PRETERM BIRTH RATES – GREECE
Rank: 162 –Rate: 6.6% Estimated # of preterm births per 100 live births
(USA – 12 %, Global Average: 11.1%)
Greece, officially the Hellenic Republic, is a country in Southeast Europe. It is situated on the southern tip of the Balkans, and is located at the crossroads of Europe, Asia, and Africa. Greece shares land borders with Albania to the northwest, North Macedonia and Bulgaria to the north, and Turkey to the northeast. The Aegean Sea lies to the east of the mainland, the Ionian Sea to the west, and the Sea of Crete and the Mediterranean Sea to the south. Greece has the longest coastline on the Mediterranean Basin, featuring thousands of islands. The country consists of nine traditional geographic regions, and has a population of approximately 10.4 million. Athens is the nation’s capital and largest city, followed by Thessaloniki and Patras.
Greece has universal health care. The system is mixed, combining a national health service with social health insurance (SHI). 2000 World Health Organization report, its health care system ranked 14th in overall performance of 191 countries surveyed. In a 2013 Save the Children report, Greece was ranked the 19th out of 176 countries for the state of mothers and newborn babies. In 2010, there were 138 hospitals with 31,000 beds, but in 2011, the Ministry of Health announced plans to decrease the number to 77 hospitals with 36,035 beds to reduce expenses and further enhance healthcare standards. However, as of 2014, there were 124 public hospitals, of which 106 were general hospitals and 18 specialised hospitals, with a total capacity of about 30,000 beds
Remembering Dr. Lorna Breen, an emergency room physician who died by suicide during COVID-19
Feb 28, 2022
The following episode contains emotional content and a discussion about suicide. It’s intended for mature audiences. Viewer discretion is advised. If you or someone you know is in crisis, please call the National Suicide Prevention Hotline at 800-273-8255 or text ‘HELLO’ to 741741 to get 24/7 support. Corey Feist, co-founder of the Dr. Lorna Breen Heroes’ Foundation, remembers his late sister-in-law, Dr. Lorna Breen, who was a healthcare worker at the New York Presbyterian Hospital during the height of the pandemic. Dr. Lorna Breen died by suicide on April 26, 2020, and Corey shares her story in hopes to normalize conversations around mental health and prioritize the wellbeing of our healthcare workers. To learn more about how you can help support healthcare workers, please visit: participant.com/healthcareworkers.
NEONATAL INTENSIVE CARE UNIT NURSE TRAINING IN IDENTIFYING ULTRASOUND LANDMARKS IN THE NEONATAL MEDIASTINUM.
A training program for nurses in North-Eastern Greece
Full length Article| Volume 66 | E22-E26| Sept 01, 2022
- Tutoring NICU nurses to recognise basic mesothoracic structures by ultrasound
- Training improved the ability to accurately identify more lung structures
- Collaboration of nurses and interdisciplinary teams can benefit high-risk infants
To demonstrate methods and landmarks for mediastinum ultrasound as part of ultrasound examination of the lung for nurses. This will be the first step in their education to detect finally the tubes and lines malpositioning in order to distinguish emergency conditions of the lungs in neonates hospitalized in neonatal intensive care units.
Design and methods
Theoretical and practical interventions were developed to create a 3-month training program based on similar medical courses. The study was approved by the hospital’s ethics committee. The program was performed in the neonatal intensive care unit of a single academic institution. Participating nurse was supervised by a paediatric surgeon and trained in lung ultrasound (a safe method without radiation) by a paediatric radiologist.
During the practical period (2 months), the neonatal intensive care unit nurse examined 50 neonates (25 + 6–40 + 4 weeks gestational age; 21 males) separated into two subgroups of 25 neonates each for each training month. In the first month under supervision, the nurse was trained to recognise the aortic arch, the right pulmonary artery, the esophagus, the tracheal air, and the ‘sliding lung sign’ in the anterior, lateral, and posterolateral aspects of the thoracic cage. In the second month, the nurse recorded the ultrasound examinations. The identified structures were then assessed and graded by the supervising radiologist. The overall estimated success rate (5 landmarks × 25 neonates = 125) was 90.4%.
Although this is the first report of the design of a ‘hands-on,’ lung ultrasound training program for neonatal intensive care unit nurses, our findings demonstrate that it is a safe and useful program for all neonatal intensive care unit nurses because the overall success rate of the 3-month program was determined by accurate identification of basic anatomical structures (90.4%) by the nurse.
This study describes the first educational training program for NICU nurses designed to recognise basic structures in the neonatal mediastinum. If the program is effective, NICU nurses will be able to identify respiratory emergencies. NICU nurses can inform doctors about emergencies according to tubes and lines malpositioning in a timely manner to avoid negative consequences.
Expanding International Access to Children’s Mental Health Care
April 7, 2021
As families everywhere continue to cope with the extraordinary challenges of the coronavirus pandemic, the Child Mind Institute is proud to announce a new initiative to advance children’s mental health treatment.
Supported by a landmark grant from the Stavros Niarchos Foundation (SNF), we are launching an ambitious five-year project to bring our evidence-based clinical expertise to children’s mental health professionals across Greece. The initiative will develop a comprehensive care and referral system that will revolutionize Greek children’s access to the care, support and guidance they need to thrive.
In partnership with local providers, our work with SNF will build children’s mental health infrastructure in Greece through three main avenues:
• Extensive training and clinical supervision of children’s mental health professionals
• Development of a national referral center to give providers guidance on complex cases
• Expansion of technological capacity for telehealth services and specialized online tools
“Every child deserves access to professional, compassionate and dignified health care — including for mental health — and this program represents a significant first step toward a new paradigm for children’s mental health in Greece,” said SNF Co-President Andreas Dracopoulos.
The new grant is part of SNF’s Health Initiative, which aims to ensure access to quality care for everyone in Greece by strengthening the country’s health system. SNF has been a steadfast supporter of the Child Mind Institute since its founding, partnering to address challenges to child mental health for over a decade.
“Building on our rich history and partnership, we have an unparalleled opportunity to transform children’s mental health care in Greece,” said Child Mind Institute Founding President and Medical Director Dr. Harold Koplewicz. “Bringing together the visionary leadership of the Stavros Niarchos Foundation and the proven experience of the Child Mind Institute, we can create an international model for mental health care that will change the trajectory for children and adolescents struggling with their mental health in Greece and beyond.”
For all the latest updates on the Child Mind Institute’s work supporting children and families dealing with mental health and learning challenges, sign up for our newsletters.
wrs x Andromache – If you were alone / Sta matia sou | official video
1,263,884 views Jul 8, 2022 wrs
Maria Delivoria-Papadopoulos: the legendary pioneer in perinatology and mother of neonatology- Obituary
Pages 3631-3632 | Published online: 27 Sep 2020
Maria Delivoria-Papadopoulos was born in Athens, Greece. The hard times before, during and after World War 2, followed by the Greek civil war, severely affected her leftist family. However, hardships did not prevent her from receiving a scholarship and finishing with distinction her secondary education in the Greek-French School “Saint Josef;” from studying philosophy at the Greek section of the Sorbonne University; from occupying herself with literature, poetry, arts and theater, attending -despite her very limited resources- numerous theatrical performances; from receiving her medical degree from the National and Kapodistrian University of Athens, Medical School. Upon graduation Maria was trained in Pediatrics in “Aghia Sophia” Children’s University Hospital in Athens, where she gained great experience in using the iron lung in children with polio. Later, in Canada and the US, she will be the first clinician worldwide to apply mechanical respiratory support to another category of children: premature neonates.
A special feature of young Maria was her enthusiastic involvement with Girl Guiding, the principles of which, especially the offer to fellow human beings and society as a whole, Maria not only deeply embraced, but applied throughout her life. She quickly gained a high degree and educated a large number of children (me included) and adolescents, among them Princess Sophia, the later queen of Spain.
Her desire to participate to the latest developments in Pediatrics, urged her to move to the US. Nevertheless, the political history of her family was an insurmountable obstacle in getting a visa. Help will come from the highest possible level: the then Head of the body of Greek Girl Guides, Princess Sophia, signifying Maria’s incredible ability to unite opposite ends! Thus, with her husband, physician Christos Papadopoulos, Maria departs from Greece in 1959 to spend 61 years, the rest of her life, in the US, Canada and again the US, becoming a naturalized U.S. citizen in 1970, but always keeping with pride, deep in her heart, her beloved country of origin and her characteristic double Greek name. Extremely arduous, yet so productive years will follow, leading her soon to international recognition.
In the US and Canada, she completed residencies and fellowships in several state and University hospitals, training in Pediatrics, Neonatology, Obstetrics/Gynecology, Physiology and Embryology, thus, in all fields of Perinatal Medicine. She received a post-doctorate degree in Physiology from the University of Pennsylvania, where she spent the next 29 years as a faculty member. Further, she held numerous faculty and hospital appointments in the Philadelphia area. In 2006 she was awarded the Ralph W. Brenner Chair in Pediatrics at St. Christopher’s Foundation for Children.
Maria has given Grand Rounds several times per year at Universities and Medical Centers throughout the U.S, and functioned as Visiting Professor and keynote speaker in innumerous countries in South America, Europe and Asia for over 50 years. She has received a great number of prestigious awards, starting in 1961, e.g. “Teacher of the Year Award” for 1962, 1964, 1973, 1974, 1978, 1992, 1993, 1996, 2004, 2006, “NIH Special Research Fellowship Award 1966”, “NIH Young Investigator Award 1968”, “NIH Career Development Award 1968”, “American Academy of Pediatrics Lifetime Achievement Award”, “National Lifetime Achievement Award from Castle Connolly”, “Legends in Neonatology Award” (2007) together with Mildred Stahlman and Mary-Helen Avery. She was named “Top Doctor” by Philadelphia magazine (2012–2016). She had served several terms for the National Institutes of Health, as well as for many academic and hospital committees; she was a member of numerous scientific societies; had received honorary degrees from three universities (Nancy, Thessaloniki and Athens); was a reviewer for top scientific journals, including the New England Journal of Medicine. Her publications are over a thousand, mostly focusing on neonatal care, neonatal brain injury and neonatal physiology.
Maria’s clinical work was marked by two innovations. The implementation for the first-ever time of mechanical respiratory support to premature neonates in 1963, and a bit later of parenteral fluids to preterms, saving hundreds of thousands of lives. Her pioneering scientific work focused besides respiratory distress syndrome and physiology of pulmonary fluid, on oxygen-hemoglobin binding in adults and fetuses/newborns, cerebral blood flow, mechanisms of hypoxic/ischemic encephalopathy in the fetus and neonate, as well as the mechanisms of cerebral cells apoptosis.
Maria had generously mentored countless young doctors from countries all over the world, devoting them endless time, care and love. Despite her phantastic achievements, she remained a person of exemplary modesty, contemptuous for material goods, with huge charitable activity not only for children but also for any adult in need. She used to spend every summer a month in her favorite Greek island Ithaca, fishing, donating her “catch” to the poor and gratis examining each evening consecutively all children of the island.
This homage to Maria will close with spontaneous words by colleagues, when informed on her passing: “so impressed by her sweetness, smartness and profound culture, but also her firm capability to teach and to carry on research, she as a woman in times when the most was run by men!” (Gian Carlo Di Renzo), “a true trailblazer in our field, a kind, gentle care giver” (Helen Christou), “a unique, wonderful, exemplary, inspiring woman” (Umberto Simeoni), “Maria leaves a great legacy” (Neena Modi), “really impressed by her legacy” (Hugo Lagercrantz), “Maria is an example for all of us” (Vassilios Fanos), “we will strive to honour her” (Mark Hanson).
May she rest in peace!
Health-care workers reveal how pandemic affected their mental health, home lives
Apr 8, 2022 CBC News
Health-care workers say the emotional and physical toll of the COVID-19 pandemic has had an impact on them at work and at home.
PREEMIE FAMILY PARTNERS
New Guidance Encourages Moms to Nurse for Two Years
Michelle Winokur, DrPH
According to the American Academy of Pediatrics new guidelines, mothers are now encouraged to nurse for two years – up from one year. A mother’s willingness or ability to initiate breastfeeding is dependent on many factors, including support from family, close friends, and the hospital or birth center where the child is born. However, many other barriers can potentially keep moms from exclusively nursing for even six months, long considered the benchmark before introducing “nutritious complementary foods.”
Barriers to Breastfeeding:In recognition of the challenge of a lengthened breastfeeding period, the AAP concurrently released a technical report (2) identifying hurdles and approaches to support nursing moms. Among the challenges moms face are:
Societal judgment: Upwards of 80% of women breastfeed initially, establishing the practice as a “cultural norm.” However, just one-third of infants are nursed beyond one year. (3) This sharp decline can lead to judgment and comments from well-intentioned yet misinformed relations – or strangers – who may not recognize the value of longer-term breastfeeding. Similarly, providers should support nursing beyond one year, though there is evidence that is not always the case.
Workplace barriers: The United States is one of only a handful of upper-income countries that does not guarantee paid maternity leave. Lack of income or loss of job protection forces some moms back to work sooner than they would like. Furthermore, few businesses provide on-site childcare, making it more convenient for moms to nurse during the workday. The country also lacks requirements for workplace breaks and the provision of a clean, private space to nurse or express milk.
Insurance coverage: In most cases, insurance will provide or reimburse for select breast pumps, but coverage varies by plan and is not guaranteed. Similarly, only some insurers cover lactation support. While most hospitals and birth centers provide an initial consultation, many moms require additional guidance and support to continue nursing.
Benefits of Breastfeeding:The benefits of breastfeeding for babies and moms are numerous. Babies who nurse receive immunities from their moms, making them less likely to develop ear infections and less susceptible to stomach bugs. They also experience sudden infant death syndrome at lower rates. Moreover, breastfed babies have a lower risk of developing certain conditions, including asthma, obesity, and type 1 diabetes, as they grow. Moms who nurse likewise reap long-term benefits, including reduced risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure.
There is no better time than now, during National Breastfeeding Month, to reflect on the AAP’s updated guidance and recommit to reducing barriers that discourage moms from breastfeeding. Providers, policymakers, employers, insurers, and communities all have opportunities to support nursing moms and their babies
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Managing relationships after premature birth
Having a premature baby can have a huge impact on the whole family. Here we talk about how you may all feel and what you can do to support each other.
How premature birth may affect the parents
Research has found that both parents of premature babies are more likely to experience extreme stress and mental health problems than parents whose babies arrived full term.
A lot of parents have told us that they felt a lot of complex emotions after their baby was born, such as helplessness, fear and confusion. Some even feel guilty or wonder if they could have done something to prevent it. Feelings of failure are also common. Some parents feel like their body has failed them or that they have failed at parenthood before they have even started.
Dads and partners may also feel helpless or out of control. Some partners have told us that they felt alienated in the baby unit.
Depending on how long the baby is in hospital, partners may need to go back to work before your baby goes home. This may mean that they can’t spend as much time with the baby as the other parent. This may leave them feeling isolated, scared or stressed that they can’t do more.
This can create anxiety and tension. Even the healthiest relationships can strain in stressful situations, so try not to let any worries about you as a couple overwhelm you. It’s really important that you stay open and honest with each other about how you feel. Talking to each other about your fears, worries and feelings can help you to support each other better and understand each other. Try to understand things from each other’s point of view and give each other space.
How premature birth can affect siblings
If you have any older children, they may be affected by the experience of having a new baby brother or sister who is born prematurely. Children are very sensitive to what is going on, and if you are concerned about the baby – even if you don’t talk openly about it – they will probably be aware of this. They are also likely to be confused if the baby needs to stay in hospital for a while.
The way they react will depend on how old they are and their personality. Try to explain what’s happening in a way you think they’ll understand. Try to be as honest with them as you can and be prepared for the possibility that they may have some questions. Let them know that they can talk to you about what’s happening whenever they need to.
Try to involve them as much as you can. Perhaps they could draw a picture for the new baby or you could take them to buy a present for them. If it’s possible for them to visit their new sibling, explaining what the hospital environment may be like before you go may help.
There are books available that are aimed at siblings of premature babies to help them understand what’s happening. Ask your local bookseller or go online to find recommended books about prematurity for children.
How premature birth can affect grandparents
Grandparents may be feeling anxious for all of you. Try to keep them in the loop about what’s happening.
They may be keen to help but unsure of what they could do. You could suggest they could do some practical things like make some frozen meals for you, help to keep your house tidy or look after any older children if you have them.
Managing competing demands after premature birth
Your family and friends will hopefully become a vital support for you during the early weeks and months of your baby’s life.
But because everyone has different needs, having lots of people to worry about can make it stressful too. For example, you may feel that you need to spend all your time at the baby unit, but perhaps you have older children who need your time too. Or perhaps one parent wants to talk about a traumatic birth, but the other is not ready. Or maybe family and friends want to check in and see how you are, but you are feeling too tired or stressed to call or message anyone.
This can be stressful. You will also be trying to cope with your own feelings so it can be difficult when you feel you need to look after other people too.
If tensions are rising, try to talk things through. If you can be honest and open about how you’re feeling, it can often help prevent misunderstandings, hurt or resentment later.
How others can help
Family and friends may be an essential support at this difficult time, but not everyone is good at dealing with this sort of situation. You may be surprised by the people who rally round, and disappointed that others offer less support than you hoped for.
Don’t be afraid to ask for help or take it when it’s offered. They will probably be pleased to help by keeping you company, cooking meals or offering to help with your other children.
If people say unhelpful or insensitive things, try to ignore them. Most people will have no understanding of what you’re going through and would probably be horrified at their own insensitivity if they did.
Celebrating your premature baby’s breakthroughs
Many families find that they are so busy focusing on their baby’s health problems that there is little space to think about the good things. It is important to allow yourself to feel grief when you’re going through hard times. But when your baby has a breakthrough, such as coming off a particular treatment, or going home, it can be helpful to celebrate that too.
Sharing good news
Many parents like to mark these events in some small way and to share them with others. This might simply involve sending out a group text to loved ones telling them the news, sharing a glass of bubbly or having a meal with close friends or family. You might prefer to simply note them down in a journal if you keep one.
Try to hold on to that positive feeling for as long as you can and focus on how far your new family has come already.
Tommys: Our Story
From a campaign that began in a spare cupboard in St Thomas’ Hospital, Tommy’s is now the largest UK charity researching the causes and prevention of pregnancy complications, miscarriage, stillbirth, premature birth and neonatal death.
HEALTH CARE PARTNERS
Dr. Lorna Breen Health Care Provider Protection Act Signed Into Law
March 18, 2022
On March 18, President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act, named for a Columbia emergency medicine physician, into law. The act will provide federal funding for mental health education and awareness campaigns aimed at protecting the well-being of health care workers.
The new law—the first to provide such funding—is named for Lorna Breen, MD, an emergency medicine physician and faculty member at the Vagelos College of Physicians and Surgeons and NewYork-Presbyterian/Columbia University Irving Medical Center who died by suicide in April 2020 at the peak of the first COVID surge.
“Health care professionals often forgo mental health treatment due to the significant stigma in both our society and the medical community, as well as due to the fear of professional repercussions,” says Angela Mills, MD, chair of emergency medicine at Columbia University Vagelos College of Physicians and Surgeons. “This law will provide much needed funding to help break down the stigma of mental health care, providing education and training to prevent suicide, address other behavioral health issues, and improve well-being.”
Health care workers have always experienced extraordinarily high levels of stress. To protect their careers, however, most with mental health issues suffer in silence. The COVID pandemic has only intensified the stress and suffering.
Breen’s death highlighted the need to help front-line health care workers cope with the stress of their jobs.
The goal of the Dr. Lorna Breen Health Care Provider Protection Act is to prevent suicide, alleviate mental health conditions and substance use disorders, and combat the stigma associated with seeking help. It provides up to $135 million over three years to improve mental health and resiliency and train medical students, residents, nurses, and other professionals in evidence-based mental and substance use disorders strategies.
Grants will go to medical schools, academic health centers, state and local governments, Indian Tribes and Tribal organizations, and nonprofit organizations.
Health care worker stats
- One in five health care workers quit their job during the pandemic.
- 400 physicians in the United States die by suicide every year.
- 60% of emergency doctors feel burned out
Virtual nursing programs help hospitals overcome staffing shortages and support onsite nurses in providing patient care.
September 01, 2022
Healthcare organizations across the U.S. are under tremendous pressure as the growing need for nurses outpaces a shrinking workforce. There have been unprecedented challenges from the large, aging baby boomer population. Nurses are also getting older, with a median age of 52 — 4.7 million are projected to retire by 2030.
“None of us are going to have the complement of nurses that we would like to have moving forward, so we have to get creative with the way that we provide care,” says Jennifer Ball, director of virtual care at Saint Luke’s Health System in Kansas City, Mo.
Healthcare systems like Saint Luke’s are increasingly turning to virtual nursing to address the shortage. Virtual nurses work in remote centers with videoconferencing technology to observe and answer questions from patients, speak with family members and ease the burden on bedside nurses by performing tasks that don’t require physical proximity, such as conducting admissions interviews and providing discharge instructions.
“What better way to retain those experienced nurses who might be thinking of retiring or leaving the field early?” Ball says. “It’s a great way to allow them to continue their careers
There has been a 34 percent increase in the number of virtual nursing programs around the U.S. in the past year, says Laura DiDio, principal at research and consulting firm ITIC. The growth was spurred by the pandemic, “but it shows no signs of slowing down,” she adds.
Virtual nurses support bedside nurses in healthcare facilities, but they can also see patients at home using remote monitoring tools to collect clinical data, DiDio says. During the pandemic, virtual nurses used high-definition cameras and tablets to connect patients in isolation with their loved ones. Digital hospice and palliative care visits became commonplace.
“You will always have hands-on bedside care. That’s not going away,” Ball says. “But we must expand the types of caregivers that we have. I think virtual nursing is the wave of the future.”
The Technology Behind Virtual Nursing
Virtual nurses typically operate in remote centers manned with fully loaded workstations. At Saint Luke’s, each workstation uses a mix of multiple monitors, including HP monitors, the Epic Monitor dashboard feature and the Teladoc virtual healthcare platform, which includes a microphone, camera and videoconferencing software. Saint Luke’s also uses LogMeIn (now called GoTo) for remote desktop access so that virtual nurses can document as second nurse.
All the technologies used by Saint Luke’s virtual nurses were in use before the program launched. Even the workstations’ 5-foot adjustable desks were repurposed from an older project, Ball says. “We have been really lucky because we didn’t have to start from scratch with new technology,” she adds.
At Atrium Health in North Carolina, patient rooms use one of two setups to enable observation for its virtual nursing program to support newer nurses. New facilities are designed with audio and video capabilities, so the push of a button calls the virtual nurse, who appears on screen. Older facilities use wheeled poles with mounted cameras, speakers, microphones and monitors. Atrium Health uses the Caregility telehealth platform, Cerner cameras and software, and Microsoft Teams.
Vanderbilt University Medical Center in Nashville, Tenn., uses mobile devices with audio and video capabilities for its “virtual sitter” program, which allows nurses to monitor multiple patients at once. “They kind of look like a robot that you would see in a cartoon,” Karen Hughart, senior director of nursing informatics at VUMC, says of the devices.
VUMC’s virtual sitter program launched in 2019, when a dramatic increase in patients needing observation — those at risk of falls or other types of harm — coincided with Nashville’s booming economy, making it difficult to hire entry-level patient-care attendants.
“Sometimes, patients just need somebody to redirect them if they start to get out of bed because they’re confused,” Hughart says. “We’re not relying on patients to press their call bell. There’s somebody available to monitor them to determine if the patient needs immediate assistance, and they’re notifying the patient’s bedside nurse directly instead of waiting until the patient has had a bad outcome.”
Virtual sitters, who use 24-inch Dell monitors to observe patients centrally, can even use recorded messages from family members to reorient patients. “Sometimes a voice that they recognize is more effective with redirecting their behaviors,” Hughart adds.
The pandemic placed stressors not only on practicing nurses but also on those in training. “Nursing school students didn’t get the same experience that some of us more seasoned nurses have because their clinical rotations were cut short,” says Becky Fox, Atrium Health’s vice president and chief nursing informatics officer.
Health systems like Atrium and Saint Luke’s assigned experienced virtual nurses to mentor recent graduates. They can walk bedside nurses through procedures, interact with the care team on rounds and even listen in on a patient’s lungs via a remote stethoscope, Fox says.
“Imagine you’re a new graduate, and you’re concerned that your patient is taking a turn for the worse. It helps knowing that you’ve got someone on screen who has your back,” she adds.
Atrium Health has seen call bell volumes go down while patient satisfaction scores have risen, Fox says. It also saw a decrease in the number of rapid response team calls, in which the whole care team rushes to a patient’s bedside amid a crisis, because virtual nurses can spot problems before they escalate.
The organization was already using video capabilities in other areas, such as translators and disease education specialists, to help nurses manage patients’ care. Atrium Health expects the use of video capabilities to develop further.
At VUMC’s virtual sitter program, Hughart sees similar potential. It’s currently in use only in the adult hospital, but VUMC would like to expand virtual care capabilities. Some vendors provide not only the equipment to support such programs, but also the virtual nurses themselves, she adds.
“That’s very attractive to us right now,” Hughart says, “because like a lot of other facilities, we’re struggling to keep pace with the demand for nurses.”
Saint Luke’s has seen many benefits from its virtual nursing program. Patients always have immediate access to someone, and bedside nurses have help with time-consuming tasks, such as ordering meals for patients and completing quality checks.
“Care is delivered on time, and everything is double- and triple-checked,” Ball says. “It allows for a more efficient hospital stay.”
Other staff, such as pharmacists and social workers, have expressed interest in using the virtual center. The four smaller critical-access hospitals in the Saint Luke’s network have already installed virtual care equipment in their rooms to gain greater access to specialists throughout the system. For instance, a diabetes education specialist can now meet with a patient in one location through the videoconferencing tools, and then 30 minutes later, meet with another patient who’s two hours away.
“I think there will be a lot of ways to use this technology in the future, and we’re probably not even aware of everything we can do,” Ball says. “This is an opportunity for us to provide more holistic care to all patients.”
STEPS TO VIRTUAL NURSING SUCCESS
The purpose of the virtual nurse is to work alongside the bedside nurse, but that’s often easier said than done.
“Early on, nursing staff would get frustrated because they felt they either weren’t warned soon enough or they were being interrupted every five minutes to check on patients,” says Hughart. It took months of repeated education and meetings to work through ongoing problems.
Saint Luke’s holds joint training sessions with virtual and bedside nurses so they can learn to collaborate as a team, says Ball.
Here are a few lessons on how to build a successful virtual nursing program:
1. Involve everyone — from clinical staff to IT and quality assurance — from the start.
2. If possible, start in a new facility. “There are always challenges when you go into an existing unit and change the culture,” Ball says.
3. When hiring, look for experienced nurses with strong communication skills.
“You want knowledgeable staff because you’re looking to them to do the teaching and the education for the patients,” Ball adds.
4. Make sure buildings have adequate wireless bandwidth. “We have to continue expanding capacity and building in redundancy to keep up,” Hughart says.
5. Focus on the communication workflows between unit-based nursing staff and staff who monitor patients virtually, Hughart adds. For the technology to have maximum impact, those using it must understand its capabilities and limitations, and there must be collaboration between the onsite and virtual teams that centers patient care.
6. Build strong device support processes, with quick turnaround on repairs for critical equipment, says Becky Fox, vice president and chief nursing informatics officer for Atrium Health.
7. Don’t be afraid to change workflows when starting new programs. “The best ideas on paper don’t always work in real life,” Ball says.
How do children develop after being born very preterm? Four likely outcomes
Children born very preterm can be divided into different subgroups, each with a different profile of developmental outcomes.
Washington, DC June 28, 2022
A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that, among very preterm born children, subgroups can be distinguished with distinct outcome profiles that vary in severity, type, and combinations of deficits.
Children born very preterm, that is, after a pregnancy duration of less than 32 weeks, have a higher risk for difficulties during development than peers who are born after a normal pregnancy duration. What kind of difficulties and to what degree, however, varies strongly from child to child. Nevertheless, very preterm born children are usually considered as one group. According to new research, this assumption is unjustified.
Researchers from the Obstetrical, Perinatal and Pediatric Epidemiology Research Team at Inserm and the French National Institute for Health and Medical Research followed the development of 2,000 very preterm born children from all over France from birth until the age of 5.5 years. Their findings suggested that the population of very preterm born children could be divided into four subgroups, each with a different profile of developmental outcomes.
Almost half of the children (45%) belonged to a subgroup of children who had no difficulties and functioned at similar levels as their full-term born peers. However, 55% of the children belonged to one of three subgroups with suboptimal developmental outcomes. The first subgroup consisted of children who primarily had difficulties in motor and cognitive functioning, whereas a second group of children primarily had difficulties in behavior, emotions, and social relationships. A small subgroup of children had more severe impairments in all domains of development.
“Very little is known about the specific needs of subgroups of very preterm born children,” said lead author Sabrina Twilhaar, PhD. “Our study is the first large-scale study to distinguish very preterm born children based on their profile of outcomes across multiple important developmental domains. After all, how children function in everyday life is not determined only by their IQ or behavior. We now have a better understanding of which difficulties are prominent in different subgroups and which difficulties often occur together. This is important information for the development of targeted interventions.”
The researchers were also interested to know the predictors of these developmental outcomes. They found that children in the three subgroups with suboptimal outcome profiles were more often boys or had parents with a lower level of education or with a non-European migration background. Children who were diagnosed with prematurity-related lung disease (i.e., bronchopulmonary dysplasia) also had a higher risk for suboptimal developmental outcomes.
New insights are highly needed for very preterm born children. Preterm birth rates are increasing as are survival rates, especially among the most immature infants who have the highest risk for impairments. Thus, the number of very preterm born children with impairments growing up in our societies is rising. These impairments generally persist when children get older and there is currently little evidence in support of interventions that meaningfully improve long-term outcomes. These insights may be used to tailor support programs to the specific needs of subgroups of children to improve their effectiveness.
Dr. Twilhaar: “Instead of taking a one-size-fits-all approach, the findings emphasize the importance of taking individual differences much more into account. The average of the population is not representative of the individual children that it consists of. Moving forward, we should thus aim to understand how certain combinations of difficulties arise in specific groups of children, whereas others encounter no difficulties at all. This will aid the development of interventions that are tailored to the actual needs of individual children and target co-occurring problems, but also programs and policy to promote positive development in all children.”
Copies of this paper are available to credentialed journalists upon request; please contact the JAACAP Editorial Office at firstname.lastname@example.org or +1 202 587 9674. Journalists wishing to interview the authors may contact E. Sabrina Twilhaar, PhD; e-mail: email@example.com
Osteopathic Manipulative Treatment in Neonatal Intensive Care Units
Cicchitti, L.; Di Lelio, A.; Barlafante, G.; Cozzolino, V.; Di Valerio, S.; Fusilli, P.; Lucisano, G.; Renzetti, C.; Verzella, M.; Rossi, M.C. Osteopathic Manipulative Treatment in Neonatal Intensive Care Units. Med. Sci. 2020, 8, 24. https://doi.org/10.3390/medsci8020024
The aim of this study was to assess the impact of osteopathic manipulative treatment (OMT) on newborn babies admitted at a neonatal intensive care unit (NICU). This was an observational, longitudinal, retrospective study. All consecutive admitted babies were analyzed by treatment (OMT vs. usual care). Treatment group was randomly assigned. Between-group differences in weekly weight change and length of stay (LOS) were evaluated in the overall and preterm populations. Among 1249 babies (48.9% preterm) recorded, 652 received usual care and 597 received OMT. Weight increase was more marked in the OMT group than in the control group (weekly change: +83 g vs. +35 g; p < 0.001). Similar trends were found in the subgroup of preterm babies. A shorter LOS was found in the OMT group vs. the usual care group both in overall population (average mean difference: −7.9 days, p = 0.15) and in preterm babies (−12.3 days; p = 0.04). In severe preterm babies, mean LOS was more than halved as compared to the control group. OMT was associated with a more marked weekly weight increase and, especially in preterm babies, to a relevant LOS reduction: OMT may represent an efficient support to usual care in newborn babies admitted at a NICU.
Using AI to save the lives of mothers and Babies
Thought Leaders -Patricia Maguire-Professor of Biochemistry-University College Dublin As part of our SLAS Europe 2022 coverage, we speak to Professor Patricia Maguire from the University College Dublin about their AI_PREMie technology and how it can help to save mothers and babies lives.
Please could you introduce yourself and tell us what inspired your career in artificial intelligence (AI)?
My name is Patricia Maguire, and I am a professor of biochemistry at University College, Dublin (UCD). Four years ago, I was appointed director of the UCD Institute for Discovery, a major university research institute in UCD, and our focus is cultivating interdisciplinary research. In that role, I first became excited by the possibilities of integrating AI into my research.
AI has seen increased attention in recent years, especially concerning its adoption in healthcare settings. Despite this, obstacles still need to be overcome before it is commonplace within research. What do you believe to be some of the biggest challenges surrounding the adoption of AI in clinical settings?
I think there are two major obstacles to adopting AI in healthcare. The first is that when it comes to the actual deployment of that AI in a clinical setting in the real world, there is a significant gap from that lab-based tech development to getting it deployed in the clinic and operationalized there. The second is that once that AI is operationalized, the frontline staff may have difficulty adopting it. Staff are going to be really busy, and their time is valuable. We need to offer them practical solutions that give them reliable results that augments their clinical decision-making.
You are currently the director of the ConwaySPHERE research group at University College Dublin. Please could you tell us more about this research group and its missions?
I co-direct the UCD Conway SPHERE Research Group with my hematology colleagues, Professor Fionnuala Ní Áinle and Dr. Barry Kevane. Our mission is to understand and help diagnose inflammatory diseases, and we work together as a group of clinicians, academic staff, and scientists, collaborating both nationally and internationally. For AI-PREMie it is a truly transdisciplinary team that we have brought together– encompassing clinicians and frontline staff from the three Dublin maternity hospitals. In doing so, we have covered 50% of all births in Ireland. We have brought these hospitals together with a host of scientists from across University College Dublin and data scientists from industry, namely the SAS Institute and Microsoft. The whole AI-PREMie team’s mission is to get this prototype test to every woman who needs it worldwide because we believe we will save lives.
You are giving a talk at SLAS Europe 2022 titled ‘AI_PREMie: saving lives of mothers and babies using AI.’ What will you be discussing in this talk, and what can people expect?
I will discuss our project AI-PREMie, which brings together cutting-edge biochemical, clinical, and machine learning expertise. By bringing them together, we have developed a new prototype test for risk stratification in preeclampsia.
As demonstrated in your latest research, AI-PREMie can accurately help to diagnose preeclampsia, a serious complication affecting one in ten pregnancies. What are the benefits of accurately diagnosing preeclampsia not only for the women and their babies but also for healthcare settings?
Fifty thousand women and 500,000 babies are lost to preeclampsia every year, and an additional 5 million babies are born prematurely – sometimes very prematurely – because of preeclampsia. It is easy to see how devastating preeclampsia is as a disorder: it affects our most vulnerable in society, their whole families, and their whole communities. If we can diagnose preeclampsia in a much timelier manner, we can deliver efficient, effective healthcare that can have a massive impact on the societal good. Not only will this allow us to prevent premature births, but we can also save lives.
What are some of the benefits of using AI tools such as AI_PREMie in diagnosis compared to current diagnostic methods?
There have been no significant advances in preeclampsia diagnosis. We are still using screening tests that were introduced decades ago. We look at high blood pressure, and we look at protein in the urine when we are screening these women, and sometimes these metrics do not predict the outcome. There is simply no test available to tell a clinician that a woman has preeclampsia. There is also no test to predict how that preeclampsia will progress. This means there is no test to tell a clinician or a midwife when to deliver that baby. AI-PREMie, our prototype test, will hopefully be able to not only diagnose preeclampsia but also predict the future in a sense and tell the clinician the best time to deliver that baby – because every day in utero for that baby counts.
Are you hopeful that with continued innovation within the artificial intelligence space, we will see more clinical practices turning to this technology to help aid healthcare? What would this mean for global health?
The field of AI is moving so fast, and healthcare is trying to keep up with it. I do see a future where our healthcare information will be available to us much like our banking information is securely, maybe even on our mobile phones, and that way, we can move global health to treat disease to a status where we predict disease and prevent disease.
Do you believe that AI_PREMie could also be applied to other clinical diagnoses? What further research would need to be carried out before this could be possible?
The patented biomarkers underlying AI PREMie are derived from the information stored within the platelet of sick, pregnant women, and we have studied that information or that ‘cargo’ stored within the platelet. We know that this is a marker – a form of a barcode – of the health status of an individual. In our lab, we are currently looking at this cargo in other diseases involving inflammation and vascular dysfunction concerning the platelet. Right now, we have projects ongoing on multiple sclerosis, cancer-associated thrombosis, and also COVID-19 to look to see if we can find new biomarkers in the platelets for these diseases.
Are there any particular areas where you are excited to see AI incorporated within the life sciences sector?
We have shown in our project that incorporating AI into data-driven life sciences projects has the potential to be truly transformative. If you look at what is available now, eye diseases can be detected using neural networks of three-dimensional retinal scans, but also in critical care, there are now sepsis warnings based on AI, which has dramatically reduced the number of deaths from sepsis in these hospitals. The potential is just so exciting.
What’s next for you and the ConwaySPHERE research group?
Next year, excitingly, we are planning to take AI PREMie across Ireland – so we want to increase the recruitment and data collection across Ireland and grow the group even more.
Golden Hour Education, Standardization, and Team Dynamics: A Literature Review
The “golden hour” is the critically important first 60 minutes in an extremely low birth weight neonate’s life that can impact both short- and long-term outcomes. The golden hour concept involves several competing stabilization priorities that should be conducted systematically by highly specialized health care providers in both the hospital and transport settings for improvement in patient outcomes. Current literature supports utilizing an experienced team in the golden hour process to improve patient outcomes through standardization, improved efficiency, and positive team dynamics. Although a variety of teaching methods exist to train individuals in the care of extremely low birth weight infants, the literature supports the incorporation of low- or high-fidelity simulation-based training. In addition, initial and ongoing educational requirements of individuals caring for a golden hour-eligible infant in the immediate post-delivery phase, as well as ongoing care in the days and weeks to follow, are justified. Instituting standard golden hour educational requirements on an ongoing basis provides improved efficiency in team function and patient outcomes. The goal of this literature review was to determine whether implementation of golden hour response teams in both the inpatient and transport setting has shown improved outcomes and should be considered for neonatal intensive care units admitting or transporting golden hour eligible infants.
Maternal, Infant, and Child Health Outcomes Associated with the Special Supplemental Nutrition Program for Women, Infants, and Children
A Systematic Review
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is intended to improve maternal and child health outcomes. In 2009, the WIC food package changed to better align with national nutrition recommendations.
To determine whether WIC participation was associated with improved maternal, neonatal–birth, and infant–child health outcomes or differences in outcomes by subgroups and WIC enrollment duration.
Search (January 2009 to April 2022) included PubMed, Embase, CINAHL, ERIC, Scopus, PsycInfo, and the Cochrane Central Register of Controlled Trials.
Included studies had a comparator of WIC-eligible nonparticipants or comparison before and after the 2009 food package change.
Paired team members independently screened articles for inclusion and evaluated risk of bias.
We identified 20 observational studies. We found: moderate strength of evidence (SOE) that maternal WIC participation during pregnancy is likely associated with lower risk for preterm birth, low birthweight infants, and infant mortality; low SOE that maternal WIC participation may be associated with a lower likelihood of inadequate gestational weight gain, as well as increased well-child visits and childhood immunizations; and low SOE that child WIC participation may be associated with increased childhood immunizations. We found low SOE for differences in some outcomes by race and ethnicity but insufficient evidence for differences by WIC enrollment duration. We found insufficient evidence related to maternal morbidity and mortality outcomes.
Data are from observational studies with high potential for selection bias related to the choice to participate in WIC, and participation status was self-reported in most studies.
Participation in WIC was likely associated with improved birth outcomes and lower infant mortality, and also may be associated with increased child preventive service receipt.
On National Child Day, meet clean water activist Autumn Peltier | CBC Kids News
You know something’s wrong when a child speaks up. That’s how Autumn Peltier, a 16-year-old from Wiikwemkoong First Nation in Ontario, framed her fight for clean drinking water in Canada’s Indigenous communities. The teen, who’s originally from Manitoulin Island but currently living in Ottawa, told CBC Kids News she’d rather spend her free time doing normal kid stuff. Instead, she’s making speeches on the international stage about the fact that some Canadians don’t have access to clean water. “Water is a basic human right. Everyone deserves access to clean drinking water, no matter what our race or colour is or how rich or poor we are,” Autumn said. Autumn seized the opportunity to share that message with the world when she addressed the United Nations in 2018 and again in 2019. In 2019, she was also named chief water commissioner by the Anishinabek Nation, which means she speaks on behalf of 40 First Nations in Ontario. As of October, more than 40 Indigenous communities in Canada had boil water advisories in place, which means residents have to boil their water before it’s safe to drink. During the federal election campaign in 2015, Prime Minister Justin Trudeau promised to get rid of all boil water advisories in the country by March 2021. Now leaders in many of those communities are saying Trudeau’s government won’t meet that deadline. In October, the prime minister said more than 100 boil water advisories have been lifted since that promise was made, and his government continues to work “very hard” to reach its goal. As for Autumn, she said the idea that time is running out “keeps me up when I can’t sleep at night.” Click play to watch Autumn tell her story in her own words. CBC Kids News is a website for kids, covering the information you want to know. Real Kids. Real News. Check it out at CBCKidsNews.ca.
Cat Video! Here’s looking at you, kid!
Please celebrate #nicuawarenessmonth and #prematureawarenessmonth this Fall season with our beloved global neonatal community!
We will be highlighting our GRATITUDE towards each of the 12 nations we have explored this past year in our Annual Instagram Post. Each of the themed postings will showcase a homemade national dessert of the country celebrated paired with some fun Fall 2022 fashion.
While exploring each country’s best desserts we sought to further connect with our Global Preterm Birth/Neonatal Womb Warrior community and illustrate our GRATITUDE to every one of you! Each of you do/have empowered, educated, inspired and progressed the well-being of our Community in a dynamic myriad of ways. THANK YOU 😊
We invite you to explore our Instagram post @katkcampos to view our gratitude pics!
Country Dessert Fall 2022 Fashion
- Morroco- Moroccan Orange Cake-Equestrian/full length body suit
- Costa Rica – Costa Rican Orange Pudding-Hot Pink
- Sudan -Sudanese Peanut Macaroons-White Tee shirt/Tank Top/big clogs
- Nigeria – Shuku Shuku Nigerian Coconut Macaroons-All Over Sheen
- Japan – matcha swiss roll-Sporty
- Serbia -Fresh Fruit Cup-Basics
- Peru – Suspiro de limena-Leather on leather
- Ireland – Chocolate Guinness Mousse-Boardroom minis
- Uzbekistan – Tajik Cookies-Maxi skirt
- Philippines – Filipino Egg Pie-Bomber Jacket
- Norway -Whipped Crème Krumkake-Oversized Sweater
- Somalia- Queerbaad Cookies-Abstract
Christmas surf with friends, last waves of 2019 Greece!
Dec 28, 2019 Αγγελος Περαθωρακης
happy times in the water ,surfing some swell in creta!