Agency, the Centers for Disease Control and Prevention, and the Institute of Medicine. The new analysis, to be published in the journal Environmental Health Perspectives online March 29, is the first to examine the costs of premature births due to air pollution in the U.S., according to the study’s authors. Researchers say air pollution is known to increase toxic chemicals in the blood and cause immune system stress, which can weaken the placenta surrounding the fetus and lead to preterm birth. Please see the interesting article and graph at:
Please see the interesting article graph–https://www.sciencedaily.com/releases/2016/03/160329101031.htm
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