FELLOWS, FUTURES, FAMILIES

Senegal, officially the Republic of Senegal, is the westernmost country in West Africa, situated along the Atlantic Ocean coast. It borders Mauritania to the northMali to the eastGuinea to the southeast and Guinea-Bissau to the southwest. Senegal nearly surrounds The Gambia, a country occupying a narrow strip of land along the banks of the Gambia River, which separates Senegal’s southern region of Casamance from the rest of the country. It also shares a maritime border with Cape Verde. The capital and largest city of Senegal is Dakar.

Healthcare in Senegal is a center topic of discourse in understanding the well-being and vitality of the Senegalese people. As of 2008, there was a need to improve Senegal’s infrastructure to promote a healthy, decent living environment for the Senegalese.

Additionally, the country needs more doctors and health personnel, particularly general practitionersgynecologistsobstetricianspediatricianspulmonologist, and cardiologists. In fact, Senegal has seven doctors per 100,000 citizens, while 32% of rural citizens have no access to medical care at all. Moreover, there is a strong need to have more of these personnel in rural areas: in 2008, Senegal had only twenty full-fledged hospitals, seven of which are in Dakar.

From approximately 1905 to the present, there have been significant shifts in Senegal’s healthcare system, the system’s structures, specific diseases that are problematic in Senegal, as well as issues affecting women and children and access to healthcare in the country. As of 2019, there were 1,347 medical facilities, including 20 major hospitals.

 Problem Statement: Neonatal Intensive Care Unit (NICU) trainees experience high intensity situations under suboptimal physiologic and psychologic conditions that can lead to burnout and/or secondary traumatic stress. The mental health of NICU fellows can have significant impact on their well-being and the quality of patient care they provide. The overall goal of this project is to improve Neonatal Fellow mental health and well-being in a level 3 NICU by using Trauma Informed care (TIC) principles to identify needs that may warrant connection to further resources.

Abstract:

Methods:

 Key stake holders were identified: the ACGME director, the fellowship program director, the associate program director, the chief fellow, the psychologist, the fellow cohort, division chief, lead NNP, and the program coordinator. We aimed to develop a wellness curriculum and standardize the frequency of sessions, duration of sessions, attendance of sessions, confidentiality, location and topics. Key drivers rooted in the 6 principles of TIC became the foundation of the topics explored during the Wellness Sessions. These six principles / primary are 1. Safety, 2. Trustworthiness and Transparency, 3. Peer Support, 4. Collaboration and Mutuality, 5, Empowerment, voice, and choice, 6. Cultural sensitivities. These promoted the following standardized topics: Crucial conversations with mentors, Performance anxiety, Debrief challenging cases, debrief death, Navigating personal relationships (motherhood, significant other, daughter/son), Work life balance, Individualizing wellness, Cognitive behavioral strategy for stress management. A force field diagram was the QI tool used to mediate conversations to gain approval for this Wellness curriculum pilot. Driving forces in support of this pilot were having a dedicated NICU psychologist, ACGME recommendation for embedded Wellness training, fellow interest, previous match history, program evaluation demonstrating a gap for wellness training and existing private fellow office space. Restraining forces included scheduling time away from board preparation didactics, patient care and research duties, 360 degree buy in, post-call protected time, literacy of NICU psychologist role, and human bias to new process. Our outcome measure is compliance with monthly meetings characterized by completed monthly sessions from November 2023 to April 2024. The process measure is compliance with attendance for fellows that desired to attend the wellness session and not encounter barriers.

Results:

In the initial 6 months implementation period from November 2023 to April 2024 there was 30% compliance with monthly meetings. PDSA cycles revealed the challenges to completing a session. These included the available protected didactic times were filled with other lectures and case conferences, preparation for In-training-exams (ITE’s), research timelines, graduating fellow interviews, schedule gaps for anticipated and unanticipated medical leaves, and fellow graduation exit procedures. Compliance for attendance of the fellows conflicted with patient care duties and lack of commitment to protected time away from the NICU. Qualitative feedback from fellows was in support of establishing the permanence of this wellness curriculum and they specifically appreciated the topics and the time to pause and reflect on their experiences. Fellows’ feedback included: “mental health sessions are equally as important as the pathophysiology lectures,” the curriculum prioritizes “resetting the mindset more positively” and “improve work-related satisfaction.” This feedback, the start of the new chief fellow term, and persistent advocacy to establish this wellness curriculum enabled this pilot to continue for an additional 6 months. The frequency of sessions has increased in collaboration with program director approving bimonthly sessions.

Conclusions:

Implementation of a fellow wellness program was met with initial resistance, but over time has proven beneficial in fellow satisfaction and performance leading to increased support from key stakeholders, increased frequency of scheduled sessions and reduction in barriers to allow for fellow attendance. Future direction is to incorporate fellow wellness curriculum into monthly didactic schedule and standardize a curriculum to be replicated.

Source: https://neonatologytoday.net/newsletters/nt-sep25.pdf

The latest statistics from the MSAS reveal a critical shortfall: there is currently only one midwife available for every 1,197 women of reproductive age.

This shortage has left numerous health centers, especially in rural areas, operating without qualified personnel capable of providing prenatal care or safely assisting with deliveries.

In some of the country’s most isolated communities, pregnant women are still forced to travel dozens of kilometers in search of professional medical assistance.

This persistent gap in healthcare access continues to put adolescent girls, expectant mothers, and newborns at risk, especially when it comes to managing high-risk pregnancies.

In response, the government has initiated a targeted recruitment drive under the broader SWEDD+ program—an initiative for Women’s Empowerment and the Demographic Dividend in West Africa.

The project aims to recruit a total of 500 midwives across 11 of Senegal’s most vulnerable regions, where the shortage is most pronounced.

The newly announced recruitment of 220 midwives marks the first wave of this effort, which is supported by key international partners including the World Bank and the United Nations Population Fund (UNFPA).

Beyond simply filling vacant roles, the goal is to ensure that skilled healthcare professionals are present and retained in the country’s most neglected areas—regions often bypassed by young professionals due to poor infrastructure and difficult living conditions.

Authorities hope this measure will significantly reduce maternal mortality, limit preventable childbirth complications, and improve access to essential services for women and adolescents.

However, health experts warn that recruitment alone will not be enough. For the initiative to succeed in the long term, newly deployed midwives will require proper housing, transportation, equipment, and incentives to remain in rural posts.

Despite these challenges, the decision signals a shift in policy direction. While the number of recruits may not fully meet the country’s needs, the move represents a concrete and long-overdue commitment to rebuilding Senegal’s maternal healthcare system from the ground up.

Source: https://dailymailafrica.com/senegal-recruitment-of-220-midwives-to-tackle-maternal-health-crisis/

The World Health Assembly has officially designated November 17 as World Prematurity Day! The recent WHO endorsement is a major step forward – calling on governments around the world to prioritize preterm birth in their national health agendas. 

“As one of the founding organizations of World Prematurity Day in 2008, we at GFCNI are deeply proud to see it officially recognized by the World Health Organization,“ says Silke Mader. “This milestone is a tribute to our tireless efforts together with parent and patient organizations, healthcare professionals, and advocates around the world. A heartfelt thank you to Doris, whose dedication made this endorsement possible. Together, we have turned a vision into a worldwide movement for preterm babies and their families.”

This is truly a huge milestone for the global movement for premature babies,” adds Doris Mollel, founder of the Doris Mollel Foundation in Tanzania, whose tirelessly advocacy, supported by the Tanzanian government, has been pivotal in bringing global attention to the needs of preterm infants. “This is just the beginning. Together, we are building a future where every child has a fighting chance, and every life matters.”

Source: https://www.gfcni.org/campaigns/world-prematurity-day

The latest statistics from the MSAS reveal a critical shortfall: there is currently only one midwife available for every 1,197 women of reproductive age.

This shortage has left numerous health centers, especially in rural areas, operating without qualified personnel capable of providing prenatal care or safely assisting with deliveries.

In some of the country’s most isolated communities, pregnant women are still forced to travel dozens of kilometers in search of professional medical assistance.

This persistent gap in healthcare access continues to put adolescent girls, expectant mothers, and newborns at risk, especially when it comes to managing high-risk pregnancies.

In response, the government has initiated a targeted recruitment drive under the broader SWEDD+ program—an initiative for Women’s Empowerment and the Demographic Dividend in West Africa.

The project aims to recruit a total of 500 midwives across 11 of Senegal’s most vulnerable regions, where the shortage is most pronounced.

The newly announced recruitment of 220 midwives marks the first wave of this effort, which is supported by key international partners including the World Bank and the United Nations Population Fund (UNFPA).

Beyond simply filling vacant roles, the goal is to ensure that skilled healthcare professionals are present and retained in the country’s most neglected areas—regions often bypassed by young professionals due to poor infrastructure and difficult living conditions.

Authorities hope this measure will significantly reduce maternal mortality, limit preventable childbirth complications, and improve access to essential services for women and adolescents.

However, health experts warn that recruitment alone will not be enough. For the initiative to succeed in the long term, newly deployed midwives will require proper housing, transportation, equipment, and incentives to remain in rural posts.

Despite these challenges, the decision signals a shift in policy direction. While the number of recruits may not fully meet the country’s needs, the move represents a concrete and long-overdue commitment to rebuilding Senegal’s maternal healthcare system from the ground up.

Source: https://dailymailafrica.com/senegal-recruitment-of-220-midwives-to-tackle-maternal-health-crisis/

Was your baby born more than 3 weeks early? Premature development differs from full-term, but there’s no need to worry! Let’s explore effective ways to understand and support your baby’s growth and milestones. Premature babies are often born with more extended (straight) positions, while full-term babies get a curled up (flexed) feeling from being in the womb longer. Babies need both flexion and extension to help their motor skill development. Try these activities to aid your preemie’s physical growth and work on their flexion. Always consult your healthcare provider for personalized advice. • Swaddling: Helps bring your baby’s arms to the middle, providing comfort and aiding in muscle development. • Side Lying: Reduces gravity’s impact, making it easier for your baby to move their arms and legs. • Bringing Arms and Legs to Midline: Encourages flexion by helping your baby bring their limbs to the center of their body. • Tummy Time: Strengthens neck, back, shoulder, and core muscles crucial for overall development.

 👪 ABOUT PATHWAYS.ORG Pathways.org is a non-profit organization that provides free, trusted resources so that every parent is fully empowered to support their child’s development. Our milestones are supported by American Academy of Pediatric findings. Our resources are developed with and approved by expert pediatric physical and occupational therapists and speech-language pathologists.

Source: file:///C:/Users/Kathy%20P/Downloads/Global_Preterm_Birth_Organizations_Map_2025.html

Join Our Global Community

If your country or region isn’t yet listed, we’d love your help expanding this network.  Share your local preemie-family organization, NICU support group, or foundation by contacting us at NeonatalWombWarriors@gmail.com Together, we can make sure every family and their communities — no matter where they are — are able to gain needed support. We are stronger together.

Having a baby in the hospital NICU is a very stressful time for all members of a family, including big brothers and sisters. Siblings often feel confused, anxious, or even left out during a NICU stay. Children look to adults for reassurance, so it’s important to guide them through the experience with honesty, love, and consistency.

This guide offers simple, practical tips for NICU sibling support that help kids feel included, valued, and secure during this challenging time.

Helping Children Cope with a NICU Stay

BE CONSISTENT

Maintaining normal routines like bedtime, meals, and school helps young children feel safe. Consistency is especially important during a time when so much else is changing.

SET ASIDE SPECIAL TIME

Even small moments of connection, like reading a bedtime story, a short walk, or a chat in the car, can go a long way. Your time and attention matter more than perfection.

ASK FAMILY AND FRIENDS FOR HELP

Don’t be afraid to lean on your support system. People want to help, but they don’t always know how. Let them know what you need. Ask friends or family to help with school drop-offs or meals. Giving others a chance to help allows you to show up more fully for your children.

SURROUND THEM WITH FAMILIAR PEOPLE

If you have family members and friends providing child care, have them come to your home as much as possible. With so many changes, having a known and trusted adult around will help younger children cope, especially if they have a difficult time being separated from mom and dad. Familiarity offers comfort when parents are spending long hours at the hospital.

ADAPT THEIR DAILY ROUTINES

Routines are an important part of helping children cope with the NICU. You may have to temporarily change up your child’s routines to align with having a baby in the NICU. If your usual family dinners are now spent at the hospital, try shifting that special time to breakfast or bedtime instead. Flexibility can help kids still feel connected.

LEAVE NOTES OF LOVE

Leave your children love notes and messages when you have to be away. You may even sign some messages from the baby: “I am so lucky to have you as my big sister!” This can help them feel connected to the baby, especially if they can’t visit them.

CELEBRATE THEI ROLE AS BIG BROTHER OR SISTER

Remind siblings how important they are. Make a list of all the things your older children can do that the new baby can’t do and share it with them. Talk about their role in the family and how they will be helping to teach the new baby about these things.

ENCOURAGE YOUR CHILDREN TO TALK ABOUT THEIR FEELINGS

Even if they don’t ask, make time to talk. Let them know that it is okay if they are feeling sad, angry, lonely or frustrated. Let them know that they can tell you if they feel like they need you to spend some time with them. Create space for your children to talk about how they’re feeling by asking simple questions like: “What was the best part of your day?” or “Is anything making you feel sad or worried today?” Let them know it’s okay to feel all their feelings, and that you’re always there to listen.

LET THEM ASK QUESTIONS

Children often have big imaginations and need help making sense of what it means that the baby is in the NICU. Giving them age-appropriate, honest answers can ease their fears. For example: “The baby is in a special place where doctors are helping them get stronger.”

What are they worried about? What do they think might happen? Let their questions guide your conversations.

Model Coping and Resilience

Kids learn by watching you. Show them that it’s okay to be sad or overwhelmed, and that those feelings don’t last forever. Let them see you ask for help, take breaks, and care for yourself.

You Are Not Alone

The NICU experience can be tough on siblings, but it can also bring families closer. The most important thing we can do for our children is to give them support, encouragement, information and most of all reassurance that they are still important members of the family. With thoughtful support and simple routines, you can help your children feel secure, seen, and loved during this time.

Source: https://handtohold.org/im-special-too-how-to-support-siblings-when-your-baby-is-in-the-nicu/

Abstract

Purpose

The purpose of this research is to evaluate how AI integration in nursing education influences educational and practice performance outcomes, and to understand the roles of technological acceptance and institutional support in this process. Issue: AI’s role in nursing education and practice is not fully understood, particularly in terms of its effects on performance and the barriers to its effective implementation.

Method

A sample of 500 participants was surveyed, and data was analyzed using Smart-PLS 4.0 to assess the direct, indirect, and moderating effects between variables like AI integration, performance outcomes, and institutional factors. Results showed significant positive relationships between AI application in practice and nursing performance, with technological acceptance acting as a strong moderator.

Findings

AI integration in nursing education positively affects nursing performance (p < 0.001). Technological acceptance significantly enhances both educational and clinical outcomes, with interaction effects between technological acceptance and AI integration improving performance (p < 0.001).

Research policy implications

Policy should focus on supporting AI adoption in nursing curricula, with investments in faculty training, technological infrastructure, and fostering technological acceptance to maximize AI’s benefits in healthcare settings.

Conclusion

AI integration is crucial for advancing nursing education and practice, with technological acceptance and institutional support playing key roles in successful AI adoption. The findings underline the importance of targeted policy initiatives to foster these elements.

Introduction

Artificial Intelligence (AI) is rapidly transforming healthcare and nursing, providing new opportunities for education and practice. The integration of AI in nursing education is reshaping the way nursing curricula are developed, while the application of AI in clinical settings is enhancing the efficiency and accuracy of patient care. Despite these advancements, the impact of AI on global nursing education and practice remains inadequately explored, with few studies addressing both its benefits and challenges. This research aims to provide a comprehensive understanding of how AI integration in nursing education influences nursing performance, both in academic and clinical settings, and how AI applications in practice improve patient outcomes and care efficiency (Iqbal et al., 2025)

The adoption of AI in nursing education and practice is growing at an unprecedented rate, offering tools that range from curriculum enhancement through AI-driven learning tools to decision support systems (DSS) in clinical settings. AI is revolutionizing nursing by providing advanced technology for clinical training, decision-making, and patient monitoring (Chowdhury et al., 2021; Rana et al., 2024). However, the integration of AI in nursing education is often challenged by factors such as curriculum development, technology access, and the need for comprehensive training. Similarly, in clinical practice, the application of AI for clinical decisions and patient monitoring is reshaping nursing roles, yet concerns remain about how these technologies affect nursing practice performance (Denecke et al., 2020; Iqbal et al., 2023, 2024). Despite these changes, few studies have explored how these technological advances impact both nursing education and clinical performance in a holistic manner.

Although AI is increasingly being implemented in nursing education and practice, there is a lack of comprehensive research examining the direct effects of AI integration on nursing education performance (NEP) and nursing practice performance (NPP). Moreover, the factors that moderate or mediate the influence of AI such as technological acceptance, institutional support, and infrastructure have not been fully investigated. Understanding how these variables interact can provide valuable insights into the effectiveness and challenges of AI implementation in nursing.

These main three main research questions are:

1. How does AI integration in nursing education (curriculum design, technology access, and clinical training) influence nursing education performance, including academic performance, skill development, and clinical competency?

2. In what ways do AI applications in nursing practice (clinical training, decision support, and patient monitoring) affect nursing practice performance, particularly patient outcomes, satisfaction, and clinical accuracy?

3. How do factors such as technological acceptance and institutional support mediate and moderate the effects of AI integration and application in nursing education and practice?

These main three main research objectives are:

1.To examine the impact of AI integration in nursing education on nursing education performance (NEP).

2. To assess how AI applications in nursing practice affect nursing practice performance (NPP).

3. To analyze the role of technological acceptance and institutional support in moderating and mediating the relationship between AI integration and performance outcomes in nursing education and practice.

This study will provide crucial insights into how AI integration in nursing education and practice affects various performance outcomes, offering actionable recommendations for educators, healthcare policymakers, and technology developers. By exploring the moderating and mediating effects of technological acceptance and institutional support, the research will help identify strategies to overcome barriers to effective AI adoption in nursing. The findings will also contribute to the development of a conceptual framework for evaluating AI’s role in nursing education and practice, promoting more effective and sustainable implementation of AI in these fields.

This study will be conducted using Smart-PLS 4.0 to analyze the relationships between AI integration in nursing education and practice and its impact on nursing performance outcomes. The research will include an examination of the independent variables (AI integration in education and practice) and their effects on the dependent variables (nursing education and practice performance). Additionally, the moderating effects of technological acceptance and the mediating role of institutional support will be explored. This will lead to a set of practical recommendations for the integration of AI into nursing curricula and clinical environments.

Section snippets/Literature review

Artificial Intelligence (AI) has emerged as a transformative force in both nursing education and clinical practice. The integration of AI into nursing education, through innovations in curriculum design, clinical training, and simulation, is reshaping how nurses are trained and prepared for modern healthcare challenges. Similarly, AI applications in nursing practice, such as decision support systems (DSS) and AI-enhanced patient monitoring, are changing the way nurses deliver care, improving

Research methodology

This study will employ a quantitative research methodology to examine the impact of Artificial Intelligence (AI) integration on global nursing education and practice. The research will use Smart-PLS 4.0, a software tool for structural equation modeling (SEM), to analyze the relationships between the variables outlined in the study framework. SEM is chosen due to its capability to handle complex models involving multiple independent, dependent, mediating, and moderating variables (Hair et al.,)

Result analysis and discussion

The path coefficients in Table 1 reveal strong, significant relationships between AI integration and nursing performance outcomes. The T-values consistently exceed the threshold of 1.96, confirming the statistical significance of the direct paths. In Table 2, total indirect effects show meaningful mediating influences, with T-values above 1.96 for most variables, indicating significant indirect relationships. Confidence intervals in Table 3 further validate these findings, with narrow ranges

Conclusion

This study has demonstrated the significant impact of AI integration in both nursing education and practice. The results show that AI Application in Nursing Practice (AIANP) and AI Integration in Nursing Education (AIINE) have substantial positive effects on Nursing Education Performance (NEP) and Nursing Practice Performance (NPP). Key findings include the strong relationship between AIANP and Institutional Support (IS), as well as the enhancement of Technological Acceptance (TA) through AI.

Source: https://www.sciencedirect.com/science/article/abs/pii/S1355184125001000

The unpredictable hours of residency make romantic relationships tough—but not impossible. Here’s how to date and maintain a love life during residency.

The long and unpredictable hours of residency make starting and maintaining a romantic relationship tough. But it’s not impossible.

Here’s how to date and make the most of your love life during residency.

First, let’s address the elephant in the room. If you’re going into residency single and haven’t spent much time dating or figuring out what you need from a partner, taking on this challenge during residency will be difficult. Building a deep, romantic relationship requires time, which is something you have very little of in residency.

Even the act of finding a relationship requires a significant time investment. You’ll need to put yourself out there socially, such as going to events or joining community groups, work on your own personal development, and zero in on what you’re actually looking for from a partner.

If this sounds like you as a resident, do not despair. It is possible to find and build a relationship during residency, but you need to understand both what your priorities are and how many hours you have to find and keep that special someone. If finding a relationship in this stage of your life is important to you, you’ll need to intentionally carve out and block time for it, much like when you are studying for boards.

Don’t allow your years of residency to fly by without being intentional about every aspect of your life—this includes your professional development, personal wellness, hobbies and interests, and love life.

If starting a family and settling down is a top priority for you at this stage, you need to act like it. This will mean you have less time for other things, such as research you wanted to pursue, personal hobbies, or binging Netflix shows alone.

Alternatively, you may decide a serious relationship is less important to you at this time, which is perfectly okay too. Don’t fall into the trap of doing what those around you are doing just because it seems like the logical next step. Jumping into a serious relationship or beginning to start a family because you think you should, and not because you want to, is a recipe for disaster.

With that in mind, if dating is a priority for you, it’s time to get serious about identifying your needs.

Identify Your Needs

One of the biggest questions to ask yourself is whether or not you want to be with someone in medicine, as there are pros and cons to both choices.

A partner in a medical field, such as another resident or someone pursuing another healthcare career, will share an understanding of the time-consuming nature and challenges of residency. They are more likely to be comfortable with your limited and unpredictable hours because they experience the same thing. You’ll also have plenty to talk about in the realm of medicine, but this can be both positive and negative.

Your shared interests may keep the conversation going, but you run the risk of talking about medicine all the time. A partner outside of healthcare can offer new topics of conversation, and you can learn new things from each other. Additionally, a non-resident partner can more easily work around your rigid schedule.

If both of you are pursuing a career in healthcare, you may have similarly unpredictable schedules. If you each only have one small sliver of free time, it’s likely they won’t align, making it difficult to carve out time together.

However, your career path is only one small element of determining your own needs.

Are you looking for someone who wants to have children? Are you eager to start that process right away, or do you want to wait a few years? Do you want someone who shares your passion for fitness and wellness? Is preferring Star Trek over Star Wars a deal breaker for you?

By the time you’re in residency, you likely have a better understanding of yourself and what you hope your future will look like. Determine what you’re looking for in a partner to save yourself time during the dating process, as you don’t have any time to waste. However, ensure you’re not too rigid in your quest for love. The more you idealize your perfect partner, the harder your search will be.

After all, no one is perfect, and every relationship involves compromise.

Finding a Partner

After spending time identifying your preferences, it’s time to go out and find that special someone, which is easier said than done, especially for residents.

Unlike treatment algorithms, there are no x + y + z instructions to find a partner. It takes time, patience, and a whole lot of trial and error. Put yourself out there and continue meeting new people. Choose events, groups, and activities that align with your interests so you find someone who shares your values.

For example, if fitness is a top priority for you, join a gym or athletic community group you’re interested in, such as a running club, kickboxing class, or yoga in the park. If religion is an important aspect of your life, make time to go to church or temple events, and get more involved in religious community initiatives. If you’re passionate about books and storytelling, join local library events and begin participating in a book club.

Dating apps can also help you streamline the dating process. If used effectively, they can aid residents who have very little free time. Be sure to choose dating apps that align with your needs. If you’re looking for a serious relationship with someone who wants to start a family, don’t waste your time on an app known for its hookup culture.

If you’re looking for someone who is also in medicine, there are dating apps specifically for healthcare workers, such as ForeverX and DowntoDate.

Use dating apps to your advantage, but understand their limitations. If your residency is in a small town, you will have fewer options. The pros and cons of dating apps and how to optimize online dating are discussed in video on my Kevin Jubbal, M.D. channel.

Maintaining a Healthy Relationship

Starting a relationship is just one part of the equation. As a resident, you’ll have to put in more effort than usual to help maintain it. Here’s how to keep a healthy relationship strong.

1 | Be Clear About What to Expect

The first and most important tip is to be upfront with your partner about what to expect over the next few years. This will be easier if you’re dating a fellow resident or someone in the medical field, but either way, it’s vital that both of you have clear expectations.

Your free time will be very limited. Your schedule may be so hectic at times that all you can do after a long day is go home and sleep. Your free time will also be unpredictable, as you may be on call, which can and likely will result in cancelled plans, sometimes at the last minute. Preparing your partner for these situations from the outset will prevent conflict.

When approaching commitments, use percentages. With what percent confidence can you commit to an event? Is there a 90 percent chance you can make it, a 70 percent chance, or 30? Knowing this upfront will result in fewer misunderstandings and hurt feelings.

If hurt feelings do occur, be sure to allow your partner to vent. Constantly canceling plans will be frustrating for them at the very least, and if they aren’t working in healthcare, your schedule and priorities during this time will be difficult to understand.

Being in medicine in some ways is as close to being in the military as you can get, with an arguably even more unpredictable day to day schedule at times.

Be clear right from the start that you will be under a tremendous amount of stress. This is in no way carte blanche for you to be rude or self-obsessed; however, they should know there will be times when you come home after having been chewed out by an attending or after having lost a patient. You may not always be able to put on a happy face and forget about your day the moment you walk through the door.

2 | Develop Open and Honest Communication

Next, communication is the foundation of any strong relationship, and it’s what will save you during residency. Explain when your shifts are, when you’re on call, and share your exact schedule, but strive to go beyond that. You need to share what’s going on in your inner life as well, including your feelings, concerns, and current energy levels.

Be honest. Don’t put on a brave face. They need to know how to support you through your dark days, which means you need to give them the full and honest picture of the job from the start.

If a patient dies, it’s important to share how it affected you. Don’t act as though your partner can’t help you or pretend you don’t need help when they can see that you do. If you deny your feelings, you’re more likely to crack under the immense pressure you’re under. Plus, you’re taking away your partner’s agency. Of course, they can’t help you with everything, but when they can, let them. If you have the right partner, they’ll be happy to offer you support.

However, remember that communication is a two-way street. Your partner isn’t there just so you can talk at them about how rewarding or challenging it is to be a doctor. They need to know they can vent to you when they are stressed, no matter their career path. Being a teacher, accountant, waiter, or business owner comes with its own stresses. They must be able to talk about their day too.

While the relationship does largely rely on your schedule, it’s not all about you.

3 | Don’t Allow Medicine to Rule Your Life

Next, while it’s important to be honest about your work and how it makes you feel, it shouldn’t be the only thing you talk about, and it shouldn’t rule your lives.

It is essential to take time to decompress before you see your partner and to put a time limit on hospital or clinic talk.

Dr. Joshua Goldman has found success using his drive home to transition his mindset. He has two children, so he uses his commute to move from serious plastic surgeon to playful dad. Dr. Goldman shares how he balances his family and work life in an episode of Day in the Life.

Even though it may not feel like it at times, you are more than just a doctor. Developing a healthy life outside of medicine will aid both your relationship and your career. You’ll be able to go into work fresh and ready to start again, rather than carrying it with you 24/7.

Work with your partner on finding a balance in your conversations. This is especially important if both of you are in residency. It’s great that it’s a passion you both share, but you are more than just residents. What are your hobbies and values outside of medicine? If you have to, make a rule that when on dates or when sharing a meal, you don’t talk about medicine. This will allow you to get to know each other on a deeper level and grow your connection beyond your shared careers.

4 | Intentionally Block Time for Your Relationship

The fourth tip is to intentionally make time for your relationship and your partner. Even with your busy schedule, make specific plans, put them in your calendar, and do your best to commit to them. You may only have a few extra hours each week to dedicate to your partner, but know that any time spent together is better than nothing.

Neglecting time as a couple will erode any relationship. If you’re not careful, those few hours of free time will get eaten up by something else, and before you know it, four weeks will have passed by without the two of you spending any quality time together.

You need to block time for your relationship and ensure being together occurs in some form or another. When your schedule is tight, get creative about blending other commitments. How can you turn tasks like grocery shopping, cooking, or even cleaning the house into a date?

Completing these seemingly boring tasks together will make them more enjoyable while giving you more opportunities to see each other. That said, don’t allow your only time together to be over laundry and dishes, as this is a surefire way to lose that romantic spark.

On days when you only have a few moments to spare, taking the time for a small gesture like bringing home food or flowers or just texting them a kind message can brighten your partner’s day.

Don’t only focus on what you want out of a relationship. What does your partner prefer? You might care about gifts and small gestures while what’s most important to your partner is hearing words of affirmation.

This is commonly referred to as your love language. The five love languages are physical touch, acts of service, quality time, words of affirmation, and gifts.

If you don’t know your preferred love languages, there are plenty of online quizzes you can take. While by no means scientific, they can provide insight into your own needs and preferences as well as your partner’s. If your love languages align, awesome! If they do not, don’t be discouraged. Taking the time to learn more about each other’s preferences will help you both get what you need from the relationship.

This again falls back on effective communication. Neither of you are mind readers. Make every effort to ensure both of your needs are met.

Romantic relationships during residency can be tough—but they’re rewarding too. Residency is tremendously challenging, and having someone you can lean on during this time is extremely valuable.

Source: https://medschoolinsiders.com/medical-student/dating-and-relationships-in-residency/

Abstract

Background: 

Neonatal nurses have a major role in helping parents engage with their infant. A high level of parent participation, called Parent-Partnered Care, integrates parents as full partners in the delivery of hospital care to their infants. One parent-partnered intervention that improves infant, parent, and parent-infant outcomes is H-HOPE (Hospital to Home: Optimizing the Preterm Infant Environment). H-HOPE has 2 components: Massage+ and Parents+.

Purpose: 

The purpose of this article is to present an evidence-based guide showing how to deliver Parents+ and the implications for nursing practice.

Methods: 

The nursing approach to Parents+ includes participatory guidance and social support, which fosters a partnership with parents. The guidelines for using participatory guidance include a detailed description of each teaching/learning session along with implications for nursing practice.

Results: 

Parents’ experienced many benefits from participating in the Parents+ sessions. They reported feeling more confident in the care of their infant and more satisfied with learning and delivering Massage+. Additionally, parents also reported less fears handling their infants, increased feelings of bonding/attachment, and a sensitivity/responsiveness to their infant’s behavioral cues.

Implications for practice: 

Parents+ presents an opportunity for nurses to help parents engage with their infants and increase their confidence and competence. Parents’ desire a neonatal intensive care unit culture that embraces a comprehensive collaborative approach with healthcare professionals that is individualized to their infant’s health and well-being.

Neonatal nurses have a major role in helping parents engage with their infant and provide direct care. The inclusion of parents as full partners in the care of their infant in the neonatal intensive care unit (NICU) has greatly expanded to include routine caregiving, developmentally supportive care, and engagement with the neonatal team regarding infant healthcare decisions. A high level of parent participation in the care of their infants, called Parent-Partnered Care, is defined as “approaches that center or integrate parents as full partners in the delivery of hospital care to their ill or small newborns.”

One parent-partnered intervention that improves infant, parent, and parent-infant relationship outcomes is H-HOPE (Hospital to Home: Optimizing the Preterm Infant Environment). H-HOPE is a parent-focused intervention that fits within the Parent-Partnered Model of Care where members of the healthcare team partner with parents in care delivery . H-HOPE includes both an infant-focused intervention, Massage+ (formerly termed the ATVV, Auditory, Tactile, Visual, and Vestibular Intervention), and a parent-focused intervention, Parents+. A large body of research documents that Massage+ significantly increases infant alertness, clarity of the infant’s cues, oral feeding and growth, and fosters the development of infant social communication and the parent-infant relationship in hospital. Additionally, Massage+ has been associated with reduced acute care visits and improved parent-infant interaction at 6-weeks corrected age. Massage+ is designed to be provided by parents while Parents+ provides guidance and support from nurses so parents can confidently provide Massage+ with sensitivity to their infant’s cues.

H-HOPE: one model of parent-partnered care.

As an early behavioral intervention for preterm infants and their parents, H-HOPE is designed to be integrated within a culture that supports parents as partners in care. H-HOPE incorporates 3 key elements of Parent-Partnered Care: presence, participation, and engagement. The physical presence of parents is necessary to provide them the opportunity to participate in caregiving activities like Massage+. Parents may participate in care activities with the support of nurses or independently depending upon their confidence and experience. Parents+ requires collaboration between the nurse and parent to teach parents how to understand their infant’s behavior and deliver Massage+. Engagement occurs when a parent is emotionally involved in their infant’s health and healthcare through their actions. Engagement is not fixed, rather it exists along a continuum. Over time, the delivery of H-HOPE by parents increases parents’ confidence in their caregiving and engagement with the healthcare team.

A comprehensive toolkit, including instructions and videos showing the step-by-step process of Massage+ is available to support nurses and parents in the delivery of Massage+ on Pathways.org (https://pathways.org/massage-tool-kit-H-hope) at no cost. Pathways.org also has detailed information and developmental resources for nurses to use during the Parents+ sessions. After completion of Parents+, the website is available for parents.12 These materials and videos are especially helpful for parents to review content at any time. However, detailed guidelines for the nurse to deliver Parents+ is not currently available in the literature. Therefore, the purpose of this article is to present an evidence-based guide showing how to deliver Parents+ and the implications for nursing practice.

PARENTS+ CONCEPTUAL BASIS

Parents+ consists of teaching/learning sessions that help parents understand infant behaviors and cues, shows them the steps of Massage+, and provides experiences that build parent confidence in providing Massage+ guided by their infant’s cues. The conceptual basis supporting Parents+ includes participatory guidance,principles of adult learning and experiential learning.

  • Participatory guidance occurs when a skilled clinician guides the process of learning how to perform a complex task, with the mutual goal of moving the learner from novice to expert. This approach changes the relationship from “instructor-student” to a collaboration. When using this approach, nurses foster bidirectional communication with parents.
  • Adult learning involves respecting and integrating what the parent brings to the sessions, such as their own experience in caring for an infant. It is their “history” related to the context of their lives, including their preterm infant, family, socioeconomics, cultural factors, and other responsibilities.
  • Experiential learning provides opportunities that foster integration of the new experience into the learner’s everyday skills. This learning approach provides hands on practice (Massage+) and supports parents as they gain confidence and competence while interacting with their infants. Experiential learning is also a component of Bandura’s well-known social learning theory widely used as an effective model for behavior change programs.

The learning strategies derived from these concepts promote parent participation and engagement (Parent-Partnered Care), build trust between nurses and parents, and increase parents’ confidence and competence with infant care. The integration of these strategies fosters growing parent competency. One advantage of Parents+ is its strong conceptual approach that assists nurses in conducting parent education that is both planned and effective, allowing nurses to provide consist of support across shifts and nursing assignments. This common understanding of how to conduct parent education is much needed; as noted in a recent scoping review that described the inability of health professionals to articulate the systematic teaching strategies they used.

DESCRIPTION OF THE PARENTS+ SESSIONS

Parents+ consists of 3 to 4 sessions: 2 in-hospital and 1 to 2 post-discharge. The focus of each session is the parents’ engagement with their infant, as they learn to understand their infant’s behavioral cues and how to build the parent-infant relationship. Parents learn about cues both through the nurse teaching about behavioral cues as well as the nurse asking about what cues the parents have seen in their infant and pointing out cues the infant may exhibit during the Parents+ session (Table 1). Through this repeated process, parents learn to read, interpret and respond to engagement and disengagement cues. For example, when their infant is overstimulated and exhibits a potent disengagement cue, the parent learns how to modify his/her behavior to reduce overstimulation (see Session 1 for definitions of engagement and disengagement behaviors below).

TABLE 1. – Parents+ Content: Example Session Questions and Talking Points

Open session with parent concernsLet’s start by discussing how you’re doing. How are things going for you? Do you have any questions about your baby?
Infant behavioral statesHave you noticed how your infant wakes up? What state is your infant in right now?
Engagement & disengagement cuesThese pictures show some ways infants show they are ready to interact with you or want to continue. Which ones have you noticed that your infant does?
Orally directed behaviorsHere are some things infants do to show they are getting ready to eat. What does your infant do when s/he is ready to eat?
Hunger & satiation cuesHere are some things infants do to show they are getting ready to eat or that they are full. What behaviors does your infant have when they are getting ready to eat and when they are full?
Massage+Massage+ is an activity that stimulates all your infants’ senses and is enjoyable for both of you Massage+ helps infants become alert and ready to feed, so they eat and sleep better. Do you notice any benefits for your infant when doing Massage+? Infants may like some parts and not others. Do the parts your infant likes. Remember to pause if they need a break. How does your infant respond to Massage+?
Back to sleepDo you know the best position to put your infant in for sleeping?
Signs & symptoms of illnessBefore you go home, we’d like to review what you might see in your baby that would need immediate attention.
How to calm a fussy babyDoes your infant ever get fussy? What do you do? Let’s talk about different things that you can do to calm the infant when s/he is fussy.
Feeding is more than eatingFeeding is an important time to relate to your infant Whether breast or bottle feeding, your infant needs to be close to you and have your full attention while feeding. This is a time for you and your infant to relax and enjoy each other
Tummy timeTummy time is important for your infant’s development and achievement of milestones Let’s review ways you can get tummy time in each day
Developmental milestonesInfants do not develop the same way, but knowing what developmental milestones to be on the lookout for can help you monitor their progress. Let’s review some 0-3 month milestones. Have you seen any of these in your infant yet?
Close session with parent check-inDo you have any further questions or concerns about what we’ve discussed, or anything else?

Infant behaviors and Massage+ are introduced at the first session and reviewed and practiced in subsequent sessions. While teaching Massage+, the nurse talks about infant behaviors and caregiving, adding new content to each Parents+ session. Content of Parents+ can be divided into multiple smaller sessions to accommodate both parent and nurse time constraints. When this occurs, documentation of parent education in the electronic health record (ideally into the existing parent education documentation) serves as a communication tool between nurses to ensure completion of a Parents+ session, picking up where necessary. If an infant is discharged earlier than expected, missing content can be delivered during the post-discharge visits.

Each Parents+ session follows the same plan:

  • Address (re-address) parent concerns
  • Review any previous content
  • Introduce new content
  • Complete each session by returning to the parent’s continuing concerns and any questions about their infant.

The focus on parent needs at the beginning and end of each session is in response to the high stress, anxiety and fear many parents report during their time in the NICU. Nearly all parents’ have emotional needs related to caring for their vulnerable infants and are often hesitant about even touching their infant. The psychological distress of having a preterm infant, exacerbated by the stress of the NICU environment, along with the context of parent’s lives outside the hospital, affect their ability to fully participate in caregiving of their infant and engage with the healthcare team regarding their infant and family’s needs. For parents to fully engage during this stressful time, their needs must be addressed in conjunction with the infant’s needs. However, parents are rarely given an opportunity to discuss their own feelings and needs. Parents+ helps mitigate parents’ distress by acknowledging their needs and concerns and asking what they want to learn about their baby to support their learning and engagement.21 While some concerns are too complex to be resolved or may require referrals, simply acknowledging parent concerns helps parents feel heard and builds trust. Detailed guides for each session are available on Pathways.org.

Session 1

The first Parents+ session can be initiated when the parents are physically and emotionally ready, even if the infant is not old enough to receive Massage+ (Massage+ begins when the infant reaches 31-32 weeks postmenstrual age and is physiologically stable). Infants born between 33 and 35 weeks may also begin Massage+ once they are physiologically stable. This first session includes substantial content about preterm infant behaviors and cues that are highly relevant for all parent caregiving and engagement with the infant. Sharing information about preterm infant behavior and cues prior to the infant’s readiness for Massage+ allows parents’ time to become comfortable learning to read, interpret, and respond to their infant’s cues.

During Session 1, 4 content areas related to preterm infant behaviors are discussed. Nurses use active listening to understand parents’ concerns and tailor content to support learning. The session begins with a description of infant behavioral states and engagement and disengagement cues to help parents understand the many behaviors that infants use to express themselves. These cues also include orally directed behaviors (pre-feeding behaviors) and those that indicate hunger and satiation. When working with parents, using the term pre-feeding behaviors is easier for parents to understand. Later in this session, parents learn the steps of Massage+ and practice Massage+ on their infant with guidance. Cues are further reinforced when parents learn to read, interpret, and respond to the infant’s behavior while giving Massage+ to their infant.

  • Infant Behavioral States: Behavioral states include quiet sleep, active sleep, drowsiness, active alert, quiet alert, and crying. Identifying the infant’s behavioral state indicates readiness or lack of readiness to engage. During the active alert state, the infant’s eyes are open and the infant looks around; arms and legs may be moving, indicating readiness to feed. This state is most optimal for oral feeding, regardless of whether feeding is provided by bottle or breast feeding. During the quiet alert state, the infant’s eyes are open, the infant is calm and ready for social interaction with the parent.
  • Engagement and Disengagement Cues: These cues are important indicators of the infant’s readiness to interact or needing a break. Both engagement and disengagement cues can be potent (eg, easy to understand such as looking at the parent, or cry) or subtle (eg, difficult cue for the parent to read and interpret such as hands open or grimace). Preterm infants often show more subtle engagement cues such as brow raising, facial brightening, feeding posture, and hands open with fingers slightly flexed. As they mature, the frequency of potent cues increases. Potent disengagement cues include a cry face and halt hand, turning head away, and spitting up. Subtle disengagement cues include fast breathing, gaze aversion, and yawning.
  • Orally Directed Behaviors (Pre-Feeding): Orally directed behaviors indicate the infant’s readiness to feed. These include mouthing, rooting, tonguing, hand-to-mouth, hand swipes at mouth, empty sucking, sucking on hand, and sucking on tongue.7,30
  • Hunger and Satiation Cues: Hunger cues include arms and fingers bent, facial grimace or crying, mouthing and sucking movements. Satiation cues include arms relaxed or by the infant’s side, relaxed fingers, infant has a neutral face (no expression), or infant is asleep.26,27,31 These cues provide additional indicators of the infant’s hunger or feeling full. This is important for parents who often want to feed their preterm infant the entire oral feeding even though they are exhibiting satiation cues.

Session 2

Session 2 begins 1 to 2 weeks before discharge. Planning for Session 2 well before discharge allows additional time to address parents’ questions and concerns and to support the parent-infant relationship before heading home. This session also offers additional opportunities to integrate new information with previous learning.

Session 2 content includes signs and symptoms of illness and back to sleep. This information is often already incorporated into discharge education. However, the participatory guidance approach of H-HOPE (Parents+) acts as a reinforcement of the importance of active listening to address parents’ questions with bi-directional communication and incorporating the context of the parents’ needs and concerns as they transition to home. As discussed above, this may include referrals or additional resources to support parent self-care.

Sessions 3 and 4

One or two virtual sessions occur within 2 weeks after parents are discharged home with their infant. Parent feedback from our previous research indicated that this is also a stressful time for parents and they appreciated the additional support and educational content. The purpose of these post-discharge sessions is to offer support to parents, answer questions related to Massage+ and infant behavioral cues that were taught during the first session, as well as infant care. New topics include calming a fussy baby, feeding is more than eating, tummy time, and developmental milestones. Parents are also encouraged to use the Pathways.org App for continuing information about developmental milestones that can be easily downloaded onto their phones.

Depending on the parents’ schedules at home, these 2 sessions can be combined into 1 session. However, the rationale for providing 2 post-discharge virtual sessions was developed as a result of previous research with parents’ who found these visits valuable for their transition to home.

DISCUSSION

The purpose of this article was to present an evidence-based guide showing how to deliver Parents+ and the implications for nursing practice. While parents appreciated Massage+ in previous research studies, they reported high anxiety while handling their infants and not clearly understanding their infant’s behavior. Parent feedback led to the development of Parents+ which offers parent support and guidance to improve outcomes for infants, parents, and the parent-infant relationship. Massage+ is designed to be provided by parents while Parents+ provides guidance and support from nurses so parents can confidently provide Massage+ with sensitivity to their infant’s cues.

Parents+ is a model for collaboration between parents and nurses enabling the delivery of Parent-Partnered Care, and has benefits for parents, infants and nurses, as discussed below. The first Parents+ session was intentionally designed to guide parents in learning and practicing the steps of Massage+ on their infant. When Massage+ is provided by parents, they can see their infant’s positive behavioral responses and growing developmental capacities. The process of providing Massage+, a multimodal dyadic intervention, helps parents’ experience handling their infant and responding appropriately to infant cues; skills that readily transfer to virtually all other caregiving.

Thus, the experience of providing Massage+ begins to build the parent-infant relationship. In both qualitative and quantitative assessments, parents reported feeling more confident in the care of their infant and more satisfied with learning and delivering Massage+. In other intervention and engagement studies, parents reported improved mental health, increased confidence and competence while caring for their infant. Parents also reported less fears handling their infants, feelings of bonding/attachment, and parental sensitive-responsiveness to their infant’s behavioral cues.1Significantly, this response has been proposed as the foundation for the development of the parent-infant relationship.

Benefits for Parents+.

Overall, the benefits of H-HOPE (Massage+ and Parents+) for infants have been well documented in the literature. Infants of different post-menstrual ages (31-36 weeks) responded with improved alertness, increased orally directed behaviors, faster progression from gavage to oral feeding, improved growth, and fewer illness visits after hospital discharge.2,4,6-8 In addition, other investigators reported an improvement in neurodevelopmental outcomes following interventions focused on the parent-infant relationship. Interventions that also include the transition into the home as with Parents+ Sessions 3 and 4 are ideal because this offers additional support for parents and infants post-discharge.

Importantly, Parents+ also benefits staff, providing a practical guide that both novice and expert nurses can use to more effectively help parents engage with their infants. Conducting Parents+ using a participatory guidance approach further develops interactive and teaching skills for nurses. Essentially, the participatory guidance approach can be used for any instruction with parents. These skills foster a culture for parent participation, using bidirectional communication and demonstrating how parents can collaborate with the nurse as a partner. Showing respect and understanding of the parent perspective is particularly salient, as nurses play an important role in making parents feel comfortable and welcome in the NICU environment, as well as increasing their confidence in providing care for their preterm infants.

IMPLICATIONS FOR CLINICAL PRACTICE

Increasingly, the nurse’s opportunity to provide parent support and guidance is challenged by a continually, complex clinical environment, staffing shortages and family stressors. Parents+ presents an opportunity for nurses to help parents engage with their infants and increase their confidence and competence. Physical therapists, occupational therapists, and speech language pathologists trained to administer H-HOPE are well equipped to provide the intervention and can partner with nurses’ to provide these services. However, in most NICUs, the primary responsibility will likely reside with nurses, as they are the only clinicians in the NICU who are at the bedside 24/7. Moreover, evidence-based parent focused developmental approaches to preterm infant care have been shown to affect neurodevelopmental outcomes for infants, driving the need to become a standard of care in the NICU.45 The Vermont Oxford Network issued a statement, “All care is brain care,” to emphasize the importance of developmentally based care for the preterm infant.As NICUs move forward with advancing this type of care, a unit culture that incorporates a developmental and behavioral approach to caregiving by nurses is critical and necessary to achieve optimal outcomes. To support a unit culture of developmental care, staff education and training, from orientation through skill review sessions, is imperative.

The parent perspective can be found in the literature, via feedback from parent advisory groups, and local and national parent support networks (eg, https://nicuparentnetwork.orghttps://www.marchofdimes.org/our-work/nicu-family-supporthttps://handtohold.orghttps://www.projectnicu.com). Parents desire a NICU culture that embraces a comprehensive collaborative approach with healthcare professionals that is individualized to their infant’s health and well-being. The goal for all parents is to achieve optimal outcomes for their infant.44 However, this may require more than changing the NICU culture. There are many factors besides NICU culture and socioeconomics that are barriers and challenges for parents. These include insufficient knowledge about how to care for the infant and understanding realistic expectations for growth and development, as well as access to resources to support the parent’s and infant’s needs.

A successful practice change that incorporates the parent perspective also depends upon experienced leadership; operational and clinical leaders who set consistent expectations for implementing and sustaining evidence-based standards of care. In addition, assessment of staffing needs is critical to incorporate a practice change into nursing workflow. Parents need nurses who have the time to help them learn a behavioral intervention like H-HOPE and provide essential developmental care. NICUs where parent education and engagement are highly valued, and a cornerstone of nursing practice, will likely be more willing to accept H-HOPE. It is imperative for NICUs today to focus on meeting the needs of parents’ and infants, address the challenges, and implement evidence-based practices. In addition to assessing staffing needs, each institution must consider other logistical factors, such as reimbursement for services and who conducts the post-discharge sessions. While nursing time inpatient is not reimbursable, outpatient often is, which may cover the 2 post-discharge Parents+ visits. These post-discharge visits could be completed by a discharge nurse or developmental specialist, depending on the resources of each institution.

CONCLUSION

Parents+ is an innovative behavioral intervention with benefits for parents, infants and staff. Parents+ incorporates a model of Parent-Partnered Care, which helps mitigate parent’s distress by addressing parents’ needs and concerns to support their learning and engagement with their infant. The Parents+ sessions are designed to provide education and support during the NICU stay and post-discharge. Understanding the evidence that supports developmental and behavioral care is key to recognizing the rationale for incorporating Parents+ into the standard of care by staff. Incorporating a culture of developmental and behavioral care for parents and their infants is imperative to address their needs, improve outcomes, and advance nursing practice in the NICU.

 Summary of Recommendations for Practice and Research

What we know:Parents+ is a behavioral intervention that incorporates Massage+ to help parents learn their infant’s cues and contributes to optimal neurodevelopmental outcomes. Parents+ is an evidence-based approach to behavioral care in the NICU. Nurses are essential for providing Parents+.
What needs to be studied:Further research is recommended to identify effective strategies incorporating H-HOPE into neonatal nurses’ workflow. Research is critical to describe how NICUs embrace developmental care as the standard of care. Data are needed to document parent and infant outcomes from the delivery of Parent-Partnered Care.
What can we do today that would guide caregivers in the practice setting considering the use of this evidence for guiding practice?Provide leadership support for a developmental and behavioral approach to NICU care. Educate nurses on the principles of Parent-Partnered Care. Engage parents to understand the behavioral cues of their infant as a component of their caregiving.

Source: https://journals.lww.com/advancesinneonatalcare/fulltext/2025/10000/parents___an_early_behavioral_intervention_as_a.4.aspx?context=featuredarticles&collectionid=3

Club cell secretory protein (CC16) is a pneumoprotein that has anti-inflammatory and antimicrobial properties and whose levels are reduced in preterm infants.

Objective

We sought to investigate the role of circulating CC16 in the association of preterm birth (<37 weeks) with lung function and asthma from childhood into young adult life in longitudinal and mediation analyses.

Methods

Using the BAMSE (Swedish abbreviation for Barn/Children, Allergy, Milieu, Stockholm, Epidemiology) birth cohort (2,557 participants and 10,631 longitudinal observations), we assessed plasma CC16 (ages 8 and 24 years), spirometry (ages 8, 16, 24, and 26 years), and asthma (ages 8, 12, 16, 24, and 26 years). Longitudinal associations between preterm birth, CC16, percent predicted values of FEV1/forced vital capacity (ppFEV1/FVC), and asthma were examined in longitudinal multivariable mixed models. CC16 (ages 8-24 years) was tested as a mediator for the relationship of preterm birth to pre- and postbronchodilator ppFEV1/FVC and asthma in adulthood (ages 24-26 years).

Results

Preterm birth was associated with reduced plasma CC16 (−1.15 ng/mL; 95% CI, −1.22 to −1.08; P < .0001), lower ppFEV1/FVC (−1.9%; 95% CI, −3.1 to −0.8; P = .001), and higher risk for asthma (1.83; 95% CI, 1.28 to 2.62; P = .001) across ages 8 to 26 years. CC16 deficits were related to decreased ppFEV1/FVC (P < .0001) and increased risk for asthma (P = .007) in adulthood. Multivariable mediation analyses suggested that CC16 mediated 16% and 9% of the effects of preterm birth on ppFEV1/FVC and asthma in adult life, respectively.

Conclusions

Low CC16 is a potential mediator of the effects of prematurity on lung function deficits and asthma in young adulthood. Future studies should address whether CC16 can be used as a predictive biomarker and, possibly, a therapeutic target in individuals born preterm.

Section snippets

Participants

BAMSE is an observational population-based birth cohort study that enrolled 4089 children born in Stockholm between 1994 and 1996.35 The study design and enrollment process are detailed in this article’s Online Repository at www.jacionline.org. Perinatal data were obtained from the Swedish medical birth register.36 Plasma CC16 levels were measured at ages 8 and 24 years. Spirometry was conducted at ages 8, 16, 24, and 26 years. Asthma questionnaires were answered by parents at ages 8, 12, and

Results

Overall, 2,557 BAMSE participants were included in this study, contributing to a total of 10,603 longitudinal observations for asthma (526 for preterm participants) and 6,109 for lung function (324 for preterm participants). Compared with the 1,532 excluded participants because of missing CC16 and/or phenotypic data, those included were more likely to be females and have older, nonsmoking mothers and higher-educated parents with a history of asthma (Table I). There were no significant

Discussion

In this study—using a large, long-term, population-based birth cohort—we demonstrated that low circulating CC16 levels may mediate part of the effects of preterm birth on lung function and asthma in young adult life, supporting a protective role of CC16 in obstructive lung diseases of individuals born prematurely. These findings highlight the potential of CC16 for risk stratification and, possibly, novel therapeutic strategies for preterm individuals at risk for obstructive lung disease.

The role of CC16 in the associations of preterm birth with lung function and asthma in adult life – ScienceDirect

Empowering Voices: Honoring the Educators Who Shape Our Journeys

As we begin Neonatal and Preemie Awareness Month, we celebrate not just our survival stories, but the growth and purpose that follow. For those of us who began life in the fragile space of an incubator, this month is a reminder of how far we’ve come—and of the people who continue to help us become who we are meant to be. This November, our theme is “Educators as Warriors of Empowerment”—because teachers, mentors, and guides are often the ones who help transform early struggle into lifelong strength.

Many of us know that being a preemie can mean growing up with a different pace, a different rhythm, or a different way of learning. It’s our teachers who see that difference and choose to nurture it rather than correct it. They are the ones who remind us that resilience isn’t about perfection, it’s about discovery. Whether it’s the preschool teacher who cheered every word we learned to speak, or the university professor who saw our curiosity, these educators become part of our extended story of becoming.

This month, we celebrate their quiet strength—the patience to listen, the creativity to adapt, and the belief that every child’s journey matters. They empower us to see ourselves not as “born early,” but as born with perspective—the ability to find meaning in milestones others take for granted. Through education, we learn to define our own possibilities, rewrite old narratives, and embrace the uniqueness that began long before we could even open our eyes.

To every educator who has walked beside a preemie—thank you for being part of our collective story of empowerment. And to every survivor reading this: remember, your journey didn’t stop at survival. It continues through the lessons you share, the knowledge you seek, and the lives you touch. This month, let’s honor the teachers who reminded us that we are not defined by our start in life, but by how brightly we choose to grow.

Bow Wow, OJT, WHO Listed

Liberia, officially the Republic of Liberia, is a country on the West African coast. It is bordered by Sierra Leone to its northwestGuinea to its northIvory Coast to its east, and the Atlantic Ocean to its south and southwest. It has a population of around 5.5 million and covers an area of 43,000 square miles (111,369 km2). The official language is English. Over 20 indigenous languages are spoken, reflecting the country’s ethnic and cultural diversity. The capital and largest city is Monrovia.

Liberia has 5,000 full-time or part-time health workers and 51 Liberian doctors to cater to a population of 3.8 million, according to the 2006 health survey. That’s the equivalent of one doctor serving about 76,000 civilians. Most of the hospitals, clinics and equipment were destroyed as a result of the 14-year civil war from 1989 to 2003. Strengthening the health sector faces financial problems. The government used only 16.8% of the total health expenditure in the country.

Liberia is heavily dependent on the international community for health infrastructure and assistance. International aid organizations assist the government in rebuilding medical facilities and providing basic health care to its citizens. The World Health Organization (WHO) donated equipment and helped provide and assist in vaccinating people to prevent the spread of many infectious diseases.

The Global Alliance for Vaccines and Immunization (GAVI) is investing $160 million to improve Liberia’s health care system and improve the quality of immunization services. The international medical humanitarian organization Médecins Sans Frontières (MSF) helped Liberia after the civil war (2003) by running free hospitals, treating more than 20,000 women and children each year.

Source: https://en.wikipedia.org/wiki/Liberia

Monrovia Liberia: Liberia has received a major boost to its healthcare sector as 26 leading medical professionals from the United States, Canada, Europe, and beyond have arrived for the Liberia Medical Mission (LMM) 2025. The mission, a special initiative led by President Joseph Nyuma Boakai’s administration, represents a transformative step toward improving healthcare delivery across the country.

As part of the mission, over $500,000 worth of life-saving medicines will be distributed across five counties, aligning with President Boakai’s vision for a healthier and stronger Liberia.

The mission’s launch was celebrated with a special reception at the Tea House, Executive Mansion in Monrovia, where President Boakai expressed deep gratitude for the medical team’s commitment to making a difference.

“This mission exemplifies the power of compassion and service,” President Boakai said. “You’ve left the comfort of your homes to bring healing and hope to our people. Liberia is truly grateful for your selfless contributions. My administration is committed to supporting and expanding this mission so that more lives can be saved.”

He reiterated the government’s dedication to modernizing Liberia’s healthcare system, ensuring that medical professionals and facilities are equipped to improve service delivery nationwide.

Expanding Medical Care Across Liberia’s Counties

The Liberia Medical Mission 2025 aims to provide essential healthcare services to thousands of Liberians in need. Over $500,000 worth of medicines will be distributed to hospitals and clinics in Gbarpolu, Cape Mount, Bomi, Grand Bassa, and Montserrado counties. The mission will provide the following critical healthcare services:

• Cataract Surgeries at Emirates Hospital: Restoring vision to patients from Gbarpolu, Bomi, Cape  Mount, and Montserrado counties.

• Mental Health Awareness & Training: Focused on trauma-informed care, with training for healthcare workers, educators, and security agencies.

• CPR & Emergency Training: Aimed at enhancing life-saving emergency response skills for 7 security personnel.

• Biomedical Equipment Repairs: At John F. Kennedy Memorial Hospital and other key medical centers to improve service efficiency.

• Specialized Urology Surgeries: Performed by leading urologists at JFK Memorial Hospital.

This initiative is being led by Minister Mamaka Bility, the Minister of State Without Portfolio for Presidential Affairs, and is directly overseen by the President’s Delivery Unit (PDU). Minister Bility spoke on February 21, 2025, at the event, highlighting the government’s unwavering commitment to reshaping Liberia’s healthcare sector.

“This mission reflects President Boakai’s vision for a reformed healthcare system,” Minister Bility stated. “We are honored to host the Liberia Medical Mission again this year, as their critical services will touch and improve countless lives.”

Liberians Abroad Give Back to Their Country

Many of the medical experts participating in this mission are Liberians who have spent years abroad, gaining experience in their fields, and are now returning home to contribute to the development of their country’s healthcare system.

As the mission progresses, President Boakai has called on all Liberians to work together with the medical team to maximize its life-saving impact.

“This is a national effort, and every Liberian has a role to play in ensuring the mission’s success,” President Boakai said. “My administration remains dedicated to advancing healthcare policies and mobilizing resources to build a more resilient healthcare system for Liberia.”

The Liberia Medical Mission 2025 offers free medical checkups, surgeries, and other essential services at no cost to the government or private institutions, making it a crucial component in the country’s healthcare transformation.

A Step Toward a Healthier Liberia

The Liberia Medical Mission 2025 stands as a testament to the collective efforts of both international and Liberian medical professionals who are dedicated to improving healthcare in the country. With the government’s ongoing support, this initiative is set to deliver lasting benefits for thousands of Liberians in need of medical care.

Source:https://knewsonline.com/liberia-boosts-healthcare-with-arrival-of-26-medical-professionals-for-2025-mission

The World Health Organization (WHO) has officially designated Health Canada, the Ministry of Health, Labour and Welfare/Pharmaceuticals and Medical Devices Agency (MHLW/PMDA) of Japan, and the Medicines and Healthcare products Regulatory Agency (MHRA) of the United Kingdom as WHO-Listed Authorities (WLAs), a status granted to national authorities that meet the highest international regulatory standards for medical products.

With these latest designations, WHO expands the growing list of WLAs, now involving 39 agencies across the world, supporting faster and broader access to quality-assured medical products, particularly in low- and middle-income countries (LMICs).

In addition, the Republic of Korea’s Ministry of Food and Drug Safety (MFDS) – one of the first regulatory authorities to complete the WLA assessment for both medicines and vaccines in October 2023 – has had its listing scope successfully expanded, now covering all regulatory functions.

“This recognition reflects the deep commitment of these authorities to regulatory excellence,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Their designation as WHO-Listed Authorities is not only a testament to their robust regulatory systems but also a critical contribution to global public health. Strong and trusted regulators help ensure that people everywhere have access to safe, effective, and high-quality medical products.”

Around 70% of countries worldwide still face significant challenges due to weak or inadequate regulatory systems for evaluating and authorizing medical products. The WLA framework promotes regulatory convergence, harmonization and international collaboration, allowing WHO Prequalification Programme and regulatory authorities, especially those in LMICs, to rely on the trusted work and decisions of designated agencies. This collaboration supports efficient use of limited resources, enabling better and faster access to quality-assured life-saving medical products to millions more people.

“The principle of reliance is central to WHO’s approach to regulatory systems strengthening and a cornerstone for effective, efficient and smart regulatory oversight of medical products,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Health Systems, Access and Data. “WHO-Listed Authorities are key enablers in promoting trust, transparency, and faster access to quality-assured medical products, especially in low- and middle-income countries.”

In a world where health threats, including substandard and falsified medical products, know no borders, WLAs also serve as critical pillars of preparedness and equity, making life-saving products available more broadly, rapidly and efficiently.

The designations follow a rigorous performance evaluation process carried out by WHO using its globally recognized benchmarking and assessment tools. These evaluations were reviewed by the Technical Advisory Group on WLAs (TAG-WLA), which convened in June 2025.

Canada, Japan and the UK’s regulatory authorities were previously recognized as Stringent Regulatory Authorities (SRAs). Their designation under the WLA framework marks an important step in moving beyond the old SRA system, while ensuring continuity and stability in global procurement processes of quality-assured medical products.

Launched in 2022 to replace the previous SRA model, the WLA initiative provides a transparent and evidence-based pathway for global recognition of regulatory authorities to facilitate regulatory convergence and reliance. It builds on decades of WHO leadership to help countries work together more closely on regulating medical products, speeding up access to safe, effective and quality-assured medical products for people around the world. 

Source: https://www.who.int/news/item/07-08-2025-who-designates-new-who-listed-authorities–strengthening-global-access-to-quality-assured-medical-products

Here is our list of the best team building ideas for healthcare professionals.

Team building ideas for healthcare professionals are exercises, activities, and games that build morale and keep healthcare employees positive and engaged. Examples include daily positive affirmations, Secret Number, and Mystery Diagnosis. The purpose of these activities is to build healthcare teams that are motivated to best serve patients.

These exercises are examples of team building activities for technical teamssmall group team building activitiesteam building exercises, and team building events.

This list includes:

  • team building activities for caregivers
  • communication activities for healthcare workers
  • team building exercises for nurses
  • team building ideas for doctors
  • healthcare team building games

Let’s get started!

List of team building ideas for healthcare professionals

It is not uncommon for healthcare professionals to feel stress and fatigue when under constant pressure. As a result, healthcare leaders must engage in fun and meaningful team building exercises and activities with their teams. Here is our list of the top ideas to improve bonds between teams of healthcare workers.

1. Thanks and Gratitude Circle

If you want to boost communication activities for healthcare workers in your facility, then start by fostering a culture of recognition and gratitude on your team. Building and maintaining a positive work culture can lay the foundation for a strong and successful team of healthcare professionals.

There are different ways you can show gratitude toward your team and make a fun game out of it. Communication is key in any workplace, so we recommend conducting your gratitude activity by getting your entire team together at the end of each day.

You should begin by having all team members sit together in a circle. Then, you can go around the circle and have each employee express gratitude for one teammate. A great way to think about this exercise is to have each participant start with the words, “Today, I want to thank blank.” For example, you could say: “Today, I want to thank Amanda for going above and beyond in treating her patients and helping other members of the team who were struggling with their patients.”

This communication exercise is a meaningful way for all teammates to build camaraderie by sharing words of thanks and gratitude toward other team members. Communication exercises for recognition and appreciation are also a great way to end each day.

2. Daily Positive Affirmations

One of the most beneficial team building activities for caregivers is to practice positive affirmations at work.

Positive affirmations are phrases that can help you build yourself up and overcome negative thoughts.

Here are a few examples:

  • I am making a difference.
  • I will show kindness and empathy to every patient.
  • I will care for myself as I care for my patients.
  • I help others in their most vulnerable moments.
  • I am energized and ready for the day.
  • I will make today a great day.
  • I am strong.
  • I am proud of myself and the work I do.

Affirmations like these are ideal for all employees to stay motivated and positive. Caregivers must remain positive as they work with patients dealing with difficult and sometimes life-threatening diseases and disorders.

Positive affirmations can be a great help in allowing employees to free their minds and stay positive, even during a tough day at work. Plus, the whole team can collectively build their positivity and confidence by having employees recite positive affirmations together.

3. Coffee Chats and Tea Time

As a doctor, it can be challenging to make time to socialize with your team regularly. As a result, one of the best team building ideas for doctors is to set aside time each week to socialize with their team over a cup of coffee or tea.

Gathering in the break room with your team can provide the perfect opportunity to get to know each other and take a much-needed break in the middle of a busy day. To make your coffee chat and tea time a success, you should remember to stock up your break room with various coffees and teas.

In addition, you should make a goal for yourself to chat with a new coworker new each week. It can be tempting to talk to your well-known coworkers and friends, but by chatting with a new colleague each week, you will meet different teammates while building new relationships in your workplace.

4. Line Leader

When it comes to communication activities for healthcare workers, the exercise that may help your team most is a nonverbal communication game.

Nonverbal games are an effective way to build communication skills. Instead of relying solely on spoken words, healthcare professionals can learn to look at nonverbal cues and body language to decipher patients’ and colleagues’ needs and wants.

Line leader is a nonverbal communication game in which the group must form a line in a specific order without talking to each other. Instead, teammates must ​​rely on silent cues and body language to get in the correct order while working together. The moderator is the only player allowed to speak in this game.

For example, the game’s moderator can ask the team to get in a line starting from January birthdays through December birthdays. In this case, the first player in the line should be the team member with the first January birthday, while the last player in line should be the member with the last December birthday.

Since players may not speak to each other, they must determine the correct order by using body language and signs. The game Line Leader is an ideal activity that can help healthcare professionals better understand the nonverbal communication cues they may receive from patients or colleagues.

5. Secret Number

A nonverbal communication game your team can play together is Secret Number. To play this game, you should break your group into two teams of three to ten players. These teams will ultimately compete against each other, and it is best if your teams are large.

You should begin the game by designating one player as the moderator. The game’s moderator should communicate instructions or guidelines to other players. The moderator should then give each team a piece of paper and a pencil.

Before the game officially begins, each team should devise a secret code to use throughout the activity. This secret code will come in handy when players get stumped, as they will not be allowed to speak with each other or write anything down.

You can use the following steps to ensure a smooth game:

  1. The moderator gives each team leader a “secret number.”
  2. Each leader should communicate this number to each member of their team one by one. However, the leader should not speak or spell out the number with their hands.
  3. As each team member reads the leader’s nonverbal clues, the player should write down their guess of the secret number.
  4. Once the team leader has communicated with each participant, they should signal to the moderator that their team is finished.
  5. The winner of the game is the team that finishes the fastest and can guess the correct number.

To keep the game exciting, you should switch team leaders for each turn so different players can have the opportunity to lead. Secret Number is a great way to get teams accustomed to nonverbal cues as they engage in friendly competition.

6. Care Packages

Among the different types of healthcare professionals in the workforce, nurses typically feel higher levels of stress and burnout. As a result, one of the most ideal team building exercises for nurses to combat burnout is to have the team leader send out care packages.

By sending care packages to your team, you are sending the message that you care about employee wellbeing.

Here are a few items you can include in your care packages for self-care:

  • Herbal teas
  • Bath bomb
  • Face masks
  • Candles
  • Meditation subscription
  • Positive affirmation cards
  • Snacks

Assembling care packages is a great exercise to decrease burnout, boost morale, and increase employee satisfaction. A well-rested team of nurses is most likely to provide the utmost level of care to patients.

7. Question of the Day

One of the most classic healthcare team building games is icebreakers. This team building activity works well for new teams that are just meeting each other or teams that want to get to know each other better.

A great icebreaker to begin each shift with is Question of the Day. As part of this icebreaker exercise, designate one person on your team to come up with the day’s question. From there, the employee tasked with creating the question should kick off the icebreaker exercise by stating the question and their own answer. Question of the Day is a great icebreaker to help coworkers learn more about each other.

A few suggestions for Question of the Day prompts include:

  • What is one important skill that all nurses should have?
  • If you had an extra hour in your day, what would you do during that time?
  • If you were not a nurse, what kind of job do you think you would have?

Icebreakers can help teams build unity by learning more about each other. Plus, when a team feels more united, they are more likely to excel in their roles and keep hospital operations running smoothly.

8. Workshops

Workshops provide an excellent opportunity to learn new things while spending time with coworkers. We recommend organizing monthly workshops that employees can attend throughout the work day or on their breaks.

Although the workshop may take place during the workday, it is important to know that these sessions do not have to be directly related to job training or building on-the-job skills. Instead, these workshops should focus on building camaraderie while promoting employees’ well-being.

Here are a few suggestions for the types of workshops that you can get your team excited about:

  • Yoga and meditation
  • Healthy habits
  • Journaling
  • Resume writing
  • Networking

Each workshop will provide employees with the opportunity to decompress while learning new skills that can help them in their daily job.

9. Board Games

If you are looking for healthcare team building games to engage your group, start with board games. Board games are a fun and competitive way to get your team to interact.

Some suggestions:

  • Monopoly
  • Sorry!
  • Trouble
  • The Game of Life
  • Taboo
  • Operation

It can be a good idea to keep a handful of board games in your facility’s break room. Having easy access to a few board games allows your team to choose different options to play with teammates during their lunch break or at other team building events.

10. Escape Room

If you are looking for a team building activity that promotes problem-solving and resolution skills, then consider completing an escape room challenge. Escape rooms are activities in which teams are locked in a room full of puzzles and tasks that they must complete to escape.

To successfully complete an escape room, team members must communicate effectively to solve the many puzzles and challenges. You can find a variety of themes to meet the needs and interests of your whole team.

Fun escape room themes include:

  • Mystery
  • Science or high-tech
  • Fantasy
  • Horror or suspense
  • Holiday

Although teammates may have differing perspectives and ideas, all players need to work together to escape the room within the given time frame. Escape rooms contain different puzzles and clues that teams must work together to solve, making this activity an optimal choice for a team of healthcare professionals looking to boost teamwork and trust.

11. Team Outing

Engaging with your team outside the workplace can provide a much-needed change of scenery while providing an opportunity to get to know each other and socialize more. Fun activities and team outings can help boost employee happiness and morale.

A few examples:

  • Happy Hour
  • Boat ride
  • Fancy dinner
  • Karaoke night
  • Paint and sip class
  • Science museum
  • Art museum

When it comes to team building ideas for doctors, you cannot go wrong with visiting a science museum. In fact, a group of doctors may be especially excited to enjoy a trip to the local science museum and spend an afternoon learning and exploring.

12. Mystery Diagnosis

Role-playing is one of the best team building exercises for nurses that can help improve their patient care skills. To conduct a role-playing exercise with your team, you will need to choose one team member who will act as the doctor.

Here are a few steps to keep in mind when participating in this role-playing game with your team:

  • You can start by having the team “doctor” leave the room. Once this player leaves, the rest of the team should come up with an illness or injury. The players should discuss symptoms and scenarios they can later share with the team’s doctor.
  • When the doctor comes back into the room, they will diagnose the patient based on the information the remaining players share.
  • To make the game challenging, you should give the doctor a timeframe of about 90 seconds to fully diagnose the patient.
  • If the team doctor can provide the correct diagnosis in the given timeframe, then the doctor can be declared the winner. The other players win the game if the doctor fails to provide the correct diagnosis.

You can encourage your staff to act out rare and obscure diseases or illnesses to make the game even more fun. For example, some players may pretend to fall asleep while doing everyday activities. The doctor of the game would then need to understand why patients are exhibiting such strange behavior, and ultimately provide a diagnosis.

Role-playing can be helpful for nurses to build upon their analysis, critical thinking, and problem-solving skills. This role-playing exercise is also a great way for a team of nurses to improve their relationships with each other as a team.

13. Bake-Off

Having a team bake-off is a fun way for your team to show off their baking skills while building collaboration skills.

To host a team bake-off, you should split your group into teams of three. Next, have each team choose a pastry or dessert to bake together. You can provide a two-hour time limit for each team to bake their dessert.

Once the teams have finished baking, you should have a team of judges taste each creation to determine a winner. A team bake-off is a great team building exercise as you can get teammates in the kitchen with each other working together on a tasty dessert.

Conclusion

Team building exercises are a great way to get your team of healthcare professionals more comfortable with each other. These activities also have the power to motivate teams to work more efficiently and in sync with one another, especially when serving patients.

Overall, team building is essential for healthcare professionals and it is a great skill for all teams to master. By engaging in team building exercises, you are taking the right steps toward improving relationships between team members with each other, which can lead to happier employees and satisfied patients.

FAQ: Team building ideas for healthcare professionals

Here are answers to questions about team building ideas for healthcare professionals.

What are team building ideas for healthcare professionals?

Team building ideas for professionals are activities that build camaraderie among healthcare teams while keeping employees motivated and happy. Healthcare professionals need to build their team’s morale and collaboration skills with each other both in and out of the workplace. As a result, team building exercises and activities come in handy when you are looking to form a stronger and more united team.

What are some good team building ideas for healthcare professionals?

There are many team building ideas to engage healthcare teams. Here are a few examples of team building exercises and activities for healthcare professionals:

  • Icebreaker
  • Coffee break
  • Team outing
  • Escape rooms

Team building activities can motivate employees to work effectively as a team, which can also help employees when they are caring for patients or working hard to solve a problem.

How do you encourage teamwork on healthcare teams?

It is important to encourage your team to work efficiently and collaboratively. A creative way to encourage teams to work together is by organizing team building activities for caregivers and other healthcare professionals.

Team building activities are sure to get your entire team working together as they have fun.

Source: https://teambuilding.com/blog/healthcare-team-building

If a baby is born before 37 weeks, they’re considered a preemie, and their senses might develop a bit differently from those of full-term babies. This doesn’t mean you need to worry! Knowing this can help you better understand and support your little one! During pregnancy, babies develop their senses in a specific order: touch, movement and balance, smell, taste, hearing, and vision. But once they’re born, these senses begin to work in reverse order. This means your preemie’s vision and hearing are quickly adjusting to the lights, sounds, and new environment around them. Preemies have their milestones adjusted for their corrected age, but their visual development might align more closely with their actual age. To help your baby’s vision, use toys with black, red, and white colors—these are easiest for them to see in the early months.

There are many different members of the health care team that you may meet in the NICU. Besides a bedside nurse, every baby has a NICU medical team managing the overall care of your baby. Each team is supervised by an attending neonatologist. Below is some basic information on the other members of your health care team.

Attending Neonatologists: Doctors who specialize in the care of newborns (neonates).

Chaplains: Give emotional and spiritual support to families and patients of all faiths and
cultures.

Clinical Leaders and Charge Nurses: Senior staff members who are able to take care of any problems or concerns.

Fellows: Doctors that are training to be neonatologists.

Lactation Team: Trained to help you reach your breastfeeding goals and answer any pumping/breastfeeding questions.

Licensed Practical Nurses (LPN): A nurse who works under the supervision of an RN to provide direct patient care. LPNs give much of the same care as RNs, except they do not give IV medicines.

Neonatal Nurse Practitioners (NNP): A nurse who has finished advanced graduate education and training. A NNP can help the Attending Neonatologists and Pediatric Surgeons treat babies and perform certain procedures.

Nurse Case Managers: Registered Nurses who provide care coordination for you and your baby while you are at the hospital. They will also help with the discharge process.

Nutritionists /Dieticians: Make sure babies are getting the right amount of calories and nutrients for the best growth and development. They will also give nutrition education for special diet needs.

Occupational Therapists (O.T.) and Physical Therapists (P.T.): Focus on babies’ movements and motor development. An O.T. may also help with feeding and oral stimulation.

Parent Advisors: Other parents who have had babies in the NICU. They give emotional support to families. Also, they lead the weekly Parent Pizza Night.

Patient Care Assistants (PCA): Also known as Patient Support Assistant (PSA), they work under the supervision of an RN. They can take vital signs, perform heel sticks, give baths, and feed babies.

Pharmacists: Help the doctor prescribe drugs for your baby. They also watch how well the drugs work for your baby and make sure the drug levels are right in the blood.

Registered Nurses (RN): Nurses who specialize in the nursing care of your baby. They assess your baby’s condition and progress and carry out the doctor’s orders. The RN will tell the doctor or NNP if there are any changes in your baby’s condition.

Residents: Doctors who are training to become pediatricians (a doctor who cares for children).

Respiratory Therapists: Manage and adjust the ventilators and other breathing equipment. They perform treatments that help with breathing and lung function.

Social Workers: Give emotional support, crisis intervention, information on community resources, and help with communication between families and the medical team.

Unit Clerks: Often the first people you meet when you enter the NICU. They answer the phone when you call to check on your baby and take care of many of the NICU’s administrative needs.

Volunteers: NICU volunteers have attended special training, and they help with many different tasks in the unit. They can hold and rock babies (if you wish) when parents are not able to.

Source: https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/resources-for-parents-and-kids/nicu-resources/general-information/meet-your-childs-care-team

Tiny fingers grasp at invisible demons as the sterile beeps of hospital monitors become the haunting soundtrack to a newborn’s first memories. This haunting image raises a profound question: Can babies experience Post-Traumatic Stress Disorder (PTSD) from birth? As our understanding of infant mental health grows, researchers and healthcare professionals are increasingly exploring the possibility that even the youngest among us may be vulnerable to the lasting effects of trauma.

PTSD, a mental health condition triggered by experiencing or witnessing a terrifying event, has long been recognized in adults. The American Psychiatric Association reports that approximately 3.5% of U.S. adults are affected by PTSD in any given year. However, the concept of PTSD in infants is a relatively new area of study, challenging our preconceptions about early childhood experiences and their long-term impacts.

As we delve deeper into the realm of infant mental health, it becomes crucial to consider the potential for trauma during the earliest stages of life. The birth process itself, along with the immediate postnatal period, can be a source of significant stress for newborns. This realization has led to a growing awareness of the importance of nurturing infant mental health from the very beginning.

The Possibility of PTSD in Babies: Exploring the Evidence

Current research on infant PTSD is still in its infancy, but emerging studies suggest that babies may indeed be capable of experiencing trauma-related stress responses. While the traditional diagnostic criteria for PTSD were developed with adults in mind, researchers are now adapting these frameworks to better understand and identify trauma in non-verbal infants.

One of the primary challenges in diagnosing PTSD in babies lies in their inability to verbalize their experiences and emotions. Unlike adults who can describe their symptoms and traumatic events, infants communicate their distress through behavioral and physiological cues. This necessitates a different approach to identifying and assessing trauma in the youngest patients.

Despite these challenges, healthcare professionals have identified several signs and symptoms that may indicate trauma in babies. These can include heightened startle responses, difficulty sleeping, excessive crying or irritability, and problems with feeding. Some infants may also exhibit a withdrawal from social interactions or show signs of hypervigilance, constantly scanning their environment for potential threats.

It’s important to note that while these symptoms may be indicative of trauma, they can also be associated with other developmental or medical issues. This underscores the need for comprehensive assessments and a nuanced understanding of infant behavior and development when evaluating potential trauma responses.

Potential Causes of Birth-Related Trauma in Infants

Several factors during the birth process and immediate postnatal period can potentially contribute to trauma in newborns. Complicated or traumatic deliveries, such as those involving emergency cesarean sections, forceps, or vacuum extraction, may be particularly stressful for infants. These interventions, while often necessary for the safety of mother and child, can introduce an element of physical and emotional distress that may have lasting effects.

Premature birth is another significant risk factor for infant trauma. Babies born before 37 weeks of gestation often require extended stays in the Neonatal Intensive Care Unit (NICU), exposing them to a range of stressful experiences. The NICU Stays and Babies: Long-Term Effects, Impact, and Potential for PTSD can be profound, influencing both physical and psychological development.

Separation from parents immediately after birth can also be a source of distress for newborns. The importance of early bonding and skin-to-skin contact is well-documented, and disruptions to this process may contribute to feelings of insecurity and anxiety in infants. This separation is often unavoidable in cases of medical emergencies or when babies require specialized care, but its potential impact on infant mental health should not be overlooked.

Medical interventions and procedures, while often life-saving, can be another source of trauma for newborns. Frequent blood draws, intubation, and other invasive procedures can be painful and frightening for infants, potentially contributing to a heightened stress response and increased risk of trauma-related symptoms.

PTSD in NICU Babies: A Closer Look

Babies who spend time in the Neonatal Intensive Care Unit (NICU) face unique challenges that may increase their vulnerability to trauma-related stress. The NICU environment, while designed to provide life-saving care, can be overwhelming for fragile newborns. Constant noise from medical equipment, bright lights, and frequent handling can disrupt an infant’s developing sensory systems and sleep patterns.

Research on the long-term effects of NICU stays on infant development has revealed a range of potential impacts. These can include delays in cognitive and motor development, difficulties with emotional regulation, and increased risk of behavioral problems later in childhood. While not all NICU graduates will experience these challenges, the potential for lasting effects underscores the importance of trauma-informed care in these critical early days.

Studies examining PTSD symptoms in NICU graduates have yielded intriguing results. A study published in the Journal of Perinatology found that infants who spent time in the NICU showed higher rates of PTSD-like symptoms compared to full-term infants who did not require intensive care. These symptoms included heightened startle responses, difficulty with emotional regulation, and problems with attachment.

It’s important to note that while these findings suggest a potential link between NICU experiences and trauma-related symptoms, more research is needed to fully understand the relationship. The complex interplay of medical, environmental, and developmental factors in the NICU makes it challenging to isolate the specific causes of these symptoms.

Recognizing and Addressing Trauma in Infants

Identifying trauma in non-verbal infants requires a keen eye and a deep understanding of infant behavior and development. Behavioral and physiological indicators of infant distress can include changes in sleep patterns, feeding difficulties, excessive crying or irritability, and withdrawal from social interactions. Some infants may also exhibit physical symptoms such as increased heart rate, rapid breathing, or sweating in response to perceived threats.

The importance of early intervention cannot be overstated when it comes to addressing potential trauma in infants. Research has shown that early experiences play a crucial role in shaping brain development and laying the foundation for future mental health. By identifying and addressing trauma-related symptoms early, healthcare providers and caregivers can help mitigate the long-term impacts and promote healthy development.

Trauma-informed care for newborns and NICU babies is an emerging approach that recognizes the potential for early life experiences to impact long-term well-being. This approach emphasizes creating a nurturing environment that minimizes stress and promotes healing. Key elements of trauma-informed care include minimizing painful procedures when possible, promoting skin-to-skin contact with parents, and creating a calm, low-stimulation environment.

Supporting Infant Mental Health and Preventing PTSD

Promoting infant mental health and preventing trauma-related stress begins with recognizing the importance of early bonding and attachment. Skin-to-skin contact, also known as kangaroo care, has been shown to have numerous benefits for both full-term and premature infants. This practice helps regulate an infant’s body temperature, heart rate, and breathing, while also promoting feelings of security and reducing stress.

Minimizing separation between infants and parents is another crucial aspect of supporting infant mental health. When possible, rooming-in arrangements that allow parents to stay with their newborns can help promote bonding and reduce stress for both babies and parents. In cases where separation is necessary due to medical needs, efforts should be made to facilitate frequent visits and involvement in care routines.

Creating a calm and nurturing environment for newborns is essential, particularly in hospital settings. This can involve reducing noise levels, dimming lights during rest periods, and minimizing unnecessary handling or procedures. In the NICU, practices such as clustered care (grouping necessary interventions to allow for longer periods of undisturbed rest) can help reduce stress on fragile infants.

Providing support for parents of traumatized infants is also crucial. Postpartum PTSD: Recognizing and Overcoming Birth Trauma is a reality for many parents, particularly those who have experienced complicated deliveries or have babies in the NICU. Offering counseling, support groups, and education about infant mental health can help parents better understand and respond to their baby’s needs while also addressing their own emotional well-being.

As our understanding of infant mental health continues to evolve, it becomes increasingly clear that the experiences of our earliest days can have profound and lasting impacts. While the concept of PTSD in babies may still be controversial in some circles, the growing body of research suggests that infants are indeed capable of experiencing trauma-related stress responses.

Ongoing research in the field of infant PTSD is crucial to further our understanding of how early life experiences shape long-term mental health outcomes. As we continue to explore this complex topic, it’s essential to approach newborn and NICU care with a trauma-informed perspective, recognizing the potential for both positive and negative impacts on infant development.

By acknowledging the importance of infant mental health and implementing practices that support early bonding, minimize stress, and promote healing, we can work towards ensuring that every child has the best possible start in life. As we move forward, it’s crucial that healthcare providers, researchers, and policymakers continue to prioritize the mental health needs of our youngest and most vulnerable patients, recognizing that the foundations of lifelong well-being are laid in these earliest moments of life.

Source: https://neurolaunch.com/can-babies-have-ptsd-from-birth/

Abstract

Introduction

Premature infants require specialized care, and nurses need to have specific skills and knowledge to provide this care effectively.

Objective

To evaluate the impact of an on-the-job training program on the improvement of nurses’ knowledge and practice related to creation of a healing environment and clustering nursing procedures.

Methods

From January to April 2022, a study utilizing a one-group pre- and post-test design was conducted at NICUs in governmental hospitals. The study participants involved 80 nurses working in these NICUs. Researchers used predesigned questionnaire and checklist practice to collect the data pre and post the intervention.

Results

37.5% of the participants were aged between 25 and less than 30 years, with a mean age of 28.99 ± 7.43 years. Additionally, 73.7% of the nurses were female, with a mean experience of 9.45 ± 3.87 years. Prior to the intervention, the study found that a majority of the nurses (62.4%) demonstrated poor knowledge. However, after the intervention, a significant improvement was observed, with 60.0% of the nurses demonstrated good knowledge. Likewise, prior to the intervention, the study revealed that the majority of the nurses (83.8%) exhibited incompetent practice. However, post-intervention, a substantial improvement was observed, with 81.3% of the nurses demonstrated competent practice.

Conclusion

On-the-job training had significant improvements in nurses’ knowledge and practices regarding applying healing environments and clustering nursing care. On-the-job training is suggested as an adaptable, effective and low-cost technique to train nurses. To maintain the improvement achieved, ongoing instruction, feedback, assessment/reassessment, and monitoring are encouraged.

Source:https://journals.sagepub.com/doi/10.1177/23779608241255863?icid=int.sj-abstract.similar-articles.3

Abstract: Effective leadership in today’s dynamic environments rests not simply on experience, but on intentional coaching and apprenticeship. This article explores how coaching emerging leaders through structured apprenticeship models foster transferable skills, organizational continuity, and leadership identity. Drawing on scholarly research in leadership education, youth development, and coaching theory, it outlines actionable strategies for embedding coaching-as-apprenticeship within professional settings. Case studies and frameworks highlight how critical reflection, mentor guided practice, and identity formation synergize to elevate both individual and organizational performance.

Closing teaser: If you are ready to transform your leadership legacy by raising apprentices, not just subordinates, read on to discover how to build, guide, and sustain the next generation of leaders

Introduction: The Leadership Gap and the Coaching Imperative Organizations often struggle with leadership continuity, not because of a shortage of talent, but due to the lack of developmental pathways for emerging leaders. Traditional training is often episodic, outcome-focused, and disconnected from real-world work. In contrast, apprenticeship-style coaching integrates on-the-job practice, guided reflection, and mentor scaffolding, offering a more durable model for leadership development. This approach recognizes that leadership is not merely a set of competencies, but a mindset and identity forged over time. The urgency to shift from transactional leadership development to transformational apprenticeship-based coaching is underscored by the increasing volatility of organizational environments, where agile and empathetic leadership is critical. Coaching emerging leaders through apprenticeship enables them to learn by doing, internalize the organization’s values, and develop the confidence necessary to lead effectively in complex situations.

Coaching Young Leaders: Foundations and Key Benefits:

Research increasingly supports the idea that coaching has a disproportionate impact when targeted at younger or less experienced leaders. Not only do these individuals exhibit higher growth trajectories in leadership identity and self-efficacy, but they also tend to show increased engagement and retention. Coaching becomes a vehicle for establishing positive habits, fostering psychological safety, and creating alignment with core organizational values at the earliest stages of one’s leadership journey. Coaching supports the holistic development of young leaders, improving both their technical capabilities and their emotional intelligence. Moreover, when coaching is introduced early, it becomes embedded in their leadership DNA, making them more likely to coach others in the future. This creates a ripple effect of development, where coaching becomes not just a practice but a cultural norm. Organizations that invest in coaching young talent are investing in a long-term, sustainable leadership pipeline.

Apprenticeship as a Leadership Model:

Unlike ad hoc mentorship, apprenticeships are structured to emulate expert-apprentice learning paradigms found in fields such as medicine or skilled trades. These involve a deliberate, phased progression: observation, participation, leadership with supervision, and finally autonomous execution. Apprenticeships in leadership also emphasize the social construction of leadership identity. Through cycles of feedback and reflective inquiry, the emerging leader gradually integrates personal values with professional expectations. This model positions leadership as an evolving identity, not a static role. Apprenticeship also enables learning from lived experience rather than abstract instruction, reinforcing the importance of real-world exposure, feedback loops, and relationship based development. It fosters humility in the coach and curiosity in the apprentice, setting the stage for deep trust and mutual growth. Apprenticeships elevate leadership development from sporadic training to an intentional journey of transformation.

Shared and Super-Leadership: Enabling Young Leaders:

Shared leadership refers to distributing leadership responsibilities across roles rather than concentrating them in a single position. When younger leaders are empowered to co-lead projects, they not only gain experience but also receive validation as future in-fluences. This approach builds confidence, fosters innovation, and enhances team collaboration. Super-leadership, defined by the ability to help others lead themselves, offers another powerful coaching mindset. Rather than creating dependents, leaders cultivate autonomy, encouraging apprentices to develop their own leadership identities and decision-making capabilities. Super leaders invest in unlocking the potential within others by fostering critical thinking, self-direction, and ownership. These frameworks challenge traditional hierarchical models, favoring instead a collaborative environment where every team member is seen as capable of contributing leadership value. By doing so, organizations not only enhance their leadership capabilities but also foster cultures of empowerment and resilience.

Designing a Coaching-Apprenticeship Program:

Building a coaching-apprenticeship program begins with intentional matching; coaches should be trained not only in their disciplines but also in delivering feedback and reflective questioning. Programs should incorporate a phased structure with clear goals per stage, shadowing opportunities, and assigned leadership responsibilities. Embedding reflection points, journaling, peer discussions, or coach debriefs, creates a feedback-rich environment that accelerates development and reinforces critical thinking. Designing such a program also entails aligning the apprenticeship with the organization’s strategy. What leadership behaviors and mindsets are most critical for your future? These should be embedded in coaching conversations, project assignments, and developmental goals. Regular check-ins, performance reviews, and cross-functional exposure can enhance the apprentice’s understanding of broader business operations. Moreover, integrating the program into HR and L&D systems ensures sustainability, scalability, and accountability.

Case Examples & Research Evidence:

 Data from academic institutions and corporations demonstrate measurable improvements in leadership capability, confidence, and identity when coaching and apprenticeship programs are implemented in tandem. One study found that undergraduates who received leadership coaching outperformed their peers in self-evaluation, initiative-taking, and communication. Similarly, organizations that pair junior executives with seasoned leaders on real-world projects report greater succession readiness and improved cultural continuity. For instance, a healthcare system implemented a year-long leadership apprenticeship for high-potential clinical managers, resulting in a 25% increase in internal promotions and significantly reduced turnover. These examples underscore the power of experiential learning and the trust it fosters between generations. The most impactful programs are those that strike a balance between structure and flexibility, allowing apprentices to stretch while remaining supported. The case for apprenticeship is not just anecdotal; it is data-driven and results-proven.

Overcoming Challenges in Coaching Apprentices:

Leaders struggle to find time for coaching or mistakenly default to giving directives. An effective apprenticeship requires a shift in mindset: from command to inquiry, from short-term results to long-term development. Another challenge is the temptation to clone oneself—coaches must resist imposing their exact styles. Instead, they should encourage apprentices to explore and refine their voices, emphasizing authenticity and self-discovery over replication. Leaders must also learn to relinquish control, allowing apprentices to make mistakes, learn, and recover. For the apprentice, imposter syndrome and fear of failure can hinder growth, coaches must be adept at building psychological safety and modeling vulnerability. Lastly, organizational structures must support this effort; when performance metrics favor only short-term outcomes, coaching can be deprioritized. Addressing these challenges requires intention, effective communication, and a commitment across all leadership levels.

Measuring Success and Institutionalizing the Practice:

To sustain apprenticeship models, organizations must define clear metrics of success and integrate coaching into their leadership pipelines. Effective metrics include observable behavior changes, feedback from peers and supervisors, and progression into formal leadership roles. Making coaching part of job expectations, and distributing time in calendars and budgets, signals organizational commitment and reinforces its strategic value. Institutionalizing the practice also requires training and support for coaches. Not everyone is naturally equipped to coach; it must be seen as a skill to be developed. Recognition and reward systems can further encourage participation and excellence. Over time, the goal is to normalize coaching-as-apprenticeship as a cultural standard, not a temporary initiative. When embedded deeply, it becomes self-perpetuating: today’s apprentices become tomorrow’s coaches.

Action Plan – Six-Month Coaching Apprenticeship Template: Month Activity

1. Identify apprentice and coach pair; set mutual goals. Clarify expectations and agree on communication rhythm.

2. Shadowing senior leader in meetings, decision-making, and interpersonal scenarios. Focus on observation and questioning.

¾. Apprentice leads small initiatives or portions of projects under supervision. Provide real-time feedback and adjust tasks as needed.

5. Deep reflection session: discussing key learnings, identify growth areas, and recalibrate developmental objectives.

6. Final project debrief: summarize progress, co-create a personal leadership vision statement, and develop a transition roadmap.

This plan is not a rigid template but a guide for phased development. Each month’s focus allows for a gradual transition from observation to ownership. Coaches facilitate experiences while ensuring support and reflection. By the end of six months, apprentices should not only demonstrate enhanced skills but also articulate a personal leadership philosophy shaped by feedback and experience.

Conclusion:

Coaching young leaders through an apprenticeship approach creates multiplier effects, developing not only leadership skills but also leadership identity, confidence, and organizational continuity. This shifting paradigm, from managing tasks to growing people, challenges leaders to measure legacy by who they raise, not just what they achieve. Investing in apprenticeship coaching today helps ensure stronger, more adaptive organizations tomorrow. By embracing apprenticeship as a strategic imperative, leaders cultivate a lasting impact, one that extends far beyond their tenure and

shapes the trajectory of future generations.

More importantly, the coaching-as-apprenticeship model restores a human-centric ethos to leadership development. It recognizes the power of relationships, trust, and long-term investment in others. It transforms organizations into learning communities, where leaders are not only accountable for business outcomes but also for building capacity in others. The impact ripples outward, from individual apprentices to teams, departments, and entire institutions.

Every seasoned leader has the opportunity —and the responsibility —to create space for others to grow. Leadership, at its best, is not a destination but a legacy to be passed down. Moreover, that legacy is measured not only in profit margins and productivity metrics, but in the readiness, values, and courage of those who follow. Coaching future leaders as apprentices ensures that the mission and values we lead with today endure and evolve through those we mentor tomorrow.

Challenge question: As a leader, are you merely managing today’s results, or are you actively shaping tomorrow’s leaders through intentional apprenticeship?

Source:https://neonatologytoday.net/newsletters/nt-jul25.pdf

Health care challenges have long stood in the way of Liberia’s national development. With limited access to quality medical services, many Liberians have found themselves traveling abroad or relying on prayer and hope in the face of serious illness.

But a new chapter is unfolding, one driven by local leadership, global standards, and a bold commitment to change.

Located along the Congo Town back road, WPMC delivers safe, customer-centered, world-class services, all provided by Liberian professionals. Its offerings range from advanced laboratory diagnostics to outpatient care and medical screenings for international visa applicants.

Metering system installation services.

WPMC’s practices are in line with national and international standards and are supported by technologies sourced from the U.S., Europe, and Asia. From the outset, the center has been designed to restore trust in Liberia’s medical system.

The official launch ceremony brought together distinguished guests, including former President Ellen Johnson Sirleaf, health sector leaders, staff, and the general public. The event not only marked a major milestone in health care delivery but also celebrated the vision and leadership that made it possible.

At the heart of WPMC is Dr. Nicole Cooper, the facility’s Medical Director. A passionate health leader, who shared the journey that led to the creation of the center.

“I’ve seen too many people praying outside hospital rooms, hoping that everything aligns just to save a life,” she said. “Too many are forced to leave the country for basic health care because they don’t trust that it can be done here.”

That reality, Dr. Cooper explained, planted a seed back in 2009, the early inspiration behind what would eventually become Wellness Partners. In 2021, she returned to Liberia with the goal of building a system that met international standards but remained accessible and reliable for all Liberians.

She began with Wellness Partners Clinic, a small pilot that tested health care delivery models, affordability, and customer care strategies. From those humble beginnings, the initiative expanded into the full-fledged Wellness Partners Medical Center.

“We’re different,” she said. “We invest in our people, prioritize quality and safety, and put transparency at the center of what we do.”

“Our vision is bold yet simple: to become the safest, most reliable, and most convenient network of medical care in Africa,” she told attendees. “This is what’s possible when we believe in ourselves and build from the inside out.”

Representing the WPMC Board of Directors, Mrs. Monique Cooper Liverpool echoed that sentiment, calling the center “a homegrown solution led by Liberian talent with world-class expertise.”

Also speaking at the event was Mrs. Sophie Parwon, CEO of Benson Hospital, who highlighted the growing contribution of the private sector in Liberia’s health care ecosystem.

“While the government remains the main provider of health services, the private sector is increasingly stepping up, contributing to service delivery, financing, innovation, and capacity building,” she said.

Mrs. Parwon praised Dr. Cooper as a “public health icon” and called on government and development partners to strengthen support for private health initiatives that align with national priorities.

As WPMC opens its doors, it does more than offer medical services. It offers hope, hope for a health care system where Liberians no longer need to look abroad for basic care, where dignity and quality go hand in hand, and where innovation is driven from within.

Abstract

Objective To assess the feasibility and clinical utility of daytime polysomnography (PSG) in infants ❤ months of age.

Methods A prospective observational study of a convenience cohort analysing PSGs that were conducted for clinical purposes in infants less ❤ months of age, between 1 May 2021 and 31 May 2024. A comparison was made between results for daytime PSG in the neonatal intensive care unit (NICU) and overnight PSG in the sleep laboratory. The type of PSG performed (daytime vs overnight) was based on the workflow of the sleep laboratory. Primary outcomes were successfully completed PSGs (feasibility) and per cent sleep efficiency (clinical utility). Secondary outcomes compared other sleep parameters between groups. Patient and public feedback directly informed the development of the research question and outcome measures.

Results Of 60 PSGs, 28 were daytime and 32 were overnight. Daytime studies had a younger age (median 18 vs 55 days, p<0.001) and shorter median recording time (8.2 vs 10.4 hours, p<0.001). All daytime PSGs were successful, indicating feasibility. After adjusting for age at PSG and total recording time, per cent sleep efficiency was equivalent in the two groups (95% CI −12.4 to 5.7; p 0.456), indicating their clinical utility. For secondary outcomes, daytime PSGs had a higher % rapid eye movement (REM) sleep by 9.9% points (95% CI 1.1 to 18.8; p 0.028) compared with overnight PSG. Parameters that were not different included: frequency of spontaneous arousals, REM latency, sleep latency, Apnoea-Hypopnoea Index and Obstructive Apnoea-Hypopnoea Index. A decline in requests for overnight PSGs and a corresponding increase in daytime PSGs over the course of the study were observed.

Conclusion Daytime PSGs performed in NICU were feasible and provided clinically useful results in infants ❤ months of age. Availability of daytime PSGs performed at the infant’s bedside expands resource capacity and has the potential for cost savings.

Source: https://bmjpaedsopen.bmj.com/content/9/1/e003641

With support from the World Health Organization (WHO), the National Public Health Institute of Liberia (NPHIL) and the Ministry of Health concluded a residential hands-on in-country training on genomic sequencing and bioinformatics at the National Public Health Reference Laboratory (NPHRL) from 29 September to 19 October 2024 in Margibi County. Facilitated by a team of experts from the Noguchi Memorial Institute for Medical Research in Ghana, a total of 10 national laboratory technicians received a 2-week intensive training followed by a 1-week practice session. 

Genomic surveillance plays a critical role in tracking emerging pathogen variants. It has become a fundamental global public health tool for detecting, monitoring, and responding to infectious disease outbreaks, as demonstrated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. During the in-country training, national laboratory scientists analyzed additional mpox-positive samples and detected another mpox strain, clade IIb.

“Before the training, we were reliant on international laboratories to identify the circulating pathogen strains. Now, we have the capability to conduct sequencing and bioinformatics analysis in-country, enabling us to rapidly identify emerging pathogens and their geographic origins,” Francis Omega Somah, laboratory technologist at the National Reference Laboratory in Liberia.

This training is a significant milestone in the integration of pathogen genomics and bioinformatics into public health surveillance, outbreak detection, and investigation, which will enhance disease control and prevention efforts in Liberia. “This is a game-changer for the country as we will now have the national capacity to sequence and characterize pathogens of epidemic prone diseases in our country. We thank WHO for this strategic investment and their continuous technical and financial support towards strengthening Liberia’s capacity to detect and manage epidemics,” said Dr Dougbeh Nyan, Director General of NPHIL. 

In 2022, WHO published a global genomic surveillance strategy to support countries in expanding their capacities. Unfortunately, 50% of Member States, including Liberia, lacked domestic sequencing capacity. To address this gap, WHO, under the AFRO HERA project, is supporting six African nations: Liberia, Burundi, the Central African Republic, Comoros, Eritrea, and Togo to establish and strengthen genomic sequencing and bioinformatics capacity, thereby expanding detection and genomic surveillance of epidemic-prone priority pathogens across the African Region. WHO has significantly invested on the continent in infectious disease and genomics surveillance. 

“The most important aspect of capacity building is training the right experts. When a country has skilled professionals with the right platform, expertise, and infrastructure, they can respond swiftly and effectively to public health emergencies,” said Dr. Coulibaly Sheik, WHO AFRO Lead Diagnostic and Laboratory Services Unit.

Dr. Peter Clement, WHO Country Representative, thanked the team of facilitators and WHO AFRO for supporting Liberia through the EU-funded project which will strengthen the country’s laboratory systems. “By empowering local experts with the skills to conduct genomic sequencing and bioinformatics analysis, we are ensuring that Liberia is better prepared to rapidly identify emerging threats and implement timely interventions,” said Dr. Peter Clement, WHO Liberia Representative.

Source: https://www.afro.who.int/countries/liberia/news/strengthening-liberias-capacity-detect-and-manage-epidemics-through-genomic-sequencing-and

The Healing Power of Comfort Pets in Children’s Hospitals

In the high-stakes environment of a children’s hospital, every source of comfort matters. Beyond the dedicated medical staff and cutting-edge technology, one often overlooked hero is the comfort or service pet. These animals, specially trained to provide emotional support, offer more than companionship—they bring a sense of calm, joy, and connection during some of the most challenging times in a young patient’s life.

For pediatric patients, comfort pets can help reduce anxiety, ease feelings of isolation, and even promote healing. A gentle nuzzle or playful paw can break through the walls of fear that sometimes build during hospital stays. Studies have shown that interaction with therapy animals can lower stress hormones, improve mood, and provide a sense of routine and normalcy for children who are often navigating complex medical treatments. In the neonatal context, while the infants themselves may not directly interact with pets, families of NICU babies experience the calming presence of therapy animals, helping them manage stress, fear, and the emotional weight of having a critically ill newborn.

Families may benefit greatly from the presence of comfort pets. Parents and siblings frequently carry their own anxieties as they support a hospitalized child. In the NICU, where the emotional toll is heightened by uncertainty and intensive care routines, therapy animals offer brief but meaningful moments of relief, allowing families to smile, laugh, and connect. These moments can strengthen the parent-child bond, provide emotional grounding, and even support parents’ ability to be present and engaged in their baby’s care.

Healthcare workers often report the positive impact of comfort pets. Long shifts, high emotional demands, and the intensity of neonatal and pediatric critical care can take a toll on staff well-being. Therapy animals provide a moment of grounding and a reminder of the simple joys in life, helping to reduce burnout and improve morale.

In NICUs and pediatric wards alike, the presence of a comfort pet is a win-win: patients receive care enriched by joy, families feel supported, and staff experience a boost in their own emotional resilience.

Our very own Bennie Boo (hypoallergenic, gentle, and loving) may be a perfect candidate for comfort care training in his future. This is a pathway we may consider next year when he turns two.

Anthony gets a lesson from Liberia’s first ever surfer, Alfred Lomax. He doesn’t catch a wave, but locals manage to catch more than enough fish for a fresh seafood feast, served with a beer, of course!

NW Warriors – Call to Action!

The Dominican Republic is a North American country located on the island of Hispaniola in the Greater Antilles of the Caribbean Sea in the North Atlantic Ocean. It shares a maritime border with Puerto Rico to the east and a land border with Haiti to the west, occupying the eastern five-eighths of Hispaniola which, along with Saint Martin, is one of only two islands in the Caribbean shared by two sovereign states. In the Antilles, the country is the second-largest nation by area after Cuba at 48,671 square kilometers (18,792 sq mi) and second-largest by population after Haiti with approximately 11.4 million people in 2024, of whom 3.6 million reside in the metropolitan area of Santo Domingo, the capital city.

There are three tiers of healthcare in the country:

  • Subsidized regime, which is financed by the government for unemployed, poor, disabled and indigent people.
  • Contributive regime, which is financed by workers and employers
  • Contributive subsidized regime, which is financed by independent workers, technical workers, and self-employed people, but subsidized by the state[16]

Even those for whom care is supposedly provided may have to pay for medical supplies. However, considerable progress in health and overall development was experienced in the country. For instance, there is a substantial increase in health coverage in the nation that is the health insurance coverage from 23% in 2011 to 65% in 2015 (Centers for Disease Control and Prevention n.p). Significantly, updating the list of beneficiaries was the major challenge since the list based on disease prioritization and financial sustainability. Therefore, the first fitness elements, such as migration, poverty education, and gender-based, should be considered in the strategy of hindrance suites.

Government expenditure on healthcare is about $180 per person per year, slightly more than half the average for the Latin American and Caribbean region.

Essentially, there are steps considered by healthcare in the Republic. Firstly, the sponsored organization that caters to the poor, unemployed, and disabled people. Also, the active personnel contained a contributive establishment. Though the low-classes are dependents, the majority of the population is independent on matters of health, according to the Dominican Republic (World Health Organization n.p). Therefore, government expenditure per person is slightly higher in the Dominican Republic compared to other states.

Source:https://en.wikipedia.org/wiki/Health_in_the_Dominican_Republic

Europe needs new ideas and solutions to address the disparities in the care of preterm and ill babies. The European Standards of Care for Newborn Health project presents such a solution by providing European reference standards for this health care area.

With its transdisciplinary focus and international composition of the working groups, the project sets new benchmarks for the care of preterm and newborn babies and can serve as a role model for countries in Europe and worldwide. About 220 experts from more than 30 countries accepted to dedicate their free time to work on this ambitious project over several years. At the time of the launch of the standards, 108 healthcare societies and associations as well as 50 parent organisations have accepted EFCNI’s invitation to officially support the newly developed standards.

Through its multi-stakeholder approach, the perspective of parents, healthcare professionals, and relevant third parties were equally considered, aiming at identifying current best practice. Industry partners were involved in the project by supporting it financially. Their representatives could join the Chair Committee meetings in an observing role and they were welcome to share their knowledge and expertise without exerting influence. Initiated by patient (parent) representatives for patients, it is a true patient-centred project and, for the first time, patients were involved in absolutely every step in the development of the standards. All project participants work together in an open and respectful partnership to pave the way for change and set newborn health on the international and national agendas.

On a political level, addressing European Standards of Care for Newborn Health will stimulate a new debate that can help questioning existing structures, identify gaps and deficiencies, and advance national healthcare systems. To read the standards and to learn more about their development, please visit our project website European Standards of Care for Newborn Health.

On the project website, you also find further information like a project report, an information brochure or social media graphics.

The European Standards of Care for Newborn Health now available in Italian – Gli Standard Assistenziali Europei per la Salute del Neonato sono disponibili in italiano

The Italian Society of Neonatology (SIN) and Vivere ONLUS, the Italian National Coordination of Parents’ Associations, took the initiative to translate the standards into Italian, with Italy becoming the first European country to make this important document available in their national language. The first two sets of standards can be downloaded from our project page.

Call to Action for Newborn Health in Europe

The UN Convention on the Rights of the Child has been ratified by 196 countries and proclaims that “the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth”.  Article 6 affirms every child has the right to life, survival, and development. Furthermore, children have a right to be cared for by their parents and should not be separated from them, as far as possible (Articles 7 and 9). However, upholding the Rights of the Child in reality remains a major challenge.

The European Standards of Care for Newborn Health help support these rights from the beginning of life by serving as a reference for the development and implementation of binding standards and guidelines on a national and international level. European and national policy makers, hospital administrators, insurers, professional and patient associations, and industry should work together to bring the standards into practice and to ensure quality, equity, and dignity for the smallest.

Download the Call to Action Brochures: The Call to Action is available in about 20 languages and can be downloaded here.

News provided by March of Dimes Inc.   Mar 18, 2025

ARLINGTON, Va., March 18, 2025 /PRNewswire/ — March of Dimes, the leading organization committed to improving the health of moms and babies, has been named the United Food and Commercial Workers International Union’s (UFCW) Labor Partner Charity of Choice for 2025. As UFCW’s designated national charity partner, March of Dimes and UFCW will work together to support and advocate for healthy pregnancies, strong families, and improved maternal and infant health outcomes in the US.

“For more than 85 years, March of Dimes has stood alongside labor unions to champion the health and well-being of working families,” said Cindy Rahman, President and CEO of March of Dimes. “Our partnership with UFCW builds on this proud legacy, strengthening our ability to advocate for policies, provide essential resources, and drive meaningful change to improve maternal and infant health outcomes. We will work together to ensure that every family—no matter where they live or work—has access to the care and support they need for a strong, healthy start.”

The US remains the most dangerous high-income nation for childbirth, earning a D+ for a third consecutive year in March of Dimes’ latest Report Card, which measures the state of maternal and infant health in the US. Through this partnership, UFCW and its more than 1.2 million members will have opportunities to engage in fundraising efforts, volunteer initiatives, and awareness campaigns aimed at addressing this growing crisis.

“The UFCW Charity Foundation is committed to supporting organizations that make a real difference in the lives of working families,” said UFCW International President Marc Perrone. “March of Dimes has led the fight to improve maternal and infant health for decades, and we are proud to stand with them in this important work. By joining forces, we have the opportunity to help even more families access the care and resources they need for healthy pregnancies and strong futures.”

Partnering with labor unions to protect the health of working families is a cornerstone of March of Dimes’ mission. We’re honored to have strong and long-standing national and local partners like UFCW through our Labor of Love movement, which raises critical funds to pioneer research, advocate for change, and pave the way for greater equity to give all families the best possible start.

Before being named UFCW’s Charity of Choice, UFCW members have actively supported March of Dimes, raising over $3 million through golf outings, sporting clay events, auctions, and March for Babies teams. They have also uplifted the voices of their own members, like Daniel Scott of UFCW Local 1996, whose twins spent time in the neonatal intensive care unit (NICU) after a challenging pregnancy. For families like the Scotts, March of Dimes’ work is more than a cause—it’s a lifeline, ensuring that babies born too soon or facing complications receive the critical care they need.

For more information on how to get involved, visit https://www.marchofdimes.org/get-involved/partner/labor-union

About March of Dimes
March of Dimes leads the fight for the health of all moms and babies. We support research, education, and advocacy, and provide programs and services so that every family can get the best possible start. Since 1938, we’ve built a successful legacy to support every pregnant person and every family. Visit marchofdimes.org or nacersano.org for more information. Follow us on social at @marchofdimes.  SOURCE March of Dimes Inc.

Source: https://www.prnewswire.com/news-releases/march-of-dimes-named-2025-labor-partner-charity-of-choice-for-united-food-and-commercial-workers-international-union-302404305.html

Andrew Bush    Anne Greenough    Alvar Agustí 

To the Editor:

Premature birth has consequences across the course of life, including reduced life-expectancy, and the most prematurely born have the worst outcomes [12]. Survivors of prematurity have increased respiratory morbidity and mortality, airflow obstruction, asthma-like symptoms and COPD, and cardiovascular disease [14]. A history of prematurity is often not sought in adult clinics [5]. We hypothesised that the long-term consequences of prematurity are insufficiently appreciated, likely with detriment to patient care.

We used an online survey developed by a panel of neonatologists, paediatricians, allergologists and pulmonologists. The survey included 21 items addressing four main topics: 1) awareness level among respiratory care providers regarding the long-term respiratory risks of premature birth; 2) communication of neonatal information between different medical specialties; 3) healthcare journey of preterm babies to paediatricians and other respiratory care providers; 4) the knowledge gaps and potential solutions. The survey was customised to each specialty: seven items were for neonatologists only; three for paediatricians; one each for allergologists and respiratory consultants; five for paediatricians, allergologists, and respiratory consultants; and four for all specialties.

We invited 14 651 neonatologists, paediatricians, allergologists and respiratory consultants from Australia, France, Germany, Italy, Spain, the UK, and the USA to participate, excluding physicians with less than 2 years’ experience; 1002 (7%) responded. A web link was emailed from listings extracted from Chiesi Farmaceutici S.p.A and from proprietary databases of external healthcare providers. All had previously consented to email contact. Two email reminders were sent and incomplete surveys were rejected.

Sample size was opportunistic in the absence of data enabling a power calculation. The survey results were analysed using Microsoft Excel and Microsoft Power BI. All items involved categorical answers, and absolute and relative frequencies were calculated. All frequencies were treated descriptively. No geographical comparisons were performed due to sample size limitations. The questionnaire is available on request from the corresponding author.

Results are summarised in figure 1. Of the 1002 respondents, 91% had been in practice for more than 5 years, and 62% were practising in an outpatient facility. In terms of specialities, 282 (28%) were neonatologists, 183 (18%) paediatricians, 290 (30%) allergologists, and 247 (24%) were respiratory consultants. Figure 1a shows that neonatologists regarded the presence of respiratory symptoms as being most important in the decision to refer. By contrast, for paediatricians, birth weight was the most important factor, irrespective of respiratory symptoms (figure 1b). All specialists highlighted that the most important gap was lack of clear recommendations for follow-up (figure 1c) and the need for continuing medical education programmes (figure 1d). Most (96%) respondents considered prematurity and bronchopulmonary dysplasia (BPD) risk factors for lung diseases in adulthood. Nevertheless, 74% of respondents perceived only moderate to very low awareness among colleagues. Adult pulmonologists perceived the lowest level (85%) of awareness among the specialties surveyed.

FIGURE 1

Reasons for neonatologists (a) and paediatricians (b) to refer preterm-born patients to a respiratory specialist. The gaps and potential solutions to improve the long-term respiratory care of preterm-born individuals are shown in (c) and (d). The bars show the percentage of participants who selected each option. NICU: neonatal intensive care unit; BPD: bronchopulmonary dysplasia.

Most (77%) paediatricians “always” took a perinatal history, compared with allergologists (34%) and pulmonologists (21%). Irrespective of specialty, the proportion who always took this history increased with increasing years of clinical experience. Most (95%) neonatologists shared information on gestational age, birth weight, need for supplemental oxygen and respiratory support, BPD diagnosis and other lung sequelae of prematurity (>80%), and this was consistently reviewed by paediatricians (83%). This information was mainly through medical records (57%) and by oral communication (52%). Allergologists and respiratory consultants used feedback from other physicians (58% and 37%, respectively) and electronic medical records (43% and 26%, respectively) to gather neonatal information. They reviewed less neonatal information, although BPD diagnosis and lung sequelae were reviewed by 72% and 65% of allergologists and respiratory consultants, respectively.

Most neonatologists (99%) shared information with parents and caregivers, and more than 70% of paediatricians and allergologists received information from the caregivers. Only 59% of adult pulmonologists acknowledged receiving information from parents and caregivers.

Most neonatologists (70%) followed up preterm babies for two years, but 27% for only 1–2 years. Most (>75%) of all those surveyed, believed that premature babies should be followed up lifelong.

Most (>80%) allergologists modified clinical management, at least partially, if they were aware that the patient was born preterm. Only 60% of adult pulmonologists adapted management pathways in preterm survivors.

Most (>60%) respondents considered that preterm-born individuals and their parents and caregivers should be empowered to ensure they receive the best respiratory care. Other suggested initiatives were measuring lung function during follow-up from 5 years of age, streamlining access to the perinatal medical history and the development of a portable record with neonatal information. Going forward, the use of a lifelong electronic patient record, accessible to all who are involved in patient care, would likely greatly facilitate communication between specialist groups.

In summary, there is inadequate awareness of the importance of preterm birth for management across the life course; communication between specialist teams is inadequate; and there is lack of clear guidance as to how to follow-up preterm born survivors.

The European Respiratory Society [6], and the American Thoracic Society [7] have published guidelines with conditional recommendations on low strength evidence. However, the former only covered the follow-up of BPD survivors [6], and the latter were limited to the follow-up of preterm-born children and adolescents with respiratory symptoms [7]. These guidelines are limited, not least because we now know that the risk of compromised lung health later in adulthood exists even for early term born infants [489]. However very few paediatricians actually referred extremely preterm or low birth weight babies to a respiratory specialist. An international consensus on how to structure respiratory follow-up remains an unmet need [110].

Most allergologists (80%) and adult pulmonologists (60%) modified diagnostic pathways and treatment approaches, at least partly, when they were aware the patient was born premature. Lack of appreciation of the implications of prematurity across the life course may lead to wrong treatment being prescribed. For example, school-age wheeze and variable airflow obstruction is common in preterm survivors [11]. Some may respond to treatment with inhaled corticosteroids (ICS) [12] but in others there is no evidence of type 2 inflammation so they should not be treated with ICS [13]. They may have dysanaptic airway growth [14], which is known to be associated with poor outcomes in term-born children [15]. More work is needed to determine disease pathology in preterm survivors and to stimulate new research. Trials to stimulate lung development at birth and control airway inflammation in extremely premature babies are underway with stem cell-based therapies, insulin-like growth factor 1 and intratracheal surfactant/budesonide.

Proposed mitigation strategies to improve the current situation include better continuing medical education. Another is empowering patients and caregivers by supplying accurate information which they can ensure is available to subsequent caregivers, including during transition to adult services.

The main strength of the survey is that it includes >1000 physicians from different specialties and countries. There are some limitations. The overall response rate was relatively low, although similar to the British Thoracic Society survey [5], and there is a risk of selection bias. General practitioners were not invited, and this was a mistake given their role in follow-up care.

In conclusion, we need to increase awareness of the long-term implications of prematurity to ensure optimal follow-up for these babies, and design studies to obtain an evidence base for the development of improved guidelines.

Source:https://publications.ersnet.org/content/erjor/11/1/00643-2024

Juan Luis Guerra 4.40 – El Farolito (Live) (Video Oficial)

Juan Luis Guerra

3 years ago #JuanLuisGuerra #ElFarolito #EntreMaryPalmeras

Juan Luis Guerra 4.40 – El Farolito (Live)

Houda M. Abdelrahman; Suzanne M. Jenkins; Michael P. Feloney.

Last Update: November 12, 2023.

When the hymen, a thin membrane of stratified squamous epithelium circumscribing the vaginal introitus, does not spontaneously rupture during neonatal development, it is referred to as an imperforate hymen. An imperforate hymen is a rare cause of primary amenorrhea and can present with obstructive symptoms of the female genital and urinary tracts during the perinatal, pediatric, or adolescent years. Timely diagnosis and prompt treatment are critical. Specific pediatric and gynecologic knowledge and skills are necessary to provide comprehensive, patient-centered care. In addition to the anatomical and physiological aspects of imperforate hymen, its clinical presentation, and potential complications, the psychological impact on affected individuals must be understood. Best practices will ultimately improve patients’ quality of life and reproductive health outcomes. This activity reviews the evaluation and treatment of imperforate hymen and highlights the role of the interprofessional team in improving care for patients with this condition.

Continue for training and assessment!

Source: https://www.ncbi.nlm.nih.gov/books/NBK560576/

Jun 17, 2023

Spilling the Tea is an educational series for new preemie moms and dads brought to you by TEACUP Preemie Program®. These brief but in-depth videos will explore aspects of prematurity including emotional and mental effects, the NICU environment, breastfeeding & pumping, reclaiming attachment & bonding, and others. Preemie parents share their experiences through intimate video journals, and experts in infant development and prematurity offer guidance and information. Episode 3: Dads in the NICU, takes you through the emotional rollercoaster experienced by Beau, Chris, and Steve, three preemie dads who have been there. Get ready to be moved and inspired by their stories of resilience, love, and the extraordinary bond they formed with their little miracles.

Mitigating the iatrogenic psychological effects of medical care in the Neonatal Intensive Care Unit (NICU) and beyond is a moral and ethical imperative for quality healthcare delivery. Research has long established the lifelong effects of early childhood adversity, toxic stress, and the critical role of pediatric clinicians in addressing these challenges, and most recently, the American Academy of Pediatrics (AAP) published a clinical report and policy recommendations for the adoption of a trauma-informed paradigm across all child health services.  Provenzi and Montirosso  confirm that preterm birth is an early adverse experience characterized by exposure to toxic stress and reduced access to the buffering effects of maternal care. Understanding the concepts of infant medical stress and its association with alterations in brain growth and development highlights the biological relevance of a trauma-informed developmental approach to care in the NICU and beyond.

Early life adversity, often mediated through relationships with caregivers, is associated with attachment disturbances, posttraumatic stress disorder (PTSD), and developmental trauma disorder (DTD) in survivors . Experiences of maternal separation and cumulative toxic stress within the NICU have profound implications for infants, families, and the healthcare team . Adversity during infancy is associated with significantly poorer health outcomes, risky health behaviors, and socioeconomic challenges . Parents, too, experience significant emotional and psychological distress, which can persist for decades, further reinforcing the need for trauma-informed approaches to care).

During sensitive and critical periods of development, the experiences associated with critical illness and hospitalization take on new meaning as they direct and disrupt biological processes in the wake of toxic stress. These biological processes, mediated by epigenetic mechanisms, have lifelong implications for an individual’s physiologic and psychological health and wellbeing . Maternal separation is the most significant trauma experienced by all newborn mammals, and preterm and critically ill newborns are no exception . Separation of mother and infant at just two days of age for 1 hour has been linked to a 176% increase in autonomic reactivity and an 86% reduction in quiet sleep . The experience of maternal separation in the NICU becomes the foundation for cumulative toxic stress exposures, ranging from inappropriate sensory stimuli to hazardous hospital routines that do not honor the personhood of the infant. These early stressors compound, leading to long-term health and developmental challenges.

 Separation also has profound implications on the parent, leading to depression, anxiety, feelings of helplessness, loss of control, and posttraumatic stress, which may last for decades. These feelings can impact parenting behaviors and the capacity to partner with clinicians in caring for their infant. Understanding the interplay of physical and emotional health, economic and social resources, medical systems, and structural inequities is critical for co-creating compassionate, collaborative, and supportive relationships with infants, families, and clinicians in the NICU.

 Trauma-Informed Care:

A trauma-informed approach realizes the pervasiveness of trauma in everyday life, recognizes its signs and symptoms in patients, families, colleagues, and self, and responds to trauma by integrating knowledge and evidence-based best practices that mitigate and prevent trauma into policies, procedures, and language; and resists re-traumatization by ensuring consistency and compassion in service delivery. The core principles of trauma-informed care—safety, trust and transparency, healthy relationships and interactions, empowerment, voice and choice, equity, anti-bias efforts, and cultural/gender affirmation—guide all interactions in the NICU.

Parenting is central to a trauma-informed approach, as caregivers play a fundamental role in mitigating the stress and trauma of early hospitalization. The research underscores the powerful buffering effect of parental presence, engagement, and nurturing care in reducing toxic stress responses and promoting infant resilience . When parents feel supported and empowered in their caregiving role, they experience lower stress levels, increased confidence, and enhanced bonding with their infant. This benefits the family’s emotional well-being during the NICU stay and has lasting implications for child development and attachment security.

The short-term outcomes of a trauma-informed parenting approach include improved neurodevelopmental stability, reduced incidences of apnea and bradycardia, and better weight gain trajectories for preterm infants. Additionally, trauma-informed care has been linked to greater autonomic stability, reduced stress hormone levels, and improved sleep patterns, all contributing to enhanced physiological regulation and early developmental progress . These immediate benefits lay the groundwork for stronger immune function and better feeding outcomes, helping infants build the resilience needed for longterm health and well-being . Parents who are actively involved in their infant’s care through practices such as skin-to-skin contact and responsive caregiving exhibit lower levels of anxiety and depression, leading to a healthier emotional environment for both the child and the family unit .

Long-term, trauma-informed parenting interventions significantly impact developmental trajectories, reducing the risk of cognitive delays, emotional dysregulation, and behavioral challenges in childhood . Secure attachment formed during these early interventions fosters resilience, social-emotional well-being, and stronger parent-child relationships well into adolescence and adulthood. Studies have also linked early trauma-informed care to improved educational outcomes and a reduced risk of mental health disorders later in life .

Providing parents with the knowledge, tools, and emotional support necessary to engage confidently in trauma-informed caregiving is critical in shaping the health and well-being of NICU graduates . By prioritizing the parent-infant dyad and leveraging evidence-based interventions, trauma-informed care offers a transformative model that extends far beyond the NICU walls, laying the foundation for lifelong resilience and well-being. When parents are given the resources to understand their infant’s cues, respond sensitively, and participate actively in care, they develop a sense of mastery and confidence that translates into more substantial, more secure attachments. This engagement benefits the infant’s immediate well-being and fosters a more compassionate, informed approach to parenting that can positively influence future generations.

 Clinical Application of Trauma Informed Care:

Parent-driven interventions in the NICU center include parents as active participants in their baby’s care, fostering attachment and reducing trauma. One such intervention is The Zaky HUG®, a therapeutic device designed to extend the parent’s presence by mimicking their hands’ touch, warmth, and scent (Fig. 1). Created by a Ph.D. engineer and former NICU and kangaroo mother, this tool emerged from a deeply personal experience of neonatal hospitalization and has since been developed to support sleep, neuroprotection, attachment, developmental care, pain management, and parental involvement. This device helps create a comfortable, warm, and predictable environment, allowing infants to rest and sleep more peacefully. It is designed to provide the benefits of multiple tools, including positioning, nesting, soothing, and attachment.

Initially motivated by the need to provide connection, continuous comfort, and reduce the association of touch with pain and her own infant’s stress, the creator of this hand-mimetic device applied principles of ergonomics and safety engineering to design a device that fosters secure attachment, supports positioning, predictable experience for the infant, family, and clinicians.

Protected sleep is critical for neurodevelopment and overall well-being. Sleep is a primary driver of brain maturation, memory consolidation, and emotional regulation in preterm and critically ill infants. Interruptions to sleep can disrupt these critical processes, leading to increased stress responses, metabolic instability, and impaired neurodevelopmental outcomes. Ensuring a supportive sleep environment requires balancing between providing necessary medical interventions and minimizing disruptions to natural sleep cycles. Frequent repositioning, environmental disruptions, and inconsistent containment can negatively impact an infant’s sleep-wake cycles. Research by Russell et al. has shown that because these nurturing devices are versatile and work for positioning, nesting, attachment, soothing, and sleep support, they reduce the need for frequent repositioning, offering a stable, soothing environment that promotes restful sleep both during kangaroo care and while in the incubator or crib. These devices help infants transition between sleep states more smoothly, reducing startle reflexes and excessive wakefulness by providing gentle, consistent containment and proprioceptive support.

Additionally, they assist in creating a cocoon-like space that mimics the security of the womb, further enhancing sleep continuity and quality. Further, consensus guidelines advocate for supporting parents in providing frequent, safe, and prolonged skin-to-skin care, reinforcing the role of these interventions in achieving sleep protection . Research has also highlighted that skin-toskin contact improves sleep patterns, stabilizes respiratory rates, and reduces cortisol levels, mitigating the physiological impacts of stress. When infants experience uninterrupted, restorative sleep, they exhibit improved feeding behaviors, enhanced weight gain, and greater autonomic stability, all crucial for their long-term development.

The Pain and Stress Prevention and Management measure prioritizes proactive pain mitigation strategies. By minimizing stress and discomfort, infants can better participate in essential activities of daily living, such as feeding and movement, which further support their growth and development. The integration of non-pharmacologic interventions such as kangaroo care, proprioceptive input, and containment through trauma-informed devices significantly enhances an infant’s ability to self-regulate and cope with stress . Parents play a vital role in this process, providing direct comfort before, during, and after procedures. Studies show that utilizing familiar, comforting sensory stimuli, such as parental scent-infused devices, can effectively minimize procedural stress and discomfort, reinforcing the protective role of parental presence in the NICU.

Activities of Daily Living, including posture, nourishment, and hygiene, are essential to infant development. Establishing predictable and supportive care routines in these areas helps to create a sense of security and stability for infants, reducing stress and promoting optimal development. Ensuring infants receive proper postural support can facilitate musculoskeletal alignment, improve digestion, and reduce discomfort caused by medical interventions. Additionally, consistent caregiving routines help infants develop circadian rhythms, supporting sleep-wake cycles and overall well-being. Kangaroo care safety devices support proper postural alignment, promoting successful breastfeeding and early oral feeding behaviors. One pair of hand mimetic devices further enhances postural stability, allowing for individualized positioning without restricting movement, facilitating optimal comfort and developmental support. These devices can also provide gentle containment, mimicking the boundaries of the womb, which is particularly beneficial for preterm infants adapting to extrauterine life. Furthermore, integrating nurturing devices in caregiving practices encourages parental involvement in routine care activities, reinforcing their role and confidence in caring for their baby even in a high-tech NICU environment.

Finally, Compassionate Collaborative Relationships focus on emotional well-being, self-efficacy, and communication. Clinicians play a vital role in supporting these trauma-informed measures, ensuring that both parents and staff are equipped with the knowledge and tools to facilitate optimal trauma-informed developmental care. These trauma-informed interventions support neurodevelopment and empower parents, reinforcing their role as primary caregivers. By enabling continuous sensory presence and minimizing separation, these devices help establish a sense of predictability, safety, and emotional security for infants and their families. The research underscores the long-term benefits of these interventions, showing reductions in parental stress and anxiety while fostering stronger attachment and advocacy skills.

By integrating trauma-informed devices and caregiving practices, neonatal teams can transform the NICU experience, bridging the gap between medical excellence and human connection. As neonatal care continues to evolve, integrating trauma-informed interventions into everyday practice is not just beneficial—it is imperative for fostering lifelong resilience in the most vulnerable patients. Prioritizing the five core measures for trauma-informed developmental care ensures that every infant and family receives care that is not only evidence-based but also deeply compassionate and developmentally appropriate.

Summary: Recognizing the trauma experienced by babies and families in the NICU is the first step toward transforming and humanizing neonatal care. This recognition must be followed by meaningful action—integrating trauma-informed practices, supporting parental involvement, and embracing innovative, evidence-based products and solutions that prioritize the holistic well-being of infants and their families. Trauma-informed interventions, particularly those that integrate parental involvement and ergonomic design, provide a compassionate, evidence-based approach to mitigating the effects of early life adversity. By centering the voices of parents and clinicians while utilizing trauma-informed tools designed to enhance neurodevelopment and emotional security, we can reshape the NICU experience and the transition to home after discharge into one that fosters healing rather than deepens distress. By leveraging these nurturing strategies, clinicians can enhance infant and family well-being, improve healthcare outcomes and satisfaction, reduce the cost of care, and foster a culture of healing and resilience in the NICU.

This shift requires dedication from institutions, practitioners, and advocates who believe in the profound impact of early experiences. Investing in trauma-informed developmental care is not just a clinical imperative—it is a moral and ethical responsibility that holds the power to transform lives. The NICU should not only be a place of survival but also one of healing, connection, and love. Every baby, every family, and every clinician deserves an environment that nurtures the body and the soul, where science and compassion intersect to create the best possible start for our most vulnerable patients. Through thoughtful, evidence-based approaches, we can transform neonatal care into a support, compassion, and empowerment model for every infant and family. Now is the time to act—to advocate, to innovate, and to implement trauma-informed care that acknowledges the human experience behind every NICU admission. The smallest among us deserve the best care, and it is our collective responsibility to ensure that their earliest moments are filled with safety, love, and hope.

Source: https://neonatologytoday.net/newsletters/nt-mar25.pdf

@HumankindVideos

CanadianPreemies  Jun 25, 2021

The birth of a premature infant has a profound effect on the family and may require a large portion of parental time, attention, finances, and psychological support. During all this time, the sibling may feel confused and left out of the loop and may resent the amount of time the parents are away with the new infant in the NICU. If the preemie is found to have a disability, these issues are compounded as the parents may be grieving and require further time away to attend several appointments. In this session, Dr. Saigal will discuss strategies to support siblings of premature babies. Dr. Saroj Saigal is a neonatologist and a Professor Emerita at McMaster University, Canada. She is internationally recognized for her long-term studies to adulthood which focuses on the quality of life and consequences of having been born extremely prematurely. She has also participated as a collaborator in several multi-center randomized perinatal clinical trials. Dr. Saigal co-founded Adult Born Preterm International Collaboration (APIC) and invited collaborators from around the world who were doing studies on premature infants in adulthood to participate in data sharing. She is the recipient of many awards from the Canadian Pediatric Society and the American Academy of Pediatrics. She was awarded the 2018 Virginia Apgar Award of the American Pediatric Society for distinguished contributions to perinatal medicine. She was also recognized by her alma mater with the McMaster Faculty of Health Sciences Community of Distinction Award, 2018.


What if a single event could sway health, exercise capacity, learning style, social interactions, and even personal identities–yet individuals had no memory of the event? Adults born preterm are an under-recognized and vulnerable population. Multiple studies of individuals born prematurely, including our 35-year longitudinal study, have found important health concerns that adult healthcare providers should consider in their assessments. Concerns include increased rates of cardiovascular disease, metabolic syndrome, depression, anxiety and attention problems, lower educational attainment and frequency of romantic relationships. A Nordic study of over six million individuals found a linear relationship between gestational age and protection against early adult mortality, with preterm individuals showing 1⋅4 times increased likelihood of early mortality as full-term peers.

At the same time, surviving premature birth has become increasingly common. For the last several decades, nearly one in nine U.S. babies is born early, and now more than 95% survive. Global prevalence and survival data indicate more than 15 million preterm birth survivors annually reach adulthood. This suggests a new population of individuals with emerging healthcare needs for adult health providers.

Birth history should be part of every patients’ medical record.5 Due to the varied risks and prevalence of premature birth, all healthcare practitioners should be aware of the potential for long-term effects. With one in ten 30-year-old patients born preterm, clinical specialists who treat long-term complications of prematurity (i.e., neurology, psychiatry, cardiology) may have more preterm-born patients. Recognizing preterm birth as a cumulative, lifelong risk factor is the first step.

As clinicians and researchers, we have observed the medical community, like society at-large, tends to view prematurity as a health event localized to infancy-something kids outgrow. Ironically, some pediatric providers report limited training and understanding of health complications for children born preterm, and little evidence exists regarding adult practitioners’ knowledge to care for these adults. Preliminary adult primary care guidelines were recently created to screen and manage prematurity-related health complications.

Health risks from prematurity are also risks to equality and justice. Women who bear social risk factors are more likely to give birth early. This includes Black women, those living in socio-economically depressed areas, and women with two or more Adverse Childhood Experiences. The many arms of racism and caste-based inequalities can complicate and worsen the health of people already at risk from preterm birth.

Attention also needs to be drawn to the prematurity research community. To date, research has focused on younger age groups and predominantly White populations. Future research needs to seek out ethnically diverse populations and comprehensively examine potential lifecourse complications of early birth. This is especially important when considering how socioeconomic factors may influence the allostatic load of individuals.

For many born preterm, prematurity is not just a health concern, it’s a matter of who they are. Their perception of health over time, or health related quality of life (HRQL), is a critical outcome. To date, this evidence varies with age, degree of prematurity and reporter; clinicians and parents tend to rate HRQL more negatively than survivors. Preterm-born individuals may not have event memories but, early birth repercussions can reverberate through family narratives and unique life experiences. Some identify as typically developed individuals who happen to have been born early, others as functional and well-adapted “preemies”, and others see prematurity as having colored their lives in negative ways. As prematurity researchers, we aim to uncover and bring awareness to the health outcomes and risks from early birth. A critical need exists for more evidence about adult health following preterm birth and yet, how do we protect individuals with statistically increased risk without unnecessarily pathologizing them?

In clinical practice and research settings, we can take the opportunity to listen to people who were too young as patients to speak for themselves but have riveting and complex stories about preterm birth’s effects. We are aware of just one other published qualitative study about the experiences of adults born preterm. Because most adult healthcare providers have yet to acknowledge and factor this experience into patient care, individuals born preterm are finding alternative avenues to be seen. Adults born preterm report seeking online community and support, connecting globally with people over shared early life experiences, while simultaneously making their needs and identities known.

As a research team, we strive to avoid labels for people born early but have nonetheless found that they are, in often subtle ways, a special group. They beat the odds as infants. Their birth and subsequent survival affected their families and communities in unprecedented ways. As clinicians and researchers, we can attend to the health risks of those born premature while acknowledging and celebrating their unique strengths and perspectives, often resulting from their early life experiences.

Source:https://pmc.ncbi.nlm.nih.gov/articles/PMC9186090/

Kevin Kafaja, MS III

As a third-year medical student, I had rotated through cardiac, neuro, and general ICUs. Each one buzzed with alarms and urgency, charged with adrenaline. But the NICU was different. It didn’t scream. It whispered.

My mother is a pediatrician, and I spent much of my childhood in the corners of her clinic—listening in on patient visits and soaking in the soft rhythm of care. I thought I understood Peds. But the NICU was something else entirely. It was intimate. Intentional. There were hours of serenity—gentle beeping monitors, quiet footsteps—but the stillness could break in an instant. A desaturation alarm. A sudden change. A Code White echoed overhead, and then the team would move—fast, focused, all hands in motion.

That’s where I met her—in the corner of the NICU, they lovingly called Toybox Inn 11, home to some of the tiniest, most vulnerable patients. Her crib was tucked neatly within that space, surrounded by soft blankets, daily goal charts, and quiet victories.

She was born on January 9th at just 31 weeks and 1 day, weighing 940 grams. Her mother’s pregnancy had been complicated— monochorionic diamniotic twins, Twin Anemia-Polycythemia Sequence (TAPS), and maternal hyperthyroidism managed with antithyroid medication. She was delivered via C-section under emergent conditions, including ruptured membranes and maternal fever. She required a partial exchange transfusion and respiratory support on 100% FiO₂ shortly after birth.

When I met her on March 5th—Day of Life 55—she had already fought through respiratory distress syndrome, anemia of prematurity, hyperbilirubinemia, and bradycardic spells. She was breathing room air, feeding fully by mouth, and steadily gaining strength. She was growing stronger, one quiet breath at a time.

In my mind, I called her The Little Engine. I loved toy cars growing up—tiny vehicles that raced like giants. She reminded me of that: small but full of force. Her strength wasn’t loud. It was steady. Unshakable.

At first, I was cautious. How do you care for someone so small? But the NICU team showed me—how to cradle her safely, how to monitor her saturation, how to read her tone and anticipate spells. She’d had a few brief episodes—one during a feed, another while asleep—but none in the final 72 hours before discharge.

The Toybox wasn’t just a clinical space. It was a nursery in progress. A pink blanket draped above her crib. A chart titled “My Day” tracked goals and daily wins. Books sat at her bedside— Goodnight Moon and When I Grow Up I Want to Be…, the latter filled with colorful flaps. I’d read it while keeping watch, wondering who she might become and what her future might hold.

Around her were all the quiet markers of care: diapers, wipes, a milk warmer, and an infant stethoscope. Her corner of Toybox Inn 11 was filled with love and progress, written in the smallest details.

Every Wednesday, during interdisciplinary rounds, we reviewed her journey: apnea monitoring, growth tracking, iron and Epoetin for anemia, and feed progression—35 mL of fortified formula every 3 hours. Her hemoglobin held at 9.9, and her reticulocyte count was strong at 5.4. She crossed the 2000-gram milestone. Each marker is a step closer to going home.

Her mother was a constant presence—gentle and calm. Watching her feed and hold her daughter reminded me that medicine begins not with machines but with presence.

She stayed in the NICU for 2 months and 8 days, and on March 18th, she went home—discharged at 40 weeks and 6 days corrected age, weighing 2170 grams. Her final measurements were length 43 cm, head circumference 34 cm, and abdominal girth 27 cm. She left wrapped in pink, lying in her open crib, breathing independently on room air.

Her discharge plan included a high-calorie formula, follow-up with her pediatrician for weight and EPO management, appointments at the High-Risk Infant Clinic, and a referral to the Regional Center within 1–2 months. I was there the day she left. I watched her resting peacefully in her open crib, bundled and ready to go. Her parents arrived later after I had already stepped away. But when I heard she had gone home—to reunite with her twin brother—it felt like a quiet victory. One we all shared.

In The Toybox, I learned that strength doesn’t always shout. Sometimes, it weighs just over two kilograms, sleeps under a pink blanket, and softly breathes while growing stronger every day.

She was my patient. But more than that, she was my teacher. And in that quiet corner of the NICU, I learned that even the smallest hearts can leave the most lasting marks.

Source:https://neonatologytoday.net/newsletters/nt-mar25.pdf

Highlights

– Adults born preterm report experiences of social exclusion such as being bullied

– They report high sensitivity, reduced stress resilience and tire more easily

– Many report that family, peer and mental health support has helped them most

– Prematurity should be recognized as lifelong condition by health professionals

– Many express gratitude for their life and lead a good life

Abstract

Background

Adults born preterm face greater social, cognitive, mental and physical challenges in adulthood than their full term born peers according to longitudinal studies. In contrast, little is known about the lived experiences of adults born preterm.

Objective

The study investigates the lived experiences of adults born preterm across the life course and their views on health care support.

Methods

A qualitative study of 21 participants completing semi structured interviews analyzed through content analysis.

Results

Over half of adults born preterm report trauma and feeling of otherness since early childhood, high sensitivity to the environment, higher introversion/shyness and social or performance related anxiety. Over half reported that their parents were traumatized by the preterm birth and tried to compensate by overprotective parenting that, however, stifled them becoming independent. Over half experienced bullying victimization and many have continuing mental health problems. Overload by demands in school or work is a consistent theme that makes it hard to have the energy to socialize. Many received physical therapy in childhood and most had psychotherapy in adulthood. Many feel that health professionals trivialize the long-term effects of prematurity and most find support from their parents or peer network.

Conclusions

Prematurity has significantly shaped the life of adults born preterm. Greater awareness and recognition of the unique needs of this group are essential to provide adequate support. Existing services fail to address these needs highlighting an urgent demand for enhanced social and psychological services for educational and workplace settings.

Source: https://www.sciencedirect.com/science/article/pii/S0378378225000581

Magdalena Sroka, Content Writer   30.08.2024

Neonatology startups aim to take care of newborns, especially premature babies. These highly vulnerable beings require exceptional care, as even the smallest changes can significantly impact their health and development. Sometimes, even the experience and knowledge of doctors aren’t enough to save the little one. Therefore, in a world where technology plays an increasingly vital role, neonatology startups become invaluable support for medical care. By combining advanced technology with specialized knowledge, it is possible to provide newborns, particularly those born prematurely, with the best care and a chance for a healthy start in life.

Necessity is the mother of invention. When designing medical devices for newborns, it is crucial to remember that they will serve the most fragile patients. This often requires an unconventional and comprehensive approach to problem-solving. In this article, we present 10 neonatology startups, whose innovative ideas have the potential to transform this field of medicine.

Neonatology Startups Which Can Shape The Future

  1. AMNION LIFE
    Amnion Life is working on an advanced incubator called AmnioBed, designed to replicate the conditions inside the womb. The goal is to support the development of premature infants by regulating temperature, protecting the skin, and managing fluids. The device is intended to provide warmth, humidity, and protection to newborns in a way that prevents hypothermia and water loss.
  • PRAPELA
    Founded in 2018, Prapela is a startup developing a device that uses vibrations to improve breathing patterns and sleep in newborns. This is aimed at helping stabilize breathing and oxygenation, particularly in infants suffering from apnea, intermittent hypoxemia, and neonatal opioid withdrawal syndrome (NOWS).
  • PEDIAFEED
    PediaFeed’s mission is to improve the feeling process for newborns who struggle with it. The company is developing a special type of tube for neonatology and pediatric patients, which minimizes the risk of tube displacement. It is also designed to be easy to insert and remove both in hospitals and at home, while causing minimal discomfort to the baby. Without proper nutrition it is hard to provide a healthy development.
  • PREGANBIT PRO
    This startup has developed a telemedical device for monitoring fetal well-being through cardiotocography (CTG). The portable device enables remote diagnostics and allows regular monitoring of the health of both mother and baby, including fetal heart rate and uterine contractions. Thanks to this technology, women can perform tests at home between medical visits, with results being transmitted and analyzed by doctors. Pregnabit Pro aims to enhance early detection of potential risks, increase pregnancy safety, and provide peace of mind to expectant mothers.
  • ZOUNDREAM
    Zoundream utilizes artificial intelligence and sound recognition to develop technology that can identify and interpret different types of newborn’s cries. The technology not only focuses on distinguishing the baby’s needs (hunger, tiredness) but is also capable of alerting parents to potential pathologies or developmental disorders. Zoundream’s goal is to provide a tool that enables faster responses to an infant’s needs while offering better support for parents.
  • VENTORA
    Ventora aims to create a device that allows precise real-time monitoring of airway pressure in newborns. The company is working on a solution that improves the process of mechanical ventilation while minimizing the risk of complications associated with traditional ventilation. Additionally, Ventora’s device is designed to assist in selecting the best therapy for the youngest patients.
  • OTONEXUS
    OtoNexus is a startup developing a diagnostic device (in the form of an otoscope) to detect middle ear infections and distinguish their origins in children and infants. The technology behind it is based on ultrasound, which enables quick and precise diagnosis, helping doctors make informed treatment decisions. Moreover, this approach could reduce the number of misdiagnosed and unnecessary antibiotic treatments.
  • BAMBI MEDICAL
    Bambi Medical has developed a wireless system for monitoring the vital signs of newborns, such as breathing, pulse, and temperature. Their solution replaces traditional invasive methods that rely on wires and cables. This provides greater comfort and freedom of movement for preterm infants, and is also gentler on the skin. The device sends data to the NICU monitor and alarm system, collected via a silicone strap placed on the baby’s chest, and alerts when apnea occurs.
  • PREEMIE SENSOR
    Preemie Sensor is working on an advanced device to analyze breast milk for nutrient content, specifically measuring fat, protein, and caloric value. The sensor is paired with software, allowing for the monitoring and optimization of nutrient intake by babies. Ensuring proper nutrition reduces the likelihood of complications associated with prematurity.
  1. OWLET BABY CARE
    Owlet Baby Care is a startup specializing in the creation of smart devices for supervising the vital signs of infants, such as heart rate and blood oxygen levels. The data is collected via socks worn on the baby’s foot and then displayed in a mobile app. This technology provides continuous monitoring, giving parents peace of mind and a chance to feel less stressed and anxious.

Summary

The solutions developed by these neonatology startups not only make it easier to monitor and manage the health of the youngest patients, but also enhance the safety and comfort of both children and their parents. Although not all devices are available on the market yet. Some are awaiting certification, yet they offer hope for saving more premature babies. Thanks to these innovations, the future of neonatal care is becoming increasingly promising, bringing relief and peace of mind to families around the world. Good job startupers! 🫶

If you’re interested in supporting or helping shape the future of neonatal care, don’t hesitate and get in touch with us!

Source:https://consonance.tech/blog/top-10-neonatology-startups-medical-devices/

New evidence from a world-leading Victorian study following premature babies into adulthood shows that babies born before 28 weeks’ gestation are doing surprisingly well as young adults in their twenties.

In a paper published in PEDIATRICS, new data released from the Victorian Infant Collaborative Study (VICS) 1991-92 cohort reveals insights from the 25-year point of the long-term study.

The study, co-led by the Royal Women’s Hospital and Murdoch Children’s Research Institute (MCRI), shows that extremely prematurely born adults are just as likely to have completed secondary school, be in paid work, and be in a romantic relationship, compared to their peers born at full term.

Dr Lauren Pigdon, Research Officer at MCRI, analysed the new data from the unique Australian geographic cohort who were recruited at birth and followed for 25 years.

“A strength of this study is that it represents the earliest survivors of the post-surfactant era to navigate the transition into adulthood and fills a gap in knowledge,” Dr Pigdon said.

The introduction of exogenous surfactant in the early 1990s was a game changer in treating respiratory distress syndrome in newborn intensive care. Since then, there has been a dramatic rise in survival of infants born extremely preterm (younger than 28 weeks’ gestation) or with extremely low birthweight (less than 1000g).

With increased survival rates of even the tiniest babies, concerns arose that these tiny babies might have increased chances of health and developmental problems as children and adults. And that this may in turn have an impact on their transition into adult life. But is this true?

“Our data paints a positive and encouraging picture,” Dr Pigdon said. “There were minimal group differences in self-reported general interpersonal relationships, satisfaction with different aspects of life, and current smoking behaviour.”

However, Professor Jeanie Cheong, Consultant Neonatologist at the Women’s and Co-Group Leader of the Victorian Infant Brain Studies group at MCRI, said there were some differences between the groups.

“More adults born extremely preterm had their main income source from government financial assistance and more had not yet moved out of the parental home compared with their peers born full term,” Professor Cheong said.

“Data from the past 25 years has allowed us to look at how, over time, care has improved for Victoria’s youngest and most vulnerable patients,” Professor Cheong said.

“While survival rates have gone up, we now also know that these babies have the chance to become fully functional members of our society.

“Findings from our study are relevant when counselling families after their baby is born, to put into perspective what the long-term outcomes may mean for their child.”

Meet Duane:

Duane has certainly grown up since he was born extremely premature at 26 weeks’ gestation in March 1992. He weighed only 886 grams at birth.

“I was so tiny that my father’s wedding ring could fit all the way up my arm to my shoulder,” Duane remembers.

After a happy and normal childhood, Duane completed high school and became a competitive slalom skier, trying out for the Australian National Team. While he is an experienced downhill racer avoiding major obstacles, Duane faced a few health issues and injuries in his early 20s.

Duane is now a professional skiing and snowboard instructor. He follows the snow seasons and enjoys living and working abroad. He spent a long time in Austria, where he completed a sports diploma in Innsbruck, and now speaks German fluently.

Currently, Duane is keen for his torn ACL in the knee to heal. Then he plans to hit the slopes again and has offers to work in the USA, Japan and Europe.

Source:https://www.thewomens.org.au/news/prem-babies-become-capable-adults-when-grown-up-new-study-confirms

British Association of General Paediatrics

Bushra Rafique1, Hamid Idriss2, Rajesh Bagtharia3, Premilla Kollipara3, Geeta Subramanian3

Abstract

Objectives: Imperforate hymen (IH) is one of the most common obstructive congenital anomalies of the female genital tract. In this condition the hymen occludes the vaginal opening obstructing effluent discharge. Early diagnosis is possible, as new-born vaginal secretions stimulated by maternal oestrogen cause hymenal bulge, which is an abnormal finding.

The aim of this abstract is to highlight potentially missed opportunities for a neonatal diagnosis of IH. Delayed presentations are associated with significant morbidity such as chronic and severe abdominal pain, acute urinary retention, obstructive uropathy and endometriosis.

A full physical examination of the new-born within 72 hours after delivery is the required standard of the New-born and Infant Physical Examination Screening Programme (NIPE) and National Institute of clinical Excellence (NICE) quality standard 37, statement 7. This includes anogenital examination looking at patency of orifices at birth and at 6 weeks check.

Methods: We conducted a survey, using Survey Monkey portal with the objective to review current clinical practice in postnatal examination. The link was distributed via WhatsApp and email to paediatric trainees, general practice trainees and clinical fellows at our trust and London wide.

Responses were collected over 12 weeks. Following questions were asked looking for a yes or no response.

– Do you perform a genital examination in NIPE?

– Are you aware that NIPE recommends complete examination of the genitals to check for normal

  appearance and patency?

– Do you examine for hymenal opening in female babies by separating labia?

– Are you aware of the findings in imperforate hymen?

– Are you aware of the consequences of delayed diagnosis of imperforate hymen?

– Have you ever picked up an imperforate hymen in neonatal examination?

Results: Out of 220 doctors, 132 responded to the survey questions which resulted in a 60% response rate.87.8% performed a genital examination as a part of NIPE.78.7% were aware that normal patency and appearance of the genitals must be checked. Only 25.7% were examining hymenal opening by separating the labia majora and 35.6% were aware of the findings of IH. 7 out of 132 doctors had made a diagnosis in the neonatal examination. 60% were aware of consequences of a delayed diagnosis.

Conclusion: Our survey highlights insufficiencies in female new-born genital examination. There is a need for increased awareness amongst clinicians about this condition, as there exists a window of opportunity to make an early diagnosis and minimise suffering and morbidity.

Source: https://adc.bmj.com/content/108/Suppl_2/A103.2

Preemie Power: Global Voices, Lasting Impact

🌍 WARRIORS: A Global Conversation for Preemie Survivors

Premature birth doesn’t end at discharge—it echoes throughout life. As survivors, we are not defined by our early start—we are defined by our strength, our resilience, and the legacy we choose to build. From the NICU to adulthood, our stories carry both scars and strength. And now, more than ever, the world needs our voices.

The NW Warriors community reflects a growing global collective—of preemie survivors, families, clinicians, researchers, and advocates—who recognize that prematurity is not a condition left behind in infancy. It is a thread woven into identity, healthcare, and social equity across the lifespan. Whether you were born early, raised a NICU warrior, or cared for one—you are part of a movement greater than any diagnosis.


💥 Why the Warrior Movement Matters

Prematurity is not just a medical event—it’s a lifelong journey. Survivors grow into athletes, educators, scientists, artists, and caregivers. Some carry physical or emotional complications. Others carry memories of separation, struggle, or stigma. All carry a story of endurance.

This is a historic moment. For the first time, the world is witnessing a full generation of NICU survivors reaching adulthood in global numbers. Their experiences bring urgency to overlooked conversations—on trauma-informed care, long-term health, and identity. Their insights are reshaping how neonatal care is defined, not just in the early days, but across the life course.

We are not just patients.
We are architects of change.
We are storytellers.
We are warriors.


🌐 A Growing Global Dialogue

Across countries and cultures, NICU survivors and neonatal communities are coming together. We are asking new questions:

  • What does it mean to be born too soon—and grow into your power?
  • How can we center survivor experiences in clinical and policy conversations?
  • What role does memory, trauma, or advocacy play in healing?
  • How do we recognize preterm birth not just as a medical statistic, but as a lived reality that shapes lives and futures?

There is no single answer. But there is space for all of us here. Some find their power through writing, art, research, or mentorship. Others speak through quiet acts of presence and parenting. Some fight for structural change. Others simply want to be heard, held, and understood.

What unites us is this:
We were born into adversity—and we rise with intention.


🛡️ Rewriting the Narrative

As adults born preterm, or as families and clinicians who lived that journey, we are no longer hidden in hospital charts or lost in long-term data. We are here—visible, vocal, and unafraid to lead.

This movement doesn’t require permission. It begins in honest conversations, in shared memory, in reclaiming our stories from silence. It grows as we listen to each other, uplift survivor narratives, and demand that care systems honor the full trajectory of human life.

We are not asking for pity. We are offering power.
We are not defined by fragility. We are evidence of strength.
We are not waiting. We are rising.


Join the Conversation

Wherever you are—in policy, in practice, in healing, in hope—this conversation is yours. The warrior journey is not just about what we survived. It’s about what we build next.

#NWWarriors #PreemieStrong #GlobalNICU #BornToLead #EchoesOfPrematurity

With love, Kathryn

Building Community: Mohamed Anowar´s Youth Environment

The World Around

MEET THE YOUNG CLIMATE PRIZE COHORT! After Mohammed Anowar fled Myanmar with his family to a refugee camp in Bangladesh, he saw hundred of trees being cut down and decided to start a climate hub. The Community Climate Action Initiative aims to tackle pressing climate challenges such as heatwaves, landslides, and flooding through a multifaceted approach. The project includes a Tree Planting Campaign designed to combat deforestation and mitigate heat impacts by increasing local green cover. Complementing this, Climate Awareness Sessions are held to educate community members in the Kutupalong refugee camp about climate change and effective resilience strategies. Additionally, Youth Leadership Training is provided to equip young leaders with the skills needed to advocate for climate action and promote sustainable practices. The initiative is expected to yield a range of positive outcomes, including an improved local environment, heightened climate awareness, and a cadre of empowered youth spearheading climate resilience efforts in the community.

I Am We, A Book of Community

Renee Walters

TIPS, SUPRISES, and RESOURCES

Singapore, officially the Republic of Singapore, is an island country and city-state in Southeast Asia. The country’s territory comprises one main island63 satellite islands and islets, and one outlying islet. It is about one degree of latitude (137 kilometres or 85 miles) north of the equator, off the southern tip of the Malay Peninsula, bordering the Strait of Malacca to the west, the Singapore Strait to the south along with the Riau Islands in Indonesia, the South China Sea to the east, and the Straits of Johor along with the State of Johor in Malaysia to the north.

Singapore has a generally efficient healthcare system, even though health expenditures are relatively low for developed countries.  The World Health Organisation ranks Singapore’s healthcare system as 6th overall in the world in its World Health Report. Singapore has had the lowest infant mortality rates in the world for the past two decades. In 2019, Singaporeans had the longest life expectancy of any country at 84.8 years. Women can expect to live an average of 87.6 years with 75.8 years in good health. The averages are lower for men.[479] Singapore is ranked 1st on the Global Food Security Index.

Source: https://en.wikipedia.org/wiki/Singapore

By OnlineMedEd     February 1, 2025

Key Takeaways:

  • Financial Considerations: Medical professionals often face significant student loan debt, which can impact career choices and personal life decisions.
  • Technological Integration: The integration of technology like telemedicine and electronic health records is transforming how doctors provide care and stay updated with medical advancements.
  • Communication In Medicine: Effective communication skills significantly enhance doctor-patient relationships and improve treatment outcomes, emphasizing their importance alongside medical knowledge.

In the fast-paced and ever-evolving world of medicine, doctors and residents commit to a lifelong calling. These dedicated individuals spend countless hours honing their expertise, driven by a deep commitment to patient care and medical excellence. While the white coat and stethoscope symbolize readiness and a passion for their practice, the reality of their journey is far more complex, filled with challenges and responsibilities that often play a crucial role in shaping their careers and the care they provide.

This article goes beyond common perceptions, revealing ten surprising facts about doctors and residents that highlight the depth and complexity of their roles. Whether you’re a medical student preparing for the road ahead, an educator nurturing future providers, or a healthcare professional seeking deeper insight, these realities offer a fresh perspective on the field. 

Understanding these intricacies fosters greater appreciation, resilience, and professional growth, ensuring that the next generation of physicians is equipped not only with medical knowledge but also with the tools to thrive in both their careers and personal well-being.

Fact 1: Many Doctors Face Student Loan Debt Long Into Their Careers

Becoming a doctor is one of the most rewarding professions, but the financial burden is significant. Many physicians graduate with over $200,000 in student loan debt, impacting career choices and personal milestones. Here are ways that student loan debt can impact medical professionals: 

  • Influences Specialty Decisions: Some choose higher-paying fields over passion-driven specialties.
  • Delays Major Life Events: Homeownership, marriage, and family planning may be postponed until studies are completed.
  • Requires Strategic Financial Planning: Understanding repayment options and budgeting is crucial.

Fact 2: Doctors Must Continually Update Their Knowledge

Medicine evolves rapidly, requiring lifelong learning to provide optimal patient care. Continuing education ensures physicians stay updated on the latest research, treatments, and technologies. Here are some reasons why: 

  • USMLE And CME Requirements: Ongoing exams and certifications keep doctors current.
  • Medical Advancements: New treatments, AI tools, and clinical protocols evolve constantly.
  • Efficient Learning Strategies: Consistent review of clinical content allows doctors to maintain their medical mastery and mitigate skill decline.

Fact 3: Technology Is Transforming How Doctors Practice Medicine

Technology is revolutionizing healthcare for the better and improving efficiency. Below are some ways technology is changing the healthcare game: 

  • Electronic Medical Records (EMRs): Digitally store and organize patient health information, improving accessibility, documentation accuracy, and care coordination.
  • Telemedicine: Expands access to remote and underserved populations.
  • AI And Automation: Enhances diagnostics, workflows, and patient care.

Fact 4: Many Doctors Pursue Research Alongside Clinical Practice

For many doctors, the desire to discover new medical knowledge is as strong as the calling to patient care. Many doctors balance clinical work and medical research to push the field forward. 

Medical research:

  • Advances Evidence-Based Medicine: Research findings shape treatment protocols.
  • Improves Patient Outcomes: Clinical trials lead to breakthrough therapies.
  • Strengthens Analytical Skills: Evaluating data sharpens clinical decision-making.

Fact 5: Communication Skills Are As Important As Medical Knowledge

Beyond expertise, strong communication enhances patient trust and treatment outcomes by ensuring clarity, collaboration, and understanding. Below are some communication skills that medical professionals should value: 

  • Clear Explanations: Helps patients make informed decisions.
  • Interdisciplinary Teamwork: Ensures seamless care coordination.
  • Active Listening: Strengthens doctor-patient relationships.

Fact 6: The Number Of Female Physicians Is On The Rise

In recent years, the medical field has witnessed a transformative shift as the number of female physicians steadily increases. Women now make up over 50% of U.S. medical school students, creating a more inclusive healthcare environment. 

This change not only reflects broader societal advancements but also heralds a new era where diverse perspectives lead to more comprehensive patient care. Here are a few reasons why this trend is a positive force in the medical community: 

  • Enhancing Patient Perspectives: Women in medicine improve representation and inclusivity.
  • Expanding Leadership Roles: More female doctors are entering executive positions.
  • Shaping Mentorship And Education: An increasing number of programs support future generations of female physicians.

As more women enter the field, efforts to support career advancement, mentorship, and leadership opportunities continue to grow. These changes contribute to a more balanced healthcare workforce, ensuring that medical education and patient care reflect the diverse needs of the communities they serve.

Fact 7: Residents Are Both Students And Employees

Residents face a tough battle, as they are expected to balance learning with employment. The responsibilities of patient care, combined with a deep, unyielding commitment to mastering the breadth and depth of medical knowledge, create a unique dynamic.

Residents deal with: 

  • Hands-On Experience: Residents manage cases under supervision, participate in medical procedures, and deliver expert care in high-stakes environments.
  • Long Hours And High Stress: Demanding schedules prepare residents for independent practice.
  • Balancing Education And Work: Requires strategic planning and smart time management to stay sharp.

Fact 8: Doctor-Patient Relationships Influence Treatment Outcomes

At the heart of every successful treatment plan lies a strong doctor-patient relationship. This dynamic significantly impacts treatment outcomes, as trust and communication form its foundation. Here’s why this bond is essential to a positive healthcare experience: 

  • Empathy Improves Patient Engagement: Positive experiences with doctors encourage patients to follow treatment plans accordingly.
  • Communication Enhances Understanding: Simplified explanations of medical conditions and solutions lead to informed decisions.
  • Trust Strengthens Compliance: Patients are more likely to return for follow-ups and engage in routine check-ups when they trust their healthcare provider.

Developing effective communication and interpersonal skills allows physicians to foster meaningful connections with their patients. When patients feel understood and respected, they are more likely to adhere to medical advice and treatment plans, ultimately leading to improved health outcomes.

Fact 9: Wellness Programs Are Becoming More Common In Medical Training

The rumors are true: Becoming a doctor is an incredibly long and arduous process. Thankfully, in recent years, wellness programs have been developed to support students and residents with healthy coping mechanisms. These initiatives, including the ones listed below, are a testament to the growing recognition of the demanding pressures faced by medical students and residents and their impact on mental health and overall well-being. 

  • Mental Health Support: Resources such as counseling help prevent burnout.
  • Work-Life Balance Strategies: Encouraging self-care and mindfulness.
  • Peer Support Networks: Strengthening community and resilience.

Fact 10: Global Health Opportunities Are Available To Doctors And Residents

Joining global health initiatives allows medical professionals to see firsthand the different healthcare challenges that occur worldwide. This experience can be pivotal in developing resilience and adaptability, skills that are crucial in any medical setting. For residents, these opportunities can be eye-opening, offering real-world applications of their clinical skills in diverse environments. Here’s why global opportunities can be beneficial for the careers of doctors and residents: 

  • Exposure To Diverse Medical Environments: Broadens clinical expertise and adaptability to different clinical settings.
  • Develops Problem-Solving Skills: Teaches current and aspiring healthcare providers how to work with resource-limited care strategies.
  • Strengthens Public Health Impact: Contributes to underserved communities worldwide.

These opportunities enrich one’s medical expertise and broaden perspectives on health disparities, resource management, and cultural sensitivity. 

Final Thoughts

The road to becoming a doctor is filled with challenges, sacrifices, and unexpected realities, yet it remains one of the most enriching careers. Understanding these crucial facts about doctors fosters greater empathy and appreciation for those dedicated to medicine. While the path is demanding, each step brings the opportunity to grow, refine skills, and make a meaningful impact on patient care.

By embracing a structured and comprehensive approach to medical education, future providers can develop true mastery. Investing in both clinical knowledge and personal well-being ensures not only success in training but also longevity and fulfillment in practice. Whether you’re a medical student, resident, or educator, every effort you make strengthens your ability to provide exceptional, compassionate care, shaping the future of healthcare for the better.

Source: https://www.onlinemeded.com/blog/facts-about-doctors

Benjamin Kheng Nov 28, 2024 #BenjaminKheng #REALLYINLOVE

REALLY IN LOVE Written by: Benjamin Kheng Produced by: Benjamin Kheng, Evan Low Performed by: Benjamin Kheng Mixed & Mastered by: Charlie Kurata Spatial Audio Master by: Luke Nicholas Foo

Elisha Tushara UPDATED Oct 04, 2024, 01:00 PM

SINGAPORE – Her son weighed just 700g when he was born at 24 weeks after she spent the two weeks prior in hospital due to vaginal bleeding and cervix dilation.

Ms So Bee Leng’s son, Ethan Ang, was born in 2017 with multiple disabilities stemming from his extreme prematurity. At seven days old, he underwent his first major surgery when his intestines were operated on.

For the next five years, he underwent four more major operations, which included implanting a cochlear hearing device, laser eye surgery to help with his vision and placing a feeding device through his belly to the stomach.

It is currently a challenge to identify mothers at risk of giving birth to premature babies as the only gauge is when mothers have had previous preterm births, like Ms So, said Professor Teoh Tiong Ghee, director of maternal and child global health and care transformation at KK Women’s and Children’s Hospital (KKH).

To proactively reduce and prevent prematurity, a 10-member team of doctors specialising in newborn care and high-risk pregnancies from KKH and Singapore General Hospital (SGH) will start work on a new Preterm Pregnancy Prevention Programme in October.

The team aims to create a national database of all preterm pregnancies to identify risk factors, and then use this information to develop a screening prediction tool that can accurately assess the risk of preterm pregnancies.

A baby born before 37 full weeks of pregnancy is considered to have been born preterm or prematurely. A preterm baby’s organs may not be fully developed. 

A full-term pregnancy typically lasts about 40 weeks, and babies’ birth weights typically range from 2.5kg to 4.5kg.

Globally, 13.4 million babies – 10 per cent of all births – are born prematurely each year and one million die from preterm complications.

Prematurity is the leading cause of death for children under five.

In 2023, 8.2 per cent of births in Singapore were premature, slightly lower than the 8.8 per cent recorded in 2014.

Recalling the dilemma she faced when told she might deliver early and her baby would develop health complications, Ms So, 38, said: “I was given the choice to either terminate the pregnancy or continue with bed rest in the hospital until I gave birth.

“After weighing the pros and cons, and discussing with my husband, we decided to carry on and accept whatever may come in the future.”

When she conceived again in 2023, her doctor told her she was at risk of another premature delivery. She was referred to the Preterm Birth Clinic at KKH’s Stork Centre, where she was closely monitored.

She underwent a procedure to stitch her cervix – the birth canal opening – when she was 12 weeks along, paving the way for the full-term birth of her daughter, Alysha Ang, at 38 weeks.

Called a cervical cerclage, the procedure is done to help the cervix hold a pregnancy in the womb to prevent preterm birth.

Dr Ilka Tan, a senior consultant at KKH’s department of maternal foetal medicine who oversaw Ms So’s care during her second pregnancy, said that infants are able to survive outside the uterus at 24 weeks.

She added that though there are rare cases of infants surviving when born at 22 or 23 weeks, the “outcome is still not very good” for these babies.

Acknowledging that there have been reports from around the world of some babies born around 22 weeks who have survived, she said: “Those are single anecdotal cases, but it’s not the norm.”

If diagnosed through screening and predictive tests early, mothers who are at risk of preterm births can undergo various treatments to help them bring the pregnancy to term, Dr Tan said.

These include taking the hormone progesterone and getting a cervical cerclage.

The Preterm Pregnancy Prevention Programme will use information collated to study common characteristics among women who deliver prematurely. This in turn can be used to develop a prediction tool to identify expectant mothers who are at risk of preterm births early, so that preventive measures can be taken.

“What we’re trying to do is to get all these demographics, and use biomarkers from blood and cervical length measurements, to try to predict each woman’s personalised risk so as to target with specific therapy,” said Prof Teoh.

The programme is funded by a $500,000 grant from Far East Organization.

Besides the child potentially suffering long-term health consequences and an increased risk of disability and developmental delays, the parents and the rest of the family experience long-term stress too, Prof Teoh noted.

“Some have to stop work to look after the kid. So not only does it have a psychological impact on the family, it’s got a big financial impact as well,” he added.

Dr Tan also leads the Preterm Birth Clinic at KKH that provides specialised care for women who may have a higher risk of having premature babies.

The clinic began operations in July 2021 and had 100 patients that year. In 2024, 402 patients were referred to the clinic from January to September.

Ms. So said she received personalised care and attention at the Preterm Birth Clinic to help her carry her second child to term.

“I was seen by the same doctor – it wasn’t random. So I felt well-looked after and relieved. I was assured that there was a plan to help me, and that was important.”

Souce:https://www.straitstimes.com/singapore/team-from-kkh-sgh-aims-to-develop-screening-tool-to-identify-women-at-risk-of-premature-births

Credit: Pixabay/CC0 Public Domain

by Erin Digitale    Stanford University     August 7, 2024

Skin-to-skin cuddling with a parent has lasting cognitive benefits for premature babies, according to a new Stanford Medicine study. Preemies who received more skin-to-skin contact, also known as kangaroo care, while hospitalized as newborns were less likely to be developmentally delayed at 1 year of age, the study found.

The research, which was published online July 11 in The Journal of Pediatrics, showed that even small increases in the amount of skin-to-skin time made a measurable difference in the babies’ neurologic development during their first year.

“It’s interesting and exciting that it doesn’t take much to really improve babies’ outcomes,” said the study’s senior author, Katherine Travis, Ph.D., who was an assistant professor at Stanford Medicine when the study was conducted and is now an assistant professor at Weill Cornell Medical School and Burke Neurological Institute.

The study’s first author is Molly Lazarus, a clinical research coordinator in pediatrics previously at Stanford Medicine and now at Weill Cornell Medical School.

The intervention is simple: With the baby only in a diaper, a parent holds the baby on their chest, next to their skin. But because hospitalized preemies are small and fragile, and often hooked to lots of tubes and wires, holding the baby can seem complicated. Parents may need help from their baby’s medical team to get set up. That work is worth it, the study showed.

“It didn’t matter if the baby was from a high- or low-income family; the effects we found were the same. And it didn’t matter if the baby was sicker or less sick—both responded to this treatment,” Travis said.

Neurological complications are challenging

Over the last 50 years, preemies’ survival rates have improved dramatically thanks to better treatments for many of the complications of prematurity, which is defined as being born at least three weeks early. For instance, neonatologists have developed effective approaches to help preemies breathe, even with immature lungs, while in the neonatal intensive care unit.

But premature birth still leaves babies at risk for long-term neurodevelopmental problems, including developmental delays and learning disabilities. Doctors and families have long hoped for treatments they could use during the newborn period to prevent such challenges.

“Ultimately, we want our patients to be healthy kids who can achieve the same milestones as if they didn’t come to the NICU,” said study co-author Melissa Scala, MD, clinical professor of pediatrics. Scala is a neonatologist who cares for preemies at Lucile Packard Children’s Hospital Stanford.

“Our finding legitimizes skin-to-skin care as a vital intervention in the neonatal intensive care unit to support our goal of getting that child out of the hospital, able to learn and develop,” Scala said.

Skin-to-skin care was first used in low-income countries to boost babies’ survival, where it is often used for healthy infants born after full-term pregnancies. In rural or impoverished areas, it is an essential way to keep newborns warm, promote parent-child bonding and facilitate the start of breastfeeding.

It’s been slower to catch on in the United States, especially for premature babies, who generally receive high-tech intensive care. But a growing body of research suggests that the practice has benefits for preemies’ brains, possibly because it could offer some of the same developmental inputs they would have received if they had not been born early.

More skin-to-skin was better

The research team reviewed medical records for infants who were born very prematurely, meaning at least eight weeks early, and were cared for at Lucile Packard Children’s Hospital Stanford between May 1, 2018, and June 15, 2022. Nurses in the hospital’s NICU had begun making notes in patients’ medical charts about developmental care practices, including the amount of time parents held babies skin-to-skin, shortly before the study began.

The study included 181 preemies who did not have genetic or congenital conditions known to affect neurodevelopment and who had received follow-up evaluations after they left the NICU. All very premature babies are eligible for care through California’s High Risk Infant Follow-Up program until age 3. The program provides developmental testing and connects families to appropriate therapists if their children have developmental delays.

The study used records from follow-up evaluations that the babies received at 6 and 12 months’ adjusted age, meaning their ages were corrected to account for how early they were born.

The evaluation included measures of visual-motor problem solving in standard tasks (such as dropping a cube into a cup) and expressive and receptive language skills (such as turning to see where the sound of a bell is coming from).

In addition to accounting for infants’ gestational age (how early they were born), the outcomes were adjusted for families’ socioeconomic status and for four common complications of prematurity: bronchopulmonary dysplasia, a breathing complication; brain hemorrhage, or bleeding; sepsis, an infection of the bloodstream; and necrotizing enterocolitis, an intestinal condition.

The infants in the study were born, on average, at about 28 weeks’ gestation, or about 12 weeks before their due dates. They stayed in the hospital for an average of about two and a half months.

Babies in the study averaged about 17 minutes a day of skin-to-skin care, usually in sessions lasting more than an hour but occurring less than two days per week. Seven percent of families did not do any skin-to-skin care, and 8% did more than 50 minutes per day.

Small increases in the amount of skin-to-skin care were linked to large differences in 12-month neurodevelopmental scores. An average of 20 minutes more per day of skin-to-skin care was associated with a 10-point increase on the scoring scale used for neurodevelopment. Similar to an IQ test, the scale has an average of 100 points; a score of 70 or less suggests significant developmental delays.

The frequency and duration of skin-to-skin contact predicted 12-month cognitive scores even after controlling for possible confounding factors, including the infant’s gestational age and medical complications, and the family’s socioeconomic status and frequency with which they visited the NICU.

How does it work?

Although the study was not set up to explore how skin-to-skin care benefits babies’ brains, the researchers have some educated guesses.

“We think of the womb as our benchmark for preterm babies. In utero, a fetus is physically contained, listening to the maternal heartbeat, hearing Mom’s voice, probably hearing her digest her sandwich,” Scala said. “In the NICU, they’re not next to anybody, and they hear the fan in the incubator; it’s a very different environment. Skin-to-skin care is probably the closest we can get to mimicking the womb.”

Parents can also benefit from skin-to-skin care, and this in turn may benefit their newborns, the research team said.

“The environment of the NICU is very stressful for parents and babies, and skin-to-skin care may buffer that,” Travis said, noting that it is not unusual for parents with a very tiny, sick baby to develop post-traumatic stress disorder.

In addition, many preemies are not developmentally ready to breastfeed, and skin-to-skin care can provide an alternate way to promote bonding between parents and babies.

The researchers hope their findings will motivate medical teams to help parents provide skin-to-skin care in NICUs across the country and will encourage parents by showing them the long-term benefits of this simple but important technique.

Packard Children’s recently expanded its infant developmental care program by hiring neurodevelopmental nurse practitioners, more physical and occupational therapists, a psychologist, and child life and music therapy experts for their NICU and intermediate care nurseries. The expanded team can make customized developmental care plans for high-risk infants.

Scala hopes other hospitals will follow suit.

“I would love for people to see this as part of the medical plan, not just something nice we’re doing, but to be really intentional about it,” Scala said. “Our findings underscore the value of having parents on the intensive care unit, doing this important part of infant care.”

Source:https://scx1.b-cdn.net/csz/news/800a/2024/preterm-infant.jpg

Imagine giving birth at 22 weeks—facing the uncertainty, the emotional rollercoaster, and the challenges of an 8-month NICU stay. For Asma, this journey was life-changing, but it also ignited her passion for advocacy, helping other parents navigate the NICU experience with confidence and strength. Join us as Asma shares: ✅ Her raw & real experience as a NICU mom to baby Cylia Maria ✅ The emotional & logistical challenges of a long NICU stay ✅ The transition home—what she wishes she knew ✅ How sharing her story has fueled her passion for advocacy & parent empowerment ✅ Guidance for parents: questions to ask & how to take an active role in their baby’s care.

International Council of Multiple Birth Organisations / ICOMBO

International Federation of Spina Bifida and Hydrocephalus / IFSBH

International Patient Organistion for Primary Immunodeficiencies / IPOPI

Country Specific Organizations

It can be very stressful having a baby in the NICU. During this time, it is helpful to include siblings as much as possible; to explain in simple terms what is happening with your new baby; to reassure them that they have not caused the baby to be early, sick, or small; and to remind them that they are not the source of your current worries. Most of all, you should reserve special time just for them, and remind them daily of your constant and unconditional love. More than ever, they need to feel secure, valued, safe, and loved by you and others.

Platypus Media is proud to offer a number of NICU sibling support resources. We hope these will be meaningful and useful for families experiencing the difficulty of having a child in the NICU. 

The Come Home Soon coloring book series (available for baby boys and girls, in both English and Spanish) will help you guide your children to an understanding of why their baby sister or brother is in the NICU, and what they can do to help.

Rich and Creamy for Our Preemie, by Naomi Bar-Yam, ACSW, Ph.D., available in English and in Spanish, is a coloring book about how the NICU, milk banks, and families work together to help preemies. 

Here is a list of other NICU sibling support resources: 

  • Hand to Hold sibling support webpage (www.HandToHold.org) offers sample activity pages and NICU video tour.

  • No Bigger than My Teddy Bearby Valerie Pankow describes the NICU experience through the eyes of a new big brother.

  • My Brother is a Preemie/My Sister is a Preemie:A Children’s Guide to the NICU Experienceby Abraham R. Chuzzlewit & Dr. Jos. A. Vitterito II gives a child-friendly introduction to the NICU.

  • The Invisible Stringby Patrice Karst reassures children that even when loved ones are apart, they are always in each other’s hearts.

Keep reading for a list of organizations that help preemie families…

Different Dream serves as a gathering place for parents with special needs children.

Hand to Hold provides resources and support to parents of preemies, babies with special health care needs and new parents who have lost a baby.

Human Milk Banking Association of North American provides information and resources on donor milk banking for parents and health care providers. It also sets safety guidelines for all non-profit mothers’ milk banks in North America.

Kangaroo Mother Care promotes skin-to-skin contact, a universally available and biologically sound method of care for all newborns, and preemies in particular.

La Leche League International is a mother-to-mother breastfeeding support organization. They are a source of information and firsthand accounts related to providing preterm babies with breastmilk.

Managing the Neonatal Intensive Care Unit is an article from the Loyola University of New Orleans’ online nursing resource center. A great resource for students, professionals, and even parents of babies in the NICU.

March of Dimes (MOD) has a wealth of information about the NICU. They support an online community especially for NICU families. March of Dimes NICU Family Support programs operate in many NICUs. (Also available in Spanish.)

National Premature Infant Health Coalition consists of a variety of support organizations focused on improving the lives of parents and their preemies.

NICU Parent Support Site provides information, resources, and encouragement to reassure and support NICU parents.

Prematurity strives to support preemie parents by providing information on prematurity and preemie care.

Preemie Parent Alliance(PPA) represents a number of organizations that help support the parents of preemies and strives to improve the quality of the care they provide.

Preemie World brings together parents and professionals in the NICU. They strive to educate and help make the transition to home easier for everyone.

Ronald McDonald House serves as a home away from home for families with children receiving medical treatment. Families can do laundry, eat freshly cooked meals, sleep in private rooms, and gain/give support with other families.

Supplemental Security Income (SSI) and Medicaid Programs provide financial assistance for NICU medical expenses. Eligibility for assistance is determined by a baby’s birth weight rather than an income. You must apply for these programs shortly after your baby is born. Ask your social worker or care manager for assistance.

WIC (Women, Infants, and Children) provides nutritious foods to supplement diets, information on healthy eating, and referrals to health care for women, infants, and children up to 5 years. Even if you have been denied Medicaid due to financial reasons, you might still qualify for WIC.

This list can be found in the Resource for NICU Families section of our award winning Coloring Book for the Big Brothers and Big Sisters of the NICU.

Source: https://www.platypusmedia.com/resources-for-nicu-families

Fetal heart rate (FHR) patterns are a critical tool for assessing a baby’s well-being during pregnancy and labor. Nurses must understand how to interpret these patterns to ensure safe care. Here are the key takeaways:

  • Baseline FHR: Normal range is 110-160 bpm. Below 110 bpm (bradycardia) or above 160 bpm (tachycardia) may signal distress.
  • Variability:
    • Moderate (6-25 bpm): Healthy oxygenation.
    • Absent or minimal: Potential concern.
    • Marked (>25 bpm): Possible distress.
  • Decelerations:
    • Early: Harmless, mirrors contractions.
    • Late: Indicates uteroplacental issues, requires action.
    • Variable: Linked to cord compression, may need intervention.
  • Three-Tiered Classification:
    • Category I: Normal.
    • Category II: Indeterminate, needs closer monitoring.
    • Category III: Abnormal, requires urgent action.

Nurses must act quickly on abnormal patterns by repositioning the mother, administering oxygen, or preparing for emergency delivery. Accurate monitoring, documentation, and clinical judgment are essential for ensuring the safety of both mother and baby.

Source:https://blog.nursecram.com/nursing-content-reviews-ngn-focused/fetal-heart-rate-patterns-nursing-interpretation-tips/

|@LevelUpRN   

Joseph B. Philips, III, MD

The moonlighter had just returned with our dinners when the code alarm sounded. Almost simultaneously, our pagers went off “Code infant 3312.” We all knew who it was. The 23-week gestation, two-day-old baby had coded earlier in the afternoon and had been doing poorly since. Oxygen saturations were in the low 80s despite maximal support, and blood pressures were marginal on dopamine, dobutamine, and epinephrine drips. Upon entering the room, we found the infant with saturations in the 40s and a heart rate in the 50s. We quickly assumed our positions around the warmer. The resident began chest compressions, the respiratory therapist hand bagged, the fellow at the head of the bed assessed the airway and ordered fluid pushes and medications, the bedside nurse administered the medications, and I, the attending physician, oversaw it all. The nursing staff also rapidly began their roles, one opening the crash cart and drawing up drugs, another charting, and multiple others observing and ready to assist if needed.

We quickly fell into our all-too-familiar routine, counting “one, two, three” for chest compressions, followed by “breath.” Over and over again. “Ten mils normal saline,” said the fellow, followed by “epi, point 0 five” every five minutes. The intern took over the chest compressions after about 10 minutes, but the cadence remained the same. Blood was bubbling up the endotracheal tube, indicating the presence of a pulmonary hemorrhage. A nurse was dispatched to retrieve emergency-release blood from the blood bank. The saturation and heart rate were steadily falling.

The mother was literally rolling on the floor, wailing, “Save my baby! Save my baby!” over and over again.

Despite several rounds of fluids and epinephrine plus a push of the blood, the baby continued to deteriorate. I knelt beside the mother, put my hand on her shoulder, and asked her to listen. She immediately stopped her wailing and looked me in the eye. I told her that her baby was dying, that we were going to stop CPR as it was not working, and that her baby’s brain had been irreversibly damaged. She nodded in agreement.

“Stop,” I said. The scene instantly shifted from the hustle and bustle of a code to a stony silence pierced only by the sobs of the mother whom the nurses had assisted into a recliner chair. The monitor was turned off, the ventilator and lines were disconnected, syringes and other debris were removed from the bed, and the baby was wrapped in a blanket and placed in mom’s arms. The nurses began their familiar postmortem care routine. The fellow auscultated the baby’s chest and confirmed the death.

We returned to the workroom and ate Chinese takeout. I had cashew shrimp. I conducted a debrief during our meal, asking everyone how they felt. The intern was visibly shaken, with a tear trickling down her cheek. It was July, and this was the first death of a patient in her charge since she had become a real doctor. “His life slipped through my hands when you told me to stop,” she said. One of the upper-level female residents hugged her as she sobbed for a while before regaining her composure and resumed picking at her food.

For myself and the fellow, this death was one of many, but each death is new all over again and is a fresh reminder of our human frailty.

Few outside our world would understand a situation like this. We were eating while a baby had just died and a mother was grieving. For her, life had just changed forever. For us, we had to nourish ourselves to have the strength to continue caring for the living. Nothing taught in medical school can prepare one for these moments. They must be experienced first-hand, processed, and reflected upon. Doing so is what gives us the strength to move forward.

Source:https://www.neonatologytoday.net/newsletters/nt-feb25.pdf

Physician Health – By Georgia Garvey, Contributing News Writer  Mar 18, 2025

Good health care leaders realize that physicians need more than free food and thank yous to thrive. Well-meaning expressions of appreciation that do not address the root cause of burnout or stress cannot alleviate physicians’ stress or stave off burnout the way that truly feeling valued can.

But it takes more than knowledge to change a work environment—it takes concrete action.

“Many leaders know the importance of teamwork and communication,” said Jill Jin, MD, MPH, an internist and senior physician adviser for professional satisfaction and practice sustainability at the AMA. “But where they kind of struggle is, how do you actually support the individual at a level that is meaningful for them?”

Dr. Jin discussed “muffin rage,” a phrase that came about as a result of a 2021 Los Angeles Times op-ed by Jillian Horton, MD, when she—deep in the throes of work-related burnout and distress—happened upon a “resident appreciation” event handing out muffins. 

“Muffin rage is what we feel when there is a vast chasm between our actual needs and what another person or an institution thinks we need,” Dr. Horton wrote.

Dr. Jin spoke alongside Jane Fogg, MD, MPH, physician director of organizational transformation for the AMA, in a recent webinar on how health care organizations can make doctors feel valued, which highlighted an AMA STEPS Forward® playbook on the topic.

During the event, Drs. Jin and Fogg touched on some of the ways that health systems, organizations and leaders can take actions that will make physicians feel valued in a way that avoids muffin rage, a crucial effort with implications for physician well-being, burnout and even the quality of patient care.

Understand feeling valued, burnout link

Physician burnout rates have fallen somewhat from their historic highs during the COVID-19 public health emergency, but too many physicians continue to suffer its damaging effects. And when physicians quit or cut back their hours due to overwork and overstress, the impact is felt by patients and colleagues. 

In fact, physician turnover can cost organizations anywhere from $500,000 to $1 million or more for every physician who leaves. 

“Aside from it being the humane thing to do, there is also a financial benefit—a business case—for investing in your people,” Dr. Jin said. 

For those looking to lessen the load on physicians, a key avenue to pursue is helping them understand the crucial role they play in their organization. Dr. Jin pointed out that research shows feeling valued correlates strongly with lower burnout rates, mentioning a 2022 study published in JAMA Health Forum that found physicians who felt valued had a 37% burnout rate, compared with 69% for those who did not.

As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.

Help physicians know their worth

Once the importance of feeling valued as a key mitigator for physician burnout has been understood, Drs. Jin and Fogg said, the next step is determining what, exactly, helps physicians know and understand their worth in an organization.

Instead of superficial gestures like the one described in Dr. Horton’s piece, Dr. Jin said there are ways to effectively communicate gratitude to physicians. Those ways have much more to do with actions than with words.

Some key ways to show doctors they are valued, as described by Drs. Jin and Fogg, were to support: 

  • Schedule flexibility and autonomy.
  • Paid time off (PTO).
  • Professional development.
  • Individual resilience and self-care.
  • Care during and after trauma.

Make work-life balance a priority 

Often it can be difficult to justify costly changes aimed at improving physicians’ work conditions, said Dr. Fogg, but overwork and lack of autonomy in matters such as scheduling result in burnout, which is even more expensive. 

“Productivity is a pressure that we often feel because of falling revenues across the health care landscape,” she said. “With pressure to fill our schedules, we can lose valuable time for our continuity patients. This tension between being productive and being available to our own patients often lies in how we design and manage our schedules.” 

The key, Dr. Fogg said, is giving doctors the ability to “co-design the scheduling processes with their operational team. Make sure you partner with operational leaders to have a physician voice in designing the optimal schedule system for patient access, continuity, and work life balance.”

PTO is another area of concern for organizations looking to create a culture of value, Dr. Jin said.

Health care leaders can be role models in taking time off themselves, and organizations can proactively block off vacations, celebrate time off and resist the impulse to praise working while out of the office. Physicians’ responsibilities should also be fully covered when they’re on vacation, and compensation models and appointment schedules should take PTO into account

Support the physician as a person

To show a physician that they are more than just a cog in the machine, their professional development must be supported, recognizing their individual aspirations and passions beyond the clinical practice of medicine. 

“Feeling valued means the people around you—your supervisor in particular—know who you are, what excites you and what makes you passionate” outside the confines of the clinic or hospital corridor, Dr. Fogg said. “Asking physicians about their long-term goals and offering opportunities to get involved in a variety of activities outside of clinical practice can create a stronger sense of feeling valued. Some opportunities for growth include teaching, research, process improvement initiatives, leadership, community engagement and more.

And, said Dr. Jin, while “self-care” is not a replacement for—and should not be the major focus of—systemic efforts to reduce burnout, organizations can support an individual’s resilience by helping physicians set boundaries, prioritize tasks and limit their distractions. Leadership also should provide resources for and support physicians in self-care, promote collegiality and create spaces for breaks.

Health care organizations should address both individual and collective trauma, Dr. Fogg said, by creating peer-support programs and providing confidential mental health services. They should consider developing develop suicide-prevention plans and response teams in some situations.

Additionally, the credentialling process should remove questions about mental health care so they don’t discourage physicians from seeking care if needed. 

“Burnout is not a sign of mental illness, but there is a lot of overlap that happens when we are severely distressed by the way in which we’re practicing and what we’re witnessing in our practices,” she said.

For more information on this and other topics, explore the AMA STEPS Forward open-access toolkits and playbooks, which offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent burnout, create the organizational foundation for joy in medicine and improve practice efficiency. 

Combat physician burnout

Event: American Conference on Physician Health (ACPH) Sept. 11-13, 2025, focusing on steps organizations can take to improve physician well-being

CME: How health systems can reduce physician burnout

Calculate: See the cost of physician burnout to your organization

Video: Latest trends in physician burnout by specialty

Playbook: Wellness-centered leadership

Source: https://www.ama-assn.org/practice-management/physician-health/4-actions-health-leaders-must-take-show-doctors-they-are

Original Investigation  Pediatrics  November 20, 2024

Asma M. Ahmed, PhD, MD, MPH1Sonia M. Grandi, PhD, MSc2Eleanor Pullenayegum, PhD, MA2; et alSarah D. McDonald, MD, MSc3Marc Beltempo, MD, MSc4Shahirose S. Premji, RN, PhD, MScN5Jason D. Pole, PhD, MSc6Fabiana Bacchini, MSS7Prakesh S. Shah, MD, MSc8Petros Pechlivanoglou, PhD, MSc2

JAMA Netw Open. 2024;7(11):e2445871. doi:10.1001/jamanetworkopen.2024.45871

Key Points

Question  Do individuals born preterm have a higher risk of short-term and long-term mortality compared with those born at term?

Findings  In this cohort study of 4 998 560 births, individuals born preterm had a higher risk of mortality from birth to age 36 years, with the highest risk observed from birth through early childhood. The risk of mortality varied by gestational age at birth and was more pronounced at lower gestational ages.

Meaning  The findings of this study suggest that preterm birth is associated with increased risk of death from infancy to adulthood.

Abstract

Importance  Preterm birth (PTB) is a leading cause of neonatal mortality. However, evidence on mortality beyond the neonatal period is limited, especially in North America.

Objective  To examine associations of PTB with all-cause and cause-specific mortality from birth through 23 to 36 years of age.

Design, Setting, and Participants  This population-based matched cohort study of live births in Canada included individuals born between January 1, 1983, and December 31, 1996, and followed up until December 31, 2019. Data were analyzed from June 1, 2023, to April 30, 2024.

Exposure  PTBs, between 24 and 37 weeks’ gestation (with gestational age [GA]-specific subcategories of 24 to 27 weeks, 28 to 31 weeks, 32 to 33 weeks, and 34 to 36 weeks) compared with term births (37-41 weeks’ gestation).

Main Outcomes and Measures  All-cause mortality and cause-specific mortality were the main outcomes. Risk differences (RDs) and risk ratios (RRs) were estimated for all-cause mortality using log-binomial regressions and hazard ratios were estimated for cause-specific mortality using Cox proportional hazards regression models (censoring individuals who died from other causes) within prespecified age intervals (ages 0-11 months and ages 1-5, 6-12, 13-17, 18-28, and 29-36 years). Observed confounding was accounted for using coarsened exact matching on baseline characteristics.

Results  Of 4 998 560 births (54.2% male), 6.9% were born preterm (with GA-specific subcategories of 0.3% born at 24-27 weeks, 0.6% at 28-31 weeks, 0.8% at 32-33 weeks, and 5.1% at 34-36 weeks). During a median of 29 years of follow-up, 72 662 individuals died (14 312 born preterm and 58 350 at term). PTB was associated with an increased risk of death in all age intervals, with the highest RDs and RRs from birth through infancy (ages 0-11 months) (RD, 2.29% [95% CI, 2.23%-2.35%]; RR, 11.61 [95% CI, 11.09-12.15]) and in early childhood (ages 1-5 years) (RD, 0.34% [95% CI, 0.31%-0.36%]; RR, 2.79 [95% CI, 2.61-2.98]) and the lowest RDs and RRs among those between ages 18 and 28 years (RD, 0.07% [95% CI, 0.04%-0.10%]; RR, 1.13 [95% CI, 1.07-1.19]). We identified increased risks of mortality associated with several causes, including respiratory, circulatory, and digestive system disorders; nervous system, endocrine, and infectious diseases; cancers; congenital malformations; and conditions originating in the perinatal period. No associations were found for external causes of deaths. Associations by GA categories suggested lower risks with higher GA.

Conclusions and Relevance  The findings of this population-based matched cohort study suggest that individuals born preterm were at an increased risk of death from birth until their third and fourth decades of life, with higher risks as GA decreased. Some of these associations may have been partly due to underlying health determinants that affected PTB and mortality. These findings suggest that PTB should be recognized as a risk factor for mortality and could inform preventive strategies. 

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2826512?widget=personalizedcontent&previousarticle=0

EDITORIAL article Front. Pediatr. , 12 January 2025 Volume 13 – 2025 | https://doi.org/10.3389/fped.2025.1552262

This article is part of the Research Topic What is new on the Horizon in Neonatology? Recent Advances

Minesh Khashu1Karel Allegaert2,3,4*

  • 1Department of Neonatology, University Hospitals Dorset NHS Foundation Trust, Dorset, United Kingdom
  • 2Department of Development and Regeneration, KU Leuven, Leuven, Belgium
  • 3Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
  • 4Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Netherlands

Introduction

Neonates and infants are commonly referred to as “therapeutic orphans” due to the overall scarcity of therapeutic interventions that have been developed and tailored to their needs and specific characteristics (12). This is well known by care providers and researchers active in this field, but is perhaps less on the radar of authorities, funding bodies or the broader public. There is significant health inequity when comparing newborns to other age populations in terms of specific drug and device development and therapeutics (12). In addition there are health inequities in the provision of neonatal care globally which require special attention in terms of improvement (3).

Bronchopulmonary dysplasia, neonatal seizures, poor growth, necrotizing enterocolitis (NEC) and short bowel, hypoxic-ischemic encephalopathy, retinopathy of prematurity (ROP), neonatal infections and sepsis hereby serve as a non-exhaustive list of “orphan conditions” in need of more equity, through adequately and urgently funded research and improvement.

The good news is that there have been increased efforts, in recent years, by researchers and regulatory bodies to focus on the provision of drugs, devices, and treatment modalities tailored for neonatal use, while further advocacy remains an obvious need (245). This brings perspective and explains the initiative taken to organize a focused research topic on what is on the horizon as well as recent advances.

Overview of the topics covered

We targeted emerging or new aspects related to monitoring, diagnostics and therapeutics in neonatal care for the current research topic. Fortunately, this research topic was perceived as very relevant by the research community, as 135 authors expressed their interest as contributors, resulting in 20 accepted papers. This serves as a signal of the importance to continue to work on this topic.

Post-hoc, and in a somewhat arbitrary way (because of overlap in these subcategories) these papers were subdivided by the editors into different subcategories, with focus on (1, 5 papers) perinatal biomarkers in blood and urine and how these relate to or predict outcomes, (2, 6 papers) adaptations of existing and newly emerging equipment in neonatal units, (3, 3 papers) needed advances in pharmacotherapy, (4, 3 papers) machine learning or deep learning applications in neonatal care, and finally, (5, 3 papers) underreported aspects of contemporary NICU care, with a focus on the holistic nature of care for the infant and the family.

Perinatal biomarkers in blood and urine and how these relate to or predict outcomes

Two papers focused on biomarkers related to gestational diabetes, with reflections and data on maternal and neonatal outcomes. Postnatal maternal levels of glycated albumin and hemoglobin A1c in mothers of large-for-gestational-age (LGA) informed us of the relevance of accurate diagnosis during pregnancy. This is because postpartum women without diagnosis during pregnancy had higher glycated albumin values, associated with LGA and associated complications (Železnik et al.). Interestingly and related to this paper, Yin et al. reported on a untargeted metabolomics study in women with gestational diabetes, with the recommendation of a maternal serum metabolite panel to forecast neonatal adverse outcomes (hypoglycemia and macrosomia) (Yin et al.).

Other papers focused on the use of vitamin D, acid-base and biomarkers associated with fetal growth restriction with impaired neurodevelopmental outcome. In a cohort of 217 preterm neonates, a multivariate regression analysis identified antenatal steroids as protective, and lower birth weight, duration of ventilation, sepsis and the serum 25-(OH)D vitamin as risk factors to develop ROP (Yin et al.). Musco et al. reported on a systematic review on blood biomarkers indicating risks of adverse neurodevelopmental outcome in fetal growth restricted infants (Musco et al.). While the authors retrieved some data on neuron specific enolase and S100B, the overall conclusions reflect a call for further research. Finally, an association between lactate levels in umbilical cord blood and cerebral oxygenation in preterm neonates was studied as a secondary outcome analysis (Dusleag et al.). In non-asphyxiated preterm neonates with respiratory support, lactate levels were negatively associated with cerebral and arterial oxygenation. In term neonates without respiratory support, no associations were observed.

Adaptations of existing and newly emerging equipment in our units

In a review on emerging innovations in neonatal monitoring, Krbec et al. concluded that there is an urgent, still unmet need to develop wireless, non- or minimal-contact, non-adhesive technology, capable to integrate multiple signals in a single platform, tailored to neonates (Krbec et al.). Related to this call of action, Svoboda et al. reported on their pilot experience with contactless assessment of heart rate, applying imaging photoplethysmography (Svoboda et al.). Rectal and axillary temperature monitoring on admission were compared in a cohort of preterm (n = 80, <32 weeks gestational age) by Halabi et al., reporting that rectal measurement was likely more reliable in the event of hypothermia (Halabi et al.). Ultrasound-guided measurement of anterior cerebral artery resistive index in the first week of life in 739 preterm neonates (<35 weeks) was not associated with subsequent co-morbidities on admission or during neonatal stay (asphyxia, sepsis, NEC) (Singh Gill et al.). A case series of neurally adjusted ventilatory assist to rescue pulmonary interstitial emphysema in 5 extremely low birth weight infants illustrated the potential value of this ventilatory equipment and strategy and need for further study (Chen et al.). Finally, van Rens et al. compared a conventional to a modified Seldinger technique (a dedicated micro-insertion kit) for peripherally inserted central catheter (PICC) placement, illustrating the relevance of developing “low risk, high benefit” type of medical devices, adapted to the specific needs of neonates (van Rens et al.).

Advances needed in pharmacotherapy

The currently available medicines and dosing regimens in neonatal care are limited and there is an urgent need for improvement in this domain. This was illustrated by articles on sepsis, septic shock and steroids. Inequity in provision of neonatal care across the globe ought to be a major focus of improvement. Gezahegn et al. described the outcome in neonates admitted with sepsis in Harar (Ethiopia). Low white blood cell count, desaturation, preterm birth, absence of prenatal maternal care, and chorioamnionitis were important risk factors for sepsis-related mortality (Gezahegn et al.). Addressing these prognostic factors hold the promise to act as levelers to improve outcomes. A pilot study compared noradrenaline and adrenaline as first line vasopressor for fluid-refractory sepsis shock (Garegrat et al.). Both interventions were comparable to resolve the septic shock, while the overall mortality (13/42, 30%) remained significant, highlighting the need for better diagnostic and therapeutic options. Finally, in a systematic review, outcome of postnatal systemic corticosteroids (hydrocortisone to dexamethasone) were compared as reported in randomized controlled trials (Boscarino et al.). The authors concluded that dexamethasone appeared to be somewhat more effective than hydrocortisone in improving respiratory outcomes, but with inconclusive but relevant concerns on the uncertainties on long-term neurodevelopmental outcome, again highlighting the need for better therapies for prevention and management of chronic lung disease of prematurity.

Machine learning or deep learning applications in neonatal care

Artificial intelligence is a rapidly advancing area with fast evolving clinical applications in healthcare, including in the NICU (6). It is no surprise that the current research topic also contains papers illustrating its relevance to improve our practices and outcomes. Two papers hereby focused on NEC, and a 3rd paper on prediction of significant patent ductus arteriosus (PDA). In a mini-review, Cuna et al. reports on the various pathophysiological processes underlying NEC endotypes, and how artificial intelligence holds the promise to influence further understanding and management (Cuna et al.). An approach to enhance surgical decision making in NEC is illustrated by Wu et al. Based on x-rays from 263 neonates diagnosed with NEC (94 surgical cases), a binary diagnostic tool was trained and validated, with Resnet18 as approach applied (Wu et al.). For PDA, an ultrasound-based assessment of ductus arteriosus intimal thickness in the first 24 h after birth was applied in 105 preterm neonates. A prediction model for closure on day 7 included birth weight, mechanical ventilation, left ventricular end-diastolic diameter, and PDA intimal thickness (Hu et al.). Such models can be considered to better target future study, integrated in a precision medicine approach. Use of AI and big data have the potential to significantly improve our understanding of neonatal conditions and also support neonatal researchers in asking better research questions.

Underreported aspects of contemporary NICU care, holistic care

As part of this research topic, we also accepted papers reporting on the use of music on pain management, on multisensory stimulation to improve maternal milk volume production, and parents’ experiences related to congenital cardiac surgery. All these 3 papers reflect the need for holistic care and to further integrate the perspectives of (former) patients and parents into neonatal practice.

In a systematic review, Ou et al. demonstrated that music is an effective intervention to relief procedural pain (e.g., Premature Infant Pain Profile score) in preterm neonates, as it reduced some markers of stress, and improved blood oxygen saturation (Ou et al.). Multisensory stimulation (audiovisual, or audiovisual + olfactory) compared to a control setting improved maternal milk volume production, with evidence of positive effects of both interventions, even more pronounced if both interventions are combined (Cuya et al.). Finally, a quantitative analysis of parent’s experiences with neonates admitted to NICU with a congenital heart disease reinformed us on the importance of actively focusing on parental experiences of care (Catapano et al.).

From advances in neonatal care to implementation

In our opinion, this research topic nicely illustrates the diversity in ongoing clinical research activities, that all hold the promise to improve our clinical management practices, with the overarching aim to improve neonatal outcomes. There is an urgent need to focus on the current health inequities in the provision of care to neonates (3). The trend towards a “neuro” dedicated NICU care is an illustration on how relevant progress may occur. This progress is based on improved neuromonitoring techniques (7), improved management and precision medicine in the field of anti-epileptic drugs (8), and integrating families as partners in neonatal neuro-critical care and similar improvement programs (9). The good news is that we are already experiencing a shift in the right direction. The neonatal community and all other relevant stakeholders need to work better together to improve the pace and scale of this improvement.

Source: https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2025.1552262/full

Sprecher, Alicia MD; Roeloffs, Kimberly NNP; Czarnecki, Michelle L. APN; Labovsky, Kristen MD; Kissell, Anna PharmD; Hornung, Genesee MSN, RN; Uhing, Michael MD Editor(s): Dudding, Katherine PhD, RN, RNC-NIC, CNE; Nist, Marliese D. PhD, RNC, Section Editors Advances in Neonatal Care 25(1):p 18-27, February 2025. | DOI: 10.1097/ANC.0000000000001234

Abstract

Background: 

Postoperative pain management in the neonatal period is an area of high variability and a source of staff dissatisfaction. Pain management is a key component of high-quality care; however, pain assessment in infants is difficult and analgesics can negatively impact the developing brain.

Purpose: 

We aimed to improve postoperative pain control for infants in our neonatal intensive care unit (NICU), limit variability in the approach to pain management, and increase staff satisfaction.

Methods: 

This project was completed between April 2019 and March 2022 with sustainment tracked through December 2023. Interventions took place in a 70-bed level IV NICU using quality improvement methodology. Interventions included efforts aimed at improving pain assessment as well as development and implementation of a pain management guideline. Outcome measures included frequency of uncontrolled postoperative pain and measures of staff satisfaction. Process measures included compliance with pain assessment cadence and guideline recommendations. Opioid exposure within 24 hours of surgery was included as a balancing measure.

Results: 

Pain management was assessed in 811 infants: 392 prior to guideline implementation, 273 during implementation, and 146 during sustainment period. Uncontrolled postoperative pain decreased from 26% pre-implementation to 18% post implementation and into the sustainment period. Staff satisfaction improved from 67% to 83%. These improvements were associated with decreased variability in postoperative pain management and a decrease in postoperative opioid exposure.

Implications for Practice and Research: 

The use of a postoperative pain management guideline can improve pain control, decrease drug regimen variability, decrease opioid exposure, and increase staff satisfaction.

Source:https://journals.lww.com/advancesinneonatalcare/abstract/2025/02000/a_nicu_postoperative_pain_management_improvement.5.aspx

Health Care Heros – Environmental Service Workers

Healing Forward: Health & Wellness

In Singapore, where skyscrapers rise and medicine meets innovation, a new kind of wellness journey is unfolding—one led by the smallest among us.

Our Womb Warriors who began life in the NICU are not just survivors—they are thrivers, growing through challenges and emerging with strength forged in the most fragile beginnings. Today, health and wellness for these preemie survivors extends far beyond the hospital walls. It means developmental follow-up, skin-to-skin care, nutrition support, and emotional well-being—not just survival, but quality of life.

Singapore’s approach is inspiring. With personalized risk assessments, neurodevelopmental care programs, and parent-empowering tools like kangaroo care, the wellness journey begins from day one. And studies now confirm what many NICU parents already knew in their hearts: the closeness, love, and presence of family are as powerful as any machine.

As our Warriors grow, their wellness becomes more than a checklist—it becomes a rhythm. Physical therapy. Play. Sensory exploration. Nourishment. Love. And for the parents walking beside them? Wellness looks like deep breaths, long walks, and the quiet courage to ask for help.

Whether your little one is a few months or a few years out of the NICU, this season is a reminder: wellness isn’t a destination—it’s a daily act of love.

Spring into Strength

Spring is a season of becoming—of blooming boldly, stretching softly toward the light, and waking up to what’s possible. For our Womb Warriors, it’s also a reminder that wellness is not about perfection—it’s about progress, presence, and power.

Whether you’re a preemie kid discovering new abilities, a teen navigating your story, or an adult survivor reclaiming your narrative, this season invites you to grow on your terms. Your early beginnings may have been fragile—but your spirit is anything but.

Health and wellness don’t have to look the same for everyone. What matters most is listening to your body, honoring your journey, and celebrating how far you’ve come.

🌸 For Kids

  • Make movement magical—build obstacle courses, splash in puddles, or stretch like your favorite animal.
  • Explore foods that help you grow strong: yogurt parfaits, rainbow fruit plates, or protein-packed pancakes.
  • Practice deep breathing with bubbles or belly-breathing “dragon breaths.”

🌱 For Teens

  • Journal your thoughts under a tree or start a mood-boosting playlist for mental clarity.
  • Try out yoga, trail walks, or a new sport—your strength isn’t defined by speed, but by showing up.
  • Fuel yourself with purpose: balanced snacks, hydration, and sleep that heals.

🌞 For Adults

  • Redefine strength: maybe it’s finishing a workout, setting boundaries, or resting when you need to.
  • Revisit your NICU beginnings—use them to empower your healthcare choices and connect with your past.
  • Create a spring ritual: a morning stretch, a quiet walk, or a personal mantra. Wellness isn’t trendy—it’s transformative.

In Singapore, hospitals are leading the way in early screenings and personalized care to help preemies not just survive, but thrive. That same spirit of innovation and renewal lives in each of us.

So here’s to you—this spring, let’s grow wildly. Heal gently. Thrive loudly.
Because once a Neonatal Womb Warrior, always a Warrior—and you are in full bloom.

Wellness is a journey. In this insightful talk, learn about the PATH model: Perception, Analysis, Trial and Error, and Habits, as a framework for achieving personal well-being. This talk empowers audiences to embrace the process and find a path to a healthier, more fulfilling life. Hi everyone, I’m Alysha! I am a student in grade 11 and I’m one of the speakers for TEDEd’s Empowerment event. Having been part of the club since grade 9 and now as president, I’m really excited to share my talk with everyone! I’ll be talking about wellness and taking autonomy over your own mental health. I’m super excited that this is our first charitable event and can’t wait to see you all there!

10-minute guided meditation for kids 🧘 mindfulness for kids 🕊 Bye Bye Worry Balloons🎈 Worry-Free 💛

Relax, breathe, and feel calm with this simple meditation for kids. In this guided meditation for kids, we’ll say ‘bye-bye’ to worries and hello to happy thoughts. ☀️🎈

Mr. Hassell’s Brain Breaks

Exercise your body and mind with this Spring themed brain break! In this fun and engaging workout video, we play a game of “Would You Rather” by picking our favorite Spring choices and performing exercises!! Perfect for a PE warmup, classroom brain break and at home workout!

Written by published children’s author, Jennifer Marino Walters, “Surprising Spring” tells the simple story of the beauty that Spring brings and its many flowering surprises.


[OFW] WAVEHOUSE Sentosa | Surfing in Singapore

5 years ago     Renan El Viajero

Wave House Sentosa located on the sandy beaches of Sentosa is Asia’s only installation in an archipelago of global Wave Houses that stretches from Durban in South Africa, San Diego in California, Santiago in Chile, and Mallorca in Spain. Singapore has long been a crossroads for surfers seeking the perfect waves at beaches around Southeast Asia, however the island itself lacks the giant waves which surfers long for. With its opening, Wave House Sentosa puts Singapore on the global surfer destination map with its perfect and world famous 10′ FlowBarrel wave.  

Horizons, ND Impairment, Parent Personalization

Slovakia,  officially the Slovak Republic,  is a landlocked country in Central Europe. It is bordered by Poland to the north, Ukraine to the east, Hungary to the south, Austria to the west, and the Czech Republic to the northwest. Slovakia’s mostly mountainous territory spans about 49,000 km (19,000 sq mi), hosting a population exceeding 5.4 million. The capital and largest city is Bratislava, while the second largest city is Košice.

Slovakia is a developed country with an advanced high-income economy. The country maintains a combination of a market economy with a comprehensive social security system, providing citizens with universal health carefree education, one of the lowest retirement age in Europe and one of the longest paid parental leaves in the OECD.  Slovakia is a member of the European Union, the Eurozone, the Schengen Area, the United NationsNATOCERN, the OECD, the WTO, the Council of Europe, the Visegrád Group, and the OSCE. Slovakia is also home to eight UNESCO World Heritage Sites. The world’s largest per-capita car producer, Slovakia manufactured a total of 1.1 million cars in 2019, representing 43% of its total industrial output.

Healthcare in Slovakia has features of the Bismarck, the Beveridge and the National health insurance systems. It has public health system paid largely from taxation. The cost of national health insurance is shared between the employees and the employers. The part of these taxes are paid by the employees as a deduction from theirs wages and the remaining part of these taxes is paid as compulsory contribution by employers. Sole traders pay the full amount of these taxes.  

These taxes are managed by health insurance companies. Current healthcare system has 3 health insurance companies, namely Union (12,4%), Dôvera (32,4%) and Všeobecná zdravotná poisťovňa (55,2%)(market share). Všeobecná zdravotná poisťovňa is a state-run insurance company, the other two are private. These insurance companies have contracts with outpatient clinics, hospitals, rehabilitation centres, pharmacies, etc. Despite this, not everywhere and not always the insurance company covers the costs. The costs are not covered for all medicines, or the full price of them. Also, it is not covered dental treatment.

The government pays health insurance for children, students, pensioners, invalids, people performing activities for a church, religious or charitable community, etc.

Source: https://en.wikipedia.org/wiki/Slovaki

CR’s experts say it’s much safer for children to wear their winter coat backward and on top of their car seat harness.

“You better bundle that baby up or she’s going to catch a cold!” I knew before I turned around what was happening: The well-meaning lady in the grocery store parking lot wanted to know why my child didn’t have a coat on in her car seat, even though it was the middle of winter.

The reason? Because a bulky coat and a child car seat can be a dangerous combination. As a general rule, winter coats should not be worn underneath a car seat harness because that can leave the harness too loose to be effective in a crash. 

Source: https://www.consumerreports.org/babies-kids/car-seats/the-dangers-of-winter-coats-and-car-seats-a5483582251/

Author affiliations – Naomi R Hemy1 Amber Bates1 Belinda Frank2 Anne McKenzie2 Shannon J Simpson1 3

Abstract

Background It is essential to embed patient and public perspectives into every stage of the research journey, including setting the future research agenda. The substantial gaps in our understanding of prematurity-associated lung disease presented a timely opportunity to determine the community’s research priorities.

Objective To conduct a priority setting partnership (PSP) to determine the top 10 research priorities for preterm lung health.

Design We undertook a modified James Lind Alliance methodology comprising three main stages: (1) an idea generating survey with open questions to ascertain the community’s most important ideas for future preterm lung health research, (2) prioritisation survey to distill the main themes into a shortlist of 20 and (3) consensus workshop where participants were tasked with ranking their final top 10. This PSP is reflective of the view of preterm-born individuals, parents of preterm children and healthcare professionals in an Australian healthcare setting.

Results We collated 144 submissions from the idea generating survey from which 27 prioritisation themes were developed. From the 150 prioritisation survey responses, the 20 themes receiving the most votes were taken to the consensus workshop. Participants identified the following top 10: (1) lifelong impacts; (2) interventions, treatments or supports; (3) ongoing lung health follow-up; (4) diagnostic tools, resources and education for primary healthcare providers; (5) resources to inform and empower families; (6) relationship to physical health and developmental issues; (7) preventing and/or treating lung infections; (8) additional supports, resources and research for minority groups; (9) impact on mental well-being; and (10) likelihood of asthma diagnosis.

Conclusion Priorities identified through the PSP will be invaluable in informing future research into prematurity-associated lung disease.

Full Study-https://bmjpaedsopen.bmj.com/content/9/1/e003050

Posted on 27 January 2025 by Keith Barrington

Neonatal Research

Following important research in neonatology / newborn medicine from around the world

I have written frequently about my concerns with “NDI” as an important measure of neonatal outcomes, indeed, it seems to be often thought of as if it were the only important measure. It has very often been included as part of a composite outcome measure “death or NDI”.

So why am I disturbed about the use of NDI as a primary outcome measure? NDI is itself already a composite measurement, including some indicator of delayed development (most commonly one of the various iterations of the Bayley Scales of Infant Development), some severity of motor disorder expected to be permanent, i.e. Cerebral Palsy, some severity of hearing loss, and some severity of visual impairment. It was a composite invented by neonatologists and follow up specialists as a way of trying to quantify the impacts of adverse cerebral impacts of prematurity. There are many problems with this, both in the actual importance of each component of NDI, and also in the permanence of the finding. For example, most infants with low scores on developmental screening tests at 2 years do not have intellectual impairment at follow up. In the follow up of the CAP trial, for example, only 18% of babies who had a low Bayley score at 18 months (version 2 MDI <70) actually had a low IQ at 5 years (WPSII <70). This is unlike CP, for which a diagnosis at 2 years is very accurate (not 100%, but appears to be about 95% PPV) as a predictor of long term motor dysfunction, but the severity of the problem can vary, especially after a diagnosis at 2 to 3 years, where about 1/3 of infants will change their classification on the GMFCS, either to a higher or a lower score. Visual and auditory impairments seem to be more permanent and invariable, but are a much smaller part of the NDI.

And, of course, combining NDI with death as part of a composite outcome implies that they are equally important, and means that an intervention which decreases death may not be found to be significant is there is an increase in low BSID scores in the survivors (for example).

Do parents of babies who are labelled as having NDI think that their infants are impaired? That is the question asked in a new publication from the follow up centres across Canada (Canadian Neonatal Follow-Up Network, CNFUN). Richter LL, et al. Parental and Medical Classification of Neurodevelopment in Children Born Preterm. Pediatrics. 2025. Over 1000 very preterm infants are involved in the study, and their parents were asked if they thought that their child had a developmental impairment when they attended a follow-up clinic appointment, but before they completed the standardised evaluation. They then had their evaluation and were classified as having no NDI or :

“to have a mild-moderate NDI if they had any 1 or more of the following: CP with GMFCS 1 or 2; Bayley-III motor, cognitive, or language composite scores 70 to 84; hearing loss without requirement for hearing devices or unilateral visual impairment. A child was considered to have a severe NDI if they had any 1 or more of the following: CP with GMFCS 3, 4, or 5; Bayley-III motor, cognitive or language composite scores <70; hearing aid or cochlear implant; or bilateral visual impairment.”

As this table shows, there was poor agreement between what the parents thought, and what the standardised evaluation stated. Most of the disagreements were parents considering their infants to not be impaired, or to be less impaired than the standard classification. There were 185 infants with “severe NDI” according to the definition above, only 23 parents thought their child was severely impaired, in contrast, among the 596 with no NDI, there were 11 parents who found their child to have severe impairment, and 104 thought they had mild-moderate impairment.

Some of the details of the analyses are quite interesting, for example, the small number of infants with serious CP, GMFCS 4 or 5, were mostly considered to have moderate or severe impairment by parents. The cognitive scores of infants who agreed that their infant, with CNFUN defined severe NDI, had at least moderate impairment were lower (median 70) than those who disagreed (median 80).

Many problems faced by families with ex-preterm infants are not captured by “NDI”. This is reflected, I think, by those parents who thought their child was impaired despite not satisfying CNFUN definitions, such infants were much more likely to be using technology at home, and more likely to have been referred for occupational therapy, or to see a psychologist or other therapist. Needing re-hospitalisation also made parent more likely to agree that their infant had an impairment.

Because we haven’t measured some of the things that impact families, such as behavioural disturbances, feeding problems, and sleep disruption, we really don’t know if they are affected by any of our NICU interventions. It wouldn’t surprise me if some interventions, ranging from postnatal steroids to skin-to-skin care or light cycling, might have major impacts on those outcomes. We just don’t know.

What should we do about findings such as these newly published data, and others from the Parents’ Voices project? Defining a single ‘yes or no’ outcome variable is the old-fashioned way of designing research and determining the benefit of an intervention. There are much better ways of comparing outcomes between groups, ways which can take into account the variety of outcomes, and the preferences of parents. It takes some extra work to define the kind of ordinal outcomes which reflect the values of parents and the relative importance of each component, but that is hugely preferable to using composite outcomes which implicitly value each component as being equivalent. Being dead, having a Bayley Cognitive composite of 69, having severe visual loss all qualify as “dead or severe NDI”, but the implications are enormously different.

In the future outcomes we measure should focus on how infants function, and should recognize that the answer to the question “how is your child doing?” is not a dichotomous choice.

Source: https://neonatalresearch.org/2025/01/27/neurodevelopmental-impairment-who-decides-what-it-is/

Subhasish DasThomas McClintock, Barbara E. CormackFrank H. Bloomfield,Jane E. Harding & Luling Lin Pediatric Research volume 97, pages67–80 (2025)

Abstract

Background

Appropriate protein intake is crucial for growth and development in children born preterm. We assessed the effects of high (HP) versus low protein (LP) intake on neurodevelopment, growth, and biochemical anomalies in these children.

Methods

Randomised and quasi-randomised trials providing protein to children born preterm (<37 completed weeks of gestation) were searched following PRISMA guideline in three databases and four registers (PROSPERO registration CRD42022325659). Random-effects model was used for assessing the effects of HP (≥3.5 g/kg/d) vs. LP (<3.5 g/kg/d).

Results

Data from forty-four studies (n = 5338) showed HP might slightly reduce the chance of survival without neurodisability at ≥12 months (four studies, 1109 children, relative risk [RR] 0.95 [95% CI 0.90, 1.01]; P = 0.13; low certainty evidence) and might increase risk of cognitive impairment at toddler age (two studies; 436 children; RR 1.36 [0.89, 2.09]; P = 0.16; low certainty evidence). At discharge or 36 weeks, HP intake might result in higher weight and greater head circumference z-scores. HP intake probably increased the risk of hypophosphatemia, hypercalcemia, refeeding syndrome and high blood urea, but reduced risk of hyperglycaemia.

Conclusions

HP intake for children born preterm may be harmful for neonatal metabolism and later neurodisability and has few short-term benefits for growth.

Impact statement

  • Planned high protein intake after birth for infants born preterm might be harmful for survival, neurodisability and metabolism during infancy and did not improve growth after the neonatal period.
  • Protein intake ≥3.5 g/kg/d should not be recommended for children born preterm.

Conclusion (Full Study)

Planned high protein intake in the first weeks after preterm birth had few benefits and may be harmful for survival, neurodisability and biochemical abnormalities in neonatal care. However, there are few data beyond the toddler period and considerable unexplained heterogeneity. Longer-term follow-up and an individual participant data meta-analysis of existing trials, including data on total energy intake, would be helpful to clarify the effects of high protein intake for children born preterm.

FULL Article:https://www.nature.com/articles/s41390-024-03296-z

Marlyse F. Haward a, Antoine Payot b c, Chris Feudtner d e, Annie Janvier b c

Abstract

Communication with parents is an essential component of neonatal care. For extremely preterm infants born at less than 25 weeks, this process is complicated by the substantial risk of mortality or major morbidity. For some babies with specific prognostic factors, the majority die. Although many of these deaths occur after admission to the intensive care unit, position statements have focused on communication during the prenatal consultation. This review takes a more comprehensive approach and covers personalized and parent-centered communication in the clinical setting during three distinct yet inter-related phases: the antenatal consultation, the neonatal intensive care hospitalization, and the dying process (when this happens). We advocate that a ‘one-size-fits-all’ communication model focused on standardizing information does not lead to partnerships. It is possible to standardize personalized approaches that recognize and adapt to parental heterogeneity. This can help clinicians and parents build effective partnerships of trust and affective support to engage in personalized decision-making. These practices begin with self-reflection on the part of the clinician and continue with practical frameworks and stepwise approaches supporting personalization and parent-centered communication.

Section snippets

Part 1: Antenatal consultation

Current recommendations for the antenatal consultation focus on equalizing knowledge imbalances by providing parents with physician-derived sets of information to facilitate rational, data-driven choices.14 These information sets span short and long-term morbidities, survival and mortality statistics determined by physicians, with little input from parents. Although recommendationssuggest exploring values, they fall short in acknowledging the ‘process’ of relationship building.

Part 2. Communication during the neonatal hospitalization

Parent-centered communications during neonatal hospitalizations follows similar concepts. This section will add how continuity of care and ‘good parenting beliefs’ can help manage uncertainty, hope, and realism. We will consider the case of Ms. Gladwell.

Part 3. Dealing with death: the importance of a stepwise approach

Generally, for babies born at less than 25 weeks, neonatal death occurs relatively early when the infant does not respond to interventions, often within the first 3 days of life for the most immature babies.84 Other babies die when respiratory support is removed after death is judged inevatable, or for quality of life concerns.15 For parents like Ms. Gladwell, when death is not immediate, time permits knowledge to be acquired and values to be clarified influencing how choices are interpreted.

Conclusion

Parents and families will live with these experiences for the rest of their lives. How they remember the communication process and care their infants received depends on their perceptions of the relationships built with clinicians and their ability to ‘justify’ what happened within the context of their values. Behaviors that make them feel disrespected or their infant not valued can leave lasting impressions, whereas trusting partnerships solidifies their roles as parents.

Source:https://www.sciencedirect.com/science/article/abs/pii/S0146000521001658?via%3Dihub

Efficiently Natural    Jan 24, 2021   #medicalschool #residency #doctorcouple

Here’s another video in our Journey Through Medicine series where we talk about what it was like for us to have a child while both completing our medical residencies. There’s never a perfect time to have a child during medical training, but here’s how we made it work. #medicalschool #residency #doctorcouple

NatureNeonatal Neurocritical Care Series 19 December 2023

Abstract

The survival of preterm infants has steadily improved thanks to advances in perinatal and neonatal intensive clinical care. The focus is now on finding ways to improve morbidities, especially neurological outcomes. Although antenatal steroids and magnesium for preterm infants have become routine therapies, studies have mainly demonstrated short-term benefits for antenatal steroid therapy but limited evidence for impact on long-term neurodevelopmental outcomes. Further advances in neuroprotective and neurorestorative therapies, improved neuromonitoring modalities to optimize recruitment in trials, and improved biomarkers to assess the response to treatment are essential. Among the most promising agents, multipotential stem cells, immunomodulation, and anti-inflammatory therapies can improve neural outcomes in preclinical studies and are the subject of considerable ongoing research. In the meantime, bundles of care protecting and nurturing the brain in the neonatal intensive care unit and beyond should be widely implemented in an effort to limit injury and promote neuroplasticity.

Impact

  • With improved survival of preterm infants due to improved antenatal and neonatal care, our focus must now be to improve long-term neurological and neurodevelopmental outcomes.
  • This review details the multifactorial pathogenesis of preterm brain injury and neuroprotective strategies in use at present, including antenatal care, seizure management and non-pharmacological NICU care.
  • We discuss treatment strategies that are being evaluated as potential interventions to improve the neurodevelopmental outcomes of infants born prematurely.

https://www.nature.com/articles/s41390-023-02895-6

Leading Edge Seminars  May 23, 2017

Compassionate Inquiry is a psychotherapeutic method developed by Dr. Gabor Maté that reveals what lies beneath the appearance we present to the world. Using Compassionate Inquiry, the therapist unveils the level of consciousness, mental climate, hidden assumptions, implicit memories and body states that form the real message that words both express and conceal.

Your friend or family has finally brought their preemie baby home from the NICU, and you’re excited to meet their little miracle, but unsure of how to approach the family altogether.

Don’t worry, as long as you stick to these simple do’s and don’ts written by a preemie mom, visiting a premature baby will be a happy and smooth time for everyone!

Do Listen to the Preemie Parents’ Conditions (and Comply)

Before visiting a premature baby, ask the parents if they are ready to receive visits in their home. And under which terms.

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It’s not uncommon that when we take our babies home, the doctors impose a no visit rule until we can complete the first vaccination schemes (which more often than not include at least three shots of the Synagis shot.) The complete process can take up to three months.

We didn’t allow almost any visit from friends or family until my son was around four months old (2 months old adjusted), some of our friends were understanding, and some weren’t.

We knew that we were doing what was best for our son, so we stuck to it!

If your friend says it’s OK to visit their baby, find out if they have any special request for your visit.

Some of the petitions may seem weird but know that they come from a very real place (the NICU), and visiting a premature baby during her first months is much like visiting babies in the NICU: short and strict.

Some parents may ask you to keep your cell phones at the entrance of the house (phones are full of germs),  wash your hands for five minutes, visit straight from home, or tie your hair, take a shower just before visiting, or wear a surgical face mask. Whatever it is, by doing as they say you’ll help protect their baby and their peace of mind.

Do Bring Extra Clean Clothes for Interacting with the Preemie Baby

This is especially true if you are visiting a premature baby after being all day outside of your home.

The street is full of germs and contamination, and we preemie parents tend to develop a germ-vision.

By bringing freshly laundered clothes and changing into them as soon as you arrive at the house you are visiting you will show them that you are on their side, and support their every measure to keep their baby safe.

It is even more likely that they will let you hold the baby if you do this since she won’t be directly exposed to dirty clothes.

Do: Wash your Hands as Soon as you Enter, Wash your hands thoroughly.

Make sure you wash the space between your fingers, your palm, and the back of your hand.

You’ll be amazed to know the number of diseases we can avoid by just washing hands. Simple, right?

Even so, many of us neglect this standard practice.

When a baby is in the NICU, the nurses teach us parents about the importance of hand-washing, the correct techniques to do so, the right moment to do it. We wash our hands so frequently that we get rashes most of the time (since the NICU soap is strong.)

It is second nature to us to wash our hands when visiting babies!

Having said all this, once our babies are bigger and stronger, we’ll be a bit laxer about this. After all, germs do help develop the immune system, we just don’t want to expose our miracles before they are ready for this!

Do Keep the Visit Short and Simple

There will be time for the lengthy visits that you may be dreaming about. In the months and years to come, you’ll be able to kiss and smooch the baby to your heart’s content, and stay during weekends, afternoons, and evenings!

But right now, the preemie family may be in need of some alone time. And though seeing you will surely help them, keep your visit under 30 minutes if possible.

Most breastfeeding moms need time adjusting to… well…breastfeeding, but this is especially the case of us preemie moms. We came from pumping our way in the NICU to actually breastfeeding a baby. That transition takes time to get used to.

Additionally, like all new parents, we are most likely to be sleep-deprived. Partly because our babies wake us up all night and partly because of the monitors beeping or ourselves waking up to check that the babies are doing fine.

Keeping a short visit is a long time investment in your relationship with NICU families.

Don’t Go if You’re Not Feeling Well

If your head hurts, your throat is sore or your nose itches, reprogram your visit.

Even if you are feeling well but visited someone who has had the flu within seven days before your visit you may be carrying the virus, so it’s also best to reprogram.

RSV and pulmonary infections are dangerous for preemies.

Ollie had simple flu when he was 12 months old and turned into pneumonia and bronchiolitis in less than 24 hours. We had to rush him to the ER because he wasn’t breathing. He was in the hospital on oxygen for ten days until he recovered. The younger the baby, the higher the risk of infection.

We limited our visits to non-flu visitors until Ollie was well over 8 months. And, we still ask everyone who may be sick to wear a facemask. We don’t overprotect our son, he goes to crowded places and has had the flu several times by now at 24 months. But we still don’t want to risk it by letting someone with the flu hold him without wearing a facemask.

Don’t Hold the Preemie Baby

Unless the parents ask you to hold their baby, don’t press them into it.

You’ll have plenty of opportunities. Just make them feel comfortable by knowing that you are OK just looking at the baby. If they are comfortable with you holding her, they will let you know.

Also, to keep on the safe side, avoid kissing the baby and holding her hands.

Don’t Compare their Preemie to any Other Baby

As preemie parents, the greatest joy in the world comes with sorrow.

We love our baby and wouldn’t change him for anyone else, nor would we want him to be any different. So we try not to compare our baby to anyone else’s. But, sometimes it is inevitable, and we internally cave in.

My son looked like a newborn during his first four months. He didn’t smile until he was eight months old and had to go through weekly Physical Therapy to move his hands and arms. He is healthy, bright, and has no significant delay. But when the children of my friends were smiling, walking, and talking, he wasn’t, and it’s human nature to worry and to compare them.

It gets even worse when people pity my boy or openly compare him to others. It feels as if they are undermining us as if they don’t know or don’t care about our background.

A few months ago a fellow mom who has a son two months younger than Ollie (but bigger and heavier), raved on and on about how small and fragile my Ollie was. She held him without my permission and said that she remembered the times when her son was smaller. She went as far as to congratulate me for being so chill and not overprotecting him. He was evidently so weak (to her eyes.) She seemed to be following an anti-manual for visiting a premature baby.

Needless to say, I despised every second we spent together, and I’ve never seen her again.

Don’t Talk about other Full-Time Pregnancies

Us moms also grieve about the weeks that we should have been heavily pregnant and weren’t.

Sometimes I see other moms complaining about their heavy wombs. Begging for their babies to come early so that they can stop being feeling uncomfortable. I understand that they don’t know what they are saying, but it hurts.

My son was born at 31 weeks, which means that I missed out on nine weeks of pregnancy. Some women dream about their pregnancies their whole lives. They imagine them picture perfect, so we miss what we didn’t have. And in some cases, what we’ll never have.

So it’s better to play it safe and stay clear of that topic.

That’s a Wrap

I’m sure you’ll love visiting a premature baby. Take it one step at a time and be patient with us preemie parents. We do want what’s best for our children, even if sometimes it is hard to express ourselves.

Most of all, you’ll see how powerful and miraculous a person can be, no matter how small!

Have you visited a preemie recently? Are you planning a preemie visit? Or, are you a preemie parent and would like people to know how to plan their visits? Tell us all about it in the comment section!

Source: https://preemiemomtips.com/visiting-preemie-dos-donts/

By Jessica A. Stern, University of Virginia and Joseph P. Allen, University of Virginia

Posted on January 14, 2025

Empathy — the capacity to identify others’ needs and emotions, and to provide supportive care that meets those needs.

Our recent research shows that parents who express empathy toward their teenagers may give teens a head start in developing the skill themselves. In addition, adolescents who show empathy and support toward their friends are more likely to become supportive parents, which may foster empathy in their own offspring.

How we did our work

The KLIFF/VIDA study at the University of Virginia has tracked 184 adolescents for more than 25 years: from age 13 well into their 30s.

Starting in 1998, teens came to the university every year with their parents and closest friend, and a team of researchers recorded videos of their conversations. Researchers observed how much empathy the mother showed to her 13-year-old when her teen needed help with a problem. We measured empathy by rating how present and engaged mothers were in the conversation, whether they had an accurate understanding of their teen’s problem, and how much help and emotional support they offered.

Then, each year until teens were 19 years old, we observed whether teens showed those same types of empathic behaviors toward their close friends.

A decade later, when some of those same teens were starting to have children of their own, we surveyed them about their own parenting. We also asked them about their young children’s empathy. For example, parents rated how often their child “tries to understand how others feel” and “tries to comfort others.”

We found that the more empathic a mother was toward her teenager at age 13, the more empathic the teen was toward their close friends across the adolescent years. Among teens who later had kids themselves, the ones who had shown more empathy for close friends as adolescents became more supportive parents as adults. In turn, these parents’ supportive responses to their children’s distress were associated with reports of their young children’s empathy.

Why it matters

The ability to empathize with other people in adolescence is a critical skill for maintaining good relationshipsresolving conflict, preventing violent crime and having good communication skills and more satisfying relationships as an adult.

Adults want teens to develop good social skills and moral character, but simply telling them to be kind doesn’t always work.

Our findings suggest that if parents hope to raise empathic teens, it may be helpful to give them firsthand experiences of being understood and supported.

But teens also need opportunities to practice and refine these skills with their peers. Adolescent friendships may be an essential “training ground” for teens to learn social skills such as empathy, how to respond effectively to other people’s suffering, and supportive caregiving abilities that they can put to use as parents. Our lab’s most recent paper presents some of the first evidence that having supportive teenage friendships matters for future parenting.

What’s next

We’re continuing to follow these participants to understand how their experiences with parents and peers during adolescence might play a role in how the next generation develops.

We’re also curious to understand what factors might interrupt intergenerational cycles of low empathy, aggression and harsh parenting. For example, it’s possible that having supportive friends could compensate for a lack of empathy experienced from one’s family.

While it’s true that you can’t choose your family, you can choose your friends. Empowering teens to choose friendships characterized by mutual understanding and support could have long-term ripple effects for the next generation.

Source: https://youthtoday.org/2025/01/a-25-year-study-reveals-how-empathy-is-passed-from-parents-to-teens-to-their-future-children/

*We checked to  confirm these organizations are still active in February, 2025.There was only one resource we were unable to locate. We have also attached the website links!

It really does take a village for preemie parents by Kinsey Gidick Nov.24, 2020

Only the parents of a premature baby can understand the emotional toll it takes to care for such a fragile child. That’s why finding a community of parents and caretakers who have been through similar circumstances is so important. Fortunately, there are many online resources for parents experiencing the challenge of navigating the NICU and raising a premature baby, from preemie support groups to virtual counseling sessions to even social media accounts.

While each is different, the focus is the same: to provide a space where preemie parents can bring their worries, wins, and concerns to each other and get help and feedback from those going through the same situations. 380,000 babies are born before 37 weeks gestation each year in the U.S. per March of Dimes — that’s 1 out of every 10 American babies. That’s a lot of babies receiving extensive medical intervention including respiratory support, invasive treatments, and extended Neonatal Intensive Care Unit stays. In many cases, these spaces are like lifelines for parents who are afraid of not only the unknown, but the known as well.

Rather than shoulder that burden alone, preemie support groups offer all kinds of resources from chat rooms to virtual mentors, podcasts to classes. It’s the kind of care one won’t often find in a clinic or hospital — ongoing assistance a preemie parent can turn to whether a child is 3 weeks or 3 years old.

1. A space for NICU transition support

Graham’s Foundation, a not-for-profit support group based in Ohio, was founded with a mission that no one should experience prematurity alone. To that end, the organization has a number of programs designed to help pre-term birth families including NICU transition to home care packages, preemie parent mentors who can be contacted 24/7, an app called MyPreemie, and many online forums for parents to engage with other preemie families. –https://www.grahamsfoundation.org/

2.A community of peers

Hand to Hold is an organization created to guide preemie families through the long journey from a NICU stay to home, as well as provide comfort and support in times of loss. To do so, the website maintains forums for its 63,000 online community members. But it’s not just for preemie families. There are also resources for NICU professionals including podcasts and an ambassador program of bedside support volunteers who visit NICUs and provide additional help. –https://handtohold.org/

3.A place for bereavement support

Bereavement support is something all too many families of premature babies need. And High Risk Hope is one place they can find it. The 501(c)3 believes that “there is no foot too small that it cannot leave an imprint on this world.” To do so, the Florida-based organization connects families with other organizations to provide ongoing grief support and counseling. –https://highriskhope.org/

4.One-on-one care

Support 4 NICU Parents Support 4 NICU Parents aims to improve psychosocial support for NICU parents and enhance training and support for NICU healthcare providers, ensuring families and babies thrive together.  https://www.pqcnc.org/node/13721

5.Parental Zoom chats

Tiny Miracles is a nonprofit charity based in Fairfield County, Connecticut, that is dedicated to helping families with premature babies. Like many premature baby groups, it offers all kinds of resources for families, but its most popular offerings are free weekly Zoom support chats that anyone can join. Held every Thursday at 8 p.m. EST, they’re a way for people to get to know other parents beyond a virtual chat room or forum.-https://www.projectsweetpeas.com/

6. Material support

Care packages, hospital events, peer-to-peer support, financial aid, educational materials, these are all the work of Project Sweet Peas. Families can reach out directly for all of the above and receive the care they need from this nonprofit. And for those who have simply been touched by a premature birth and want to give back, they can donate to Project Sweet Peas’ effort which has sent 23,126 NICU care packages to families and 4,909 bereavement boxes as well.-https://www.projectsweetpeas.com/

7.Facebook Preemie Page

Social media sites, like Facebook, are a natural home for support groups and the Parents of Preemies/Premature Babies is one of the biggest for this specific demographic. With 15.3K members, it’s a private group you must ask to join. It was started in 2007 when founder Heather Armstrong writes that she couldn’t find a similar support space. It invites members to discuss topics related to the raising of premature children but doesn’t allow fundraising, self-promotion, or requests for medical advice. It includes parents of preemies from around the world.-https://www.facebook.com/groups/2304668997

8. Helping hand from March of Dimes

Not every hospital has a March of Dimes NICU Family Support program, but it’s worth inquiring should a family find itself with a baby in the newborn intensive care unit. The nonprofit that’s committed to improving the health of mothers and babies organized its NICU Family Support program to provide families with essential materials during their child’s NICU stay. Those include things like “keepsake booklets for their NICU baby, a guide for parenting in the NICU, and a NICU guide” according to the organization’s website. For families with an infant having a shorter NICU stay, March of Dimes provides materials as well. There’s also a helpful app where families can explore their questions and concerns.-https://www.marchofdimes.org/find-support/compassbymarchofdimes

9.Support for babies less than 2 pounds

Premature babies are not a monolith. There are varying levels of prematurity and some of the most at-risk children are those born less than 2 pounds and before 27 weeks. That’s why the Micro Preemie Parents Facebook support page exists, to be there for parents of these special children. Only parents of so called “micro preemies” will be accepted to the private page. Once in, they can expect to be able to join conversations specific to this very unique experience with other parents and guardians who understand where they’re coming from. –https://www.facebook.com/groups/micropreemiemoms

10. A Space for Black Preemie Parents

Black Preemie Parents Community is a Facebook group just for Black parents to find “support, advice, share stories, or just vent as you go through your journey.” It’s a small group with less than 400 members providing those who join with an intimate circle of friends to reach out to during challenging times. –https://www.facebook.com/groups/blackpreemieparentscommunity

11. Where to go when they grow

The premature parenting journey doesn’t end when a child leaves the NICU. It’s a lifelong path and one that might find parents looking for support well into their child’s teens and twenties. For that there’s Parents of Older Preemies. Another Facebook group, this 1.5K member page is for “parents to share their stories of their preemie(s) and how far they have come in their lives in a caring and supportive environment. This group shares triumphs, setbacks, frustrations and positive advice to others that are on their continued “preemie journey.”-https://www.facebook.com/groups/276697059074997

12. Visual Support

Preemie baby support isn’t limited to Facebook and nonprofit organizations. Instagram has also become a network where people kind find kinship in navigating life with a preemie. For instance, preemiesupermoms is an Instagram page dedicated to prematurity awareness. The page posts images of premature babies along with inspiring quotes and stories

For families looking for someone to listen or a place to gather strength, these organizations are here to help. All families need to do is ask. –https://www.instagram.com/preemiesupermoms/

Introduction

Neonates and infants are commonly referred to as “therapeutic orphans” due to the overall scarcity of therapeutic interventions that have been developed and tailored to their needs and specific characteristics . This is well known by care providers and researchers active in this field, but is perhaps less on the radar of authorities, funding bodies or the broader public. There is significant health inequity when comparing newborns to other age populations in terms of specific drug and device development and therapeutics . In addition there are health inequities in the provision of neonatal care globally which require special attention in terms of improvement .

Bronchopulmonary dysplasia, neonatal seizures, poor growth, necrotizing enterocolitis (NEC) and short bowel, hypoxic-ischemic encephalopathy, retinopathy of prematurity (ROP), neonatal infections and sepsis hereby serve as a non-exhaustive list of “orphan conditions” in need of more equity, through adequately and urgently funded research and improvement.

The good news is that there have been increased efforts, in recent years, by researchers and regulatory bodies to focus on the provision of drugs, devices, and treatment modalities tailored for neonatal use, while further advocacy remains an obvious need (245). This brings perspective and explains the initiative taken to organize a focused research topic on what is on the horizon as well as recent advances.

Overview of the topics covered

We targeted emerging or new aspects related to monitoring, diagnostics and therapeutics in neonatal care for the current research topic. Fortunately, this research topic was perceived as very relevant by the research community, as 135 authors expressed their interest as contributors, resulting in 20 accepted papers. This serves as a signal of the importance to continue to work on this topic.

Post-hoc, and in a somewhat arbitrary way (because of overlap in these subcategories) these papers were subdivided by the editors into different subcategories, with focus on (1, 5 papers) perinatal biomarkers in blood and urine and how these relate to or predict outcomes, (2, 6 papers) adaptations of existing and newly emerging equipment in neonatal units, (3, 3 papers) needed advances in pharmacotherapy, (4, 3 papers) machine learning or deep learning applications in neonatal care, and finally, (5, 3 papers) underreported aspects of contemporary NICU care, with a focus on the holistic nature of care for the infant and the family.

Perinatal biomarkers in blood and urine and how these relate to or predict outcomes

Two papers focused on biomarkers related to gestational diabetes, with reflections and data on maternal and neonatal outcomes. Postnatal maternal levels of glycated albumin and hemoglobin A1c in mothers of large-for-gestational-age (LGA) informed us of the relevance of accurate diagnosis during pregnancy. This is because postpartum women without diagnosis during pregnancy had higher glycated albumin values, associated with LGA and associated complications (Železnik et al.). Interestingly and related to this paper, Yin et al. reported on a untargeted metabolomics study in women with gestational diabetes, with the recommendation of a maternal serum metabolite panel to forecast neonatal adverse outcomes (hypoglycemia and macrosomia) (Yin et al.).

Other papers focused on the use of vitamin D, acid-base and biomarkers associated with fetal growth restriction with impaired neurodevelopmental outcome. In a cohort of 217 preterm neonates, a multivariate regression analysis identified antenatal steroids as protective, and lower birth weight, duration of ventilation, sepsis and the serum 25-(OH)D vitamin as risk factors to develop ROP (Yin et al.). Musco et al. reported on a systematic review on blood biomarkers indicating risks of adverse neurodevelopmental outcome in fetal growth restricted infants (Musco et al.). While the authors retrieved some data on neuron specific enolase and S100B, the overall conclusions reflect a call for further research. Finally, an association between lactate levels in umbilical cord blood and cerebral oxygenation in preterm neonates was studied as a secondary outcome analysis (Dusleag et al.). In non-asphyxiated preterm neonates with respiratory support, lactate levels were negatively associated with cerebral and arterial oxygenation. In term neonates without respiratory support, no associations were observed.

Adaptations of existing and newly emerging equipment in our units

In a review on emerging innovations in neonatal monitoring, Krbec et al. concluded that there is an urgent, still unmet need to develop wireless, non- or minimal-contact, non-adhesive technology, capable to integrate multiple signals in a single platform, tailored to neonates (Krbec et al.). Related to this call of action, Svoboda et al. reported on their pilot experience with contactless assessment of heart rate, applying imaging photoplethysmography (Svoboda et al.). Rectal and axillary temperature monitoring on admission were compared in a cohort of preterm (n = 80, <32 weeks gestational age) by Halabi et al., reporting that rectal measurement was likely more reliable in the event of hypothermia (Halabi et al.). Ultrasound-guided measurement of anterior cerebral artery resistive index in the first week of life in 739 preterm neonates (<35 weeks) was not associated with subsequent co-morbidities on admission or during neonatal stay (asphyxia, sepsis, NEC) (Singh Gill et al.). A case series of neurally adjusted ventilatory assist to rescue pulmonary interstitial emphysema in 5 extremely low birth weight infants illustrated the potential value of this ventilatory equipment and strategy and need for further study (Chen et al.). Finally, van Rens et al. compared a conventional to a modified Seldinger technique (a dedicated micro-insertion kit) for peripherally inserted central catheter (PICC) placement, illustrating the relevance of developing “low risk, high benefit” type of medical devices, adapted to the specific needs of neonates (van Rens et al.).

Advances needed in pharmacotherapy

The currently available medicines and dosing regimens in neonatal care are limited and there is an urgent need for improvement in this domain. This was illustrated by articles on sepsis, septic shock and steroids. Inequity in provision of neonatal care across the globe ought to be a major focus of improvement. Gezahegn et al. described the outcome in neonates admitted with sepsis in Harar (Ethiopia). Low white blood cell count, desaturation, preterm birth, absence of prenatal maternal care, and chorioamnionitis were important risk factors for sepsis-related mortality (Gezahegn et al.). Addressing these prognostic factors hold the promise to act as levelers to improve outcomes. A pilot study compared noradrenaline and adrenaline as first line vasopressor for fluid-refractory sepsis shock (Garegrat et al.). Both interventions were comparable to resolve the septic shock, while the overall mortality (13/42, 30%) remained significant, highlighting the need for better diagnostic and therapeutic options. Finally, in a systematic review, outcome of postnatal systemic corticosteroids (hydrocortisone to dexamethasone) were compared as reported in randomized controlled trials (Boscarino et al.). The authors concluded that dexamethasone appeared to be somewhat more effective than hydrocortisone in improving respiratory outcomes, but with inconclusive but relevant concerns on the uncertainties on long-term neurodevelopmental outcome, again highlighting the need for better therapies for prevention and management of chronic lung disease of prematurity.

Machine learning or deep learning applications in neonatal care

Artificial intelligence is a rapidly advancing area with fast evolving clinical applications in healthcare, including in the NICU (6). It is no surprise that the current research topic also contains papers illustrating its relevance to improve our practices and outcomes. Two papers hereby focused on NEC, and a 3rd paper on prediction of significant patent ductus arteriosus (PDA). In a mini-review, Cuna et al. reports on the various pathophysiological processes underlying NEC endotypes, and how artificial intelligence holds the promise to influence further understanding and management (Cuna et al.). An approach to enhance surgical decision making in NEC is illustrated by Wu et al. Based on x-rays from 263 neonates diagnosed with NEC (94 surgical cases), a binary diagnostic tool was trained and validated, with Resnet18 as approach applied (Wu et al.). For PDA, an ultrasound-based assessment of ductus arteriosus intimal thickness in the first 24 h after birth was applied in 105 preterm neonates. A prediction model for closure on day 7 included birth weight, mechanical ventilation, left ventricular end-diastolic diameter, and PDA intimal thickness (Hu et al.). Such models can be considered to better target future study, integrated in a precision medicine approach. Use of AI and big data have the potential to significantly improve our understanding of neonatal conditions and also support neonatal researchers in asking better research questions.

Underreported aspects of contemporary NICU care, holistic care

As part of this research topic, we also accepted papers reporting on the use of music on pain management, on multisensory stimulation to improve maternal milk volume production, and parents’ experiences related to congenital cardiac surgery. All these 3 papers reflect the need for holistic care and to further integrate the perspectives of (former) patients and parents into neonatal practice.

In a systematic review, Ou et al. demonstrated that music is an effective intervention to relief procedural pain (e.g., Premature Infant Pain Profile score) in preterm neonates, as it reduced some markers of stress, and improved blood oxygen saturation (Ou et al.). Multisensory stimulation (audiovisual, or audiovisual + olfactory) compared to a control setting improved maternal milk volume production, with evidence of positive effects of both interventions, even more pronounced if both interventions are combined (Cuya et al.). Finally, a quantitative analysis of parent’s experiences with neonates admitted to NICU with a congenital heart disease reinformed us on the importance of actively focusing on parental experiences of care (Catapano et al.).

From advances in neonatal care to implementation

In our opinion, this research topic nicely illustrates the diversity in ongoing clinical research activities, that all hold the promise to improve our clinical management practices, with the overarching aim to improve neonatal outcomes. There is an urgent need to focus on the current health inequities in the provision of care to neonates (3). The trend towards a “neuro” dedicated NICU care is an illustration on how relevant progress may occur. This progress is based on improved neuromonitoring techniques (7), improved management and precision medicine in the field of anti-epileptic drugs (8), and integrating families as partners in neonatal neuro-critical care and similar improvement programs (9). The good news is that we are already experiencing a shift in the right direction. The neonatal community and all other relevant stakeholders need to work better together to improve the pace and scale of this improvement.

Source:https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2025.1552262/full

Abstract

Background

The prenatal shunt, ductus arteriosus (DA), typically closes during the cardio-pulmonary transition at birth. We evaluated maternal and neonatal factors associated with delayed closure of DA in term-born neonates.

Method

We conducted a retrospective cohort study that included full-term neonates from the prospective observational Copenhagen Baby Heart cohort study. We assessed the association between maternal and neonatal factors and delayed ductal closure.

 Results

We included 19,566 neonates, of whom 48% were female. Echocardiography was performed at a median age of 12 (IQR:9-15) and eight (IQR:2-13) days for neonates with no DA and an open DA, respectively. Associations with delayed ductal closure included maternal obesity adjusted risk ratio=2 (95%CI:1-3.8), maternal hypothyroidism during pregnancy aRR=2.02 (95%CI:1.2-3.4), low Apgar 2.6 (95%CI:1.2-6), high weight aRR=1.81(95%CI:1.2-2.6), and length at birth aRR=1.7(95%CI:1.1-2.6).

Conclusion:

The identified risk factors for delayed ductal closure in term-born neonates may help increase clinical attention and improve neonatal care.

Source:https://karger.com/neo/article/doi/10.1159/000543915/921437/Maternal-and-Neonatal-Factors-Associated-with

17 February 2025

Prospects for Children in 2025: Building Resilient Systems for Children’s Futures is the latest edition of Global Outlook, a series of reports produced each year by United Nations Children’s Fund (UNICEF) Innocenti – Global Office of Research and Foresight, which look at the key trends affecting children and young people over the following 12 months and beyond.

In this new report, new and intensifying crises for children – including climate change, conflict and economic instability – are shown to be closely interconnected.

For instance, climate change is disrupting the water cycle, leading to widespread water scarcity, threatening food production and livelihoods across the economy. This disruption poses direct and indirect risks to children, as it impacts the availability of safe water, food, and family income.

The report also notes that debt burdens are forcing governments to cut essential public services, including those related to water, sanitation, and hygiene. These challenges are compounded by a lack of investment in long-term development.

According to UNICEF, rising geopolitical tensions and competition among nations are hindering the implementation of solutions that will protect young people’s lives and build more resilient futures for them.

The report calls for resilient national systems that prioritize children’s health, education and wellbeing, and emphasizes the importance of including children’s rights in climate action.

Download the report here.-https://www.unwater.org/news/unicef-2025-global-outlook-prospects-children-2025-building-resilient-systems-children%E2%80%99s

Hey, Neonatal Warriors!

Empathy and compassion is the foundation of the powerful bond we share as a community. It’s more than just understanding the struggles of others—it’s about truly connecting with their experiences and emotions. As we continue on our journey from the neonatal unit to where we are today, empathy strengthens our resilience and fosters a sense of unity. This connection gives us the strength to support one another, celebrate our victories, and face challenges together.

In the video you’re about to watch, we’ll dive deeper into how our shared experiences and collective empathy can empower us to not only overcome adversity but also to thrive. It highlights the importance of understanding and supporting each other, offering both comfort and encouragement in meaningful ways. Through storytelling and the exchange of our journeys, we create a community that is stronger, more resilient, and ready to face whatever challenges come our way.

I wanted to share this video because it perfectly encapsulates the power of empathy and how, together, we can elevate each other. It’s a reminder that even in difficult times, we are never alone—our shared experiences and collective strength can light the way forward.

Let’s continue to harness the power of empathy as we watch and reflect on the message in this video. Together, we are unstoppable.

What Is The Difference Between Empathy, Sympathy, and Compassion

The Power of Emotional Competency

Expert Reveals the Truth About Empathy, Sympathy and Compassion | Doug Noll

This video shows you the difference between empathy, sympathy, and compassion

 • Sympathy is pity-based and is selfish

• Empathy is a learned skill

• Compassion is empathy with an impulse to relieve distress

This video is for our younger friends to help them understand empathy, which means caring about how others feel and being kind to them. Mark Ruffalo and Murray Monster from Sesame Street will show us what empathy is and give fun examples of how we can be kind and helpful to others. I wanted to share this video because it’s a great way for younger kids to learn how to show empathy and support for their friends and family. Let’s watch and see how we can all use empathy to make the world a kinder place! Enjoy watching!

Sesame Street – Empathy With Mark Ruffalo

This video is perfect for helping young students understand what empathy is. Murray Monster and Mark Ruffalo talk about what empathy means and go through several examples. Use this helpful video for introducing important social skills to your K-2 students!

SnowboardZezula      Jul 11, 2022

Mrkni na report z Quiksilver & Roxy Czech and Slovak Surfing Championship 2022

👉 https://snbz.cz/report-surfchamp-2022

AsianNeo, Mentors, SOS Préma

Malaysia is a country in Southeast Asia. A federal constitutional monarchy, it consists of 13 states and three federal territories, separated by the South China Sea into two regions: Peninsular Malaysia and Borneo‘s East Malaysia. Peninsular Malaysia shares a land and maritime border with Thailand and maritime borders with SingaporeVietnam, and Indonesia. East Malaysia shares land borders with Brunei and Indonesia, as well as a maritime border with the Philippines and Vietnam. Kuala Lumpur is the national capital, the country’s largest city, and the seat of the legislative branch of the federal governmentPutrajaya is the administrative centre, which represents the seat of both the executive branch (the Cabinetfederal ministries, and federal agencies) and the judicial branch of the federal government. With a population of over 34 million, the country is the world’s 43rd-most populous country. Malaysia is tropical and is one of 17 megadiverse countries; it is home to numerous endemic speciesTanjung Piai in the Malaysian state of Johor is the southernmost point of continental Eurasia.

Healthcare in Malaysia is under the purview of the Ministry of Health of the Government of MalaysiaMalaysia generally has an efficient and widespread system of health care, operating a two-tier health care system consisting of both a government-run public universal healthcare system along with private healthcare providers. Within the public universal healthcare system, specialist services are either free or have low user fees for procedures (however, appliances are fully self-funded out of pocket by the patient, even within the public healthcare system); as such the public healthcare system suffers from high demand, routine congestion, long wait lists, chronic widespread delays along with persistent shortages in healthcare personnelmedical equipment and healthcare supplies.

Therefore, private healthcare providers play a pivotal role in providing specialist consultants and general practitioner (GP) services to the Malaysian population; the private healthcare providers complements or supplants the public healthcare system in terms of availability, types of treatments provided and types of materials used.

Source: https://en.wikipedia.org/wiki/Malaysia

Introduction

Reducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed to improving the quality of neonatal care; however, the involvement of low-to-middle-income countries was limited. This project aims to form an international collaboration among neonatal networks in Asia (AsianNeo), including low-, middle- and high-income countries (or regions). Specifically, it aims to determine outcomes in sick newborn infants, especially very low birth weight (VLBW) infants or very preterm infants, with a view to improving the quality of care for such infants. Methods and analysis Currently, AsianNeo comprises nine neonatal networks from Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan and Thailand. AsianNeo will undertake the following four studies: (1) institutional questionnaire surveys investigating neonatal intensive care unit resources and the clinical management of sick newborn infants, with a focus on VLBW infants (nine countries/regions); (2) a retrospective cohort study to describe and compare the outcomes of VLBW infants among Asian countries and regions (four countries/regions); (3) a prospective cohort study to develop the AsianNeo registry of VLBW infants (six countries/regions); and (4) implementation and evaluation of educational and quality improvement projects in AsianNeo countries and regions (nine countries/regions). Ethics and dissemination The study protocol was approved by the Research Ethics Board of the National Center for Child Health and Development, Tokyo, Japan (reference number 2020–244, 2022–156). The study findings will be disseminated through educational programmes, quality improvement activities, conference presentations and medical journal publications.

ABSTRACT

Introduction  Reducing neonatal deaths in premature infants in low- and middle- income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed to improving the quality of neonatal care; however, the involvement of low- to- middle- income countries was limited. This project aims to form an international collaboration among neonatal networks in Asia (AsianNeo), including low-, middle- and high- income countries (or regions). Specically, it aims to determine outcomes in sick newborn infants, especially very low birth weight (VLBW) infants or very preterm infants, with a view to improving the quality of care for such infants. Methods and analysis  Currently, AsianNeo comprises nine neonatal networks from Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan and Thailand. AsianNeo will undertake the following four studies: (1) institutional questionnaire surveys investigating neonatal intensive care unit resources and the clinical management of sick newborn infants, with a focus on VLBW infants (nine countries/regions); (2) a retrospective cohort study to describe and compare the outcomes of VLBW infants among Asian countries and regions (four countries/regions); (3) a prospective cohort study to develop the AsianNeo registry of VLBW infants (six countries/regions); and (4) implementation and evaluation of educational and quality improvement projects in AsianNeo  countries and regions (nine countries/regions).Ethics and dissemination  The study protocol was

approved by the Research Ethics Board of the National Center for Child Health and Development, Tokyo, Japan (reference number 2020–244, 2022–156). The study findings will be disseminated through educational programmes, quality improvement activities, conference presentations and medical journal publications.

Full (compelling!) publication: https://www.researchgate.net/publication/382243432_Asian_Neonatal_Network_Collaboration_AsianNeo_a_study_protocol_for_international_collaborative_comparisons_of_health_services_and_outcomes_to_improve_quality_of_care_for_sick_newborn_infants_in_Asia_-

Authors: Wan Mazwati Wan Yusoff,  International Islamic University Malaysia Mashitah Zainol Abidin

Abstract

Premature babies are very vulnerable and exposed to various life-threatening diseases. World Health Organization reported that many premature babies were saved from morbidity and mortality when they were fed with breastmilk starting from within the first hour after their birth. The rate of premature birth in Malaysia has increased exponentially since 2018—more than 20 percent premature births. Therefore, hospitals should have enough supplies of breastmilk to save the lives of the precious premature babies. However, only one hospital in Malaysia provides supplies of breastmilk on demand. This study employed philosophical method to argue for the establishment of breastmilk collection centre. It examined the concept of maqāṣid al-sharīʿah to justify the proposal of the establishment of breastmilk collection centres in hospitals throughout Malaysia to save the lives, intellects, and progenies of the at-risk premature babies. The primary issues resulting from breastmilk sharing according to Islamic perspective were examined and practical steps were proposed to rectify them. The steps involved obtaining signed consent from wet nurse and her husband; screening of wet nurse’s health and personality characteristics; screening of the breastmilk by the milk collection centre; obtaining signed consent from the premature baby’s parents; feeding breastmilk to the premature baby with the consent of witnesses; meeting between wet nurse and her family and the baby’s parents and family; and completing wet nursing document to be given to the newly formed milk kinship family. 

Source:https://doi.org/10.31436/alburhn.v7i2.310

Rody Azar, MHA, RRT-NPS

Introduction:

Trust is an essential element of effective teamwork. It fosters an environment where team members feel safe communicating openly, sharing ideas, and collaborating towards common goals. Without trust, relationships become strained, communication breaks down, and organizational performance suffers. According to a study by Gallup, organizations with high employee engagement, which is closely related to trust, report 21% higher profitability (Gallup, 2020). This paper explores trust in teams, examining how it can be fostered and its profound impact on organizational success.

The Importance of Trust in Teams:

1. Enhanced Communication: Trust creates a safe space where team members can share their thoughts and feelings without fear of judgment. This openness leads to improved communication, enabling teams to function more effectively. When team members trust each other, they are more likely to engage in candid discussions, ask for feedback, and share constructive criticism. This process encourages continuous improvement and innovation.

2. Improved Collaboration: Teams characterized by trust collaborate more seamlessly. Trust encourages team members to share resources, support one another, and seek each other’s abilities. This collaborative spirit leads to better problem-solving and decision-making, as individuals are more willing to listen to diverse perspectives.

3. Increased Engagement: Trust enhances commitment and engagement within teams. Employees who feel trusted and valued are more likely to invest their time, energy, and creativity into their work. This higher level of engagement results in better performance and productivity, as engaged employees are motivated to achieve team goals.

4. Effective Conflict Resolution: Conflict is a natural occurrence in any team dynamic. However, team members are more likely to address conflicts directly and constructively in a trusting environment, allowing them to express their disagreements without fear of damaging relationships. This approach leads to more effective and quicker resolutions, which helps support a positive team atmosphere.

5. Greater Accountability: When trust exists within teams, members are more likely to hold themselves and each other accountable for their roles and responsibilities. Trusting teams create a culture of accountability where individuals take ownership of their work, leading to higher standards and better performance.

Characteristics of Trusting Teams:

  1. Open Communication: Team members communicate transparently and honestly, fostering a culture of openness and inclusivity.
  2. Mutual Respect: Trusting teams recognize and appreciate each other’s strengths, value  

 diversity, and promote an inclusive environment.

  • Shared Goals: All team members are aligned with common goals, reinforcing collaboration

        and commitment.

  • Empathy and Support: Team members show care and understanding for one another,   

 creating a supportive atmosphere that encourages sharing and vulnerability.

  • Reliability: Trusting teams foster a sense of reliability, where members can depend on each

other to fulfill commitments and responsibilities.

Strategies for Building Trusting Teams:

Building trust is an ongoing process requiring intentional effort from leaders and team members. Below are strategies to cultivate trust in teams:

1. Lead by Example: Leaders play a crucial role in shaping team dynamics. By showing trustworthy behaviors, such as honesty, integrity, and accountability, leaders set the standard for others to follow. Vulnerability in leadership (e.g., admitting mistakes and seeking feedback) can also strengthen trust within the team.

2. Foster Open Communication: Encourage team members to openly share their thoughts, ideas, and feedback. Create an environment where communication is valued, and actively listen to team members. Regular check-ins, team meetings, and one-on-one discussions can help open dialogue and build trust.

3. Encourage Collaboration: Design opportunities for team collaboration across various projects. Creating diverse project teams allows members to collaborate, share knowledge, and build relationships. Activities such as brainstorming sessions or team-building exercises can strengthen interpersonal connections.

4. Recognition and Appreciation: Regularly acknowledge and celebrate the contributions of team members. Recognition fosters an environment of appreciation, reinforcing the value of individual efforts. Simple gestures such as expressing gratitude during meetings or highlighting achievements can significantly boost trust within the team.

5. Create a Safe Environment for Risk-Taking: Encourage team members to take thoughtful risks and innovate without fear of negative consequences. Providing autonomy and support for innovative ideas helps build trust, as team members feel empowered and valued for their contributions.

6. Establish Clear Roles and Expectations: Clarify the roles and responsibilities of each team member. When individuals understand their specific roles and expectations, it fosters accountability and reduces uncertainty. Clear roles create a sense of security, allowing team members to trust that everyone is working towards the same goals and can depend on one another to fulfill their responsibilities.

7. Promote Team-building Activities: Engaging in in-person or virtual team-building activities can significantly strengthen team members’ interpersonal relationships. These activities should encourage collaboration, promote understanding, and foster positive interactions outside of day-to-day work. Such experiences can help individuals develop personal connections, creating a more profound sense of trust.

8. Provide Opportunities for Professional Development: Encouraging continuous learning and professional growth shows team members that the organization values their development. Offering training, workshops, and mentorship opportunities improves individual skills and reinforces trust, as team members see that their organization is invested in their success.

9. Practice Transparency: Transparency is a key part of trust. Leaders should share relevant information about the organization’s goals, decision-making processes, and performance metrics with their teams. When team members are informed about what is happening within the organization, they feel more involved and valued, strengthening trust.

10. Encourage Feedback: Creating a culture where feedback is valued encourages trust among team members. Implementing regular feedback mechanisms—such as one-on-one check-ins and anonymous surveys—allows team members to express their thoughts and concerns. Moreover, showing that feedback is taken seriously and leads to action, reinforcing the notion that everyone’s input is valuable.

The Impact of Trusting Teams on Organizational Success:

The presence of trusting teams can lead to transformative outcomes in an organization:

1. Higher Performance and Productivity: Organizations with trusting teams have been shown to achieve higher performance levels. Trust enhances collaboration and reduces time spent on conflicts, resulting in teams completing projects more efficiently and effectively.

2. Improved Employee Well-being: A trusting environment improves employee morale and job satisfaction. Employees who feel trusted are less likely to experience stress and burnout, resulting in a healthier workforce with higher retention rates.

3. Greater Innovation: Trust allows teams to embrace creative solutions and explore innovative ideas without fear of failure. This environment fosters innovation as team members confidently share their insights and experiment with novel approaches to work.

4. Stronger Organizational Culture: A trust-based culture promotes a sense of belonging and shared purpose. Employees are more likely to feel aligned with the organization’s mission and values, which enhances overall engagement and loyalty.

5. Resilience to Change: Organizations characterized by trust navigate change effectively. Trusting teams adapt more readily to new initiatives and challenges as members communicate openly and support one another during transitions.

Conclusion:

Building trusting teams is not just a desirable outcome but essential for organizational success. Trust enhances communication, collaboration, and accountability while fostering a positive work environment. Organizations can cultivate a culture where teams thrive by implementing strategies that promote trust-building, such as leading by example, fostering open communication, and providing opportunities for development.

Leaders must recognize that trust is a pivotal part of team dynamics and should actively work to nurture it. The benefits of trusting teams extend beyond individual relationships; they affect organizational performance, employee satisfaction, and innovation. As organizations navigate complexities in the modern workplace, prioritizing trust will be paramount for achieving sustainable success.

By building trust within teams, organizations can strengthen their foundation and position themselves for future success. As shown throughout this paper, trusting teams are the cornerstone of an effective and resilient organizational culture.

Posted on 13 November 2024

10-11 October saw 340 healthcare professionals gather in France for SOS Préma’s 15th annual training days, a pivotal event offering an empathetic view into the realities faced by families of preterm infants.

Each year, “SOS Préma”, our valued partner in France, hosts training sessions to deepen the understanding of healthcare providers around the unique challenges encountered by preterm infants and their families. Established in 2011, these events now bring together hundreds of healthcare professionals, all committed to improving neonatal care. The 15th edition, held on 10 and 11 October, attracted over 340 participants, all united in their commitment to advancing care for these vulnerable newborns.

The event revolved around four main themes, each addressing key aspects of neonatal care:

  1. Zero Separation: Couplet care from birth
    Promoting uninterrupted contact between newborns and parents from birth through hospitalisation, ensuring that critical family bonds are supported from the earliest moments.
  1. Supporting late preterm babies
    Exploring breastfeeding and Kangaroo Mother Care as essential practices to help these infants grow and thrive, reinforcing the importance of holistic approaches.
  1. Navigating difficult moments with Zero Separation
    Addressing challenging periods during hospitalisation and equipping professionals with strategies to provide consistent infant- and family-centred support.
  1. Observing newborns with family involvement
    Encouraging healthcare providers to incorporate parents as essential members of the caregiving team, fostering a collaborative environment for a more comprehensive understanding of each infant’s needs.

SOS Préma’s Charter for the Hospitalised Newborn, a cornerstone of these discussions, continues to influence practices by promoting humane and inclusive neonatal care. Parental testimonials were central to the event, with families sharing their firsthand experiences, followed by scientific insights, ensuring that every healthcare professional gains practical tools and empathetic perspectives.

Source:https://www.efcni.org/news/sos-prema-15th-annual-training-days/

Before you complete your family medicine residency or even finish medical school, there are ways that you can begin to nurture your interest in global health and prepare for service you may want to provide in the future. Here’s how to get started.

Integrating Global Health into Your Medical Education

Seeking out as many global health-related opportunities as possible during your time in medical school can help you clarify your vision for working and serving globally, and cultivate relationships through which you may contribute and be mentored.

Opportunities you should consider include the following:

  • Develop knowledge, skills, and understanding that will prepare you to work effectively in a global context. 
  • Participate in your medical school’s global health track (if available). Getting involved in a global health track during medical school is strongly recommended. A well-designed global health track provides necessary background information and skills. It can also facilitate networking, which is key to short-term international rotations, and help you find individual mentors who can help guide your decisions.
  • Participate in activities that focus on local underserved populations and/or global health (e.g., journal clubs, courses, electives, service projects, service-oriented student groups, research)
  • Volunteer for a not-for-credit experience serving an underserved population during your M1-M2 summer, or during a fall, spring, or holiday break
  • Do a research project or a scholarly/capstone project focused on a population outside of the United States or an underserved population in the United States
  • Advocate for the value and relevance of global health curriculum and experiences to your medical school. For example, you could provide the dean and the family medicine chair with information about the value of global health experiences and curriculum for your development as a physician and the school’s achievement of its mission.
  • Get involved in your medical school’s global health-related student interest group (if available)
  • Lead your Family Medicine Interest Group (FMIG) in serving a local underserved population; you might want to partner with other student groups to develop a sustainable program.
  • Engage with your medical school’s office/center/institute for global health (if available)
  • Build a foundation for long-term collaboration by developing relationships with people and organizations involved in global health; tap into your medical school’s existing partnerships and relationships, if available.
  • Aim for a longitudinal experience throughout medical school
  • Use the AAFP global health resources and network
  • Cultivate relationships with mentors who can guide your development of abilities and attributes you will need to pursue your interest in global health

Finding a Family Medicine Mentor in Global Health

Finding a mentor can be a huge help in navigating the many questions you’ll have as you become more aware of global health needs and opportunities. Here are some suggestions on finding a mentor for yourself.

  • Attend the American Academy of Family Physicians’ (AAFP’s) annual Global Health Summit. This conference is specifically designed to facilitate networking and is attended by experienced global health workers who have long-term involvement in specific cultures and countries.
  • Try personal networking. Ask colleagues, friends, and family members whether they know anyone who works in global health, and contact potential leads with emails and phone calls. The more connections you make, the greater your chances of identifying one or more physicians who would be an appropriate mentor.
  • Look for someone who is doing the type of global health work you would like to do or working in a region that interests you. Contact that person to share your background and aspirations.
  • Reach out to presenters at meetings or to authors of articles/books of interest. Ask for advice or offer to help someone with a project. People working in global health often find it rewarding to advise and work with those who are exploring an interest in global health.

For Residents

Preparing for Global Health During Family Medicine Residency

An accredited family medicine residency program provides ideal preparation for short- and long-term global health work. Family physicians are specifically trained to provide the care that is most needed in the developing world—care for patients of all ages that is comprehensive, continuous, integrated, community oriented, and team based. If you are seriously considering global health work, you should select a residency program that offers:

  • Support and guidance for interest in global health
  • A patient population that includes a variety of ethnicities, cultures, and languages so that you can become proficient in the use of translators and cultural interpreters
  • A robust global health track that provides additional training in tropical and poverty-related diseases, advanced procedural skills, and cultural competence; the opportunity to participate in global rotations; and a network of international contacts. Getting involved in a global health track during residency is strongly recommended.

Once you have started your family medicine residency, the following steps can help you prepare for global health work:

  • Develop competence in a team-based approach to medical care; attention to the whole family; preventive and community-oriented care; and provision of continuous care to a defined population
  • Develop specific interventional skills (e.g., procedures that are commonly performed at the primary care level in developing countries, such as repair of complex lacerations and interpretation of diagnostic ultrasound examination)
  • Find a faculty mentor or advisor who is involved in global health work and can help you prepare yourself and your family. A faculty mentor might also be able to help you use your global health experience to develop a scholarly presentation or paper.
  • Complete additional (e.g., fellowship-based) training in advanced obstetrics and gynecology (including c-section) or disaster relief. Although a fellowship is not essential for an effective contribution to global health, it can be helpful.

Family Medicine Residency Programs with International Rotations

The AAFP Center for Global Health Initiatives has compiled a director of family medicine residency programs that include international rotations. Search our free database to explore these programs.

INTERNATIONAL ROTATIONS DIRECTORY

Ways to Integrate Global Health into Your Residency Experience

Find your passion within global health.

If you want to make a lasting impact in a global health setting, it is important to find your niche within the vast array of family medicine global health opportunities. It may take time and several different experiences to discover and develop your passion. You may find that you are drawn to a certain country, culture, language area, or area of need (e.g., maternal and child health, social determinants of health, disaster relief, policy, noncommunicable diseases). Be open to the many types of experiences that are available. If possible, explore them before you are committed to long-term employment.

There may be faculty mentors in your residency program who have experience in certain areas of global health. The AAFP offers a directory of global health opportunities.

Attending conferences such as the AAFP Global Health Summit also will expose you to many different areas of interest within global health.

Form partnerships. 

Once you find your passion, partnering with individuals and organizations that share your enthusiasm will further your interest and help you have a lasting, sustainable impact. Cultivate relationships by staying connected with particular organizations or international communities. If you travel, try to return to the same area so you can deepen your commitment to that population. Partnerships and connections will help you integrate global health fully into your career, and expand your capabilities in sustainable global health efforts.

Connect with others. 

There is significant interest in global health among family medicine residents in the United States and abroad. The World Organization of Family Doctors (Wonca) Young Doctors’ Movements (YDMs) around the world connect passionate residents and young physicians in conversations about family medicine in global health.

  • The Polaris Movement for New and Future Family Physicians in North America is a YDM launced in 2014 that provides an international platform for medical students, residents, and new family physicians. Connect on their Facebook page
  • Another initiative of the Wonca YDMs is Family Medicine 360°an exchange program for family medicine residents during their elective months. These four-week exchanges allow participants to travel to a country of interest and experience primary health care delivery in that setting.
  •  

Consider completing a Master of Public Health (MPH) degree. 

Proficiency in public health is becoming increasingly important in the global health arena, especially if you want to make lasting impact on prevention and social determinants of health. Some residency programs and fellowship programs pay for pursuit of an MPH while in training. Find out if your residency program is among them.

Explore fellowships in global health.

It is becoming easier to find residency programs that offer a family medicine global health fellowship; however, there are currently more global health fellowships in emergency medicine (EM) and internal medicine (IM) than in family medicine. If this is the case at your residency program, talk with the fellowship program to find out whether these fellowships can be adapted to family medicine.

Explore electives in global health. 

Many residencies already have global health electives or tracks in place. If your residency does not offer these, consider creating your own global health elective in your area of interest. Most residency programs will accept your ideas for an elective, especially if you already have a relationship with the organization with which you will be working.

If you are unable to travel due to time or financial constraints, pursue or create electives locally that encompass global health ideals. Working with underserved or marginalized populations in your own community can create lasting positive changes. Remember, global health is not just international health; it includes efforts in your own backyard as well!

Source: https://www.aafp.org/family-physician/patient-care/global-health/education.html

Kristen Leeman, MD

Posted on March 21, 2023 by Nancy Fliesler | Our CommunityPeople

While the majority of neonatologists are women, women make up a far smaller proportion of neonatologists in leadership positions. A recent national survey led by Kristen Leeman, MD, in the Division of Newborn Medicine at Boston Children’s and Lindsay Johnston, MD, at Yale, finds that many female neonatologists face roadblocks to career development. They often miss out on speaking engagements, career guidance, additional training, networking opportunities, and above all, mentors.

To learn more about their needs, Leeman and her colleagues contacted nearly 4,000 female neonatologists from the AAP-affiliated Women in Neonatology group and a Facebook group for female neonatologists. They received 451 survey responses, revealing several additional challenges:

  • gender-based salary discrepancies, reported by 49 percent of respondents
  • delayed promotion (37 percent)
  • harassment by colleagues (31 percent), trainees (8 percent), staff (24 percent), and patient families (32 percent)
  • lack of an established mentor (61 percent).

Female neonatologists also tend to struggle more than their male counterparts with work/life balance issues, Leeman notes, making it hard to advance. “Women commented on child care stress and burnout,” she says. “The supports are not there at vulnerable times in their careers. It’s a leaky pipeline.”

Building a mentoring program for female neonatologists

Leeman and Johnston decided to address what they see as the key missing ingredient — mentors.

“Both of us have had the benefit of superb mentorship, which has been integral to our careers,” says Leeman. “We wanted to offer an opportunity for all women across the U.S. to have access to female role models to help mentor them through different elements of their careers.”

With colleagues across the country, they created the National Women in Neonatology Mentorship Program. Bringing together senior, mid-career, and junior neonatologists, the year-long pilot program, which concludes in August, has three goals:

  • to provide resources to facilitate career advancement and professional and personal satisfaction
  • to identify strategies to help female neonatologists gain appropriate compensation, promotions, and professional recognition
  • to foster a feeling of community.

In virtual and in-person meetings, the program’s 250-plus participants read and discuss materials, hear speakers, share their thoughts and experiences, network, offer mutual encouragement, and consult with mentors. The program has various subgroups, including groups for women practicing in community NICUs, groups for specific interests like global health or lab research, and groups for women from backgrounds that tend to be underrepresented in medicine.

Neonatology mentorship at Boston Children’s: Balancing medicine, research, and family

Patricia Davenport, MD, and Martha Sola-Visner, MD, neonatologists at Boston Children’s, illustrate the value of mentorship. As a junior faculty member, Davenport found herself juggling her clinical, research, and family responsibilities. In addition to caring for patients in the NICU, she joined Sola-Visner’s lab to conduct research on neonatal platelet transfusions. Sola-Visner quickly became a mentor.

“Martha’s mentorship has been crucial to me,” Davenport says. “She values her patients, her research, and her family. Holding those three things equally in your hands is really important. I had never done basic science before and needed a lot of mentoring, not just at the bench but also writing and presenting.”

Whether it’s an unfortunate patient outcome, an experiment that didn’t work, or a family emergency, Sola-Visner has been a vital support and sounding board. And the benefits of mentorship flow in both directions.

“I’m established now, and at this stage in my career, seeing other people progress and move forward is the most rewarding part of what I do,” says Sola-Visner. “Making sure that the people who I’ve mentored are succeeding becomes more and more important over time. I get great joy to see that.”

Davenport is also an enthusiastic participant in the national pilot mentorship program, where she is part of a subgroup on basic science.

“We talk about funding difficulties, how to organize a lab, wellness, how to care for yourself,” she says. “There’s a real sense of community across the nation. You’re always asking, ‘am I good enough?’ and it’s nice to hear other women having the same thoughts and feelings of ‘imposter syndrome.’ But we’re all doing good work.”

Source: https://answers.childrenshospital.org/mentorship-neonatology/

Wanglong Gou, PhD1,2,3Congmei Xiao, PhD1,2Xinxiu Liang, PhD1,2; et alZelei Miao, PhD1,2,3Meiqi Shi, MS4Yingying Wu, MS4Sha Lu, PhD4Xuhong Wang, MS4Yuanqing Fu, PhD1,2Wensheng Hu, PhD5,6Ju-Sheng Zheng, PhD1,2,3,7

Key Points Original Investigation Public Health December 19, 2024

Question  Is physical activity during pregnancy associated with preterm birth among women with gestational diabetes (GD)?

Findings  In this cohort study of 1427 pregnant women with GD, accelerometer-derived moderate-to-vigorous intensity physical activity (MVPA) demonstrated an inverse association with preterm birth. The dose-response curve for MVPA in relation to the risk of preterm birth exhibited an L-shaped pattern, with a steady decline in preterm birth rate up to approximately 74 minutes per day.

Meaning  These findings provide key evidence for the health benefits of MVPA during pregnancy and lay the foundation for establishing physical activity guidelines for pregnant women with GD.

Abstract

Importance  Physical activity, as a modifiable factor, emerges as a primary intervention strategy for the prevention and management of gestational diabetes (GD). Among women with GD, the association of physical activity during pregnancy with preterm birth remains unclear.

Objective  To examine the association of accelerometer-derived physical activity metrics and patterns with preterm birth among women with GD.

Design, Setting, and Participants  This prospective cohort study recruited pregnant women with GD in Hangzhou, China, from August 2019 to August 2023 as part of the Westlake Precision Birth Cohort study. Statistical analysis was performed between August and November 2023.

Exposures  Wearable accelerometer–derived physical activity metrics and patterns. Measurements of physical activity via wearable accelerometer were performed at a median (IQR) of 25.4 (24.6-26.6) weeks’ gestation.

Main Outcomes and Measures  Preterm birth was determined through the examination of delivery records. Incident preterm birth was defined as the delivery of infants before completing 37 weeks of gestation.

Results  Among the 1427 women meeting the inclusion criteria, the mean (SD) age was 31.3 (3.8) years, and there were 80 cases of preterm birth. An increase in moderate-to-vigorous intensity physical activity (MVPA) and the fraction of physical activity energy expenditure derived from MVPA exhibited an inverse association with preterm birth, with an odds ratio per 30 minutes of 0.64 (95% CI, 0.42-0.98) and an odds ratio per SD of 0.69 (95% CI, 0.55-0.88). In the dose-response analysis, there was a progressive decrease in the odds of preterm birth with increasing duration of MVPA per day, reaching a plateau at approximately 74 minutes per day. Furthermore, the findings indicated that active MVPA (MVPA ≥30 minutes per day), whether it was concentrated into a few days or followed a more regular pattern, had similar beneficial association with preterm birth.

Conclusions and Relevance  In this prospective cohort study, MVPA during pregnancy exhibited an inverse association with preterm birth among women with GD. Concentrated physical activity was associated with similar benefits in reducing preterm birth risk as regular physical activity.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828262

Mount Sinai Hospital   Sinai Health  March 21, 2024

Two years ago, Adiah and Adrial Nadarajah defied the odds when they were born at just 22 weeks at Mount Sinai Hospital.

The twins, who share the Guinness World Records for the youngest and lightest premature babies born, recently celebrated their second birthday, and we caught up with the family to find out how they’re doing.

Things certainly are much different in the Nadarajah household these days. “The first year of their lives was spent constantly tending to their medical needs,” reflects Shakina. And today, as the twins’ mother puts it, the family is now in the phase of “full throttle toddler parenting.”

“In the first year, the twins didn’t have much recognition of each other, so it’s beautiful to see how close they are becoming,” says Shakina. “Adrial is very affectionate and is always trying to hug his sister. He has started saying a few words too.” Some of which include: banana, potato, purple, car and of course – mama and papa.

Adiah is “the bossy one,” calling all of the shots when it comes to play time. She loves reading books, and given that both of her parents play the piano, Adiah has been naturally drawn to it.

“She is mesmerized by the piano and enjoys watching us play on it, or playing it herself,” says Shakina. “That is how she spends quality time with her dad, Kevin.”

The younger twin, Adrial was on oxygen for a period of time following a re-hospitalization after their discharge from the NICU, but went off it shortly after the twins’ first birthday. And while checking oxygen tanks and figuring out wiring across the house were not what they envisioned for their first year of parenthood, these add to their unique story of parenthood and to the twins’ story of resilience.

The twins continue to attend standard follow up appointments at Mount Sinai Hospital’s neonatal follow-up clinic, which provides families with developmental assessments for their infant(s) who received care in the NICU, and also counselling for early intervention, depending on the needs of children. The detailed assessment of a baby’s growth, feeding and development includes movement patterns, speech, play skills and problem-solving abilities, and guides families in supporting activities to enhance their development to the full potential.

“Infants who spend an extended period of time in the NICU can face long-term challenges, which is why it is important to continuously monitor these children to identify any challenges they may face as early as possible,” says Dr. Prakesh Shah, Paediatrician-in-Chief at Sinai Health. “This allows us to proactively provide optimal support, planning and timely therapy referrals for families.”

The twins were referred to different specialists, including a speech therapist, physiotherapist and an occupational therapist, and continue to get support on an ongoing basis.

“This family is a living example of what hope can do,” says Dr. Shah. “The family continuously advocated for their babies and persevered and now the twins are two years old, defying many odds.”

Although so much has changed for the Nadarajah family over the past two years, Shakina shares that “not a single day goes by” that they don’t think about the Mount Sinai Hospital NICU.

“It holds such a special place in our hearts, and was where we spent the first half year of our babies’ lives. It was our everything – our whole world. And it was amazing to have the support we received from the hospital, especially in the first year.”

Source:https://www.sinaihealth.ca/news/the-worlds-most-premature-twins-turn-two

The first app of its kind to offer information SPECIFIC to the weekly growth and development of the premature baby.”

“A comprehensive guide for parents of premature babies that helps to reshape the NICU experience. Providing and educational and empowering platform to document, record, and celebrate their preemie’s story.”

“The Peekaboo ICU PREEMIE App is inspiring parents and making an impactful difference for NICU families.”

Jun 29, 2024

The realm of neonatal care has always been a critical aspect of medical science. The delicate nature of newborns, especially preterm infants, necessitates constant innovation and improvement in technology. 

As we advance through 2024, several groundbreaking developments are revolutionizing neonatal care, ensuring better survival rates and improved health outcomes for infants. In this blog, we will delve deeper into the significant advancements in neonatal technology that are shaping the landscape this year. 

  1. Neonatal Intensive Care Units (NICUs): Modern NICUs are increasingly integrating smart technology and artificial intelligence (AI) to enhance care delivery. In 2024, many hospitals have adopted AI-driven monitoring systems that continuously analyze vital signs and predict potential complications before they become critical.

The modern NICUs use machine learning algorithms to identify patterns that may be missed by human observation, providing early warnings for serious medical conditions. In fact, more seizures are recorded in real-time when the AI algorithms are applied.

Additionally, NICUs are now equipped with advanced incubators that offer more than just a controlled environment. These incubators come with integrated sensors that monitor temperature, humidity, oxygen levels, and even the infant’s movements. Real-time data from these sensors helps healthcare providers make immediate adjustments to optimize the infant’s environment, significantly reducing the risk of complications.

  • Telemedicine and Remote Monitoring: Telemedicine has become a crucial tool in neonatal care, particularly in remote or underserved areas. In 2024, advancements in telehealth technology allow for real-time video consultations between neonatologists and local healthcare providers. 

Remote monitoring technology has also made significant strides. Wearable devices designed for neonates can now continuously track vital signs and other health metrics, transmitting data to healthcare providers instantly. These devices are minimally invasive, ensuring that they do not interfere with the infant’s comfort while providing critical health information. 

  • Respiratory Support: Respiratory support is a cornerstone of neonatal care, especially for preterm infants whose lungs are not fully developed. In 2024, advancements in this area are particularly noteworthy. 

The high-frequency ventilation and non-invasive procedures are two examples of innovations in the respiratory support systems that have been able to improve the prognosis for neonates suffering from respiratory distress syndrome. These developments also lower the likelihood of long-term problems by offering mild and efficient breathing assistance.

Furthermore, innovations in surfactant therapy, which helps to reduce the surface tension in the lungs and keep the airways open, are enhancing the survival rates and respiratory outcomes for preterm infants. 

  • Personalized Medicine and Genomics: Personalized medicine is transforming neonatal care by customising treatments to the individual needs of each infant. Advances in genomic sequencing allow for the early identification of genetic disorders enabling targeted interventions.

In 2024, whole-genome sequencing is becoming more accessible and faster, allowing for timely diagnosis and treatment of congenital conditions. Pharmacogenomics, which studies how genes affect a person’s response to drugs, is also making its way into neonatal care. 

  • Advanced Imaging Techniques: Imaging technology has seen remarkable improvements, providing clearer and more detailed views of neonatal anatomy and physiology. High-resolution screening devices such as CFM Olympic Brain Monitor specifically designed for neonates are now available, offering non-invasive ways to screen brain conditions. 

In addition, there are other advanced imaging techniques help in early detection of issues such as brain injuries, congenital heart defects, and other critical conditions, allowing for prompt and appropriate interventions.

  • Parental Involvement and Support Technologies: A number of technologies have been introduced in 2024 to encourage parental involvement in neonatal care, in recognition of the vital role that parents play in this process. 

Throughout their child’s time in the NICU, parents are offered resources to remain informed, involved, and supported. Furthermore, specially made wraps and clothes are making skin-to-skin contact—also referred to as Kangaroo care. These items enable parents to comfortably hold their infants while providing the essential medical supervision and assistance.

Summing It Up:

The advancements in neonatal technology in 2024 are profoundly transforming the care and outcomes for newborns, especially those born prematurely or with critical conditions. 

As technology continues to evolve, the hope is that these advancements will become accessible to all, ensuring that every newborn receives the highest standard of care, regardless of their circumstances.

Source: https://www.genworkshealth.com/blog/advancements-in-neonatal-technology-whats-new-in 2024#:~:text=In%202024%2C%20whole%2Dgenome%20sequencing,its%20way%20into%20neonatal%20care.

Abstract

Background

Despite healthcare improvements in Rwanda, newborn mortality remains high. This study assesses the impact of neonatal mentorship on enhancing nurses’ competencies within neonatal units, aiming to address this mortality concern and strengthen healthcare providers’ abilities.

Methods

The prospective cohort study included 25 health facilities supported by Ingobyi Activity in Rwanda, which were beneficiaries of a monthly mentorship program focusing on five critical neonatal competencies. These included adopt manipulation of neonatal equipment, effective management of small and sick newborns, stringent infection prevention and control (IPC), kangaroo mother care (KMC) implementation, and family-centered care provision. We employed an observation checklist to measure neonatal practice competencies, comparing practices at the time point of the baseline, at the 6th mentorship session, and finally at the 12th mentorship session.

Results

The program engaged 188 neonatal nurse mentees. Data analysis highlighted a substantial increase in overall neonatal practice competencies from a baseline of 42.7%–75.4% after 12 mentorship sessions. Specific competency enhancements included family-centered care (40.3%–70.3%), IPC (43.2%–84.2%), KMC (56.9%–73.3%), management of small and sick newborns (38.5%–77.6%), and manipulation of neonatal equipment (42.7%–75.4%).

Conclusions

This neonatal mentorship program was effective in enhancing nursing competencies, leading to significant improvements in neonatal care practices. Future work should evaluate the program’s cost-effectiveness and explore its potential to positively impact neonatal health outcomes, thus ensuring sustainable healthcare advancements.

Source:https://onlinelibrary.wiley.com/doi/full/10.1002/puh2.141#:~:text=Neonatal%20nurse%20mentorship%20intervention,by%20the%20project%20throughout%20Rwanda.

We are delighted to present an editorial for the Special Issue ‘Advances in Healthcare for Neonates’. This Special Issue is a testament to the excellent quality of the eleven articles submitted in the short span of just one year, far exceeding our expectations. We are humbled by the commitment of the scientific community to pursue neonatal research across the globe, which bodes well for improvements in quality of life as newborns grow into children and adults.

The survival of extremely preterm infants in the past few decades is closely linked to the discovery of surfactants in the early 1990s. Advances in neonatal care, including parenteral nutrition, gentle ventilation, and infection control practices, have further contributed to the increasing survival of extremely low birth weight (ELBW) infants. The extensive use of continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) techniques is essential for the close monitoring of infants on NIV to ensure appropriate clinical decision-making. One such method is standardizing the weaning process when using non-invasive ventilatory support. Nussbaum et al. attempted to standardize the weaning of NIV using the Silverman–Andersen score (SAS). The study did not find any differences among the groups, highlighting the fact that various factors, including interrater reliability, influence weaning from NIV, thereby limiting the predictive value of the SAS. However, the study addresses an important knowledge gap in weaning infants on NIV off respiratory support.

Neonatal units have traditionally used chest X-ray for the diagnosis of respiratory disorders in neonates. However, more recently, lung ultrasound has emerged as a useful clinical tool at the bedside. Ismail et al. have demonstrated that imaging using lung ultrasound can not only be used as an alternative to chest X-ray, but also as a high-precision tool for diagnosing various respiratory diseases in neonates, such as respiratory distress syndrome, pneumonia, transient tachypnea of the newborn, meconium aspiration syndrome, pneumothorax, and atelectasis. Incorporating point-of care-ultrasound scanning in scientific studies and training programs would certainly enhance the existing clinical applications of ultrasound, thus helping to advance the care of neonates.

Despite advances in neonatal care leading to the increased survival of ELBW infants, premature infants are at an increased risk of adverse long-term neurodevelopmental outcomes, including cerebral palsy. Assessment of motor movements based on heart rate is a novel way of detecting abnormal pathologies that could help in earlier detection of cerebral palsy. In this Special Issue, Maeda et al., from Japan, present an algorithm to extract the movement patterns of premature neonates, as assessed through a combination of heart rate and video recordings of general movements. The authors demonstrated that it is possible to use an algorithm-based approach to assess general movements using instantaneous heart rate monitoring; however, they caution that it is essential to distinguish artifacts, such as a care intervention, using a supplemental video recording . Nevertheless, as fetal movements indicate fetal wellbeing, movement pattern assessment using algorithmic tools could be valuable for assessing motor and cognitive functions in premature infants after birth.

Early diagnosis and appropriate intervention can minimize the risk of developmental delays sometimes seen in premature neonates. A randomized controlled study comparing standardized early physical therapy versus no intervention in preterm infants from 32 weeks of gestation to 2 months corrected age demonstrated no differences between the group. However, factors such as the dose, intensity of intervention, parental compliance, and the shorter duration of intervention might have contributed to an absence of difference between the groups. The authors also highlight that engaging with and educating parents demonstrating poor compliance with therapy techniques for prolonged periods is essential to derive benefits .

Implementation of neuroprotective care in the neonatal intensive care unit is essential for optimal neurodevelopmental outcomes in premature neonates. Therefore, reducing pain is critical for neuroprotective care in premature infants. Dusek et al. studied the possibilities of influencing the procedural pain associated with retinopathy of prematurity (ROP) screening using oral clonidine. The authors assessed the pain and vegetative scores of using oral clonidine versus standard care during routine ROP exams. Although they did not demonstrate any difference between the groups, the absence of severe complications with clonidine may make it a potential candidate in future studies addressing neonatal pain.

The clinical care of neonates is the focus of this Special Issue. Traumatic lumbar puncture (LP) has been a problem confounding the diagnostic evaluation of neonates, especially in extremely low birth weight infants. In addition to ensuring the proceduralist′s technique, skills, and experience, it is also essential to use the correct size of needle when performing a procedure. In a study in this Special Issue, a smaller gauge (25G) lumbar puncture needle not only resulted in a decreased incidence of traumatic LP, but also a reduction in desaturation episodes during the procedure. This study is a step in the right direction for providing neuroprotective care to these fragile infants. Future studies should address optimal positioning, non-invasive imaging techniques to facilitate easier insertion, and needle size stratification based on gestational age or birth weight in order to optimize the success of vital neonatal procedures.

Improving the outcomes of neonates is best accomplished by preventing hospital-acquired infections and ensuring the optimal screening of newborns in the intensive care unit. The World Health Organization has described antimicrobial resistance as a serious threat to public health; hence, screening fragile infants for multidrug-resistant microbes is essential. Out born infants admitted to neonatal units in Turkey were meticulously screened using perirectal swab cultures and were found to have a 27.2% and 4.8% positive screening rate for carbapenem-resistant Enterobacterales (CRE) and vancomycin-resistant Enterococci (VRE), among the 125 referrals from the outside hospitals. This result reinforces the need for antibiotic stewardship to prevent multidrug resistance, and high vigilance and attention to screening when these vulnerable neonatal patients are referred from centers in which antibiotic policies are unclear.

Next-generation sequencing (NGS) and exome and genome sequencing using targeted panel molecular genetic analysis have contributed significantly to advances in newborn care. In this issue of Advances in Newborn Care, Zaza et al. describe a neonate with a cleft palate and an aortic root aneurysm, with a pathogenic mutation of exon 8 of TGFBR2 confirming a diagnosis of Loeys–Dietz syndrome. Advances in molecular genetics will help better diagnose rare conditions using genetic mutations, thus contributing to earlier detection of conditions and better management of these infants. Neonates with special conditions and genetic syndromes require a higher level of care and treatment strategies, and standardized tools to enhance their recovery. Vogt et al. propose an enhanced recovery protocol for patients undergoing the Kasai procedure for biliary atresia. The checklist includes, among other elements, parental education, preoperative dextrose-containing fluids, maintaining normothermia, adequate analgesia, and initiation of early feeds. The checklists almost always provide a framework for clinicians to optimize outcomes in complex patients such as those requiring the Kasai procedure.

With the increasing survival of premature infants, many patients go home with an accompanying increase in respiratory morbidities post-discharge. The widespread use of palivizumab helps to reduce re-admission rates and complications from infection with respiratory syncytial virus. The feasibility of home immunization with palivizumab without any serious adverse events is reported in this Special Issue . The advantages of home immunizations include higher parental satisfaction and well-being for the whole family. This study is a step towards personalized medicine within a unique population, which may help them to avoid visiting the hospital or clinic and potentially being exposed to children with other droplet infections. On the note of personalized medicine, there is an increase in the growing adult population who were born prematurely and are thus at extremely high risk of developing various comorbidities such as systemic hypertension, metabolic syndrome, reduced exercise tolerance, pulmonary hypertension, chronic obstructive pulmonary disease, and cardiac failure. Holistically addressing the problems of adults born preterm will help promote cardiovascular health, wellness, and quality of life over their lifetime. Despite the large number of resources invested in the survival and care of extremely premature infants, it is surprising that minimal resources are available regarding commitment to wellness as infants grow into children and adults. Vital screening programs, effective communication, targeted counseling and therapeutic interventions, and a seamless transition of care from a pediatric clinician to an adult health care provider would improve the quality and longevity of life of those born extremely preterm.

Source:https://pmc.ncbi.nlm.nih.gov/articles/PMC10297648/#:~:text=Advances%20in%20neonatal%20care%2C%20including,birth%20weight%20(ELBW)%20infants.

Unsafe sleep practices may be a more common cause of sudden unexpected infant death cases where children are born exposed to drugs, according to a new study. The article, “Sleep-Related Sudden Unexpected Infant Death Among Infants Prenatally Substance Exposed,” published in the December edition of Pediatrics, looked at data from the Centers for Disease Control and Prevention SUID and Sudden Death in the Young Case Registry. Data showed that of 2,010 infants with sleep related deaths, 14% had been born drug exposed with nearly a third of all infants dying from suffocation. Among the sleep-related deaths, about half happened in an adult bed with infants sharing the space with a sleeping adult. Overall, 1 in 4 deaths of prenatally exposed infants involved supervisors who were both impaired and bedsharing. Non-Hispanic white infants were disproportionately impacted, making up nearly half of those prenatally exposed who died in their sleep. These infants were also more likely to be exposed to social drivers of poor health and family vulnerability such as poverty and barrier to prenatal care. Study authors advocated for expanded prevention efforts such as safe sleep messaging while arguing more needs to be done to address the social needs of these families.  

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

Source:https://www.aap.org/en/news-room/news-releases/pediatrics2/2024/infants-exposed-to-substances-prenatally-also-have-increased-exposure-to-unsafe-sleep-practices/

The study, led by UBC and SFU researchers in collaboration with the Medical Research Council (MRC) Unit The Gambia, has the potential to help healthcare workers diagnose babies earlier, including in lower- and middle-income countries (LMICs) where neonatal sepsis is of particular concern. The researchpublished today in eBiomedicineis funded by the National Institutes of Health and the Canadian Institutes of Health Research.

“Neonatal sepsis is caused by the body’s irregular response to a severe infection that occurs within the first 28 days of life. Globally, it affects around 1.3 million babies annually, and unfortunately, in LMICs, those rates are higher,” said first author Andy An, a UBC MD/PhD student who completed the research as a doctoral student in the department of microbiology and immunology. “Even when treatment is successful, sepsis can have lifelong effects because it can lead to developmental delay in children, imposing cognitive deficits and long-term health issues. By recognizing it as early as possible, we can treat infants promptly and ideally, head off these harms.”

Neonatal sepsis causes an estimated 200,000 deaths worldwide each year, with the highest rates in LMICs. In Canada, the risk is lower at about one in 200 live births, but higher in prematurely born babies.

Rolling the dice on health

Diagnosing sepsis is challenging for doctors and families. The symptoms can look like many other illnesses, and tests to check if sepsis is present can take several days, aren’t always accurate, and are largely only available in hospitals. The uncertainty can delay urgent treatment with antibiotics.

“Knowing that sepsis is impending would also allow physicians more time to determine the appropriate treatment to use,” said co-senior author Dr. Bob Hancock, professor in the UBC department of microbiology and immunology. “The consequences of neonatal sepsis are so severe in the most vulnerable individuals that providing an early diagnosis to assist and guide physicians could save lives.”

Equitable access to healthcare

The researchers participated in a large study in The Gambia where blood samples were taken from 720 infants at birth. Out of this cohort, 15 babies developed early-onset sepsis.

The researchers used machine learning to map the expression of genes active at birth, in search of biological markers that could predict sepsis.

“We found four genes that, when combined in a ‘signature’, could accurately predict sepsis in newborns nine times out of 10,” said co-senior author Dr. Amy Lee, assistant professor in the SFU department of molecular biology and biochemistry. “This was a unique opportunity where samples were available from all babies in this cohort on the day of birth, meaning we could study the genes expressed in the sepsis babies before they got sick. Most other studies have only published markers that were present when the babies were already ill, and this would therefore not be a predictive signature.”

“The early recognition of sepsis is vital for infants’ survival, and identifying markers that might allow us to ‘predict’ babies at particular risk would be an enormous advantage, since we could then target specific surveillance and treatment of such infants,” said Dr. Beate Kampmann, who led the clinical component of the study at the MRC Unit in The Gambia.

The researchers hope the signature will one day be incorporated not only into PCR tests in hospitals, but also in portable, point-of-care devices.

“There are point-of-care devices available that can test for gene expression, for instance, COVID-19 and influenza, with a single drop of blood. They can operate anywhere with a power source including batteries and can be used by anyone, not just trained healthcare providers,” Dr. Hancock. “These portable devices could be retooled to recognize this ‘signature’ relatively easily and inexpensively.”

The next step for the research would involve a large prospective study to show the signature is successful at predicting sepsis in other populations and prove its methodology, and then the development of point-of-care tools for approval by relevant government bodies.

Source:https://www.sciencedaily.com/releases/2024/10/241028211504.htm

Ready to kick off the new year with fresh goals and BIG dreams? This fun and interactive video is perfect for kids, parents, and educators! We’ll share simple and achievable New Year’s resolution ideas for kids to help them learn goal-setting in a positive and exciting way.

Welcoming the New Year with Hope and Resilience

As preemie warriors, we step into 2025 with gratitude and pride, not just for how far we’ve come but for the people who made our journey possible. This new year is a moment to reflect on the strength and resilience that define us—and to honor the families, parents, caregivers, and healthcare providers who stood by us every step of the way.

Our journey has been shaped by many. For some, families and communities stood as steadfast advocates, offering love and support through difficult decisions and uncertain times. For others, healthcare providers brought their expertise and compassion to the forefront, working tirelessly to help achieve the best possible outcomes. Together, these connections have been a source of strength, ensuring care and hope in moments that mattered most.

2025 is a celebration of this community of support. Together, we’ve proven that resilience is a collective effort. Every milestone we’ve reached—every breath, every step, every moment of growth—is a shared triumph, a testament to the power of unity and the impact of care.

This year, let’s continue to inspire and uplift one another. Our stories remind the world that we as preemie warriors have so much to offer, and that progress in neonatal care depends on the passion and dedication of our neonatal womb community, preemie warriors, families, and professionals alike. By sharing our journeys, we create a ripple effect—sparking change, advancing care, and building a future where every preemie has the best chance to thrive.

Here’s to 2025: a year to honor the bonds that sustain us, the progress we’ve made, and the hope we carry forward. Together, we rise, stronger and more united than ever.

CGI Animated Short Film: “Miles to Fly” by Stream Star Studio | CGMeetup

Follow your Dreams – Miles to Fly is a graduation short made by 4 students from Multimedia University, Malaysia released in 2020. The story is about an ambitious boy who dreams of becoming a pilot but is torn between helping his mother’s bakery to survive, or pursuing his dream.

Mar 12, 2018  Kembara Xscapes

OT, PIONEERS, YOUTH SUPPORT

Colombia, officially the Republic of Colombia, is a country primarily located in South America with insular regions in North America. The Colombian mainland is bordered by the Caribbean Sea to the north, Venezuela to the east and northeast, Brazil to the southeast, Ecuador and Peru to the south and southwest, the Pacific Ocean to the west, and Panama to the northwest. Colombia is divided into 32 departments. The Capital District of Bogotá is also the country’s largest city hosting the main financial and cultural hub. Other major urban areas include MedellínCaliBarranquillaCartagenaSanta MartaCúcutaIbaguéVillavicencio and Bucaramanga. It covers an area of 1,141,748 square kilometers (440,831 sq mi) and has a population of around 52 million. Its rich cultural heritage[15]—including language, religion, cuisine, and art—reflects its history as a colony, fusing cultural elements brought by immigration from Europe and the Middle East, with those brought by the African diaspora, as well as with those of the various Indigenous civilizations that predate colonization.  Spanish is the official language, although Creole, English and 64 other languages are recognized regionally.

Health care in Colombia refers to the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medicalnursing, and allied health professions in the Republic of Colombia.

The Human Rights Measurement Initiative[1] finds that Colombia is fulfilling 94.0% of what it should be fulfilling for the right to health based on its level of income.

The reform of the Colombian healthcare had three main goals:

  • The achievement of an antitrust policy, to avoid the statal health monopoly.
  • The incorporation of private health providers into the healthcare market
  • The creation of a subsidiated healthcare sector covering the poorest population.

The general principles of the law determine that healthcare is a public service that must be granted under conditions of proficiency, universality, social solidarity and participation. Article 153 of the law mandates that health insurance be compulsory, that health providers must have administrative autonomy, and that health users must have free choice of health providers.

Source: https://en.wikipedia.org/wiki/Colombia

How to provide neonatal care in low-resource environments | Thomas M. Berger | TEDxGVAGrad

Drawing on historical milestones in neonatology, Professor Thomas Berger highlights the groundbreaking discoveries that revolutionised the care of infants with respiratory distress, ultimately leading to significant reductions in mortality rates. Through his personal experiences in Namibia and the implementation of low-cost interventions in low to middle income countries, he showcases how he has taken matters into his own hands and emphasises the importance of prioritising the patient’s well-being above all else. In this inspiring speech, Professor Berger shows how grit and simple solutions can make a positive impact in saving neonatal babies. Thomas M. Berger is a Swiss paediatrician and neonatologist. His postgraduate training began in Switzerland and continued in the USA (residency in paediatrics at the Mayo Clinic, Rochester, MN; fellowship in neonatology at the Harvard Joint Program in Neonatology, Boston, MA; fellowship in paediatric critical care at the Children’s National Medical Center in Washington, DC). After returning to Switzerland, he led the Neonatal and Paediatric Intensive Care Unit at the Children’s Hospital in Lucerne for almost 20 years. In 2017, together with his wife Sabine (a paediatric nurse), he founded NEO FOR NAMIBIA – Helping Babies Survive. This Swiss NGO helps to improve neonatal care in Namibia by providing affordable and robust equipment, ensuring thorough training of local health care professionals, and measuring impact with appropriate statistics. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx


By Charlotte Gore
  – Mon 18 Mar 24

In short: A program that aims to lower the national rates of preterm and early births says it’s helped 4,000 Australian babies avoid an early birth each year since 2021.

The Every Week Counts program helps maternity hospitals redesign services to identify and treat women at risk of delivering early.

What’s next? Experts involved in the program said they hoped to challenge the belief that full term was 37 weeks gestation. 

Sheree Walsh’s twins Heidi and Connor weighed a combined 1250 grams when she delivered her babies at just 25 weeks gestation. The mother only realised she was at risk of a premature birth after she had concerns over a lack of movement and went to the hospital for a check-up. In an ultrasound she could see both babies moving and was temporarily relieved, until the doctor told her to immediately pack her bags to be admitted to the hospital for bed rest.

“I could still feel the babies, but my cervix had shortened so much that it was a risk for me to remain off bed rest,” Ms. Walsh said.

It was not long before the twins arrived.

“We had Heidi and Connor christened the day after they were born because we didn’t think Heidi would make it. She was so sick,” Ms Walsh recalled.

Every Week Counts 

A world-first Australian program, led by the Australian Preterm Birth Prevention Alliance (APBPA), has said it has managed to significantly lower the number of preterm and early births across the country. 

A preterm birth is one that occurs before 37 weeks gestation, while an early term birth is one that occurs between 37 and 39 weeks — and the Every Week Counts program has aimed to reduce the rates of both.

According to the APBPA, preterm births are the single greatest cause of death and disability in Australians under five years old, and 8 per cent of Australians are born preterm.

Australian Institute for Health and Welfare data has shown that preterm birth rates have fallen by 6 per cent since the APBPA began its work in 2018.

First Nations women are twice as likely as non-Indigenous mothers to experience a preterm or early birth. 

APBPA deputy chair Professor Jonathan Morris said recent data from the federally-funded program suggested early term birth rates had declined by at least 10 per cent.

“Over the course of the program, that means 4,000 babies that would’ve been born early have been born at an appropriate time,” he said.

“Meaning they’re more likely to be with their mothers, more likely to be healthy in the first year of life, and more likely to perform well in later life.”

‘She’s a total miracle’

Ms. Walsh said before delivering her twins she had not heard of a Neonatal Intensive Care Unit (NICU) and was yet to attend birth classes.

“A premature birth is something that you’re not prepared for,” she said.

“With many parents of preemies, their relationship doesn’t survive, but we were really lucky because we were there for each other and we had strong support from our family.”

Now almost seven years old, Heidi is vibrant and energetic, and to her parents she’s “a total miracle”.

Having a premmie baby

Most parents don’t have to leave their baby behind when they go home from the hospital.

“Heidi has very limited core strength, however it doesn’t stop her. She is the most resilient child I’ve ever come across,” Ms. Walsh said.

The mother has had a subsequent pregnancy and was able to deliver Heidi and Connor’s younger brother at full term. She said she believed that was due to the extra monitoring and treatments she received under the Every Week Counts program.

‘Misconception’ of 37 weeks as full term 

Women’s Healthcare Australasia chief executive Barb Vernon said the Every Week Counts program has helped healthcare workers across multiple hospitals reshape some services with the aim of seeing fewer preterm and early term births. Strategies included prescribing vaginal progesterone to people with a shortened cervix or who have a history of spontaneous preterm birth — a treatment that assisted Ms. Walsh in her subsequent pregnancy.

The program has also promoted the continuity of care model which sees expectant mothers meeting with the same staff. Smoking while pregnant is also strongly discouraged.

“What we’ve been doing in this program is working with the hospitals to help them redesign their own local hospital system, to help them do their best care for every woman every time,” she said. “Whether it’s their electronic medical record, their booking process for an induction, the way they communicate with women during pregnancy and the information they might give women to make informed decisions. “All of those elements of care then have an impact on supporting more women to continue their pregnancy to 39 weeks.”

Dr. Vernon said a common misconception they hoped to address with the program was the idea that a baby had reached full term at 37 weeks gestation.

“That’s an idea that has been around for more than 100 years, but what we now know is that the baby’s brain develops much more powerfully if they’re born two weeks later at 39 weeks of pregnancy,” she said.

Dr Vernon said the program was an important opportunity to help pregnant women understand they would be doing “the best possible thing for their baby” if their pregnancy could safely continue to 39 weeks gestation.

“The advice that is being given to women as part of this work is that they should be seeking to have a cervix length measurement taken when they have their mid-pregnancy scan,” she said.

Dr. Vernon said so far the program’s work had been “really inspiring” in terms of the outcomes for women and their families.

“There are hospitals across Australia, from very large services to very small rural centres, that are seeing a drop in the number of babies being born earlier than they should be born,” she said.

Trust, meaningful conversations key to improving Indigenous outcomes

While the program has seen broad improvements across the country, the positive outcomes have not extended to First Nations women, according to Indigenous obstetrician and gynaecologist Kiarna Brown who lives and works on Larrakia country in the Northern Territory.

“I have the amazing privilege of now working as an obstetrician in the town that I grew up in, and so what that also means is that throughout pregnancies, I’m looking after my cousins and my nieces,” Dr Brown said.

The experience has shown her that First Nations women have better birth outcomes when they feel safe and can trust their maternity care providers. 

Dr. Brown was part of a study that examined ten years of births at the Royal Darwin Hospital, finding the prevalence of many risk factors for preterm and early births were the same among Indigenous women compared to other expectant mothers. Those risk factors included preterm membrane ruptures, diabetes in pregnancy, blood pressure issues and whether a woman was carrying more than one baby.

But it did find Indigenous women were more likely to have shorter cervical lengths — an area Dr. Brown said needed more study. She said given preterm birth risk factors were not too dissimilar in Indigenous women, it was likely social determinants of health were responsible for First Nations women being twice as likely to experience preterm births.

“I think it boils down to people’s access to healthcare services … levels of education and employment,” Dr Brown said.

“We also need to find ways to engage and educate women — and I’m not saying we should tell women what to do — but actually getting their perspectives on how [health services] can do better.” “So, that’s what we’ve started in the Top End. We’re doing lots of yarning groups in remote communities, asking:

‘Hey, how can we do better? What do you know about this issue preterm birth? What experience have you had with maternity care?'”

She said the predominantly non-Indigenous workforce urgently needed culturally-informed training, as Western medicine has long ignored how First Nations mothers have traditionally experienced pregnancy.

Dr Brown said one example was that many mothers did not track their pregnancies in weeks or trimesters.

She said instead they might say, “‘My baby’s due in the wet season … or my baby’s as big as a mango'”.

“When they feel safe and trusted, they’re going to come [to maternity services] more often and they’re going to have more meaningful relationships with their healthcare professionals,” Dr Brown said. 

Source:https://www.abc.net.au/news/2024-03-19/australian-program-prevents-preterm-early-births/103601038

May 2, 2024 By Andis Robeznieks, Senior News Writer

Not all telehealth programs began during the COVID-19 pandemic. Ochsner Health started connecting pregnant patients with its digital medicine obstetric program in 2016 and has since achieved success across six key performance metrics including improved clinical outcomes, access to care and health equity.

Ochsner Health’s Connected MOM (Maternity Online Monitoring) initiative uses digital health tools to offer expectant mothers a convenient way to safely manage their pregnancy in collaboration with their physicians at some 20 clinical sites in Louisiana and Mississippi.

In 2022, Ochsner Health enrolled about 205 pregnant patients per month in the program, with nearly 1,600 enrolled at any given time that year and more than 2,250 patients in total for the year, according to an AMA Future of Health case study (PDF).

Ochsner Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

Patients are given a blood-pressure cuff to enable them to submit BP readings remotely via their personal smartphone.

This enables ob-gyns and patients to track key health readings and receive alerts when a reading is outside normal thresholds. Once alerted, physicians work with patients on a care plan.

Ochsner Health’s program caught the attention of Sen. Bill Cassidy, MD (R-La.), who then used it as the foundation of his Connected MOM Act, a bipartisan bill supported by the AMA (PDF). The bill would provide state Medicaid programs with remote physiologic monitoring devices and related services through Medicaid.

The Connect MOM program is especially helpful in detecting the hypertensive disorders of pregnancy, like preeclampsia, which is responsible for up to 7% of pregnancy-related deaths in the U.S.

Measures indicate success

The case study notes that the program has achieved significant success across these six dimensions.

Clinical outcomes. 

Connected MOM participants overall had 20% lower odds of pre-term. The program also helped identify patients with “masked hypertension,” which includes those who had hypertension at home but a normal BP measurement in the clinic and are nonetheless at an increased risk for adverse outcomes. Those patients were given early intervention and closer monitoring. 

Access to care. Ochsner Health’s team of more than 120 ob-gyns and certified nurse midwives delivered more than 10,860 babies—of which, about 20% were enrolled in Connected MOM. The option of substituting some in-office visits with virtual visits also was a benefit to patients with transportation challenges, and was helpful to those who otherwise would have had to take time off from work and secure child care to see their physician.

Patient, family and caregiver experience. Ochsner Health data indicates that 10.7% of patients in Connected MOM are re-enrollees, “highlighting a high level of satisfaction with the program,” says the case study.

Clinician experience. Because it is so easy to use the program’s digital tools, staff can better manage their time and offer support to more new patients. For every 1,000 patients enrolled in Connected MOM, the capacity of an ob-gyn’s clinic increases by the equivalent of 0.6 of full-time employee.

Financial operational experience. Connected MOM is offered at no additional cost to patients.

Health equity. Connected MOM supports the recruitment of a diverse demographic of patients, with more than 60% of enrollees being between 26–35 from various racial backgrounds, including 29% Black and 5% Asian, with about 30% of enrollees covered by in-state Medicaid programs.

Grant funding has helped pay for much of the program, so the passage of Dr. Cassidy’s bill would go a long way toward making the program sustainable.

“We’re asking for CMS [the Centers for Medicare & Medicaid Services] to make sure that not just the moms who go to Ochsner, but all moms across the United States are able to benefit from the Bluetooth-enabled blood-pressure devices and remote patient-monitoring devices such as those used in Connected MOM,” Veronica Gillispie-Bell, MD, MAS, head of women’s services at Ochsner Medical Center-Kenner, said in a recent episode of “AMA Update.” 

“If we’re really looking to bring resources to those individuals, to those patients who need it the most, we have to have federal support,” Dr. Gillispie-Bell added.

Support for patients and physicians

The case study also highlights how Ochsner Health leverages the foundational pillars for “addressing the digital health disconnect” described in the AMA-Manatt Health report Closing the Digital Health Disconnect: A Blueprint for Optimizing Digitally Enabled Care (PDF).

The blueprint’s foundational pillars to achieve digitally enabled care are:

  • Build for patients, physicians and clinicians.
  • Design with an equity lens.
  • Recenter care around the patient-physician relationship.
  • Improve and adopt payment models that incentivize high-value care.
  • Create technologies and policies that reduce fragmentation.
  • Scale evidence-based models quickly.

In describing how the program is built for patients, physicians and other health professionals, the case study notes that patients are sent reminders to take their BP reading. Patients also receive a weekly planner and checklist for tracking their vital signs.

“The program has been thoughtfully designed to support both patient and clinician needs,” the case study says.

Regarding the pillar on creating technology that reduces fragmentation, the case study notes that sharing data via the patient’s smartphone app means that patients don’t need to copy or transcribe the data to message their physician. “Connected MOM allows for a centralized location for both the care team and the patient to access information, track progress, [and] identify trends,” the case study says.

Source:https://www.ama-assn.org/practice-management/digital/digital-health-program-cuts-pre-term-births-20

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#JuanLuisGuerra #Juanes #VidaCotidiana

Mitchell Goldstein, MD, MBA, CML

Neonatology, a field dedicated to the care of newborns, is characterized by its rapid pace of evolution. New research findings, advanced technologies, and updated guidelines continuously reshape our understanding and practices. What was considered best practice a decade ago may be outdated as the field progresses. This constant flux can lead to disagreements among professionals, which, though potentially disruptive, play a critical role in advancing care standards and improving patient outcomes.

Navigating these disagreements with finesse ensures they contribute rather than hinder progress. Constructive disagreement is not just about airing differing opinions; it involves engaging in a thoughtful and respectful dialogue that fosters professional growth and enhances patient care. Here are several fundamental principles for managing disagreements effectively in neonatology.

1. Prioritize Respectful Dialogue

The foundation of productive disagreement is respectful.  communication. Interrupting others disrupts the flow of conversation and can escalate tensions. It is crucial to allow each participant to complete their thoughts before responding. This practice ensures that every viewpoint is fully understood and considered. Active listening is a cornerstone of respectful dialogue; it demonstrates that you value the other person’s perspective and are open to their ideas.

2. Let Everyone Speak

Equally important is ensuring that every participant has the opportunity to voice their opinions. Dominating the conversation or dismissing others’ viewpoints can stifle valuable insights and create a skewed discussion. Encourage a balanced exchange where all voices are heard. This inclusive approach not only fosters a more democratic dialogue but also enriches the decision making process by incorporating diverse perspectives.

3. Silence is Golden

In the heat of a debate, silence can be a powerful tool. It provides a moment for reflection and allows participants to process the information being discussed. Rather than rushing to fill every

pause with words, embrace moments of silence as an opportunity to gather your thoughts and consider the points raised by others. Silence can also help de-escalate tensions and allow everyone to cool down before responding.

5. Choose the Appropriate Setting for Discussions

 The context in which disagreements occur can significantly impact their resolution. Sensitive or contentious issues are often better addressed in a private rather than a public forum. A private discussion allows for more candid exchanges without the added pressure of an audience, which can lead to more effective problem-solving and reduce the risk of escalating the conflict.

6. Focus on the Issue, Not the Person

Effective disagreement involves focusing on the issue rather than allowing personal animosities to cloud the discussion. Avoid competitive “pissing contests” where the goal is to outshine or undermine the other person. Instead, concentrate on clearly articulating the opposing viewpoint and contrasting it with evidence based data. This approach ensures that the debate remains centered on the merits of the arguments rather than personal conflicts.

7. Use the Praise Sandwich Approach

One effective method for presenting a differing opinion is the “praise sandwich” approach. This technique involves beginning with a positive remark or acknowledgment of the other person’s perspective, presenting your disagreement, and concluding with another positive note. This approach helps soften the impact of dissent and maintains a positive and constructive tone throughout the discussion. It demonstrates respect for the other person’s contributions while making your point.

8. Know When to Step Back

Sometimes, despite our best efforts, discussions can become too heated to be productive. In such cases, stepping back and taking a break is wise. A pause lets participants cool down and reflect on the discussion with a clearer perspective. Revisiting the conversation later can lead to more thoughtful and constructive dialogue, fostering a better resolution.

9. Cultivate an Open Mind

Approaching disagreements with an open mind is essential for constructive dialogue. Suspend disbelief and be willing to consider new ideas, even if they challenge your current beliefs. This willingness to explore different viewpoints can lead to innovative solutions and improvements in practice. Agreeing to disagree is a natural part of professional discourse and can enhance collaboration and problem-solving.

10. Remember the Shared Goal

Regardless of the intensity of the disagreement, it is essential to remember that all participants share a common goal: improving patient care. Maintaining a sense of camaraderie and mutual respect helps to keep the bigger picture in focus. (4) Disagreements should be viewed as opportunities to refine and enhance practices rather than as personal battles.

 By adhering to these principles, disagreements can be transformed from potential conflicts into valuable opportunities for professional development and innovation. Constructive disagreement enriches the practice environment and contributes to improved physician retention and a more dynamic approach to patient care. Fostering a respectful dialogue ensures that every voice is heard and that the field of neonatology continues to advance in its pursuit of excellence.

Source: https://neonatologytoday.net/newsletters/nt-sep24.pdf

High-quality neonatal intensive care requires diverse specializations and interprofessional teamwork to include the unique contributions of neonatal therapists. Neonatal therapists include occupational therapists (OT), physical therapists (PT), and speech-language pathologists (SLP), who specialize in delivering age-specific evaluations and therapeutic interventions for premature and medically complex infants in the neonatal intensive care unit (NICU)  A neonatal therapist begins with the end in mind to mitigate adverse sequelae, optimize neurodevelopment, and strengthen infant mental health by scaffolding the infant-parent dyad Although therapists are traditionally known for their rehabilitative roots, neonatal therapists utilize a preventative, habilitative approach, emphasizing neuroprotection and neuropromotion .

 What is Neonatal Therapy? 

 Neonatal therapy is an advanced practice area for OTs, PTs, and SLPs as described by the Neonatal Therapy Core Scope of Practice©. All three professional groups share core fundamental knowledge yet recognize that each discipline adds unique and valuable contributions to the field. In part, neonatal therapy is “the art and science of integrating typical development of the infant and family into the environment of the NICU.”.  As interdisciplinary care team members, neonatal OTs, PTs, and SLPs help drive the delivery of Family Centered, developmental care and are often instrumental in the discharge planning process. In level III and IV NICU settings, neonatal therapists are integral to neonatal follow-up clinics, providing neurodevelopmental testing and triage for early intervention services.

Why is neonatal therapy considered an advanced practice area?

 Professional training programs for OT, PT, or SLP entail graduate-level or doctoral degrees. Despite this rigorous education, advanced training in the neonatal therapy subspecialty is required. An entry-level neonatal therapist requires NICU-specific continuing education and mentorship to ensure safe, well-timed, risk-adjusted neonatal care. Neonatal therapists must be familiar with the complexities of the NICU environment, recognize neonatal risk factors, precautions, and medical comorbidities, navigate NICU equipment, safely handle preterm and critically ill infants, apply trauma-informed principles when working with families, and have a solid understanding of typical preterm and newborn neurobehavior and developmental progression (1-3). This extensive education and training instills confidence in neonatal therapists’ expertise and their ability to provide evidence-based services in this highly vulnerable patient population.

What are the requirements to become a certified neonatal therapist (CNT)?

The CNT designation is internationally recognized and obtained throughthe Neonatal Therapy Certification Board (NTCB). The CNT certification requirements include: (a) credentialling as an OT, PT, or SLP for three or more years, (b) 3500 hours of experience in the NICU, (c) Forty hours of NICU-specific education in less than three years, (d) forty hours of NICU mentorship, and (e) successful completion of the Neonatal Therapy National Certification Exam.

What are the neonatal therapy practice domains?

Neonatal OT, PT, and SLP have a shared foundational knowledge, including six practice domains: (1) environment, (2) family/ psychosocial support, (3) sensory system, (4) neurobehavioral system, (5) neuromotor and musculoskeletal systems, and (6) oral feeding and swallowing, which are not fundamentally exclusive to any one discipline (1,2). Neonatal therapists use an integrative collaborative-care model when administering continual assessment and intervention cycles grounded in evidence-based decision-making (9). Ideally, therapeutic interventions begin at the earliest point of the lifespan when therapists collaborate with other disciplines and use their unique lenses to help advance infant competencies, promote parental confidence, and expedite the journey home.

What interventions do neonatal therapists provide?

From the first day of life, neonatal therapists promote healthy postures and movement patterns, reduce pain and stress, and nurture age-appropriate sensory experiences. In tandem with the bedside nurse, neonatal therapists partner with families to engage them in their baby’s activities of daily living, such as diapering, eating, dressing, bathing, etc.. Neonatal therapists can be instrumental in coaching parents with direct hand-overhand support and anticipatory guidance to help develop proficiency and confidence in their co-occupation as parents. The neonatal therapy team helps to advance individualized care plans to include environmental modifications, positive touch, therapeutic handling for posture and regulation, protection of the aerodigestive system, infant-driven feeding strategies, and parent education related to discharge needs (1, 3, 11). In many settings, neonatal therapists are considered feeding specialists with advanced training in pre-feeding strategies, breastfeeding support, and clinical feeding assessments (10, 13). Highly skilled neonatal therapy professionals will often have extensive training in any of the following areas: (a) evaluating an infant’s neurologic integrity using skilled observations and standardized testing, (b) therapeutic management of orthopedic conditions, (c) instrumental swallowing evaluations such as video fluoroscopic swallow studies (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES), and (d) lactation support as a Certified Lactation Counselor (CLC) or International Board Certified Lactation Consultant (IBCLC).

What is the best approach to successful neonatal therapy staffing?

With the rising complexity and volume of premature and medically fragile infants, there is a growing need for highly trained, multidisciplinary NICU teams . Finding and staffing NICUs with all three disciplines who also have NICU-specific expertise can be highly challenging, particularly in units with high fluctuations in their census and for smaller, more rural NICUs. Larger level III and IV NICUs have additional staffing challenges of higher acuity, heavy caseloads, and shortage of qualified therapists. The staffing models of neonatal therapy teams often vary in size and the way they delineate roles between neonatal therapists based on therapist availability, cross-discipline knowledge, therapy service requirements, budget constraints, and the individual therapist’s competence and confidence within the neonatal subspecialty. The American Academy of Pediatrics (AAP) NICU Verification Program includes neonatal therapy services for Level II, III, and IV NICUs, with certified neonatal therapists (CNTs) preferred.

Help celebrate neonatal therapists from around the world!

Every September, the National Association of Neonatal Therapists (NANT) hosts International Neonatal Therapy Week (INTW) to highlight this advanced practice area and unite neonatal OT, PT, and SLP clinicians around the globe. NANT is a professional organization that delivers NICU-specific continuing education, resources, standards, mentorship, and supportive connections to advance this specialty. During the week of September 15th-21st, 2024, NANT will celebrate the impact of this vibrant neonatal therapy community with its members, who span over thirty countries and five continents.

Want To Learn More?

• Celebrate International Neonatal Therapy Week between September 15th and 21st, 2024 and join  

   our vibrant neonatal community.

 • Attend NANT 15, the annual neonatal therapy conference, in Indianapolis, IN, from March 27th to   

   29th, 2025. Attendees typically represent all fifty states and eight or more countries.

• Join NANT’s annual Virtual Summit in December — A FREE educational event— info coming soon! • Stay informed by subscribing to NANT NEWS and visiting www.neonataltherapists.com

• Therapists interested in becoming a CNT can apply online at https://www.ntncb.com/

Cistone, Nicole MSN, RN, RNC-NIC; Pickler, Rita H. PhD, RN, FAAN; Fortney, Christine A. PhD, RN, FPCN; Nist, Marliese D. PhD, RNC Editor(s): Gephart, Sheila PhD, RN, Section Editor; Newnam, Katherine PhD, RN, NNP-BC, CPNP, IBCLE, Advances in Neonatal Care 24(5):p 442-452, October 2024. | DOI: 10.1097/ANC.0000000000001177

Abstract

Background: 

Although routine nurse caregiving is vital for the overall health of preterm infants, variations in approaches may exert distinct effects on preterm infants’ stress responses and behavior state.

Purpose: 

The purpose of this systematic review was to examine routine nurse caregiving in the neonatal intensive care unit and its effect on stress responses and behavior state in preterm infants.

Data Sources: 

A systematic search was conducted using PubMed, Embase, and CINAHL for studies published between 2013 and 2023.

Study Selection: 

Included studies enrolled preterm infants born <37 weeks gestational age and investigated nurse caregiving practices and effects on stress responses and/or behavior state.

Data Extraction: 

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data about study design, methods, findings, and limitations were extracted and summarized. Included studies were evaluated for bias using the National Health, Lung, and Blood Institute quality assessment tools.

Results: 

All 13 studies included in the review received a fair quality rating. Nurse caregiving activities, including suctioning, diaper changes, bathing, and weighing, were associated with increases in heart and respiratory rates, blood pressure, energy expenditure, and motor responses, lower oxygen saturations, and fewer sleep states.

Implications for Practice and Research: 

Adapting nurse caregiving frequency and duration, aligning caregiving with infant state, and integrating developmental care strategies may reduce infant stress responses and support behavioral rest. Further research is needed to understand how caregiving activities affect stress responses and behavior state in preterm infants, aiding in identifying modifiable caregiving stressors to promote optimal development.

Spotsylvania Regional Medical Center    Jul 19, 2021

Meet Occupational Therapist Hayley Chrzastowski and learn how a baby in the Level III NICU at Spotsylvania Regional Medical Center would receive care from an occupational therapist. Dr. C Chrzastowski will also discuss how she works to both include and support baby’s care team to best prepare them to care for baby once transitioned home.

Key Points

Your baby may have tests in the NICU to find out about health conditions and treatments she needs to grow and be healthy.

Some tests, like blood tests, are really common, and lots of babies get them. Others are just for babies with certain health conditions.

Before providers can do certain tests on your baby, you have to give permission. This is called informed consent.

Talk to your baby’s provider about tests your baby needs. Make sure you understand the test and why your baby needs it before you give permission.

Why do babies have tests in the NICU?

Your baby’s health care providers in the newborn intensive care unit (also called NICU) staff give your baby medical tests to find out about your baby’s health conditions. Test results help providers know what treatment your baby needs. For example, providers may do a blood test to check your baby for anemia. Anemia is when your baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of her body. Or providers may take an X-ray to check your baby for a lung infection. Your baby’s provider tells you what tests your baby needs and tells you the test results.

Before providers can do certain tests, they need your consent. This means they’ll ask you to read and sign a consent form. When you sign the form, you give them permission to do the test. Sign the form only when you understand what the test is and why your baby needs it. Ask your baby’s providers any questions you have about the test before you sign the form.  

What tests may your baby have in the NICU?

blood test — Tests your baby’s blood for certain health conditions. Blood tests are the most common tests done in the NICU. Test results give providers important information about your baby’s health.  They also help providers find possible problems before they become serious.

CAT scan or CT scan — Also called computed tomography scan. A test that takes pictures of the inside of the body. It’s like an X-ray, but it gives a clearer, three dimensional (also called 3D) view. Your baby goes to the radiology department for the test. She may need medicine to help keep her still during the test.

echocardiogram — A special kind of ultrasound that takes pictures of the heart. Ultrasound uses sound waves and a computer screen to make the pictures. Providers use this test to help find heart problems, including heart defects. A heart defect is a problem with the heart that’s present at birth.

EKG or ECG— Also called electrocardiogram.  A test that records the heart’s electrical activity. An EKG can show how fast your baby’s heart is beating and if the rhythm of the heartbeat is regular.

hearing test — Also called brainstem auditory evoked response test or BAER. This test checks your baby’s hearing. A provider places a tiny earphone in your baby’s ear and puts small sensors on his head. The provider plays sounds through the earphones, and the sensors send information to a machine that measures your baby’s response to the sounds. All babies get this test as part of newborn screening.

MRI— Also called magnetic resonance imaging. This test uses strong magnets and radio waves to take detailed pictures of the inside of your baby’s body. An MRI gives a more detailed view than a CT scan, X-ray or ultrasound. Your baby may need medicine to help keep her still during the test.

newborn screening test — Checks for serious but rare and mostly treatable conditions at birth. It includes bloodhearing and heart screening.

ROP exam— Also called retinopathy of prematurity exam or eye exam. Providers use this test most often for babies born before 30 weeks of pregnancy or babies who weigh less than 3 1/3 pounds. An eye doctor (also called an ophthalmologist) checks to see if the blood vessels in your baby’s eyes are developing the right way. If the doctor sees signs of problems, he checks your baby’s eyes over time to see if the condition gets better or if it needs treatment.

ultrasound — A test that uses sound waves to make pictures of the inside of the body. A provider puts a special jelly on your baby’s skin over the area of the body she wants to check. Then she rolls a small device shaped like a microphone over the area. Providers often use ultrasound to check for bleeding in your baby’s brain.

urine test — Tests a baby’s urine for certain health conditions. Urine test results can tell providers a lot about your baby’s overall condition. For example, test results can tell provider if your baby’s getting enough fluid, how your baby’s kidneys are working and if your baby has an infection. Your baby’s provider inserts a thin tube called a urinary catheter in the opening where urine passes out of your baby’s body to collect the urine.

weight — Weighing your baby at birth and as he grows and develops. Providers weigh your baby soon after birth and at least once a day in the NICU. It’s a good sign when babies start to gain weight at a steady rate.

x-ray — A test that uses small amounts of radiation to take pictures of the inside of your baby’s body. X-rays show pictures of your baby’s lungs and other organs. If your baby has breathing problems, she may need several lung X-rays each day. X-rays expose your baby to radiation, but the amount is so low that it doesn’t affect her health now or in the future. Radiation is strong energy that can be harmful to your baby’s health if she’s exposed to too much.

See also: shareyourstory.org https://www.marchofdimes.org/find-support/topics/neonatal-intensive-care-unit-nicu/common-tests-nicu

Recognize the warning signs of social anxiety and get help for your teen.

Posted December 20, 2022 |  Reviewed by Gary Drevitch

THE BASICS

Key points

  • Post-pandemic life is harder for teens with social anxiety, as restrictions that curtailed their social activities are no longer present.
  • Parents can watch for a variety of signals that indicate whether their teen is struggling with social anxiety.
  • Cognitive behavioral therapy is the gold standard of effective treatment and management for social anxiety.

Parents continue to grapple with the impact of pandemic restrictions on the mental health of their children. For teens, reentry into “normal” life brings a new set of challenges, especially for those prone to social anxiety. Most teens with social anxiety experienced profound relief during the pandemic because restrictions curtailed their social and performance situations. They didn’t have to face the many situations that commonly trigger their social anxiety, such as raising a hand in class, making idle chitchat with peers, attending a social event, and playing sports. However, their prolonged lack of exposure to these situations also set them back because they didn’t have the opportunity to learn and grow and discover that they can in fact handle being in uncomfortable social situations.

Teens’ anxiety about social and performance situations came roaring back with a vengeance when those situations returned to their daily lives. A national survey of U.S. teens aged 15 to 19 found that nearly half (48%) were concerned about experiencing social anxiety while transitioning back to “normal” life (Steinberg, 2021). Compared with pre-pandemic statistics, which indicated that approximately 10% of teens suffered from social anxiety (NIH, n.d.), this is a remarkable increase that deserves our attention.

In simple terms, social anxiety involves feeling extreme worry and fear related to social and performance situations. Individuals suffering from social anxiety can also fear being observed doing basic everyday activities, such as using a phone, texting, writing, using a computer, eating, or using a public restroom. Their worry and fear focus on concerns about feeling judged, negatively evaluated, and ultimately being rejected by others. Social anxiety doesn’t present the same way in all individuals, but it always exacts a big toll on the well-being of the sufferer.

How do I know if my teenager is struggling with social anxiety?

Observe your teen’s behaviors and listen to what they are saying. If you notice any of the following, your teen is likely experiencing social anxiety:

  • Inordinate focus on and preoccupation with concerns about how others perceive them.
  • Avoidance of social or performance situations that most peers tolerate.
  • Extreme physiological reactions (e.g., sweating, shaking, nausea, hyperventilation) in performance or social situations.
  • Excessive reassurance seeking and/or declarations that others perceive them as weird, odd, etc.
  • Requests for special accommodations from teachers, counselors, etc. to reduce or avoid being in situations that trigger worry and fear (e.g., requests to be excused from oral presentations, public speaking, competitions, or classes or activities that others tolerate easily).
  • Recess and break times spent in the library or other locations less likely to result in social interactions
  • Refusal to attend parties or other events you expect your teen would enjoy, or insistence that they simply dislike these events.
  • Spending time only with kids they know well.

If you observe any of the above, your teen is missing out and may need your help.

Why it’s important to get help for your teen

Untreated social anxiety is associated with depressionsubstance abuse, and other serious psychological problems. It can make your teen’s life miserable and limited.

Studies show that untreated social anxiety has a strong negative impact on various measures of quality of life, including academic achievement, and can interfere with people’s career paths (Vilaplana-Pérez et al., 2021). Without effective intervention, teens often come to define themselves as lacking in basic self-confidence, insecure, self-doubting, and inadequate.

These unfortunate outcomes and suffering are avoidable and repairable if the right steps are taken. Social anxiety or any other type of anxiety disorder should never define a person. These are common, highly treatable problems, just like asthma, diabetes, or allergies.

Finding treatment for social anxiety

Cognitive behavioral therapy (CBT) is the gold standard of effective treatment and management for most anxiety and related problems, including social anxiety. The basic process of CBT for anxiety disorders involves identifying distorted thinking, correcting those thinking errors, and adjusting specific behaviors. Exposures are the single most important element of successful CBT. The basic technique of exposure is to gradually face a situation that triggers anxiety, while at the same time not engaging in any safety, avoidance, or accommodation behaviors or rituals (Walker, 2021).

Finding a qualified CBT clinician, however, can be a huge challenge, and locating one who is truly experienced in CBT is not easy. You may have tried traditional talk therapy for your teen but found it ineffective. Unfortunately, after ineffective treatment, many people feel worse about themselves; like they can’t be helped. This is especially damaging to a young person developing their sense of self.

To find a therapist, visit the Psychology Today Therapy Directory.https://www.psychologytoday.com/us/blog/anxiety-relief-for-kids-and-teens/202212/post-pandemic-reentry-for-teens-with-social-anxiety

Dr Niels Rochow is a researcher and neonatologist at Klinikum Nürnberg, in Nürnberg, Germany, one of the largest municipal hospitals in Europe. 

His work, looking after newborns born early or with medical problems, keeps him very close to the topic of his research. He recalls a tense battle over the weekend to save a premature baby’s life. 

‘She was born early and was in a bad state. We fought for two and a half days to keep her alive.’ The baby’s survival depended on invasive artificial ventilation technology and external lung and kidney support. 

Although sometimes lifesaving, these devices were originally developed for adults and scaled down for neonatal care. They are not well adapted to a baby’s tiny body, are highly invasive and can damage immature lung tissue.

Currently, premature babies frequently need to be heavily medicated and connected to a mechanical ventilator pumping air into their lungs. 

‘These babies are full of tubes and essentially paralysed,’ said Rochow. This treatment often leads to side effects and can cause chronic lung disease, impacting the child’s whole life.’

Short- and long-term impact

Every year, about 15 million babies are born preterm – classified as before the 37th week of pregnancy. A full-term pregnancy is 40 weeks, but a lot happens in those last three weeks. Currently, around 7% of births in the EU are classified as preterm. 

Despite advancements in neonatal intensive care, progress in improving long-term health outcomes for these infants has been slow. Two million preterm babies lose their lives – before they even start – every year. 

In fact, the Global Burden of Disease study in 2010 estimated that preterm births were the leading cause of death and disability in children under the age of five – greater than either malaria or pneumonia.

Having missed the crucial developmental milestones that normally occur in the last part of the pregnancy, survivors also have increased risks of long-term health consequences. They are more likely to suffer respiratory issues like bronchitis and asthma, and be affected by a range of neurodevelopmental disorders due to brain injury.

Like mother’s womb

Dr Rochow is one of a team of European and international researchers that received a grant through the European Innovation Council (EIC) Pathfinder programme to work on a better alternative – a system they call an artificial placenta, or ArtPlac. 

The goal is to simulate the conditions of the mother’s womb, potentially reducing complications and improving outcomes for the most vulnerable newborns.

‘In the womb, the baby is connected to the natural placenta which serves as a lung, a kidney and a feeder,’ said Professor Jutta Arens, one of the lead engineering scientists working on the four-year ArtPlac project, which kicked off in 2023. 

‘This placenta cannot be reconnected after birth, which is why we are developing a device that replaces its functions in the most natural way possible.’ By connecting to the baby’s belly button, the artificial placenta allows the infant to develop and heal naturally, offering a less invasive alternative to current methods. 

ArtPlac will also make it easier for parents to have physical contact with their child from the start. Artificial ventilators are not only very invasive, they are also awful for parents, according to Rochow.

‘If you hear your baby cry, you want to hold it. Yet, you can’t. With ArtPlac, parents could be close to the baby and interact with it more easily.’ 

ArtPlac will undergo initial in-vitro testing in the last quarter of 2024. This will be followed by proof of principle in-vivo testing which will be carried out on a premature lamb. The aim is to be able to perform initial clinical trials on babies within the next few years. 

Early injury, lifetime consequences

Although advances in healthcare mean that more than half of all babies born before 28 weeks survive, a large proportion of these will have a lifelong disability. Even babies born late preterm – between 32 and 37 weeks – are at increased risk.

The brain damage caused by premature birth, known as encephalopathy of prematurity (EOP), can result in long-term disorders like cerebral palsy, severely impaired cognitive functions, attention deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Brain injury can also be caused by a lack of oxygen during birth (asphyxia) or a stroke around the time of birth. 

For example, it is estimated that a quarter of all cerebral palsy cases are associated with preterm birth. Diagnosing a brain injury in a preterm baby, however, is complicated and can take days to weeks. Even then, there are few options for treatment. 

Dr Bobbi Fleiss is a researcher and senior lecturer at the Royal Melbourne Institute of Technology (RMIT) in Melbourne, Australia. She leads the RMIT Perinatal Brain Injury lab and is passionate about understanding injury to the brain in newborn babies and how to make outcomes for these infants better. 

‘The standard procedure is applying cooling therapy, which has to happen within six hours after birth,’ explains Fleiss. ‘It is very stressful.’ 

Fleiss is part of a global team of researchers that received funding from the EU to develop an effective alternative treatment for preterm brain injury. Led by the French National Institute of Health and Medical Research (INSERM), the PREMSTEM project runs from 2020 to the end of 2024.

It brings together world-leading clinicians, researchers, stakeholder advocacy groups and an industrial partner specialising in neonatology and drug development from eight countries: Australia, France, Germany, Italy, the Netherlands, Spain, Sweden and Switzerland.

Brain-healing stem cells

Like ArtPlac, PREMSTEM takes its inspiration from nature’s own design. Blood that remains in the umbilical cord after birth contains a special kind of cell called a stem cell. 

These cells have the ability to grow into many different kinds of cells, such as bone marrow cells, blood cells or brain cells. This makes them very valuable for treating a wide range of diseases.

PREMSTEM is using stem cells from donated umbilical cords to create a groundbreaking and easy-to-administer new treatment that could help heal neonatal brain injuries. 

‘Think of stem cells as little factories that produce helpful chemicals and support the brain in helping itself,’ said Fleiss. ‘Our goal is to provide an intranasal treatment using a fine mist containing the stem cells.’

Specifically, a simple nasal spray containing stem cells is sprayed into the baby’s nose. From there, the stem cells travel to the brain, find the damaged areas and assist the brain in repairing itself.

PREMSTEM researchers have successfully tested different delivery systems, several of which have proven to be effective in reducing brain injury in animals. They expect that clinical trials testing the new treatment in human babies should begin in 2026. 

The success of these projects could be life-changing for millions of babies and their families. ‘Even if we help one percent of them, it’d be wonderful,’ said Fleiss.

‘My dream is to see every baby leaving the hospital with smiling families. I hope every parent’s biggest stress will be how to strap their baby into a car seat. Nothing more.’ 

Research in this article was funded by the EU’s Horizon Programme including, in the case of ArtPlac, via the European Innovation Council (EIC). The views of the interviewees don’t necessarily reflect those of the European Commission.

Source:https://projects.research-and-innovation.ec.europa.eu/en/horizon-magazine/pioneering-care-preemies-artificial-placentas-brain-healing-stem-cells

Last updated: August 21, 2024

High-risk pregnancies can be treated and managed through telehealth as long as the patient and provider have an emergency plan in place. US Dept. Health and Human Services

What are considerations for using telehealth for high-risk pregnancies?

Telehealth can provide life-saving health care for pregnant patients. Some rural patients live far from high-risk specialists. Others can’t afford to take time off work or find childcare to go to their provider’s office. There are several ways to ensure access to high quality care for high-risk patients through telehealth.

Use remote patient monitoring

There are several devices that can monitor a patient’s health without the patient having to come into the office for multiple check ups. Remote patient monitoring can also be used to gauge whether a patient has breached the high-risk threshold, meaning it’s time to seek immediate medical care.

Pregnancy-related remote monitoring devices may include:

  • Blood pressure monitors
  • Blood glucose testing
  • At home fetal monitors

Patients should be sent to in-person care when:

  • There is decreased fetal movement
  • There are known fetal abnormalities that require multiple check ups
  • The patient is experiencing pre-eclampsia symptoms
  • The patient is experiencing signs of early labor

Know when to seek in-person care

Part of your telehealth workflow should include a protocol for when to send a high-risk patient to the office or hospital. Some high-risk conditions, including pregnancies with multiple babies and certain chronic conditions, need more in-person oversight than telehealth can provide.

Partner with local resources for rural and underserved patients

Telehealth can be a life-saving resource and also the first line of defense for potential pregnancy complications. This is especially true for rural and underserved patients who may delay, or entirely forgo, prenatal care.

High-risk care tends to be more hands on than complication-free maternal health care. But there are many ways telehealth providers can make sure rural and underserved patients get the care they need, when they need it. Some examples include:

  • Identify and partner with the patient’s local clinic or hospital. Local facilities can often provide routine testing that will help you determine the best course of care, and keep an eye on potentially serious complications. This could include baseline 24 urine collection and labs for pre-eclampsia, STI panels, blood sugar monitoring, and ultrasound.
  • Work with local OB-GYNs for in-person appointments. Underserved patients may often feel more comfortable with providers that are not local to their area.
  • Research local resources and online help post-childbirth. Rural and underserved parents don’t stop needing maternal telehealth care once the baby is born. Telehealth providers can help in those first few days and weeks with telehealth lactation consulting and mental health counseling. Other potential resources following high-risk pregnancies could include maternal or pediatric specialists, local and online behavioral health support, substance use counseling, smoking cessation, and parenting classes.

More information

Telehealth for chronic conditions — Health Resources and Services Administration

Statewide Telehealth Program Enhances Access to Care, Improves Outcomes for High-Risk Pregnancies in Rural Area — Agency for Health Care Research and Quality

Spotlight

Maternal Hypertension Remote Patient Monitoring Project

Using remote patient monitoring (RPM) technology, the University of Mississippi Medical Center, a HRSA-funded Telehealth Center of Excellence, is monitoring women who are at high risk for hypertension during their pregnancy. A nurse coordinator will assist the mothers in coordinating care including connecting them to community and health resources to support a healthy pregnancy. The program also provides maternal child and chronic disease management support and virtual consultations with an obstetrician in the home.

Learn more about the University of Mississippi Medical Center’s Maternal Hypertension RPM project .

YouTube  Child Mind Institute  Apr 27, 2023

Building Resilience: Taking Charge of Your Well-Being

Navigating life as a young person today can feel like an obstacle course of challenges, from school pressures to social expectations and the quest for personal goals. But each of these experiences is also a chance to build something powerful: resilience. Resilience is the ability to bounce back from setbacks and keep going even when the going gets tough. And the good news? It’s a skill anyone can develop with a little practice.

Set Your Own Pace
Life is not a race, despite how it sometimes feels. Take a moment to step back, breathe, and check in with yourself. How do you feel? Are you pushing too hard or not hard enough? Finding your balance is key. Try setting small, achievable goals each week that help you get closer to your bigger dreams. Remember, it’s the consistent, small steps that lead to big changes.

The Power of Positive Self-Talk
Your mind can be a powerful cheerleader—or a tough critic. What you say to yourself impacts how you feel and act, so practice kindness in your self-talk. When a mistake happens, instead of thinking, “I can’t believe I messed up,” try, “I learned something valuable here. I’ll do better next time.” Resilience isn’t about never feeling down; it’s about how you lift yourself back up.

Find Your Outlet
Everyone needs an outlet to decompress and recharge. For some, that’s going for a jog or hitting the gym. For others, it’s creating art, cooking, or simply enjoying a quiet walk. Whatever brings you joy, make time for it. Life can be demanding, but even a few minutes a day spent doing what you love will help you keep your energy up and your stress down.

Celebrate Your Wins
Often, we’re so focused on what we haven’t done that we forget to celebrate what we have achieved. Did you ace that exam, complete a project, or make a new friend? Each accomplishment is worth recognizing. Celebrating even the small victories gives you the confidence to tackle the next big thing with resilience and courage.

Building resilience takes time, patience, and practice. But with each step forward, you’re creating a stronger foundation to support you through whatever life brings your way. Keep going, believe in yourself, and know that every challenge you overcome makes you that much stronger.

Mylemarks

Stress Management Tips for Kids and Teens!

Sep 3, 2020

Today, we will be learning all about stress! You’ll learn the definition of stress, how it affects you, and FIVE helpful ways of coping!

Mental Health Center Kids

Coping Skills For Kids – Managing Feelings & Emotions For Elementary-Middle School | Self-Regulation

Nov 6, 2022

Help children and teens learn how to manage big emotions. Emotional regulation for anger management, stress management, anxiety, depression, and coping strategies for many more mental health struggles. Provide a good foundation of coping skills for elementary and middle school students, and the same concepts can be applied to teenagers or high school students. Three Steps To Manage Emotions: 1) Notice And Identify Your Feelings 2) Think About Coping Skills You Can Use To Feel Better 3) Take Action By Practicing One Or More Coping Skill

        Gravedad Zero

De Colombia para el mundo. Los mejores exponentes del surf local se unieron a tres surfistas explosivos: la campeona mundial de stand up paddle Izzi Gómez, su hermano Giorgio y el panameño Oli Camarena. Dirección y Producción: Germán Bertasio. Edición: Fede Maicas. Comercial: Martín Méndez Pasquali. Productora: Mundo Zero Producciones.

EXCEPTIONAL ACTS, PERSPECTIVES, TRANSFORMING HEALTHCARE

Honduras, officially the Republic of Honduras, is a country in Central America. It is bordered to the west by Guatemala, to the southwest by El Salvador, to the southeast by Nicaragua, to the south by the Pacific Ocean at the Gulf of Fonseca, and to the north by the Gulf of Honduras, a large inlet of the Caribbean Sea. Its capital and largest city is Tegucigalpa.

The nation’s economy is primarily agricultural, making it especially vulnerable to natural disasters such as Hurricane Mitch in 1998. The lower class is primarily agriculturally based while wealth is concentrated in the country’s urban centers. Honduras has a Human Development Index of 0.625, classifying it as a nation with medium development. When adjusted for income inequality, its Inequality-adjusted Human Development Index is 0.443.

The health system consists of a public and a private sector. The former includes the Ministry of Health and the Honduras Social Security Institute . The Ministry serves the entire population in its own facilities staffed by its own physicians and nurses, but it is estimated that only 50%-60% of Hondurans regularly use these services. The Institute covers 40% of employed economically active individuals and their dependents, using its own and contracted facilities. The private sector serves some 10%-15% of the population: those who can afford to pay or are covered by private insurance. An estimated 17% of Hondurans do not have regular access to health services. 

Source:https://en.wikipedia.org/wiki/Honduras

Evelyn Lee, PhD1,2Deborah Schofield, PhD2Mithilesh Dronavalli, MPhil3Kate Lawler, BSc(Med)Hons4Hannah Uebel, MD4,5Lucinda Burns, PhD7Barbara Bajuk, MPH8Andrew Page, PhD3Yuanyuan Gu, PhD6John Eastwood, MBChB, PhD9,10,11,12,13,14Michelle Dickson, PhD15Charles Green, PhD16Lauren Dicair, MSW17Ju Lee Oei, MD4,18,19

JAMA Pediatr. Published online July 22, 2024. doi:10.1001/jamapediatrics.2024.2281

Key Points

Question  Does the increase in health care needs among children exposed to substance use during pregnancy vary by engagement in out-of-home care?

Findings  In this cohort study, children exposed to substance use during pregnancy with or without neonatal abstinence syndrome were at higher risk of adverse birth outcomes and long-term costs than children who were not exposed but a reduction in cost was associated with any out-of-home care contact.

Meaning  Increased support and timely access to services could mitigate the higher readmission risk and cost associated with substance use during pregnancy.

Abstract

Importance  

Children exposed to substance use during pregnancy have increased health needs but whether these are influenced by engagement in out-of-home care is uncertain.

Objective  

To evaluate the association between substance use during pregnancy, out-of-home care and hospitalization utilization, and costs from birth up to age 20 years.

Design, Setting, and Participants  

This was a retrospective cohort study using individual-linked population birth, hospital, and out-of-home care information of all liveborn infants from New South Wales, Australia, between 2001 and 2020 using longitudinal population-based linkage records from administrative databases. Substance use during pregnancy included newborns with neonatal abstinence syndrome (n = 5946) and intrauterine exposure to drugs of addiction (n = 1260) and other substances (eg, tobacco, alcohol, and illicit drugs or misused prescription drugs; n = 202 098). Children not exposed to substance use during pregnancy were those without known exposure to substance use during pregnancy (n = 1 611 351). Data were analyzed from July 2001 to December 2021.

Main Outcomes  

Main outcomes were hospital readmission, length of stay, and cost burden associated with substance use during pregnancy from birth up to age 20 years. Outcomes were investigated using 2-part and Poisson regression models adjusted for sociodemographic characteristics. Mediation analysis was used to evaluate whether the association of substance use during pregnancy with risk of readmission was mediated through engagement with out-of-home care.

Results  

Of the 1 820 655 live births, 935 807 (51.4%) were male. The mean (SD) age of mothers was 30.8 (5.5) years. Compared with children who were not exposed to substance use during pregnancy, those who were exposed incurred significantly higher birth hospital costs (adjusted mean difference, A$1585 per child [US$1 = A$1.51]; 95% CI, 1585-1586). If discharged alive, more children with exposure to substance use during pregnancy had at least 1 readmission (90 433/209 304 [43.4%] vs 616 425/1 611 351[38.3%]; adjusted relative risk [RR], 1.06; 95% CI, 1.06-1.07), most commonly for respiratory conditions (RR, 1.11; 95% CI, 1.09-1.12) and mental health/behavioral disorders (RR, 1.36; 95% CI, 1.33-1.41). Excess hospital costs associated with substance use during pregnancy were A$129.0 million in 2019 to 2020. Mediation analyses showed that any out-of-home care contact mediated the association between substance use during pregnancy and risk of inpatient readmission and lower health care cost (decreased by A$25.4 million). For children with neonatal abstinence syndrome, any out-of-home care contact mediated readmission risk by approximately 30%, from adjusted RR, 1.28; 95% CI, 1.19-1.35, to RR, 1.01; 95% CI, 0.98-1.02.

Conclusion and Relevance

Children who were exposed to substance use during pregnancy incurred more hospital costs than children who were not exposed up to 20 years of age, but this was reduced in association with any contact with out-of-home care. This provides insights into possible strategies for reducing health and financial burdens associated with exposure to substance use during pregnancy for children.

Source:https://jamanetwork.com/journals/jamapediatrics/fullarticle/2821473

Ashley D. Osborne, MD; Diana Worsley, MPH; Catherine Cullen, MD; Ashley Martin, MPH; Lori Christ, MD

May 08 2024

BACKGROUND

Moderately preterm infants (MPTI) comprise a large proportion of NICU admissions and are an understudied population. The unique experience of families with MPTIs has yet to be examined in the literature. Describing MPTI parent needs and preferences may inform interventions to improve care and outcomes for this population.

METHODS

Semi-structured qualitative interviews were performed with English-speaking birth parents of infants born between 32 and 34 weeks gestation to describe their NICU experience and identify areas for improvement specifically surrounding care team inclusion, education, discharge, and communication. Interviews were recorded, transcribed, and analyzed using directed content analysis. Enrollment ceased when the data reached thematic saturation.

RESULTS

Sixteen birth parents participated. Four themes emerged around parent-medical team connectedness, parental confusion, discharge readiness, and the desire for a use of a mix of in-person and electronic communication methods (e-mail, texting, apps, etc.) for communication. MPTI parents valued a strong connection with the medical team; however, they described a lack of knowledge regarding the reasons for admission and ongoing management. Near discharge, parents desired more information regarding feeding, reflux, and breathing patterns. Parents preferred in-person discussions but described a role for electronic methods to improve their understanding of their infant and discharge readiness.

CONCLUSIONS

From the MPTI parent perspective, clinicians can focus improvement efforts on communication, specifically around reasons for admission, discharge planning, and anticipatory guidance. These results may serve as a foundation for initiatives to improve the MPTI parent experience and potentially parent and MPTI outcomes.

Source: https://publications.aap.org/pediatrics/article-abstract/153/6/e2023064419/197249/Enhancing-NICU-Care-and-Communication-Perspectives?redirectedFrom=fulltext

Apr 28, 2023 #NFL #AmericanFootball #Football

Auburn’s Derick Hall survives the near-death experience of being born four months premature, rising to become one of the best defensive ends in the nation – and making a transformational impact on his Gulf Coast community.

Nicolle Fernández Dyess, MD, MEd; Perspectives| September 01 2024

Shetal Shah, MD  Neoreviews (2024) 25 (9): e531–e536.https://doi.org/10.1542/neo.25-9-e531

The modern neonate differs greatly from newborns cared for a half-century ago, when the neonatal-perinatal medicine certification examination was first offered by the American Board of Pediatrics. Delivery room resuscitation and neonatal care are constantly evolving, as is the neonatal workforce. Similarly, the Accreditation Council for Graduate Medical Education review committees revise the requirements for graduate medical education programs every 10 years, and the modern pediatric medical trainee is also constantly evolving. Delivery room resuscitation, neonatal care, and pediatric residency training are codependent; changes in one affect the other and subsequently influence neonatal outcomes. In this educational perspective, we explore this relationship and outline strategies to mitigate the impact of decreased residency training in neonatal-perinatal medicine.

Source:https://publications.aap.org/neoreviews/article-abstract/25/9/e531/199058/The-Relationship-between-Pediatric-Medical?redirectedFrom=fulltext

Dudding, Katherine M. PhD, RN, RNC-NIC, CNE; Assistant Professor

Advances in Neonatal Care 24(5):p 389-390, October 2024.

A couple of months ago, I had a conversation with a Director of Nursing Professional Development from a potential hospital site which to conduct my research. I was asked if I would consider having a couple of nurses help with my study. Without hesitation, I replied “yes, I would be happy to mentor a couple of nurses to assist me with my study.” Initially, I thought this was an odd request because I feel like that is one of my professional responsibilities as a nurse. Upon further thinking, I realized maybe others do not share the same opinion and how unfortunate this would be for our future neonatal nurses, practitioners, educators, and researchers.

According to the American Nurses Association (ANA), 18% of nurses are leaving the profession after 1 year though other sources reported even higher rates of attrition. The nursing workforce dilemma continues to be problematic with nurse turnovers and an alarming rate of nurses leaving the profession after 1 year. While other sourcesreported rates as high as 30%, education and the healthcare systems are establishing strategic interventions to retain nurses. One of these interventions is mentoring. Specifically, peer nurse to nurse mentoring is beneficial when matched into a positive mentored relationship.

MENTORING

Nurses experiencing positive mentorships are associated with intent to remain at their current positions. There is nothing like the support of a mentor when you begin your nursing career. It was the kindness of mentors that taught us and encouraged us to become the best possible nurses and achieve our dreams. The knowledge we gained from our mentors are incorporated into our everyday professional lives. There is not one of us who was not impacted by a mentor and their influence (see Supplemental Figure 1, available at https://links.lww.com/ANC/A292). Many of us will have several distinct types of mentors throughout our nursing careers.

Each mentor serves a purpose and may be time limited. There may be mentors that are experts in clinical practice, education, research, or leadership. You might even have a mentor, whose sole purpose, is your sounding board for difficult decisions. However, there will be a handful of phenomenal nurses who will become lifetime mentors. Those are the special ones that we strive to emulate.

NURSING

When nurses feel supported by administration and mentors, they remain in their jobs. Being mentored gives us the opportunity to grow our skill sets or learn new processes under the guidance of our mentor. The mentor provides the safety net when learning and a resource to ask our never-ending questions without judgment.

We all can remember the hesitation we felt the first time we attempted our first IV. Moreover, we remember the happiness we felt when we successfully started our first IV. This was, in part, due to our mentor’s willingness to mentor us and invest their time and talent into our success. Our mentors believed in us.

It does not take long before these skills in essence become second nature. Our confidence level begins to increase with more successes than failures. We are becoming competent and independent nurses. These achievements cannot help but to spill over into our own interactions with patients, our students with teaching, and our participants in research. Good mentorship also benefits those we serve whether it be our patients, our students we teach or participants in research. Why would we not pay this forward when mentoring results in the best possible outcomes for all?

As our skills are honed, this cultivates our confidence, not only as a competent nurse, but as a valuable team member. Lyu et al states that competence and being integrated into a team is correlated with retention. As a supported team member, we are unstoppable to what we can accomplish in nursing. Eventually, this often leads the nurse mentee to now becoming the mentor.

GROWING THROUGH MENTORSHIP

Being a mentor is frequently the catalyst for endless opportunities for growth and the development of a leader. This may be a leadership opportunity within your respective work environment such as a charge nurse, manager, and director. Your sphere of influence, as a leader, has the ability change practice within the nursing. Moreover, this may motivate a broader impact by earning an advanced degree to become nurse practitioners, educators, and researchers.

What a privilege it is to mentor nurses and leave a lasting impact on the nursing profession. Today’s nursing graduates are tomorrow’s nursing leaders. We have a responsibility to present and future nurses to mentor them. I, personally, will forever be grateful to all my mentors. I am truly standing on the shoulders of giants by kindness that has and continues to be given to me. This act of kindness and giving of oneself through mentoring is invaluable.

In conclusion, there is only one question that remains, “will you step up to mentor the next generation of nurses?”

—Katherine M. Dudding, PhD, RN, RNC-NIC, CNE Assistant Professor The University of Alabama kmdudding@ua.edu

Source:https://journals.lww.com/advancesinneonatalcare/fulltext/2024/10000/peer_nurse_to_nurse_mentoring__an_exceptional_act.1.aspx

July 19, 2023     Sathvik Namburar

In a May 6, 2016 photo, medical residents Dr. Wes Penn, right, and Dr. Cameron Collier, center, walk with medical students down a hallway during their daily rounding at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana. (Gerald Herbert/AP)This article is more than 1 year old.

July marks a time of change in hospitals across the country. It marks the beginning of the academic year for medical residents and fellows, with new physicians starting their training. As I begin the second year of my medical residency this month, I have been thinking about Libby Zion and Nakita Mortimer.

The former was briefly a household name in the 1980s. Libby Zion was a college student who sought care at New York Hospital (now New York-Presbyterian) with a fever in March 1984, only to pass away after her doctors missed a crucial medication interaction. Her distraught parents believed that overworked resident physicians were to blame and drove efforts to institute work-hour caps for residents.

The latter is tragically less known. Dr. Nakita Mortimer was a resident physician at Montefiore Medical Center, and she died by suicide in May 2023. My colleagues and I became aware of her untimely passing almost immediately, as this news spread rapidly through the medical world. (As with all suicides, it will remain unclear specifically why Dr. Mortimer took her own life.)

My colleagues and I reacted to Dr. Mortimer’s death with shock but not surprise. As one of the senior resident physicians in my program put it, “Residency can unmoor even the best of us.”

All of us in the medical profession know classmates or colleagues who were unable to complete their training, overburdened by the demands of the profession. Studies show that upwards of 50% of physicians report feeling burnout.

Residency is a key contributor to these issues. Usually lasting between three and seven years depending on subspecialty, resident physicians have completed medical school but are still undergoing training and cannot independently practice medicine.

Being a resident means working long hours for little pay (the average first-year resident makes about $60,000 a year). Many residency programs continue to require residents to work 28-hour shifts out of a belief that these long hours enhance continuity of care and resident learning.

But by the end of 28-hour shifts, residents are so sleep-deprived that they have the equivalent of blood alcohol contents of 0.1%, above the threshold for being legally drunk. The resident physicians who were taking care of Libby Zion were in the midst of a 28-hour-plus shift and were also responsible for 40 other patients on the night she died.

Often forgotten in the Libby Zion case is that her death led her parents to push not only for reforms in the medical residency system, but also the consideration of legal charges against the resident physicians and the threat of revocation of their licenses to practice medicine. Therefore, to my co-residents and me, her passing is both a clarion call and a warning, that even if we are tired, we must be perfect or else lose our livelihoods. Of course, with the desire for perfection comes incredible mental stress.

With the desire for perfection comes incredible mental stress.

We resident physicians recognize that our profession has societal responsibilities. It is our duty to learn and take care of patients, and we do not and should not expect to work regular 9 a.m. to 5 p.m. hours during our training. My goal is to maximize my learning opportunities so that when I complete residency, I can practice medicine independently and competently.

Physicians take an oath to “Do no harm” and try to live up to this credo. But no one can always be perfect.

Some residency programs have been implementing further reforms to protect resident physicians and patients. Over the past year, I have only had to complete one 28-hour shift, compared to my friends in other residency programs who have had to do dozens of such shifts. My residency also has a dedicated wellness curriculum, peer listening programs and access to mental health professionals.

Still, there is more to do. Residents in programs around the country are forming unions and demanding better working conditions and more pay. After 26 years of stagnation, in 2022, Congress finally approved an increase in the number of residency spots, which would decrease the work burden on residents. Our patients should support these efforts and push for further changes because well-rested, better-paid residents are more likely to provide adequate health care.

Few other jobs place physical and mental demands on employees like residency does, and few other jobs come with the awesome responsibility that being a physician has. Continuing reforms will help prevent deaths like those of Libby Zion and Dr. Mortimer. We owe it to all resident physicians and our patients to ensure that such reforms are enacted.

Editor’s note: You can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) and the Samaritans Statewide Hotline (call or text) at 1-877-870-HOPE (4673). Call2Talk can be accessed by calling Massachusetts 211 or 508-532-2255 (or text c2t to 741741).

Source:https://www.wbur.org/cognoscenti/2023/07/19/medical-residency-long-shifts-libby-zion-nakita-mortimer-sathvik-namburar

A Million Little Miracles       Premiered May 22, 2024

Feeling lost on how to advocate for your preemie in the hospital? NICU grad mom Alexis shares practical tips to help you become your baby’s champion!

Shalece was 30 weeks pregnant when she went to UPMC Magee-Womens Hospital for a follow-up sonogram. At a routine prenatal appointment the week before, doctors felt the baby was smaller than he should be, so they asked her to come back for a second look.

She told her husband, Dion, not to bother calling off work; convinced that there was no danger, she brought her aunt instead, and the two women made plans to go for lunch after the appointment.

“When I got down there, they did the first sonogram. I could tell by their reaction that something was wrong, but they didn’t want to alarm me,” she recalled. “They said, ‘We’re going to send you upstairs for a uterine sonogram and a monitor.’”

Her older son, Dion 2nd, was born at full term 11 years earlier with no complications. So while her aunt panicked, Shalece — a former nursing assistant — remained calm: “I’m not a person who panics a whole lot,” she said, adding that throughout the process, she was thinking, “It’s only 30 weeks. I’m not having this baby today.”

And then the doctor on duty came in and said that, in fact, she was. The blood in the umbilical cord was flowing backward, preventing the baby from getting vital nutrients. She would have to undergo an emergency Cesarian section.

According to Dr. Yoel Sadovsky, MD, executive director of Magee-Womens Research Institute, the reversal of blood flow in the umbilical cord is usually caused by a dysfunction in the placenta — a complication Dr. Sadovsky and other researchers at the institute study.

In such cases, delivery is induced in an effort to save the baby’s life, he noted: “If you don’t deliver someone who has these kinds of findings, some babies don’t even make it.”

But at that moment, Shalece was in denial, even though the staff advised her to call her husband and get him to the hospital.

“I was absolutely not going for it,” she recalled. “In my mind, it wasn’t happening to me; it was happening around me.”

Finally, her aunt called her husband, who arrived in time for the emergency delivery. Their son was born at 1:33 p.m., but Shalece’s blood pressure skyrocketed, so she only glimpsed him before he went to the neonatal intensive care unit (NICU).

Once she stabilized, the staff wheeled her, still in her hospital bed, to meet her tiny son.

“There were more cords and plugs than baby,” she said. “I was able to see him, really see him. From there, it was me and him.”

Little Shea spent two months and three days in the NICU. After seeing her older son on the school bus in the morning, Shalece traveled back to the hospital, where she would sing to Shea, read to him from the Game of Thrones series, and talk.

“I told him, ‘You’re a squatter in this NICU. You’re coming home,’” she said. “I willed this baby into coming home.”

Of the 380,000 babies born prematurely in the United States each year, rates are up to 50 percent higher among women of color, according to the March of Dimes. Black children face an infant mortality rate that is more than twice as high as other infants, according to the U.S. Centers for Disease Control, making prematurity the largest contributor to infant mortality disparities.

Shea spent the first few hours of his life on oxygen and was treated with bilirubin lights for jaundice. He went through several blood transfusions and experienced a brain bleed, but no surgery was required. He also had retinopathy of prematurity, an eye disorder caused by abnormal blood vessel growth in the retina of premature infants, and wears glasses now. He also undergoes physical therapy for mild cerebral palsy.

About a quarter to a third of preterm births are medically induced, Dr. Sadovsky said. Less than 5 percent of all babies need to have a medically-induced preterm delivery for growth restriction, and in the majority of these cases, the placenta is the cause.

“This is a typical case of what we’re studying in our lab,” Dr. Sadovsky said. “One of the major goals of our research is better diagnosis, and importantly, prevention of these kinds of stories.”

Despite the long odds, Shea is now in preschool, and most people don’t realize he has had difficulty walking or climbing steps in the past. He adores sports and superheroes, and he looks up to his big brother.

“He’s your average 4-year-old boy. He is loud. He is fast,” said Shalece.

She knows his premature birth will always influence other parts of his life; she’ll have to be careful about his participation in sports because of his early brain bleeds, and she pays attention to how he learns things, or even how he holds a pencil.

“Once a preemie, always a preemie. You are always on high alert,” she said. She belongs to a support group for mothers of premature infants, where she both draws and offers encouragement.

Asked what advice she would offer to a new mother of a preemie, Shalece said: “Take it one day at a time. Don’t hesitate to cry; crying is good. Don’t feel bad, and reach out for help.”

She remembers how worried she was, and looks at her 4-year-old son riding a bike and realizes how far he has come.

“You have to try a little harder as a parent,” she said, but added, “Being born premature doesn’t mean they aren’t going to be the kid you thought they were going to be.”

Jul 9, 2024 #swaddling #babytips #preemiebaby

Was your baby born more than 3 weeks early? Premature development differs from full-term, but there’s no need to worry! Let’s explore effective ways to understand and support your baby’s growth and milestones. Premature babies are often born with more extended (straight) positions, while full-term babies get a curled up (flexed) feeling from being in the womb longer. Babies need both flexion and extension to help their motor skill development. Try these activities to aid your preemie’s physical growth and work on their flexion. Always consult your healthcare provider for personalized advice.

Medically Reviewed by Amita Shroff, MD on July 30, 2023 Written by R. Morgan Griffin

By the time they’re 2, your preemie has come a long way. It may be hard to believe that your child — maybe a noisy, strong-willed toddler already — is the same person as that tiny, fragile baby you anxiously watched over in the hospital.

What comes next? As they grow, most preemies become healthy children. But some continue to have health issues. And even kids that do well generally may have lasting health effects years and even decades later.

There’s no way to know exactly how your child will grow and develop. In general, the earlier your child was born, the more likely they are to have lasting health issues. Watch out for signs of problems so you can get your child the care and treatment they need.

Your Preemie’s Long-Term Health

If your child was born prematurely, they have a higher chance of some of these health concerns:

Growth problem: Kids who were born at less than 32 weeks of pregnancy — what doctors call “very premature” — are likely to be shorter and weigh less than other kids.

Learning disabilities.Some preemies have lasting problems with how they think and learn. About 1 in 3 kids born prematurely need special school services at some point.

Behavior problems: As they grow up, preemies may be more likely to have attention deficit hyperactivity disorder (ADHD) than full-term babies. They’re also more likely to be shy or anxious.

Breathing problems and asthma:.Lots of preemies need help breathing when they’re born, since their lungs aren’t ready yet. While these issues often go away, some babies born prematurely have lasting asthma or similar problems.

Other health conditions:Some preemies have more serious long-term complications. One example is cerebral palsy, which causes problems with movement and balance. There’s no cure, but it can be managed with treatment. Other kids may have lasting problems with their vision, hearing, and digestive system.

Remember, your child may not develop any of these problems or may outgrow them. But being aware that they have a higher chance of having them is important. If you notice signs, you can get help from your child’s doctor. The faster your child gets treatment for any problems, the better.

Your Preemie in Early Childhood

While your child might have been treated for lots of health problems in the hospital when they were born — like apnea, reflux, and jaundice — most if not all of those should be gone by now. Experts say that in terms of growth, most preemies are more or less caught up to full-term babies by age 3.

When your child is still young you can:

Keep track of your baby’s developmental milestones. Milestones are skills your child will learn, like riding a tricycle or walking up the stairs on their own. They’re often linked with the average age kids are able to do them. When preemies are young, doctors use their “corrected age” — based on their original due date — instead of their birthdate when checking milestones. But by age 2, most preemies have caught up enough that you can start using their actual age.

Remember that milestones are just rough averages. All kids develop differently, whether they’re full-term or premature. It’s not a big deal if your child doesn’t meet a milestone exactly on schedule.

Get help if you need it. If you do notice your child seems to be lagging behind, talk to their doctor. Make sure to ask about a state program called Early Intervention. It offers special services to help babies up to age 3 who have higher odds of developmental delays or disabilities. Some of these services are free. Other options include referral to private therapies such as physical therapy, occupational therapy, feeding therapy, and speech therapy.

Getting Your Child Ready for School

Watching your child go off to school is exciting — and stressful, too. To help make the transition smoother and give your child support, you can:

Get in touch with the school early. Before your child starts school, talk to the staff — like their teacher or the principal — about their health issues and concerns you have. Ask questions about the school’s special education programs. If your child’s teachers understand their needs, they’ll be better able to help them succeed.

Be alert for any new problems. Sometimes, learning disabilities or behavior problems only show up once a child starts school. If your child seems to be struggling, work with their teacher — and make sure your youngster gets special services if they need them.

Gradually give your child more independence. After you spend so much time caring for your child, it can be hard to let them go off on their own. But you have to find a balance between protecting them when they need it and giving them the freedom they need to grow.

As Your Preemie Grows Up

Will the effects of being born premature last into your child’s adulthood? It’s possible. Some studies have linked being a preemie with a higher chance of getting conditions like diabeteshigh blood pressure, and lung and vision problems in adults.

But again, remember that your child only has a higher risk of these problems. They may not develop any of them. You can look at being born premature as another factor that may raise your risk of developing health issues, like a person’s genes, habits, home life and environment. After all, plenty of adults who weren’t born prematurely develop the same health conditions.

The most important need for a child who was born prematurely is to get good, consistent care — both as a child and an adult. Being a preemie can create barriers to your child’s development. But with the help of the right experts — doctors, specialists, therapists, and others — you can often find ways to work around them.

Source: https://www.webmd.com/children/preemies-growth-development-age-two-up

University of Colorado Anschutz Medical Campus    Apr 9, 2024

While a recent explosion in AI technology has exposed its possibilities to the public with online systems such as ChatGPT and Dall·E, researchers at the University of Colorado Anschutz Medical Campus have been exploring the rapidly evolving technology for years and are beginning to harness its problem-solving powers to change healthcare.

Interprofessional Education (IPE) is more than sitting passively in a classroom together. It is integrative, experiential, and about learning and practicing the skills needed to function effectively as a highly collaborative team. Interprofessional collaborative practice makes care safer, more patient-centered, and it leads to lower burnout and higher job satisfaction amongst health professionals. Explore below to learn more about the opportunities to grow your skills in collaboration.

Interprofessional Education (IPE) is an approach to teaching and learning that brings together students from two or more professions to learn about, from, and with each other in service of enabling effective collaboration. The goal of IPE is to improve health outcomes through the education of a practice-ready health care team that is prepared to respond to local health needs (WHO, 2010).

Interprofessional Collaborative Practice (IPCP), or “Practice Transformation,” in health care occurs when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, carers and communities to deliver the highest quality of care across setting (WHO, 2010). The Interprofessional Education Collaborative (IPEC) states that, “interprofessional collaborative practice drives safe, high-quality, accessible, person-centered care and improved health outcomes” (2019).

Source:https://collaborate.uw.edu/about-us/defining-ipe-and-ipcp/

Anna Baranowska-Rataj, Kieron Barclay, Joan Costa-Font,Mikko Myrskylä, Berkay Özcan

Population Studies/ Research Article

A Journal of Demography – Volume 77, 2023 – Issue 3

Abstract

Although preterm birth is the leading cause of perinatal morbidity and mortality in advanced economies, evidence about the consequences of prematurity in later life is limited. Using Swedish registers for cohorts born 1982–94 (N  =  1,087,750), we examine the effects of preterm birth on school grades at age 16 using sibling fixed effects models. We further examine how school grades are affected by degree of prematurity and the compensating roles of family socio-economic resources and characteristics of school districts. Our results show that the negative effects of preterm birth are observed mostly among children born extremely preterm (<28 weeks); children born moderately preterm (32–<37 weeks) suffer no ill effects. We do not find any evidence for a moderating effect of parental socio-economic resources. Children born extremely preterm and in the top decile of school districts achieve as good grades as children born at full term in an average school district.                                   

Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2022.2080247.

As a micro-preemie, my early days were filled with challenges, but the encouragement from my mother to engage in sports became a pivotal part of my development. Growing up, I was introduced to various physical activities, from swimming to basketball, which not only helped me build strength but also instilled a sense of confidence that was essential for my growth. Research has shown that early engagement in sports can significantly benefit the physical and emotional development of children, particularly those with a history of premature birth. According to a study published in the Journal of Pediatrics, participation in physical activities helps improve motor skills and overall health, which are critical areas of development for preemies.

The benefits of sports extend beyond physical health; they also foster social skills and emotional resilience. Engaging in team sports allowed me to develop friendships and learn the value of teamwork. These experiences helped me navigate social dynamics and build a support network that would prove invaluable throughout my life. A report by the American Academy of Pediatrics emphasizes that participation in sports can promote social interactions and enhance communication skills, which are crucial for preemie survivors as they transition into adulthood. My mother’s encouragement to embrace sports created opportunities for me to thrive socially, fostering connections with peers who understood my unique journey.

Moreover, sports provided an essential outlet for stress relief and emotional expression. As I faced the lingering effects of my premature birth, participating in physical activities became a healthy way to cope with anxiety and build self-esteem. Studies have indicated that regular physical activity can reduce symptoms of anxiety and depression, particularly in children who may feel different or face health-related challenges. This therapeutic aspect of sports not only aided in my emotional well-being but also reinforced my belief in the importance of maintaining a healthy lifestyle, which I carry into adulthood.

Reflecting on my journey, I am grateful for my mother’s unwavering support and encouragement to engage in sports. The lessons I learned and the resilience I built through these experiences have shaped who I am today. For other preemie families, I encourage you to explore the world of sports and other physical activities you and they may prefer. The benefits are profound and can lead to a brighter, healthier future for your little ones.

Mid-Atlantic ADA Center 453 views May 30, 2023

Dr. Anjali Forber-Pratt, Director of the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and two-time Paralympian, talks about the importance of adaptive and inclusive sports and recreation for people with disabilities.

5,773 views Nov 14, 2017

David Kyle explains in his talk about his journey from discovering his disabilities and being depressed to a life full of challenges, mobility and opportunity for success as an athlete. David is the director of the UAH Ability Sport Network, which is a program that encourages participation among people with physical disabilities in adapted physical activity. In addition, he is a lecturer in the Department of Kinesiology of UAH’s College of Education. David holds a master’s degree in Health and Physical Education and will complete his doctoral degree in Kinesiology in 2019. He is also a Certified Exercise Physiologist and Disability Sport Specialist. David is a member of the USA Triathlon National Paratriathlon Committee, and competed internationally for 10 years with the USA Elite Paratriathlon Team in triathlon, duathlon, and XTERRA off-road events winning multiple world and national titles in each discipline.

Miss Rosie’s Storytime   Jun 15, 2019

Froggy Plays Soccer By: Jonathan London & Frank Remkiewicz It’s the day of the big game, and Froggy is ready. His soccer team is playing the Wild Things for the City Cup. All Froggy has to do is remember the rule: “Head it! Boot it! Knee it! Shoot it! BUT DON’T USE YOUR HANDS!” But Froggy’s busy doing cartwheels and picking daisies. Uh oh, Froggy! Here comes the ball! Budding soccer players and Froggy’s many fans will welcome Froggy’s latest hilarious adventure.

2020 started off as a big kiting year. About a week after I got back from the Grenadines as buddy called saying he’d organized a trip to a little known kite spot in Honduras called Roatan. Everyone scrambled to move things around, and at the last minute it all came together.

Guides, Patterns, Stewardship

Scotland is a country that is part of the United Kingdom. It contains nearly one-third of the United Kingdom’s land area, consisting of the northern part of the island of Great Britain and more than 790 adjacent islands, principally in the archipelagos of the Hebrides and the Northern Isles. To the south-east, Scotland has its only land border, which is 96 miles (154 km) long and shared with England; the country is surrounded by the Atlantic Ocean to the north and west, the North Sea to the north-east and east, and the Irish Sea to the south. The population in 2022 was 5,439,842 and accounts for 8% of the population of the UK. Edinburgh is the capital and Glasgow is the largest of the cities of Scotland.

NHS Scotland sometimes styled NHSScotland, is the publicly–funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

At the founding of the National Health Service in the United Kingdom, three separate institutions were created in Scotland, England and Wales and Northern Ireland.

https://en.wikipedia.org/wiki/Scotland#

  • There are an estimated 29 million nurses worldwide and 2.2 million midwives. WHO estimates a shortage of 4.5 million nurses and 0.31 million midwives by the year 2030.
  • That will bring the a global shortage of health workers estimated for 2030 to 4.8 million nurses and midwives, with the greatest gaps found in countries in Africa, South-East Asia and the WHO Eastern Mediterranean Region, as well as some parts of Latin America. 
  • Nurses and midwives play a pivotal role in improving health and contributing to the wider economy. Investing in them is imperative to achieve efficient, effective, resilient and sustainable health systems. They not only provide essential care but also play a critical role in shaping health policies and driving primary health care. Nurses and midwives deliver care in emergency settings and safeguard the sustainability of health systems globally.
  • Globally, 67% of the health and social workforce are women compared to 41% in all employment sectors. Nursing and midwifery occupations represent a significant share of the female workforce.
  • More than 80% of the world’s nurses work in countries that are home to half of the world’s population. And one in every eight nurses practices in a country other than the one where they were born or trained.
  • Higher levels of female nurses are positively correlated with health service coverage, and life expectancy and negatively correlated with infant mortality.

Overview

Nurses and midwives are central to Primary Health Care and are often the first and sometimes the only health professional that people see and the quality of their initial assessment, care and treatment is vital. They are also part of their local community – sharing its culture, strengths and vulnerabilities – and can shape and deliver effective interventions to meet the needs of patients, families and communities.


WHO response

WHO’s work relating to nursing and midwifery is currently directed by World Health Assembly resolution WHA74.15 (2021) which calls on WHO Member States and WHO to strengthen nursing and midwifery through the Global Strategic Directions for Nursing and Midwifery (SDNM) 2021–2025. The SDNM is an interrelated set of policy priorities  that can help countries to ensure that midwives and nurses optimally contribute to achieving universal health coverage (UHC) and other population health goals .

The SDNM comprises four policy focus areas: education, jobs, leadership, and service delivery Each area has a “strategic direction” articulating a goal for the five-year period, and includes between two and four policy priorities If enacted and sustained, these policy priorities can support advancement along the four strategic directions: 1) educating enough midwives and nurses with competencies to meet population health needs; 2) creating jobs, managing migration, and recruiting and retaining midwives and nurses where they are most needed; 3) strengthening nursing and midwifery leadership throughout health and academic systems; and 4) ensuring midwives and nurses are supported, respected, protected, motivated and equipped to safely and optimally contribute in their service delivery settings.

WHO engages ministries of health, the Government Chief Nurses and Midwives (GCNMOs) and other relevant stakeholders to enable effective planning, coordination and management of nursing and midwifery programmes in countries. The Global Forum for the Government Chief Nurses and Midwives, established in 2004, is organized by WHO and meets every two years. It is a Forum for senior nursing and midwifery officials to develop and inform areas of shared interest. WHO also engages with academic institutions specialised in nursing and midwifery. Forty-seven academic centres are designated as Collaborating Centres for Nursing and Midwifery with WHO. The academic centres are affiliated to the Global Network of WHO Collaborating Centres for Nursing and Midwifery.

WHO has established a Nursing and Midwifery Global Community of Practice (NMGCoP). This is  a virtual network created to provide a forum for nurses and midwives around the world to collaborate and network with each other, with WHO and with other key stakeholders (e.g WHO collaborating centres for nursing and midwifery, WHO Academy, Nursing and Midwifery Associations and Institutions.) The network will provide discussion forums, a live lecture programme, opportunities to develop and share policies, WHO documents and tools, and facilitated innovation workshops, masterclasses and webinars.

The Nursing and Midwifery Global Community of Practice is free to join and available to nurses and midwives everywhere.

From May 2022 it will be possible to access the virtual community via a smartphone, by downloading the Nursing and Midwifery Global Community of Practice App Nurses Beyond the Bedside_WHO_CSW66 Side Event available for Android and IOS system via the APP store.

A 2017 Report on the history of nursing and midwifery in the World Health Organization 1948 –2017, demonstrates how WHO, since its inception, has given this workforce a voice, and highlights the critical role nurses and midwives play in improving health outcomes across the world.

Feb 8, 2024

Watch this amazing Scottish artist sing Yellow by Coldplay with me! @AndrewDuncan

Mary A. Short MSN, RN – Volumn19/Issue 5 May 24

Critical Path Institute (C-Path) announces the launch of Bridging the GAP: Empowering Neonatal Nurses in Drug Development for Neonates, a comprehensive series covering the history of neonatal drug development, approaches to promote drug development for neonates, pharmaceutical industry decision-making processes, and strategies for advocating neonatal needs. Developed in collaboration between its International Neonatal Consortium (INC) and the National Association of Neonatal Nurses (NANN), this series aims to empower neonatal nurses and interested neonatal health care professionals with the knowledge needed to actively participate in research and ensure better outcomes for our tiniest patients.

“As an organization committed to advancing neonatal research and care, we recognize the vital role nurses and clinicians play in the hospital setting,” said INC Executive Director Kanwaljit Singh, MD, MPH. “This collaboration with NANN represents a pivotal step forward in our mission to support and empower neonatal nurses and clinicians. By engaging them in developing these educational modules, we aim to enhance their understanding and involvement in neonatal clinical trials and drug development.”

The modules aim to provide foundational knowledge on innovative, regulated medicines development for neonates, including pipeline decision-making factors and addressing neonatal needs within the current environment. Upon completion of the presentations and activity evaluations, participants can earn up to 4.5 FREE CE credits and 2.56 FREE pharmacology credits. NANN is an accredited provider of nursing continuing professional development recognized by the American Nurses Credentialing Center’s Commission on Accreditation. The content is appropriate for AMA PRA Category 2 Credit. The presenters reflect the diversity of neonatal stakeholders, as illustrated in Figure 1, which outlines the module titles and the presenters involved.

Background:

Neonates are therapeutic orphans, underserved by the drug development community, and lag in the development of new, safe, and effective therapies. Most NICU drugs are off-label, impacting their safety and efficacy evaluation.  Nurses play a vital role in administering medications and monitoring their effects but often lack a comprehensive understanding of clinical trials and drug development processes in the NICU. Critical Path Institute (C-Path) is an independent nonprofit established in 2005 as a public-private partnership in response to the FDA’s Critical Path Initiative. C-Path’s mission is to lead collaborations that advance better treatments for people worldwide. Globally recognized as a pioneer in accelerating drug development, C-Path has established numerous international consortia, programs, and initiatives that currently include more than 1,600 scientists and representatives from government and regulatory agencies, academia, patient organizations, including parent/family advocates, nursing organizations, disease foundations, and pharmaceutical and biotech companies. INC, established in 2015 as a public-private partnership within the construct of C-Path, advances the unmet drug development needs in the neonatal population.

INC conducted a multistakeholder (neonatologists, neonatal nurses, parents) survey to explore communication practices and stakeholders’ perceptions and knowledge regarding the conduct of clinical trials in the NICU. Survey results indicated that most neonatologists (82%) responded that medications are insufficient to meet the needs of critically ill neonates and identified a knowledge gap for nurses regarding drug development. Degl et al. conclude that the engagement of nurses at all stages of neonatal research is suboptimal and indicates a need for nurses to be educated about research. Beauman et al. report additional findings specific to nurse respondents from the multistakeholder survey. Nurses expressed a learning need because they historically lacked effective education to prepare them for competent participation in neonatal research, especially in informing study design. The authors recommend leveraging neonatal nurses’ unique and essential role as key stakeholders from the onset of the study design to enhance the conduct of neonatal clinical research and improve care for premature and sick neonates.

To address the survey findings, industry representatives held an education workshop on Pharmaceutical Drug Development for Neonates at the 2019 INC Annual meeting intended for all neonatal stakeholders, including academics, clinicians, and regulators. The INC Communication Workgroup updated the content for the recently launched education modules, emphasizing the significance of the information for nurses, but the content remains relevant to other neonatal healthcare professionals.

Product Description:

“Consistent with our mission to elevate and transform neonatal care, NANN is grateful to bring forth this important collaboration with INC and give all neonatal nurses access to these outcome improving modules,” said NANN Executive Director Molly Anderson. “We know neonatal nurses have the expertise and knowledge to play an essential role in drug development that benefits their patients. NANN seeks out partnerships with organizations like INC that allow us to empower deepened nurse involvement with all aspects of care throughout their careers.”

The series includes access to seven on-demand video modules related to nurse-informed neonatal study design for drug development to provide context for the importance and implications for neonatal nurses. The NANN iLEARN site provides a platform for open access. Share the product flyer with colleagues to provide the QR code for access.

Jan 31, 2021       Kay Lloyd

Free patterns. Great for a beginner or just someone who wants to make for local maternity/neo natal hospital.

A Call to Action

Zukowsky, Ksenia PhD, CRNP, NNP-BC; Editorial Board Member; Savin, Michele Kacmarcik DNP, APRN, NNP-BC, CNE, FAWHONN; Assistant Professor Director; Manning, Mary Lou PhD, CRNP, CIC, FAPIC, FSHEA, FAAN; Professor Director

Advances in Neonatal Care 24(3):p 209-211, June 2024. | DOI: 10.1097/ANC.0000000000001168

Metrics

Antibiotics are life-saving drugs and essential for the treatment of many serious infections, but widespread inappropriate use is now common and has become a major contributor to the development of antibiotic resistance (ABR). ABR is an urgent global public health and socio-economic threat, generating calls for actions from the World Health Organization and the US Centers for Disease Control and Prevention (CDC). Left unchecked, ABR is poised to reverse a century of medical progress, rendering antibiotics ineffective in treating even the most common infectious diseases. Infants admitted to neonatal intensive care units (NICUs) are at high risk for the development and transmission of multidrug-resistant pathogens, particularly where hospital stays are prolonged because of prematurity or congenital anomalies.3 Worldwide, sepsis is the third leading cause of neonatal mortality, with antibiotic resistant pathogens responsible for approximately 30% of deaths.

Antibiotics are the most common medication prescribed in NICUs, with wide variability in use, regardless of the level of care or complexity of patients.5 On any given day, 40% of infants admitted to a NICU are prescribed antibiotics, with an estimated 90% exposed to antibiotics over the duration of their NICU stay. A recent study published in The Lancet Regional Health-Southeast Asia found that the most commonly prescribed antibiotics in Southeast Asia are now only 50% effective at treating sepsis and meningitis in newborns. Furthermore, there is increasing evidence that preterm infant antibiotic exposure is associated adverse outcomes including alteration in the intestinal microbiome, necrotizing enterocolitis, invasive fungal infections, retinopathy, and late-onset sepsis.5 Early life antibiotic exposure is also associated with future health problems including childhood obesity, asthma, allergic disorders, and inflammatory bowel disease. Therefore, it is important to find strategies to reduce antibiotic use in the NICU patient population.

ANTIBIOTIC STEWARDSHIP

According to the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society, the major objective of antibiotic stewardship (AS) is to achieve the best clinical outcomes related to antibiotic use while minimizing toxicity and other adverse events, thereby limiting the emergence of ABR bacterial strains. AS – a core strategy to combat ABR – is intended to ensure patient safety through the implementation of combined, coordinated interprofessional interventions to optimize how antibiotics are used. Studies indicate that the implementation of AS initiatives in NICUs is associated with a significant decrease in the overall days of therapy and reduction in use of broad-spectrum antibiotics, such as cephalosporins, without adverse issues. However, significant gaps exist between CDC recommendations to improve antibiotic use and antibiotic practices during the neonatal and newborn period. Until recently, AS interventions focused primarily on improving clinician antibiotic prescribing practices through formulary restriction and prospective audit with feedback. However, with more nurses in the frontline of healthcare than any other healthcare profession, the CDC, the American Nurses Association (ANA), the International Council of Nurses and The Joint Commission, have endorsed nurses’ active participation in AS activities to expand the reach and impact of stewardship programs. A recent survey of NICU nurses found that most were familiar with the term AS, yet over half reported administering an antibiotic to a patient who they thought was an inappropriate choice and most reported not questioning the treating provider about antibiotic choice, dose or route of administration.

THE ROLE OF NEONATAL NURSES AND NEONATAL NURSE PRACTITIONER IN ANTIBIOTIC STEWARDSHIP

As trusted professionals, expert clinicians, and advocates for their patient’s health, neonatal nurses and neonatal NPs are well qualified to make significant contributions to the reduction of ABR through active engagement in AS. There are multiple AS activities to consider now.

  • Advance your knowledge. Read the articles cited in this editorial. Participate in educational opportunities (eg, grand rounds, seminars, webinars) to advance your antibiotic, ABR and AS knowledge. Learn with and from others by starting an interprofessional AS journal club or lunch-and-learn at your practice setting. Contact the National Association of Neonatal Nurses and encourage them to provide state-of-the-science ABR and AS educational sessions specific to neonatal care and evidence-based antibiotic prescribing.
  • Advocate for the adoption and evaluation of at least one nurse driven AS recommended action in your practice setting. Many preterm infants who do not have infections receive antibiotic treatment in the setting of negative cultures. Consider implementing daily antibiotic timeouts.
  •  Antibiotic time-outs involve a daily formal antibiotic review, often conducted during clinical rounds, to determine if a modification or discontinuation of a patient’s antibiotic therapy is warranted. The time-out approach is in keeping with nurse engagement in prevention of central line-associated bloodstream infections, which includes a daily formal review of central line necessity. Bedside neonatal nurses are well positioned to lead reassessment of antibiotic treatment for they know how long a patient has been receiving antibiotic(s) and when diagnostic test results become available. For additional examples of nursing interventions that may have an important impact on promoting nurse engagement, read the recommendations from the ANA/CDC Workgroup and an article providing a framework to guide AS nursing practice.
  • Become an antibiotic stewardship champion. Neonates are entitled to receive antibiotic therapy that is based on evidence and best practice, but might be overlooked in hospital AS programs. Build and strengthen partnerships and facilitate communication between the NICU clinical staff and your organization’s AS team (physicians, clinical pharmacists, clinical laboratory personnel). Reach out to the AS team to learn about the overall AS program and specific AS NICU strategies. Engage and educate NICU staff about AS to increase their buy-in and awareness of nursing-related AS practices. Consider AS within the tenets of patient safety, and promote local-level “stewarding” behaviors that tap into the interprofessional NICU team’s collective knowledge, expertise, relationships and wisdom.15 NICU AS nursing practices should be intentionally selected, and strategically align with the organization’s AS program, giving ample consideration to the local context and tailored to the needs and resources of the NICU patients and clinical setting.
  • Monitor your antibiotic prescribing practices. A core AS strategy is tracking and reporting of provider antibiotic prescribing. Audit and feedback, includes analyzing antibiotic prescribing data and providing feedback to clinicians aimed at helping them understand their antibiotic prescribing habits. These data are most effective when individual results are compared to other clinicians in the clinician’s area and/or specialty (e.g., NNP peer comparisons). If you are a prescriber and are not receiving peer comparison audit and feedback data, work closely with your practice colleagues to develop a process to audit patterns of antibiotic prescribing to gauge appropriateness.
  • Use evidence-based clinical decision support systems. Clinical decision support systems are electronic tools or software that provide guidance to providers in making both diagnostic and therapeutic choices for patients.16 Applications range from pop-up reminders during a patient encounter, to automated order entry, to electronic guides, including dynamic interactive programs that tailor guidelines to specific patients. Such systems can be particularly useful when applied to antibiotic prescribing. Engage and partner with the NICU clinical team to identify the most useful systems to enhance clinical guideline adherence, decrease antibiotic consumption, or narrow the spectrum of antibiotic usage.

ABR has been aptly described as a subtle, slow moving catastrophe. AS programs aim to optimize antibiotic use to prevent the emergence of resistant pathogens and protect patients from the adverse effects of unnecessary antibiotics. We posit that all NICU nurses have a central role to play in the safe and responsible use of antibiotics and suggest several strategies for NICU nurses to engage in preventing unnecessary antibiotic exposure in this highly vulnerable population. We encourage you to seize the moment and become active, engaged stewards!

https://journals.lww.com/advancesinneonatalcare/fulltext/2024/06000/neonatal_nurse_and_nurse_practitioner_engagement.1.aspx

First Day of Neonatology

Dr. Glaucomflecken

Jennifer Degl, MS, Deb Discenza, MA, Mitchell Goldstein, MD, MBA, CML

In contemporary healthcare settings, the role of a Neonatal Intensive Care Unit (NICU) Volunteer Coordinator is indispensable, as it embodies the essence of compassionate care and community support for families navigating the challenges of premature births and neonatal health complications. While volunteer coordinators are often relied upon to fulfill this critical role, it is imperative to recognize the value they bring to the table and advocate for establishing a paid position dedicated to this noble cause.

Parents experience trauma regardless of what level NICU their baby is in and no matter the length of their NICU stay, and so it is vital that we push for a national campaign to address the inequity in order to help families bond and start the healing process before discharge. Not doing so can lead to trauma-related family issues at home. Currently, we largely focus on preparing parents for discharge across all things involving care of the infant. Why would we leave out the important topic of mental health Not addressing this important issue is tantamount to failure for that infant’s long term outcome, not to mention the outcome of the family unit as well. A NICU Volunteer Services Coordinator can alter that trajectory.

The NICU Volunteer Services Coordinator serves as a beacon of hope and support for families enduring the emotional rollercoaster of having their newborn hospitalized. This position encompasses a myriad of responsibilities aimed at fostering a nurturing environment within the NICU, where families feel empowered and supported throughout their journey. From recruiting additional NICU graduate parents to serve as volunteers to organizing crucial training sessions on mental health first aid and active listening, the coordinator plays a pivotal role in equipping volunteers with the necessary skills to provide invaluable support to NICU families.

 Furthermore, the coordinator is a liaison between volunteers, nursing staff, and physicians, ensuring seamless communication and collaboration for improving patient care. Facilitating regular meetings and educational events creates opportunities for peer to-peer support among parents and disseminates vital information on neonatal care practices, empowering families to make informed decisions regarding their child’s healthcare journey.

The significance of celebrating milestones and raising awareness cannot be overstated in the NICU setting. The coordinator spearheads initiatives such as NICU Awareness Month/Day and World Prematurity Month/Day, fostering community and solidarity among NICU families and staff. Moreover, their involvement n fundraising activities and grant writing endeavors ensures continued access to resources and services that benefit NICU babies and their families, underscoring their dedication to enhancing the quality of care provided.

Regarding qualifications and working conditions, the NICU Volunteer Services Coordinator must possess a unique blend of empathy, organizational acumen, and leadership skills. While a post-secondary education degree serves as a foundation, firsthand experience as a parent of a NICU graduate and previous involvement in peer mentoring or emotional support roles are invaluable assets. The flexible nature of the position, with a combination of on-site and remote work, accommodates the dynamic needs of NICU families while ensuring that the coordinator remains accessible and responsive to their concerns.

Crucially, advocating for a paid position for the NICU Volunteer Services Coordinator acknowledges the intrinsic value of their role and underscores the commitment of healthcare institutions to prioritize patient-centered care and community engagement. By investing in this position, hospitals enhance the support provided to NICU families and cultivate a culture of compassion and collaboration that is essential for fostering positive health outcomes.

In conclusion, establishing a paid position for the NICU Volunteer Services Coordinator is not merely a bureaucratic formality but a testament to the unwavering commitment of healthcare institutions to uphold the highest standards of patient care and support. By recognizing the invaluable contributions of these dedicated individuals, we affirm our collective responsibility to ensure that every NICU family receives the compassion, guidance, and support they deserve during their journey toward healing and hope. And in the end, the hospital, as a whole, wins substantially through quality improvement scores and community appreciation. It is worth the investment because the benefits are tenfold.

August 15, 2023 – by Robert Forman

Midwife care can improve pregnancy outcomes for mothers and babies, says new “Expert Review” from Yale faculty

The practice of midwifery is less common in the United States than in other countries and other cultures, which is a shame because adding care by midwives generally improves childbirth outcomes, according to two Yale faculty members who have published an “Expert Review” in the American Journal of Obstetrics & Gynecology. Holly Powell Kennedy PhD, MSN,CNM, the Helen Varney Professor of Midwifery, and  Joan Combellick, PhD, MPH,CNM, assistant professor of nursing, along with their colleagues, examined the scientific literature related to midwifery and childbirth, and conclude that many measures of successful pregnancy are elevated when midwives play a central role.

They cite the approach to midwifery that is standard in other countries, especially in wealthy European nations, where women have as much as seven times the access to midwives that they do in the United States. They report that midwifery care has improved outcomes by 56 different measures—including lower morbidity and mortality among mothers and newborns, fewer preterm births and low birthweight infants, and reduced interventions in labor.

The authors acknowledge that differences in those countries’ overall health systems make a substantial contribution to good outcomes, but say it’s the integral role of midwives that matters most. “In other countries, midwives make up the basic maternity care provider workforce, and then, obstetricians are used as the specialists that they are, surgeons who are there to handle complications,” says Combellick. “[Midwives] are the experts in normal childbirth, which happens the majority of the time.” Combellick adds that midwives also extend their care beyond pregnancy. “We also do well-person preventive care, across the lifespan from teenagers through postmenopausal people, so it isn’t only pregnancy-related.”

The Value of Midwives at the Baby’s Arrival

But the continuum of pregnancy, birth, and postnatal care is what midwives are best known for, and where the contribution of midwives can differ sharply from what is often considered standard care. Kennedy says a very basic way that outcomes can improve is because prenatal care by midwives is not squeezed into appointments of a set duration, where the provider may not have the time to fully answer the patient’s questions. Kennedy notes that in some settings, midwives caring for a woman throughout the pregnancy bring continuity and can structure longer appointments. Having more time permits building better rapport with a mother-to-be and helps her feel more respected, which often translates into a smoother pregnancy.

“In our paper, we discuss some of the research done about respect. It’s true for any kind of health care, but particularly in prenatal care,” says Kennedy. “It can amount to being highly disrespected and simply having to wait two hours for a very short prenatal visit. If people aren’t feeling respected or safe, they’re less likely to keep coming in for prenatal care.” Combellick adds that this can be especially true for women of color, for whom the cumulative race-based disrespect they endure in their daily lives can make the pressures of pregnancy more intense.

When the time for delivery arrives, a few statistics are especially striking. First-time mothers giving birth at medical centers where midwives were on their care team were 74% less likely to have their labor induced, 75% less likely to receive oxytocin augmentation, and 12% less likely to deliver by cesarean than their counterparts at medical centers without midwives in attendance.

Midwives and Ob/gyns Collaborate During Childbirth

Combellick says that on a collaborative team, the pregnant person is at the center of care, with everyone contributing their particular expertise. Whether to wait and allow labor to continue at its own pace, to induce, or to perform a cesarean can generally be a shared decision that involves patient understanding and consent. “We are collaborators,” says Combellick. “We work in conjunction with physicians. To have two viewpoints thinking about one person is a really strong style of care.”

At Yale, Kennedy and Combellick contribute to the midwifery faculty practice supporting student midwives as they learn. Faculty practice midwives are also active with obstetricians-in-training. “We contribute to the resident training program,” Combellick says. “So the residents, when they first come, are assigned to follow a midwife. Around the country, midwives often play a role in demonstrating ‘here’s what normal physiologic birth looks like,’ and that occurs at Yale.”

Hugh S. Taylor, MD, chair and Anita O’Keeffe Young Professor of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine, says this collaboration has been good for all involved. “It’s important that all of our practitioners get exposure and training on the collaborative practice model. The trainees participate in these teams and get a living example of how collaboration results in outstanding care. It was very important to establish that program—not only for patient care but for our residents and students.”

Taylor says that both for prenatal care and during deliveries, the presence of midwives on the care team can be invaluable. “Most of the prenatal care in our collaborative practice is delivered by midwives, with appropriate escalation and/or referral when things get complicated. If somebody develops diabetes or high blood pressure in pregnancy, we get the physician involved. However, for routine prenatal care or uncomplicated deliveries, we try to keep the physician in the background.”

Kennedy and Combellick both hope that the profile of midwifery in this country will rise, both through growing what Combellick now calls a “relatively small midwifery workforce” that attends only 10 to 12% of births in the United States, and by reforming practices related to health care delivery at large. “It’s not a simple, magical thing about the midwife,” Kennedy concludes, “but really about the model of care: that it’s accessible, it’s available, it’s respectful.” Those changes for the better, they say, would be nothing short of radical, and they are doing their part to gather the available evidence and advocate for change to happen.

https://medicine.yale.edu/news-article/the-value-of-midwives-during-prenatal-care-and-birth/

 UpToDate – Free

Find clinical answers at the point of care or anywhere you need them! Now you can access UpToDate’s current, synthesized clinical information — including evidence-based recommendations — quickly and easily on your iPad, iPhone, or iPod touch.

Notes: To use the mobile app you must first create an UpToDate account. Use this link on the WCMC-Q network to create an account.

 First Consult – FREE

Do you need evidence-based answers to clinical questions at the point of care? The First Consult iPhone/iPad app is your solution. The app allows First Consult’s trusted answers to be stored on your iPhone, iPad, or iPod touch. A data connection is required for the initial content download and content updates, but is not required to use the app itself.

Notes: Log in with your ClinicalKey account created from a WCMC-networked computer.

               DynaMed Plus – Free

DynaMed Plus™ is the clinical reference tool that physicians go to for answers to clinical questions. Content is written by a world-class team of physicians and researchers who synthesize the evidence and provide objective analysis. DynaMed Plus topics are always based on clinical evidence and the content is updated multiple times each day to ensure physicians have the information they need to make decisions at the point of care.


Note: To use this app begin by clicking on the “Get the DynaMed Plus Mobile App” link on the DynaMed Plus homepage. See this link for more information.

Touch Surgery, Surgical Simulator – Free

Touch Surgery is an interactive mobile surgical simulator that guides you step-by-step through every part of an operation, and every decision that’s made along the way. It’s the OR in your pocket.

Preop Eval – Free

Preop Eval organizes and presents much of the guidance that one needs in order to evaluate and prepare adult patients for non-cardiac surgery. It is based upon the guidelines on this topic from the American College of Cardiology of 2014, the European Society of Anaesthesiology of 2011, , and more. The app contains 1 algorithm and 3 resources: the cardiac evaluation algorithm, guidance on starting and stopping key medications in the perioperative period, guidance on timing of surgery after cardiac events, and guidance on preoperative testing. It also contains a review of preoperative evaluation mainly for students and residents.

AO Surgery Reference – Free

AO Surgery Reference is an online repository for surgical knowledge. It describes the complete surgical management process from diagnosis to aftercare for all fractures of a given anatomical region, and also assembles relevant material that the AO has published before.

drawMD General Surgery – Free

drawMD General Surgery’s content was developed by physicians and clinical practitioners to facilitate discussion of the most common conditions and procedures. The drawMD platform allows you to easily annotate any condition on our pertinent medical illustration or you can easily upload your own images.

*** This site also has All-Purpose Clinical APPs:

https://hslib-guides.qatar-weill.cornell.edu/c.php?g=364087&p=4181702

In Scotland, we believe that parenting is one of the most important jobs in the world. The work we do preparing our children for the future will ultimately shape our world in the years to come. With that in mind, we want to make sure that Scotland was the best place in the world to grow up in. That’s why, in 2017, we launched the Baby Box initiative, which is designed to give every single baby in Scotland an equal start in life.

Scottish Government   Jun 29, 2022

New babies need a surprising amount of stuff! Scotland’s Baby Box is packed full of clothes, bedding and lots of other useful things to help give your baby the best possible start in life

https://www.scotland.org/live-in-scotland/progressive-scotland/baby-box

by Eduardo Gonzalez-Moreira, Thalía Harmony, Manuel Hinojosa-Rodríguez, Cristina Carrillo-Prado,María Elena Juárez-Colín,Claudia Calipso Gutiérrez-Hernández, María Elizabeth Mónica Carlier, Lourdes Cubero-Rego, Susana A. Castro-Chavira, and Thalía Fernández / Published: 2 May 2023

Abstract

Background: Preterm birth is one of the world’s critical health problems, with an incidence of 5% to 18% of living newborns according to various countries. White matter injuries due to preoligodendrocytes deficits cause hypomyelination in children born preterm. Preterm infants also have multiple neurodevelopmental sequelae due to prenatal and perinatal risk factors for brain damage. The purpose of this work was to explore the effects of the brain risk factors and MRI volumes and abnormalities on the posterior motor and cognitive development at 3 years of age. Methods: A total of 166 preterm infants were examined before 4 months and clinical and MRI evaluations were performed. MRI showed abnormal findings in 89% of the infants. Parents of all infants were invited to receive the Katona neurohabilitation treatment. The parents of 128 infants accepted and received Katona’s neurohabilitation treatment. The remaining 38 infants did not receive treatment for a variety of reasons. At the three-year follow-up, Bayley’s II Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) were compared between treated and untreated subjects. Results: The treated children had higher values of both indices than the untreated. Linear regression showed that the antecedents of placenta disorders and sepsis as well as volumes of the corpus callosum and of the left lateral ventricle significantly predicted both MDI and PDI, while Apgar < 7 and volume of the right lateral ventricle predicted the PDI. Conclusions:  The results indicate that preterm infants who received Katona’s neurohabilitation procedure exhibited significantly better outcomes at 3 years of age compared to those who did not receive the treatment.  The presence of sepsis and the volumes of the corpus callosum and lateral ventricles at 3–4 months were significant predictors of the outcome at 3 years of age.

OPEN ACCESS ARTICLE HERE: Brain Sci. 2023, 13(5), 753; https://doi.org/10.3390/brainsci13050753 ; https://www.mdpi.com/2076-3425/13/5/753

Ryan Jaslow – Program Director, External Communications – Research, Mass General Brigham- rjaslow@mgb.org

06/05/24

Key Takeaways

  • A new clinical trial in Shanghai, China, in partnership with Mass Eye and Ear researchers, demonstrated the restoration of hearing in both ears in five children born with autosomal deafness caused by mutations in the OTOF gene.
  • All children gained ability to determine locations that sounds came from and improved speech perception in noisy environments.
  • The trial is the first to provide gene therapy for this form of inherited deafness to children in both ears, and the researchers hope to expand this work internationally.

Boston, Mass. — A novel gene therapy designed to target a form of inherited deafness restored hearing function in five children who were treated in both ears. The children also experienced better speech perception and gained the ability to localize and determine the position of sound. The study, the world’s first clinical trial to administer a gene therapy to both ears (bilaterally), demonstrates additional benefits than what were observed in the first phase of this trial, published earlier this year, when children were treated in one ear. The research was led by investigators from Mass Eye and Ear (a member of the Mass General Brigham healthcare system) and Eye & ENT Hospital of Fudan University in Shanghai, and findings were published June 5th in Nature Medicine.

“The results from these studies are astounding,” said study co-senior author Zheng-Yi Chen, DPhil, an associate scientist in the Eaton-Peabody Laboratories at Mass Eye and Ear. “We continue to see the hearing ability of treated children dramatically progress and the new study shows added benefits of the gene therapy when administrated to both ears, including the ability for sound source localization and improvements in speech recognition in noisy environments.”

The researchers noted their team’s goal was always to treat children in both ears to achieve the ability to hear sound in three dimensions, a capability important for communication and common daily tasks such as driving.

“Restoring hearing in both ears of children who are born deaf can maximize the benefits of hearing recovery,” said lead study author Yilai Shu MD, PhD, professor, director of Diagnosis and Treatment Center of Genetic Hearing Loss affiliated with the Eye & ENT Hospital of Fudan University in Shanghai, “These new results show this approach holds great promise and warrant larger international trials.

Over 430 million people around the world are affected by disabling hearing loss, of which congenital deafness constitutes about 26 million of them. Up to 60 percent of childhood deafness is caused by genetic factors. Children with DFNB9 are born with mutations in the OTOF gene that prevent the production of functioning otoferlin protein, which is necessary for the auditory and neural mechanisms underlying hearing.

This new study is the first clinical trial to use bilateral ear gene therapy for treating DFNB9. The new research presents an interim analysis of a single-arm trial of five children with DFNB9 who were observed over either a 13-week or 26-week period at the Eye & ENT Hospital of Fudan University in Shanghai, China. Shu injected functioning copies of the human OTOF transgene carried by adeno-associated virus (AAV) into the inner ears of patients through a specialized, minimally invasive surgery. The first case of bilateral treatment was conducted in July 2023. During follow-up, 36 adverse events were observed, but no dose-limiting toxicity or serious events occurred. All five children showed hearing recovery in both ears, with dramatic improvements in speech perception and sound localization. Two of the children gained an ability to appreciate music, a more complex auditory signal, and were observed dancing to music in videos captured for the study. The trial remains ongoing with participants continuing to be monitored.

In 2022, this research team delivered the first gene therapy in the world for DFNB9 as part of a trial of six patients in China treated in one ear. That trial, which had results published in The Lancet in January 2024, showed five of six children gained improvements in hearing and speech. Shu initially presented the data at the 30th annual congress of European Society of Gene and Cell Therapy (ESGCT) in Brussels, Belgium in October 2023, becoming the first in the world to report clinical data on using gene therapy to restore hearing.

“These results confirm the efficacy of the treatment that we previously reported on and represent a major step in gene therapy for genetic hearing loss,” said Shu. Shu trained under Chen for four years as a postdoctoral fellow at Mass Eye and Ear, with their collaboration continuing for more than a decade since he returned to Shanghai.

“Our study strongly supports treating children with DFNB9 in both ears, and our hope is this trial can expand and this approach can also be looked at for deafness caused by other genes or non-genetic causes,” added Chen, who is also an associate professor of Otolaryngology–Head and Neck Surgery at Harvard Medical School. “Our ultimate goal is to help people regain hearing no matter how their hearing loss was caused.”

Currently, there are no drugs available to treat hereditary deafness, which has made room for novel interventions like gene therapies.

Mass General Brigham’s Gene and Cell Therapy Institute is helping to translate scientific discoveries made by researchers into first-in-human clinical trials. Chen and his colleagues are working with the Institute to develop platforms and vectors with good manufacturing practice standards that would enable his team to more easily test this therapeutic approach with other genes in the future.

The authors note that more work is needed to further study and refine the therapy. The bilateral study requires more consideration compared to the unilateral (one-ear) study as operations in both ears, in the course of one surgery, doubles the surgical time. Furthermore, by injecting double doses of AAVs into the body, the immune response is likely to be stronger and the potential for adverse effects could be greater. Looking ahead, more patients as well as a longer follow-up duration are necessary, and continued analysis of gene therapies and cochlear implants in larger randomized trials will be valuable.

Paper cited: Wang, H et al. “Bilateral gene therapy in children with autosomal recessive

HEALTHMEDICAL SCIENCES 11 MAR 2024

The Neuroimaging Group, at the Department of Paediatrics, in collaboration with Bliss, the charity for babies born premature or sick, has launched a new suite of information resources for parents of neonates, designed to make them feel more confident about being involved in the care of their babies.

While evidence demonstrates that parents can play a positive role in comforting their baby during painful procedures, practice in the UK lags far behind. However new research by the Neuroimaging Group, published in the Lancet Child & Adolescent Health and Pain has brought further proof of the positive impact that being involved in their baby’s care has on parents.

The Parental touch trial (Petal) aimed to assess whether parental touch at a speed of approximately 3 cm/s to optimally activate C-tactile nerve fibres, provides effective pain relief during a heel-prick procedure. While there was no difference in the babies’ brain, behavioural or heart rate response to pain regardless of whether the parent touched their baby before or after the painful procedure, the findings did demonstrate that the majority of parents had positive emotions when involved in their child’s care – such as feeling useful and reassured – and an overall decrease in parental anxiety after their participation.

These new resources, a combination of beautifully curated and informative videos, FAQs and online information content, have been developed in light of the collaboration with parents and healthcare professionals. They are free to access online and set out in detail the many ways that parents can touch and comfort babies of all gestations during painful procedures on the neonatal unit, including skin-to-skin care.

Commenting on the research in an accompanying Lancet Child and Adolescent Health editorial, Ruth Guinsburg, said: ‘This study is an example of excellence in research. The trial was carefully designed with a clear question, strict inclusion and exclusion criteria, a well-designed and reproducible intervention based on biological plausibility, and defined outcomes, with the strength of using an objective rather than a subjective measure of pain. Only with trials like this might we transform faith in scienceand test the efficacy of traditional aspects of parental care in order to incorporate them, or not, in bundles to alleviate the pain in neonates.’

Dr. Rebeccah Slater, Professor of Paediatric Neuroscience and Senior Wellcome Fellow at the Neuroimaging Group, said: ‘Working with parents, babies and healthcare professionals to better understand how we can support premature and sick babies during painful procedures has been a highlight of my career. Developing these resources with Bliss has placed families at the heart of all the research we do, and has directly improved our engagement with families and the quality of our research. We will continue to find new ways to support parents and their babies when painful procedures form an essential component of neonatal care.’

Dr. Roshni Mansfield, a Paediatrics trainee and NIHR Academic Clinical Fellow in the Paediatric Neuroimaging Group said: ‘The Petal trial has highlighted the importance of involving parents in the provision of care and comfort for relieving their child’s pain. Future studies can build upon the insights gained from this trial including the positive parental experiences observed in this study. Prospective research might, for example, exercise a more spontaneous approach to delivering the gentle touch, such as allowing parents to stroke their child at their own pace, for as long as they need to calm and comfort their child, rather than a more mechanical and precise application.’

Dr. Maria Cobo, a postdoctoral researcher who managed the trial, added: ‘Another positive aspect of the study was the high degree of involvement by both fathers (35%) and mothers (65%) in delivering the parental touch to their babies. This contrasts with many studies, where only mothers’ opinions and involvement have been sought.’

 Caroline Lee-Davey, Chief Executive of Bliss, said: ‘We are thrilled to have worked alongside the amazing team of researchers at the University of Oxford to further our understanding on the importance of parental involvement in their babies’ neonatal care. We know that babies have the best chance of survival and quality of life when their parents are empowered to be partners in their care but, sadly, we hear all too often that parents are not informed about their babies’ procedures or the role that they can have in comforting their baby. The outcomes of this research have directly shaped a new suite of Bliss information for parents and healthcare professionals which will help to validate what families often instinctively know to be true – that no matter how unexpected or strange the neonatal environment can feel, they are still their baby’s parent and they have a vital role to play in their comfort and care.’ 

Additional funding from the Wellcome Trust enabled Bliss to develop these valuable resources for families, including new information, video content filmed at John Radcliffe Hospital’s neonatal unit giving precious insight into neonatal care, as well as translated flyers for neonatal units and a webinar for healthcare professionals on how to support parents to be involved in their babies’ procedures. These resources were created in collaboration with parents and healthcare professionals, and included a listening event with the Raham Project, a CIC supporting ethnic minority families, where four mothers shared their neonatal stories.

  https://www.ox.ac.uk/news/2024-03-11-research-shows-comforting-babies-eases-parental-stress-painful-procedures

Empowering the Unsung Heroes: Siblings of NICU Warriors

When a baby is born prematurely or with critical health needs, the entire family is thrust into a world of uncertainty and emotional upheaval. While much attention is rightfully focused on the newborn and parents, siblings often navigate this journey with a unique blend of resilience and vulnerability. These brave siblings of preemie babies deserve recognition and support for the vital role they play in the family’s NICU journey.

Siblings of NICU babies often experience a whirlwind of emotions, from fear and confusion to jealousy and isolation. It’s essential to create an environment where their feelings are acknowledged, and their contributions celebrated. Simple actions, like involving them in care routines or creating special sibling-only times, can foster a sense of inclusion and importance. Encouraging open conversations about their fears and questions can also help them feel more connected and less isolated.

Educational resources tailored to siblings can also be beneficial. Books, videos, and activities that explain the NICU environment in age-appropriate terms can demystify the experience and reduce anxiety. These resources help siblings understand the medical aspects of their baby brother or sister’s care, making the hospital environment less intimidating. Providing clear and accessible information empowers siblings by giving them a sense of control and understanding in an otherwise overwhelming situation. Resources such as Hand to Hold, Bliss, Miracle Babies Foundation, and Canadian Premature Babies Foundation, offer valuable insights and practical tips for supporting siblings during this challenging time.

Recognizing the importance of supporting siblings of NICU babies is essential for fostering a positive family dynamic and ensuring the emotional health of all children involved. By acknowledging their unique experiences and providing targeted support, parents and caregivers can help these strong siblings navigate the complex emotions and challenges they face, contributing to the overall resilience and well-being of the entire family navigating the NICU journey.

These resources provide valuable insights and practical tips to help siblings navigate the complex emotions and experiences associated with having a brother or sister in the NICU:

Hand to Hold: Sibling Support

Hand to Hold provides comprehensive resources to support siblings of NICU babies, including tips for preparing siblings for NICU visits and strategies for making them feel included in their baby brother or sister’s care.

https://handtohold.org/resources/siblings

Bliss (UK): Support for Siblings

Bliss is a UK-based charity that provides comprehensive support for families of premature and sick babies. They offer resources and guidance specifically designed for siblings, including advice on how to involve them in the care process and ways to help them understand and cope with the NICU environment.

https://www.bliss.org.uk/parents/support/siblings

Miracle Babies Foundation (Australia): Sibling Support

Miracle Babies Foundation is an Australian organization dedicated to supporting premature and sick newborns, their families, and the hospitals that care for them. They provide resources tailored for siblings, helping them navigate the emotional and practical challenges of having a brother or sister in the NICU.

https://www.miraclebabies.org.au/parents-and-families/sibling-support/

Canadian Premature Babies Foundation Sibling Support

The Canadian Premature Babies Foundation (CPBF) offers a range of resources to support families of premature babies across Canada. They provide specific guidance and materials for siblings, including educational resources and support groups to help them cope with their sibling’s NICU stay.

https://www.cpbf-fbpc.org/sibling-support

Boy’s Heart Melts As He Meets Baby Sister After NICU Stay

Sep 11, 2023

 A three-year-old boy who could not meet “his” baby sister while she spent her first days in the NICU lit up when he was finally able to hold her for the first time. Dominic “Dommy” Voso, from Rome, Georgia, told his parents the newborn would be “his” baby, having asked mom and dad for a sibling for a long time, proudly telling others when his mom was pregnant. But unfortunately for Dommy, mom Chrissy, 30, had preeclampsia during her pregnancy, which meant that Mia had be delivered at 35 weeks and four days. Mia then had trouble breathing, which caused her to spend her first 12 days in the NICU. This period was extremely tough for Dommy, as he had been desperate to meet his newborn sister, but only adults and siblings over 13 years of age could enter the NICU. Added to this difficulty, Chrissy had to spend an extra eight days in hospital, too, so Dommy couldn’t understand why he could see his mom but not his little sister. But that all changed on July 4 when Dommy sat in his family’s home and Chrissy came in holding Mia. When Dommy was then presented with his little sister, he immediately beamed with joy, holding her before bringing toys and books to share with her.

This inspiring video  highlights the experiences and resilience of siblings of Preemie Warriors:

                                 Let’s Travel!      #scotland #travelchannel #scotlandtravel

Surfing Scotland, Thurso, surf trip UK, Surfing scotland West Coast, Surfing Scotland East Coast, Surfing Dunbar, Moray firth, December surf!

Lifelines, Redirection, Neurocritical Care

Yemen, officially the Republic of Yemen, is a country in West Asia. It is located in the southern end of the Arabian Peninsula, bordering Saudi Arabia to the north and Oman to the northeast. It shares maritime borders with EritreaDjibouti and Somalia. Covering 530,000 square kilometres (204,634 square miles) and having a coastline of approximately 2,000 kilometres (1,200 miles), Yemen is the second-largest Arab sovereign state on the Arabian Peninsula.Sanaa is its constitutionally stated capital and largest city. The country’s population is estimated to be 34.7 million as of 2023. Yemen is a member of the Arab League, the United Nations, the Non-Aligned Movement and the Organisation of Islamic Cooperation.

Since 2011, Yemen has been facing a political crisis, marked by street protests against poverty, unemployment, corruption, and President Saleh’s plan to amend Yemen’s constitution and eliminate the presidential term limit. Subsequently, the country has been engulfed in a civil war with multiple entities vying for governance, including the government of President Hadi (later the Presidential Leadership Council), the Houthi movement‘s Supreme Political Council, and the separatist Southern Movement’s Southern Transitional Council. This ongoing conflict has led to a severe humanitarian crisis and received widespread criticism for its devastating impact on Yemen’s people.

The ongoing humanitarian crisis and conflict has received widespread criticism for having a dramatic worsening effect on Yemen’s humanitarian situation, that some say has reached the level of a “humanitarian disaster”. Yemen is one of the least developed countries in the world, facing significant obstacles to sustainable development and is one of the poorest countries in the Middle East and North Africa region. The United Nations reported in 2019 that Yemen had the highest number of people in need of humanitarian aid, amounting to about 24 million individuals, which is nearly 75% of its population.

Source:https://en.wikipedia.org/wiki/Yemen

  • GLOBAL PRETERM BIRTH RATES YEMEN
  • Estimated # of preterm births: UNKNOWN per 100 live births
  • (Global Average: 10.6)
  • Source- WHO Yemen – Healthy Newborn Network 6.8% preterm birth rate, 39% of infant mortality

Highlights

  • Despite expert knowledge and expertise, nurses often do not write for publication.
  • Barriers to writing for publication are commonly reported by nurses.
  • A virtual, Writing for Publication Program was convened to overcome these barriers.
  • The group of clinical and academic nurses successfully published a manuscript.
  • Recommendations for overcoming writing for publication barriers provided.

Abstract

Nurses have valuable knowledge and expertise to share. Yet, for a variety of reasons, many nurses do not write for publication. Members in one Sigma Theta Tau International chapter requested information about publishing so a writing for publication program (WPP) was convened. Ten nurses from diverse clinical and academic backgrounds participated. The goal of the WPP was to support a small group of nurses to advance knowledge and develop practical skills through the development of a manuscript with mentorship from doctorally-prepared nurses with publishing experience. The anticipated effect was that participants would share what they learned with colleagues or mentor others to publish in the future. Beginning with informational sessions to lay the foundation for writing and publishing, the WPP included biweekly, two-hour online sessions over a seven-month period whereby individual and group writing with embedded peer and WPP leader feedback occurred. WPP participants gained proficiency in searching online databases, synthesizing published literature, and working as a member of a writing team. The group successfully published a manuscript based on a topic of interest. This current article describes the structured support and mentorship provided during the WPP with recommendations for overcoming publication barriers commonly described in the literature.

Background

Barriers to writing for publication are widely reported in nursing literature. Writing barriers are described as situational or personal (Tivis & Meyer, 2018) and internal or external (Oman et al., 2016). Situational and external barriers to writing for publication include a lack of time, family commitments, lack of resources, inadequate access to technology, insufficient organizational support, or a workplace culture that does not value writing and dissemination (Ansryan et al., 2019; Oman et

Forming the group

In August 2021, the annual general membership meeting for one chapter of Sigma Theta Tau International (Sigma) was held. Based on member requests, the educational focus of the general membership meeting, held online via the chapter’s discussion board, was writing for publication. Over the three-day meeting, those with publication experience were encouraged to share insights related to publishing. Members without publication experience reflected on publishing myths and barriers to writing for

Developing the manuscript

The goal of the WPP was to train a small cohort of nurses on how to write a single manuscript on a topic of interest and submit it to a peer-reviewed nursing journal. Wood (2018) and Bourgault (2023) note that some of the earliest decisions should be selecting the topic of the manuscript, identifying the intended audience, and selecting the journal the manuscript should be submitted. Oman et al. (2016) concur that successfully writing a manuscript is enhanced when the topic relates to lived

Reflections from group members

Two months after the second manuscript was accepted for publication, participants were asked to complete an anonymous survey to ascertain perspectives about the WPP. All ten members completed the survey. Resoundingly participants believed the WPP was a ‘well run,’ ‘helpful,’ and a ‘worthwhile’ experience. WPP leaders were ‘well prepared’ and ‘professional and skilled in guiding the process.’

The topics that members were already familiar with before participating in the WPP were writing

Lessoned learned with recommendations

Reflection by WPP leaders yielded several lessons learned with recommendations for overcoming known barriers to writing for publication. Insufficient time is frequently cited as a barrier to writing for publication (Ansryan et al., 2019). The structure of the WPP program was feasible to accomplish personal and collective goals. Two-hour, bimonthly meetings allowed sufficient time to complete the session agenda without burdening participants who may have competing work and family demands.

Conclusion

Writing for publication is an expectation of all nurses because it improves the quality of patient care to achieve optimal outcomes while also advancing the nursing profession. An innovative, virtual WPP successfully guided 10 academic and clinical nurses to publish a manuscript in a respected, peer-reviewed journal (Chargualaf et al., 2023). Participants largely reported feeling more confident in their own ability to publish in the future. Thus, the goal of the WPP was met. 

Source:https://www.sciencedirect.com/science/article/abs/pii/S8755722324000267

FROM THE AMERICAN ACADEMY OF PEDIATRICS| FEBRUARY 26 2024

American Academy of Pediatrics https://doi.org/10.1542/peds.2023-065582Board of Directors  Pediatrics (2024) 153 (3): e2023065582.

The violence, suffering, and death from the terrorist attack on Israel and the Israel-Hamas War weigh on us all. Pediatricians—who are called to care for children and keep them safe and healthy—have been reaching out to the American Academy of Pediatrics expressing anguish, outrage, and a deep desire to help stop the killing, ease the suffering, and protect all children from harm.

We are shaken and pained by what is happening in Israel and Gaza, and we are also alarmed by the increasing acts of violence and intimidation we’ve been witnessing in this country toward Jews, Muslims, and those with ties to Israel or Palestine. Many pediatricians and the families they care for have experienced such incidents.

As antisemitic and anti-Palestinian hate speech have been surging on social media, acts of hate have also been increasing in the United States and around the world. There has been an unprecedented rise in incidents of antisemitism, Islamophobia, and anti-Palestinian racism in this country according to data from the Anti-Defamation League and the Council on American-Islamic Relations. And reports of violent hate crimes targeting Jews, Muslims, and Arabs have risen steeply across the United States.

As people at home and abroad confront these issues and as world leaders debate how to move forward, one thing is certain: all children affected deserve our unconditional support.

It will always be the mission of the American Academy of Pediatrics (AAP) to advocate for children’s protection, health, and safety, no matter what, no matter where—be it in the United States, Israel, Gaza, the West Bank, Ukraine, South Sudan, Armenia, Syria, Yemen, Myanmar, Ethiopia, Democratic Republic Congo, or other conflict-torn areas that receive less media attention.

As pediatricians, pediatric medical subspecialists, and pediatric surgical specialists, we understand that the profound cost of any war is measured in children’s lives—those lost to violence and those forever changed by it. We know that what happens to these children today and what we do for them will help determine what becomes of this generation tomorrow.

In 2018, the Academy published a policy statement and accompanying technical report, “The Effects of Armed Conflict on Children,” which began with the following statistic: 1 in 10 children are affected by armed conflict. By 2021, 1 in 6—or about 449 million children worldwide—were living in a conflict zone. Africa had the highest overall number of children impacted by conflict (180 million), followed by Asia (152 million), and the Americas (64 million). Today, that figure is tragically even higher.

Our policy details both the acute and long-term effects of armed conflict on child health and well-being and uses a children’s rights-based approach as a framework for the AAP, child health professionals, and national and international partners to respond in the domains of clinical care, systems development, and policy formulation.

Our policy calls on governments to safeguard children and for pediatricians and health organizations to be involved both in preventing and responding to armed conflict. It advocates for integrating core human rights principles set forth in the United Nations Convention on the Rights of the Child (UNCRC) treaty into US policy.

To fulfill these rights, the policy lays out a number of detailed recommendations for mitigating the harms of child conflict both in clinical practice and in social systems serving children. This includes ensuring child health professionals who care for children affected by armed conflict have access to training in trauma-informed care, which involves recognizing and mitigating the harmful effects of these experiences. And it highlights opportunities for public policy advocacy, which include:

  • Ending the participation of children younger than 18 years of age in armed conflict and ensuring all children are protected from torture and deprivation of liberty, including extended or arbitrary detention;
  • Upholding the Geneva Conventions with respect to maintaining the sanctity of safe places for children, ensuring medical and educational neutrality, and allowing children fleeing armed conflict to petition for asylum and be screened for evidence of human trafficking;
  • Ensuring that children are not separated from their families during displacement and resettlement, and in the event of separation, prioritizing family reunification;
  • Protecting children from landmines, unexploded ordnances, small arms, and light weapons through effective clearing efforts and strict control on their sale, ownership, and safe storage;
  • Affording children a voice in creating policy and programs that prevent and mitigate harmful effects of armed conflict; and
  • Providing children affected by armed conflict access to educational opportunities as part of an environment conducive to their reintegration into society.
2023 AAP Board of Directors2024 AAP Board of Directors
Sandy L. Chung, MD, FAAP Benjamin D. Hoffman, MD, FAAP 
Benjamin D. Hoffman, MD, FAAP Susan J. Kressly, MD, FAAP 
Moira A. Szilagyi, MD, FAAP Sandy L. Chung, MD, FAAP 
Dennis M. Cooley MD, FAAP Margaret C. Fisher, MD, FAAP 
Patricia Flanagan, MD, FAAP Patricia Flanagan, MD, FAAP 
Warren M. Seigel, MD, FAAP Jeffrey Kaczorowski, MD, FAAP 
Margaret C. Fisher, MD, FAAP Patricia Purcell, MD, MBA, FAAP 
Michelle D. Fiscus, MD, FAAP Jeannette “Lia” Gaggino, MD, FAAP 
Jeannette “Lia” Gaggino, MD, FAAP Dennis M. Cooley, MD, FAAP 
Gary W. Floyd, MD, FAAP Susan Buttross, MD, FAAP 
Martha C. Middlemist, MD, FAAP Greg Blaschke, MD, MPH, FAAP 
Yasuko Fukuda, MD, FAAP Yasuko Fukuda, MD, FAAP 
Madeline M. Joseph, MD, FAAP Madeline M. Joseph, MD, FAAP 
Charles G. Macias, MD, FAAP Angela M. Ellison, MD, MSc, FAAP 
Constance S. Houck, MD, FAAP Kristina W. Rosbe, MD, FAAP 
Joelle N. Simpson, MD, FAAP Joelle N. Simpson, MD, FAAP 

In examining the entire policy in light of the Israel-Hamas War, we determined it was missing important elements to emphasize the protection of children during war and the Academy’s opposition to religious persecution of any kind. We voted unanimously to add the following to the policy statement:

  • Children should never be harmed because of the religious, cultural, and other beliefs and values of the child and/or their family;
  • Harm to children should never be used as a tool or tactic of war or conflict; and
  • Children should be protected from the direct effects of armed conflicts and their food, housing, health, and other basic needs safeguarded.

With the magnitude of the suffering and so many children hurting at home and abroad, this is a distressing time to work in pediatrics. The pain of our members is palpable; both the urgent desire to do all we can to protect children in Israel and Gaza and the fear and concern we are experiencing as acts of hate proliferate in the United States. Yet our common mission and the outpouring of support and solidarity among our member pediatricians reminds us there is light in the darkness.

We use our platform as the world’s largest pediatric organization to speak out against violence, hate, antisemitism, Islamophobia, and enmity toward Jews, Muslims, Israelis, and Palestinians and to speak up on behalf of all children suffering in armed conflict. We stand with everyone in the pediatric profession in these times of tragedy as we continue our work of healing, protecting, and caring for the world’s children.

Source:https://publications.aap.org/pediatrics/article/153/3/e2023065582/196273/Protecting-Children-and-Condemning-Hate-During-a?autologincheck=redirected

Jane E. Brumbaugh, MD1Carla M. Bann, PhD2Edward F. Bell, MD3; et alColm P. Travers, MD4Betty R. Vohr, MD5Elisabeth C. McGowan, MD5Heidi M. Harmon, MD, MS3Waldemar A. Carlo, MD4Susan R. Hintz, MD, MS Epi6Andrea F. Duncan, MD, MS7; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network- 03/11/24

Key Points

Question  How are maternal social determinants of health associated with discussions and decisions surrounding redirection of care for infants born extremely preterm?

Findings  In this cohort study of 15 629 infants born extremely preterm, Black mother-infant dyads were significantly less likely to have redirection of care discussions than White mother-infant dyads, and Hispanic mother-infant dyads were significantly less likely to have redirection of care discussions than non-Hispanic mother-infant dyads.

Meaning  Research is needed to understand the possible reasons and solutions for differences in redirection of care discussions for critically ill infants by race and ethnicity.

Abstract

Importance  Redirection of care refers to withdrawal, withholding, or limiting escalation of treatment. Whether maternal social determinants of health are associated with redirection of care discussions merits understanding.

Objective  To examine associations between maternal social determinants of health and redirection of care discussions for infants born extremely preterm.

Design, Setting, and Participants  This is a retrospective analysis of a prospective cohort of infants born at less than 29 weeks’ gestation between April 2011 and December 2020 at 19 National Institute of Child Health and Human Development Neonatal Research Network centers in the US. Follow-up occurred between January 2013 and October 2023. Included infants received active treatment at birth and had mothers who identified as Black or White. Race was limited to Black and White based on service disparities between these groups and limited sample size for other races. Maternal social determinant of health exposures were education level (high school nongraduate or graduate), insurance type (public/none or private), race (Black or White), and ethnicity (Hispanic or non-Hispanic).

Main Outcomes and Measures  The primary outcome was documented discussion about redirection of infant care. Secondary outcomes included subsequent redirection of care occurrence and, for those born at less than 27 weeks’ gestation, death and neurodevelopmental impairment at 22 to 26 months’ corrected age.

Results  Of the 15 629 infants (mean [SD] gestational age, 26 [2] weeks; 7961 [51%] male) from 13 643 mothers, 2324 (15%) had documented redirection of care discussions. In unadjusted comparisons, there was no significant difference in the percentage of infants with redirection of care discussions by race (Black, 1004/6793 [15%]; White, 1320/8836 [15%]) or ethnicity (Hispanic, 291/2105 [14%]; non-Hispanic, 2020/13 408 [15%]). However, after controlling for maternal and neonatal factors, infants whose mothers identified as Black or as Hispanic were less likely to have documented redirection of care discussions than infants whose mothers identified as White (Black vs White adjusted odds ratio [aOR], 0.84; 95% CI, 0.75-0.96) or as non-Hispanic (Hispanic vs non-Hispanic aOR, 0.72; 95% CI, 0.60-0.87). Redirection of care discussion occurrence did not differ by maternal education level or insurance type.

Conclusions and Relevance  For infants born extremely preterm, redirection of care discussions occurred less often for Black and Hispanic infants than for White and non-Hispanic infants. It is important to explore the possible reasons underlying these differences.

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Credit…Ruth Fremson/The New York Times

By Alisha Haridasani Gupta     Published Feb. 8, 2024Updated Feb. 14, 2024

Premature births, after years of steady decline, rose sharply in the U.S. between 2014 and 2022, according to recently published data from the Centers for Disease Control and Prevention. Experts said the shift might be partly the result of a growing prevalence of health complications among mothers.

“I’m not too surprised that these are the changes we’re seeing,” said Dr. Nahida Chakhtoura, chief of the pregnancy and perinatology department at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. “We know that maternal complications have been on the rise for the same time period.”

Births before 37 weeks of gestation increased by 12 percent, though there were fluctuations during the pandemic years, with slight decreases in 2020 and 2022. Deliveries at or after week 40 declined during the study period. Increases in premature birth rates were similar across races and age groups, but the largest jump was among mothers aged 30 and above.

It is a reversal of promising trends before 2014, when premature births had been steadily declining and full-term deliveries were on the rise. Though the latest report doesn’t delve into the causes, it is “concerning,” Dr. Chakhtoura said, particularly because premature babies generally face increased risks for health complications.

One of the reasons for the rise might be that women are having babies later in life, said Dr. Vanessa Torbenson, an obstetrician and gynecologist at the Mayo Clinic in Minnesota. Older maternal age, she added, presents an increased risk of health complications that may require an early induction. Overall rates of high blood pressure in particular have been on the rise in recent years. According to the C.D.C., almost 16 percent of women who delivered in hospitals had some kind of hypertensive disorder in 2019, and those issues were most common among women 35 and older. Rates of gestational diabetes have also grown, especially among older mothers.

Generally, “the further along you go in pregnancy, the higher the chance of survival” for the baby, said Dr. Dawnette Lewis, director of Northwell Health’s Center for Maternal Health and a maternal fetal medicine specialist. Studies have found that a baby delivered at 23 weeks, for example, has a roughly 55 percent chance of survival, with chances increasing each week after that, Dr. Lewis said. The American College of Obstetricians and Gynecologists recommends inducing labor at or before 37 weeks when medically necessary.

The latest C.D.C. data is “skimming the surface,” Dr. Lewis said. One of the many unanswered questions is why there were few differences in premature birthrates across races, given that research consistently shows that rates of pre-eclampsia and hypertension are disproportionately higher among Black women. Understanding who was induced and why might shed some light on that question, she added.

Despite the concerns around later maternal age, many of the health risks can be managed, Dr. Lewis said. “Anyone who’s considering a pregnancy, regardless of their age, should see a health care practitioner so that they can be evaluated and, in case that they do have any medical conditions, that they can get those under control before attempting a pregnancy.”

Source:https://www.nytimes.com/2024/02/08/well/family/premature-births-maternal-age.html

By  Cathy Cassata  Published on May 03, 2022   Medically reviewed by Steven Gans, MD

There’s no doubt early in the pandemic, healthcare workers were pushed to their limits. Crowded hospitals required doctors and nurses to work long hours caring for patients suffering from an unprecedented and unpredictable COVID-19 virus. The pressure and demands of the situation put a physical and mental strain on those seeing patients.

According to a 2021 survey published in the Journal of General Internal Medicine of more than 500 healthcare workers and first responders, a substantial majority of respondents reported experiencing clinically significant psychiatric symptoms, including:1

  • anxiety (75%)
  • depression (74%)
  • post-traumatic stress disorder (38%)
  • recent thoughts of suicide or self-harm (15%) 

To support healthcare workers’ mental health during the pandemic, many people were inspired to establish organizations. Below are three that sprung up over the past few years and continue to make a difference in the lives of doctors, nurses, and other frontline workers bearing the brunt of caring for the public during the ebb and flow of the pandemic. 

Dr. Lorna Breen Heroes Foundation

Lorna Breen, MD, was a seasoned emergency room physician at New York Presbyterian Hospital in Manhattan when the COVID-19 crisis hit. In a period of three weeks, Breen treated COVID patients, contracted COVID herself, and returned to an overwhelming number of critically sick patients. At the peak of COVID, she worked 15 to 18-hour shifts with limited PPE, insufficient supplies, and not enough equipment to care for patients; some of who were dying in the hallways. 

When Breen called her sister Jennifer to share that she was overwhelmed and exhausted to the point that she couldn’t get out of her chair, Jennifer and her husband Corey Feist went to Manhattan and took Breen to a mental health hospital, where she stayed for 10 days, receiving the first mental health treatment of her lifetime. A few days into her stay, Breen called her sister to express concern that her career as a physician was ruined because she was receiving mental health treatment. 

When Breen returned to work on April 1, 2020, her fear continued, as she worried her colleagues would notice she couldn’t keep up. Breen died by suicide on April 26, 2020. 

What Lorna was feeling is felt by doctors and nurses across the country today. The average person can ask for help, but not healthcare workers; in [several] states, they can lose their license for seeking [treatment for mental health]. That’s unacceptable.

According to a 2022 Medscape report, when physicians were asked why they have not sought help for burnout or depression, their top reasons were:2

  • I can deal with this without help from a professional (49%)
  • Don’t want to risk disclosure to medical board (43%)
  • Concerned about it being on my insurance record (32%)
  • Concerned about my colleagues finding out (22%) 

After Breen’s death, the Feists went on the “Today” show to spread awareness about the mental health strain healthcare workers faced during the pandemic. After the show, they received an outpouring of support from the healthcare workforce, thanking them for sharing Breen’s story. One sentiment they heard often was the need for change when it comes to questions on licensure applications and hospital credentialing applications that ask about a person’s prior mental health
history. 

The responses moved them to establish the Dr. Lorna Breen Heroes Foundation, which aims to reduce burnout of healthcare professionals and safeguard their well-being and job satisfaction by: 

  1. Advising the health care industry to implement well-being initiatives
  2. Building awareness of these issues to reduce the stigma; and
  3. Funding research and programs that will reduce health care professional burnout and improve provider well-being. 

“While Lorna is our beacon and inspiration, we started the organization because we heard from the
healthcare force (hundreds) after she died that something needed to change,” said Feist. “Now, what we have is a huge subsection of our healthcare workforce who has experienced repetitive trauma for two years. For some of them, this has been 9/11 every day for two years, and because of their fear of repercussions to continue working, they are going to suffer in silence.”

On March 18, 2022, the foundation’s work helped pass the Dr. Lorna Breen Health Care Provider Protection Act, which establishes grants and requires other activities to improve mental and behavioral health among healthcare providers.

The more we talk about mental health, the more we normalize it and give others permission to speak. Lorna was the toughest person I knew in the world and she was a seasoned physician in New York. She worked through Ebola in New York and other crises. This wasn’t about being tough.

He added that many solutions to the problem are complex, but that small actions can help. 

“[Like] someone being vulnerable and recognizing the need for self-care, and peer support (recognizing a colleague who needs support) that don’t cost money. We need to make it clear that you care for yourself and colleagues just as you would your patients,” he said. 

The foundation’s next mission is to raise awareness among medical licensing boards, nursing boards, and hospital systems about the impact of including mental health questions on applications. They hope licensing boards will change questions to reflect current mental health impairment and exclude past ones. 

“We are asking all hospitals in this country to simply publish to their workforce that they can
get mental health support without repercussions, which can be a life-saving opportunity for all of the healthcare community,” said Feist. 

The Emotional PPE Project

In March 2020, Ariel Brown, PhD, neuroscientist, was talking to her neighbor and friend Daniel Saddawi-Konefka, MD, critical care physician and anesthesiologist at Massachusetts General Hospital, when she was moved to help with the COVID crisis. 

“Dr. Dan…is responsible for directing [about] 100 anesthesiology residents and was struggling with the best way to support them during the onslaught of COVID,” said Brown. “I wanted to help and so I put out a call on social media to see if any of the therapists in my network wanted to volunteer some of their time to help these folks who were fighting on the frontline of the pandemic.” 

The therapists raised their hands in droves to offer free therapy to healthcare workers. When
Brown passed on their contact information to the residents, many reached out to therapists for help
at a no-cost, no-insurance, streamlined option for healthcare workers to seek mental health care. 

Because of the goodwill of the mental health provider community and because of the great need in the healthcare worker community, things grew very quickly. I put together a team, which I led to set up to be able to scale. Two years later, we are a national nonprofit organization that has over 700 volunteer therapists and has served over 2,000 healthcare workers across the nation.

Over the course of the pandemic, she has learned that healthcare workers face significant barriers to getting support for their mental health. The Emotional PPE Project is designed to streamline mental health service by lifting barriers, including: 

  • Financial: Facilitating services at no cost and with no insurance.
  • Access: A streamlined process to connect with therapists
  • Stigma: Remaining 100 percent confidential and unaffiliated with any organization that employs healthcare workers

“Overall, we seek to take away every barrier that we can so that the folks experiencing unprecedented stress and trauma can have a streamlined connection with someone that can help,” said Brown. 

The Emotional PPE Project is also involved in research and advocacy work similar to that of the Dr. Lorna Breen Heroes Foundation, including working to reform licensing practices to protect the mental health of physicians

  • Healthcare workers, find a therapist in The Emotional PPE Project directory
  • Licensed therapists, sign up to volunteer your time
  • Anyone, support the organization by making a tax-deductible donation

Therapy Aid Coalition

As the world started to shut down due to COVID-19 in March of 2020, Jennifer Silacci, LCSW, psychotherapist, felt grateful she could work from home and shelter in place although anxious about the virus. 

I wondered, if those of us at home felt so overwhelmed, how were those on the frontlines coping? How were they processing the anxiety around constant exposure to a potentially deadly virus? And what could I do to help them?

She decided to offer free and low-cost therapy sessions to healthcare workers and asked her colleagues if they would join her. Word spread, and before she knew it, thousands of volunteer therapists from across the country joined Silacci. 

“Quite honestly, I had no idea how to manage this new, growing network of volunteers, or the thousands of emails pouring into my inbox, so I asked everyone I could think of for help. Childhood friends and even some kids I babysat (now adults) stepped up. A friend connected us with her law firm, and soon we were a fully formed 501(c)(3) public charity,” she said. 

Within months of putting out the initial call, Silacci established the Therapy Aid Coalition,
now made up of over 3,000 licensed therapists, who offered free and low-cost online therapy to essential workers in the United States. 

Because confidentiality is a concern for many healthcare professionals, and many do not want to utilize employee assistance programs (EAPs), health insurance, or support and resources from their hospitals and clinics, Silacci said her service offers them the opportunity to connect with a therapist anonymously. Over the past two years, the program has served thousands of essential workers throughout the country. 

“I think the pandemic and the amazing work of so many nonprofits…have shed light on the need for mental health support, destigmatization, and advocacy for mental wellness within the healthcare professions,” she said. 

Because the Therapy Aid Coalition continues to receive hundreds of requests monthly, Silacci said, normalizing the fact that healthcare professionals “while perhaps heroic in their actions—are still painfully and beautifully human” needs to become more understood. 

“We all have a breaking point. It is my belief that individuals that have been on the frontlines may not even fully realize the impact of their experience just yet. Some are still running on adrenaline. Some are still numb and just trying to make it through another shift,” she said. “I believe we will see a greater need for mental health support among frontline workers in the next year or two, as they finally come up for air, and have the time and space to unthaw, and digest all that has unfolded.”

Those affected also include mental health professionals, Silacci added, and taking care of therapists is also one of her objectives. While the Therapy Aid Coalition currently offers free and low-cost services, it plans to pay therapists via stipends as it accumulates grants. 

Those affected also include mental health professionals, Silacci added, and taking care of therapists is also one of her objectives. While the Therapy Aid Coalition currently offers free and low-cost services, it plans to pay therapists via stipends as it accumulates grants. 

“We want services to be free to essential workers, but we also believe it is absolutely not fair to ask therapists to continue to offer pro-bono sessions two years into the pandemic,” she said. “[Therapists] are essential workers, and also qualify for free short-term sessions with us!” 

Source:https://www.verywellmind.com/3-organizations-providing-a-free-lifeline-for-healthcare-workers-5222435

Bernard Marr/Contributor

The roles of professionals in society are shifting thanks to the development of truly useful and powerful generative artificial intelligence. Every industry will be impacted, but we have already seen that healthcare, with its heavy use of data and technology, will be disrupted more than most.

Generative AI has the potential to revolutionize the way we treat disease, develop new medicines and personalize treatments to fit individual patients. It will also fundamentally change both the day-to-day working lives of doctors, nurses and other clinical health professionals and even the way they are seen by society. As a result, they will find they are more reliant than ever on the human qualities like compassion, communication and the instinct that many who fill these jobs have for providing care.

So here’s my overview of some of the most dramatic and meaningful transformations we can expect to see in the near future, as well as some of the practical and ethical challenges that will have to be overcome.

AI As A Diagnostic Assistant

Generative AI helps with diagnosing conditions by interpreting data and providing clear, in-depth insights into what is known about the patient. It can be used to examine hundreds of X-ray, MRI and CT scans and quickly give a statistical summary of its findings. This will lead to more accurate, data-driven diagnosis of many common or not-so-common conditions.

This communication can then be fine-tuned depending on the role of the healthcare professional who is using it, whether a doctor, nurse, consultant or specialist. Communicating only the insights relevant to them means there will be less noise between the professional and the specific information they need.

The World Economic Forum has also predicted that generative AI will lead to improved outcomes as it becomes able to efficiently extract data from the many disparate and siloed sources that have traditionally existed across healthcare.

It will also increasingly be used to create synthetic data, which is artificially generated to resemble real-world information. This is particularly useful for situations with limited training data, such as with rare conditions and diseases. It can also reduce the security and data protection measures that healthcare professionals must take when working with real patients’ personal data. Synthetic data can also be used to simulate healthcare scenarios like pandemics or the emergence of antibiotic-resistant organisms that could cause a global healthcare crisis.

Automating Routine And Administrative Tasks

It will become increasingly common for medical professionals to use generative AI to automate many of the repetitive and routine administrative tasks they carry out every day. This will free up their time to focus on directly providing care, as well as continuing their training and learning.

From managing and updating patient records to scheduling appointments, healthcare professionals engage in many time-consuming tasks that can be streamlined or even entirely taken over by AI. According to one study, doctors spend half of their working day on tasks involving maintaining electronic health records.

Generative AI can drive more efficient EHR management by intelligently organizing doctors’ notes, test results and medical imaging. It can then provide quick summaries of individual patients, highlighting aspects of their health that are a concern and generating reports for other professionals. Automating many of these tasks is likely to also have the effect of reducing errors that could impact quality of care and patient outcomes.

Generative AI In Drug Discovery

The same capabilities that allow generative AI to create text and writing can also be used to develop new candidate medicines and vaccines for clinical trials. This means that researchers can speed up the lengthy process of shortlisting potential candidates.

Last year, Oxford-based biotech firm Etcembly produced the first immunotherapy drug created with the help of generative AI.

The process promises to speed the transition of potentially lifesaving new treatments from lab to patient, ultimately leading to better patient outcomes. This indicates that just like doctors and nurses, healthcare researchers and scientists will also have powerful generative AI tools to enable them to work more quickly and efficiently.

Ethical Consideration: The Human Touch

Clearly, however, integrating generative AI into healthcare in this way creates a long list of ethical challenges that can’t be ignored. This is because most use cases revolve around the use of personal data. This means that safeguarding against data leaks, losses and breaches is of paramount importance.

It’s also essential that AI algorithms make decisions that are transparent and explainable—this will be crucial for building the public trust essential for these systems’ potential to be realized.

The damage that can be caused by bias in data is also more pronounced than in nearly any other field. Its been shown that generative AI models can amplify bias present in training data. We know that women and people from minority ethnic backgrounds are more frequently diagnosed due to their underrepresentation in medical studies, and this issue could scale as AI becomes more widely used.

Data, models and outcomes must all be continually monitored and updated in order to mitigate these biases, which could otherwise further perpetuate inequalities.

Like many other professionals, those in healthcare will find themselves required to learn the skillset of the AI ethicist. This means developing the capability to evaluate potential use cases in order to determine whether applying AI is likely to cause damage, risk or danger, and ensuring adequate guardrails are in place at all times.

The Future Of Doctors And Healthcare Workers

Doctors, nurses and other clinical healthcare professionals are probably more insulated than many from the risks of being replaced by AI. Their jobs require them to function at an advanced level across many human skills that machines will not replicate any time soon. Intuition and experience all play a role, and that isn’t going to change.

AI does, however, offer the opportunity for these professionals to redefine the way they work and even their role in wider society. Shifting to models of work that allow them to spend more time with patients will also mean more time to continue their ongoing education and develop their own medical expertise.

This is likely to lead to new specializations as the need grows for clinical staff focused on AI-enhanced diagnoses, data-driven medicine and ethical AI, as well as helping patients navigate the range of new AI-assisted treatment options that will become available.

With AI handling routine analysis, record keeping and interpretation of scans, imaging and other data, doctors and nurses will spend more time getting to the bottom of more complex and nuanced patient issues.

Ultimately, the essence of providing healthcare will continue to revolve around empathy, compassion and the human touch. Generative AI creates the opportunity to augment these qualities in ways that will make professionals in this field even more essential to society. Those who are able to embrace this paradigm shift will find they are able to use their skills and training to cure sickness and improve patient lives in ever more rewarding ways.

Source:https://www.forbes.com/sites/bernardmarr/2024/03/13/how-generative-ai-will-change-the-jobs-of-doctors-and-healthcare-professionals/?sh=58f34eef974a

Dec 15, 2023

Title: Neonatal Neurocritical Care: Past, Present and Future Speaker: Fernando Gonzalez, MD Co-Director, UCSF Neuro-Intensive Care Nursery Director, Residency Molecular Medicine Track Co-Leader, SPR Pediatrician-Scientist Development Professor of Pediatrics, University of California, San Francisco Presented by leading researchers from UCSF Pediatrics, from other departments at UCSF and outside institutions, Frontiers in Child Health Research is an interactive series meant to facilitate scientific exchange and stimulate new ideas.

Front. Pediatr., 20 March 2024 Meline M’Rini* Loïc De Doncker Emilie Huet Céline Rochez Dorottya Kele Neonatal Department, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

Objective: Immediate skin-to-skin contact (SSC) is already standard care for healthy term newborns, but its use for term or preterm newborns requiring admission to neonatal intensive care unit (NICU) with or without respiratory support is challenging. This study aimed to assess the safety and feasibility of SSC during the transfer of newborn infants, using a new purpose-built mobile shuttle care-station, called “Tandem”.

Material and methods: A monocentric prospective observational study was conducted at the tertiary referral center of the Université libre de Bruxelles in Brussels, Belgium after ethical approval by Hopital Erasme’s Ethics Committee (ClinicalTrials.gov ID: NCT06198478). Infants born with a birth weight above 1,500 g were included. Following initial stabilization, infants were placed in SSC with one of their parents and transferred to the NICU using the Tandem.

Results: Out of 65 infants initially included, 64 (98.5%) were successfully transported via SSC using the Tandem. One transfer was not successful due to last minute parental consent withdrawal. The median (range) duration of continuous skin-to-skin contact after birth was 120 min (10–360). SSC transfers were associated with gradually decreasing heart rate (HR) values, stable oxygen saturation levels (SpO2), and no increase in median fraction of inspired oxygen (FiO2). Heatloss was predominantly observed during initial setup of SSC. There was no significant difference in the occurrence of tachycardia, desaturation or hypothermia between preterm and term neonates. No equipment failures compromising the transfer were recorded.

Conclusion: Skin-to-skin transfer of infants with a birthweight of equal or above 1,500 g using the Tandem shuttle is feasible and associated with stable physiological parameters. This method facilitates early bonding and satisfies parents.

Clinical Trial Registration: ClinicalTrials.gov (NCT06198478).https://www.frontiersin.org/articles/10.3389/fped.2024.1379763/full

© Pexels/Hussein Altameemi

POSTED ON 18 MARCH 2024

Fasting during Ramadan is a valuable experience for Muslims all over the world. Even though it is not compulsory for pregnant women to participate in fasting, many choose to do so. However, the question arises as to whether abstaining from food and water throughout the day could have an impact on the well-being of the unborn child. To answer this question, fourteen studies from seven countries were reviewed, involving more than 2,800 expectant mothers. The results show that Ramadan fasting influences neonatal weight and other parameters of foetal health. However, most of the effects, including the risk for preterm birth, were found to be non-significant. This indicates that fasting during Ramadan is not harmful for the baby overall, and that the decision to participate in Ramadan fasting should therefore be left to the mother.

Ramadan is a month focusing on prayer, community, and reflection for all Muslims around the world. Central to this is the Ramadan fasting (RF), which is a form of intermittent fasting in which no food or water is consumed from sunrise to sunset. The abstinence from water during the fasting period makes RF more intense compared to other forms of intermittent fasting. While RF is obligatory for healthy Muslims, breastfeeding mothers and pregnant women are exempt from fasting and can decide for themselves whether they feel fit enough to participate or not. The Muslim population makes about ¼ of the world’s population, and accordingly many pregnant women face the question if they can participate in RF without harming the foetus. This concern arises from the fact that an adequate supply of nutrients is important to meet the needs of both mother and foetus, and neonatal weight is a direct indicator of the foetus’ wellbeing.

A total of 14 studies from seven countries examined the topic and the results were analysed in an overall review. The 2,889 participating mothers lived in Turkey, Iran, Lebanon, Pakistan, the UK, the Netherlands, and Saudi Arabia.

Ramadan fasting has a significant influence on birth weight

Several different measurements indicate foetal health and can be used to analyse the effects of RF on the unborn child. One indicator is neonatal weight. The findings varied in the different studies examined, but the overall effect showed a significantly lower birth weight in fasting mothers. The amniotic fluid index (AFI), a standardised indicator of foetal well-being, also showed a significant effect. The combination of dehydration during RF, longer daytimes, and temperatures above 36°C led to a reduction of the AFI in fasting mothers. Further significant correlations were found between RF and foetal femur length and RF and lower biparietal diameter assessing foetal size in fasting mothers.

The results on gestational age at delivery were contradictory but insignificant altogether. When analysing the impact on preterm birth (PTB), only one study showed a slightly increased incidence of PTB when the mother was fasting. The increase was not statistically significant and all other studies that examined PTB reported no association, leading to the redeeming conclusion that RF has no effect on the likelihood of PTB.

Various other measures showed no significant impact of RF on foetal health, including foetal body weight, length, head circumference, and abdominal circumference of the infant. The biophysical profile also did not change for fasting mothers, nor did the foetal movements, breathing movements, tone, amniotic fluid volume or the Apgar Score.

 Fasting for expectant mothers is not harmful to neonatal health overall

Although RF affects foetal growth, it is not associated with poorer neonatal health. The negative associations between fasting and foetal well-being were stronger when the mother fasted during the second or third trimester of her pregnancy. Furthermore, all associations between RF and reduced health were predominantly found in lower quality studies, which supports the evidence that fasting is safe for pregnant women. Thereafter, current scientific evidence shows that fasting during Ramadan is not harmful to the foetus and can be practiced by pregnant women. The decision to fast should therefore be made by the pregnant woman herself, in consultation with her doctor, who will take her individual health status into account. The wellbeing of the foetus depends more on the type of food the mother eats during the fast-breaking period of Ramadan.

Source:https://www.efcni.org/news/does-ramadan-fasting-influence-risk-for-ptb/

In adulthood, these children “are more vulnerable to stress-related health outcomes, like diabetes, and mental health issues, addiction and obesity,” one expert says

By Katie C. Reilly – March 20, 2022

Are infants too young to experience and remember painful emotions or traumatic events? A growing body of research suggests no, and researchers believe that if left untreated, trauma experienced in infancy can sometimes result in lifelong health consequences.

Beyond such obvious triggers as war and terrorism, exposure to domestic violence, natural disasters such as a house fire, physical abuse and community violence are examples of experienced events that can be traumatic for infants, experts say.

Experts in infant mental health, which goes from the prenatal period up to age 3, say that babies and very young children who experience such things have higher incidences of anxiety disorders or depression that can persist into adulthood if left untreated.

“It is easy to assume that babies don’t remember trauma because they express their experiences differently,” Tessa Chesher, an clinical assistant professor of psychiatry and behavioral sciences at Oklahoma State University who specializes in infant and early childhood mental health, says in an email. “At [8 to 12] weeks of age, babies have stored enough memories that [the babies] start to anticipate their caregiver’s behavior based on previous behaviors. They start to respond based on the experiences they have had.”

‘Vulnerable to stress-related illnesses’

Evelyn Wotherspoon, a social worker specializing in infant mental health, said that as they reach adulthood “infants and very young children who have had early exposure to trauma and chronic stress … are more vulnerable to stress-related health outcomes, like diabetes, and mental health issues, addiction and obesity. These children are much more vulnerable to all of these stress-related illnesses, and their brain may not develop the way it should.”

Although infants and young children are just developing, experts in infant mental health say they can experience a wide range of feelings that includes negative emotions, sadness or anxiety. A report by the American Academy of Pediatrics found that, by age 16, more than 2 in 3 children had said they had experienced a traumatic event.

According to a Report of the Task Force of the World Association for Infant Mental Health, rates of mental health disorders in infancy (which generally includes birth to age 3) are comparable to that of older children and adolescents. And one small study of 1-year-olds found that 44 percent of those who had witnessed severe violence against their mother by an intimate partner showed symptoms of trauma afterward, such as increased arousal, increased aggression or an interference with normal infant development. Infants and young children (under age 4) can develop post-traumatic stress disorders after events, according to a study in the Journal of the American Academy of Child & Adolescent Psychiatry.

Kathleen Mulrooney, a counselor who is also program director for the Infant and Early Childhood Mental Health Program for Zero to Three, a nonprofit organization dedicated to improving the lives of babies and toddlers, said it’s important to note that not every infant who experiences a trauma will be traumatized. As with adults, it depends on the infant, “because what is traumatic for one person is not for someone else,” Mulrooney says.

“To be traumatized, one must be severely frightened,” says Charles Zeanah, a psychiatrist and the executive director of the Institute of Infant and Early Childhood Mental Health at Tulane University School of Medicine. Infants under 12 months may not always be aware that a particular situation is actually dangerous, which can potentially protect them from trauma, he says.

Caregivers can be key

In this context, caregivers can be key in buffering small children from the effects of trauma by how they react. “The ability of parents or key caregivers to provide protection, to have a co-regulating role when it comes to the stress response is critical,” Mulrooney said in an email.

If a child has a significant trauma before age 2 but following the trauma “the baby has the powerful protective factors of consistent safety, love and security; there is a decreased likelihood of having mental health problems,” Chesher says in an email. “That doesn’t mean the baby didn’t suffer or that their body doesn’t remember that trauma, it means that there were protective factors around to mitigate the effects of the trauma.”

Regina Sullivan, a developmental behavioral neuroscientist and professor of psychiatry at NYU Grossman School of Medicine, says that while a primary caregiver cannot “buffer a small child from trauma in the environment — it’s called social buffering because the child’s fear response and stress hormone response is reduced — more recently, we have shown that the caregiver is actually blocking neural activity in the amygdala, the brain area responsible for fear.”

Trauma in infancy can physically alter the developing architecture of the brain, according to the American Academy of Pediatrics. Toxic stress — strong, frequent or prolonged adversity — has been shown in various studies to harm learning capabilities, memory and executive functioning.

“Many brain areas in infants and small children are physically altered and the ability of those brain areas to talk to one another is also modified by trauma,” said Sullivan.

Trauma can be difficult to recognize

Yet trauma in infancy can be difficult to recognize given that infants are not yet verbal and rely on their caregivers to respond to their needs, which means a caregiver would have to be attuned to symptoms and seek help.

“A baby can’t just go up to you and say, ‘Hey this happened yesterday, I’m scared,’ Chesher says. “And so really learning the language of the babies is important and then educating people on how to read that language. And so, if we don’t know the red flags, then we are not identifying trauma and we can have longer term effects on the brain.”

Experts say some red flags of trauma for babies younger than 12 months are: feeding or sleep problems and not being able to be comforted by their caregiver. A toddler (between ages 1 and 3) can express themselves more verbally and physically than a baby. Some red flags of trauma in that age group can involve repeating traumatic events in their play or becoming aggressive, Chesher says.

“One of the issues is how that child expresses trauma might be through disruptive sleep or being a bit fussier,” Sullivan says, “things that occur in normal children for a host of many reasons, which makes it difficult to identify which child is going to respond to the trauma in a way that will be long lasting and damaging.”

If a parent or other caregiver is concerned, based on a child’s behavior and experiences, they should “ask to be referred to an infant and early childhood mental health specialist,” Chesher says.

Experts will look at a variety of factors, with the most critical being the relationship between the baby and their primary caregiver. In addition to observing that interaction, mental health experts may also look at “pregnancy history, birth history, medical history, development history, safety screeners, perinatal depression screener [for both parents], how the infant eats and how the infant sleeps,” Chesher says.

Different interventions

Depending on a child’s age, different interventions are available, including child-parent psychotherapy.

“It is essential that the parents or … their caregivers … are involved in a major way in the treatment because it is really through relationships with caregiving adults that infants thrive and do well,” Zeanah says.

To recover, an infant needs a caregiver in their life who can accurately read their cues and respond in a nurturing, patient manner, Wotherspoon says. “One of the most powerful therapeutic tools that we have is the relationship a child has with a nurturing caregiver and they only need one and it doesn’t have to be perfect. … An infant who gets that fairly early on can recover beautifully from trauma,” Wotherspoon says.

Increasing awareness about infant and early childhood mental health among both parents and medical practitioners is critical, experts say. But it’s also important for parents to understand what trauma is — and is not. A child “getting distressed is different than being traumatized,” Zeanah says.

“It’s important to distinguish from everyday events that might scare the child and are important in the child learning how to regulate their emotions and physiology versus trauma from horrible events such as a tornado or a parent who is repeatedly traumatizing the child unnecessarily through verbal or physical assaults,” Sullivan says.

“We want parents to enjoy this time in their life and not be fearful that they are going to traumatize their child by making them eat vegetables or get vaccinated,” she adds. “Those are normal experiences in life that the child needs to experience as part of [the] current world.”

Source:https://www.washingtonpost.com/health/2022/03/20/infant-trauma-stress-mental-health/

August 28, 2023 

DeKalb, IL – Technology developed by NIU Electrical Engineering Professor Lichuan Liu and designed to prevent hearing loss in the most vulnerable of newborns could soon find its way into hospital neonatal intensive care units, or NICUs

NICUs can be noisy. The care units are louder than most home or office environments and have sound levels that often exceed the maximum levels recommended by the American Academy of Pediatrics. Hearing impairment is diagnosed in 2% to 10% of preterm infants, versus 0.1% of the general pediatric population.

Aiming to put her electrical engineering expertise to use to benefit others, Professor Liu invented an apparatus, system and method to significantly reduce harmful noises while maintaining communication between the newborns and their parents or caregivers.

In 2014, NIU began a partnership with Invictus Medical, a Texas-based medical device company, to commercialize the technology. NIU licensed its related patents to Invictus, while the company has continued to refine the incubator-based active noise control (ANC) device, now known as the Neoasis®.

In July, Invictus announced that the company had received a U.S. Food and Drug Administration (FDA) clearance-for-use declaration for the device.

The control unit front face and home screen on the Invictus Medical Neoasis® incubator-based active noise control (ANC) device. Photo courtesy of Invictus Medical

“With this clearance for use, Invictus has made a huge step towards deploying the Neoasis® ANC device in neonatal intensive care units,” said George Hutchinson, Ph.D., Invictus Medical’s chief executive officer. “It is well documented that a quieter environment has a positive impact, including improved sleep hygiene and weight gain in infants where both are critical for development.

“The NIU team has been a pleasure to work with,” Dr. Hutchinson added. “The Office of Innovation has been a great teammate throughout the entire process.”

The Neoasis® ANC device utilizes a proprietary, innovative active noise control (ANC) system to attenuate noise with canceling sound wave technology. At the same time, it allows a parent’s voice to be directed to the infant, which can also be beneficial for cognitive development. Invictus is currently exploring relationships with strategic partners to get the Neoasis® ANC device into NICUs—now possible with the FDA clearance.

While universities and researchers can realize typically modest financial benefits from technology transfer, the primary intent is to broaden the potential impact of research through the creation of innovative products and services for public benefit, said Karinne Bredberg, director of NIU’s Office of Innovation. The office has guided Liu through the partnership, patent processes and licensing.

“This is a big deal for Dr. Liu and for NIU,” Bredberg said.

“NIU research has produced other patents and licenses, but we believe this is the first NIU-licensed technology to be incorporated into a device that has an FDA clearance-for-use declaration,” Bredberg said.

Mark Hankins, NIU’s assistant director for technology transfer, credited the ingenuity of Professor Liu, as well as a great working relationship with Invictus Medical.

“Dr. Hutchinson in particular was very diligent in trying to move this technology forward and persevered through a number of roadblocks,” Hankins said.

Professor Liu said it was about a decade ago when President Lisa C. Freeman, then serving as NIU’s vice president for Research and Innovation Partnerships, brought Liu together with Invictus Medical. While Liu developed an initial prototype, the company refined the device, making the it more commercially accommodating for NICU environments.

“It’s a little different working with industry, as opposed to academia,” Professor Liu said. “It was a learning curve for me, but Invictus Medial has been very professional and easy to work with.”

NIU Professor Lichuan Liu is now conducting research on an artificial-intelligence algorithm that can detect the meaning behind babies’ cries.

Over the years, the commercialization process received funding support from the NIU Foundation and a National Science Foundation’s (NSF) Small Business Technology Transfer grant. Liu, herself a mother of two, is excited at the prospect of hospitals using the Neoasis® ANC device.

“I think this is fantastic,” Liu said. “I kept working on this project and thought someday there would be payback.

“I have a passion or motivation to work to benefit others,” Liu added. “As a mom, I think this device is really something important. As an engineer, I’m happy to make an impact.”

Liu said her current research includes other ways to use noise cancellation. She is working on a pillow that would cancel out the racket of snoring, and she and NIU Nursing Professor Jie Chen are working on a system for adult intensive care units.

Additionally, Liu is working on an artificial intelligence algorithm that can listen to infant cries and determine whether they are normal or abnormal to potentially indicate a severe or chronic illness. Invictus might incorporate the technology into future versions of its Neoasis® ANC device.

Source:https://newsroom.niu.edu/niu-researchers-innovation-helps-lead-to-device-to-prevent-hearing-loss-in-nicu-infants/

Carla Madeleine Cuya1* Carlos Barriga2 Maria del Carmen Graf3 Mirta Cardeña1 María del Pilar Borja1 Richard Condori4 Moises Azocar5 Carlos Cuya4

Introduction: In a significant number of NICUs, mothers are unable to provide enough maternal milk to feed their premature babies, so healthcare workers rely on human milk banks. Unfortunately, this service is not available in many countries, such as Peru, where premature infants receive formula. The aim of this study was to determine the effectiveness of multisensory stimulation on mother’s own milk production.

Methods: Participants in this study were postpartum mothers of preterm infants 27–37 weeks gestational age. The participants were assigned to three groups: (1) audiovisual stimulation (SAV) (n = 17), (2) audiovisual and olfactory stimulation (SAVO) (n = 17), and (3) control (n = 16). A questionnaire was used to collect demographic and obstetric data, including a record of mother’s own milk volume.

Results: There was no significant difference between the SAV, SAVO and control groups regarding age, marital status, education level, occupation, number of children, mode of delivery, Apgar and birth weight. On the other hand, a significant difference was observed between the SAV and SAVO groups regarding the amount of milk produced, with higher production between the fourth and seventh day (Tukey p < 0.05). Similarly, milk volume was significantly greater in the SAVO group compared to the SAV and control groups (OR = 1.032, 95% CI = 1.0036–1.062, p < 0.027).

Conclusion: Multisensory stimulation in postpartum mothers of preterm infants caused an increase in the volume of mother’s own milk production. However, more research is needed to explain the findings presented in this study.

Front. Pediatr., 14 March 2024
Volume 12 – 2024 | https://doi.org/10.3389/fped.2024.1331310

Jennifer Arnold, Niranjan Vijayakumar, Philip Levy

Abstract

Advances in modeling and imaging have resulted in realistic tools that can be applied to education and training, and even direct patient care. These include point-of-care ultrasound (POCUS), 3-dimensional and digital anatomic modeling, and extended reality. These technologies have been used for the preparation of complex patient care through simulation-based clinical rehearsals, direct patient care such as the creation of patient devices and implants, and for simulation-based education and training for health professionals, patients and families. In this section, we discuss these emerging technologies and describe how they can be utilized to improve patient care.

Introduction

Simulation is a powerful tool for improving education, patient safety, and innovation in any field of medicine.1 In neonatology, the opportunity to create realistic simulations to help prepare clinicians for high risk care of vulnerable patients is paramount.2 As the field of healthcare simulation advances, technologies for simulation are diversifying. With advances in modeling and imaging, broader and more realistic tools for education and training, and even opportunities to improve direct patient care are emerging. These include realistic models for preprocedural planning and clinical rehearsals, and innovative, bespoke patient specific devices and healthcare tools to use in clinical care. Current advances in specific technologies have allowed for this expansion, including point-of-care-ultrasound (POCUS), three dimensional (3D) and digital anatomic modeling, and extended reality technologies that are immersive digital recreations of reality, such as virtual reality (VR), augmented reality (AR), and mixed reality (beyond the scope of this article). In this article we review the types of imaging and modeling technologies available and how they can be applied to improve neonatal patient care and outcomes through healthcare simulation-based education (SbE), clinical rehearsals(SbCR), and more.

Section snippets:

Point-of-care ultrasound (POCUS)

POCUS, which is ultrasound performed and interpreted in real time by bedside clinicians, has been used by adult and pediatric specialties for many decades, with recognition that this technology may enhance quality of care and improve patient outcomes.3 Pediatric anesthesiology and adult emergency medicine were early adopters of POCUS, and pediatric critical care has increasingly utilized POCUS for central line placement and diagnostic imaging.4 POCUS has more recently been utilized in

Applications of imaging and modeling

The types of imaging and modeling described above are emerging tools now available in healthcare that can be applied in three specific ways: preparation for complex patient care through SbCRs, direct application for patient care, and simulation-based education and training.

Patient specific simulation-based clinical rehearsal (SbCR)

Simulation-based Clinical Rehearsal (SbCR) refers to the practice and rehearsal by clinicians to prepare for a patient-specific procedure or complex care process before providing direct patient care. These are typically rehearsed using physical 3DP or virtual models. SbCRs can be patient-specific (utilizing the patient’s exact anatomical data to create a model for rehearsal, such as practicing a specific congenital heart disease [CHD] repair on a 3DAM before operating on the patient) or

Imaging and modeling in direct patient care

While using immersive technologies as a part of the preparation for patient care is exceedingly valuable, there are additional applications as part of healthcare services provided directly to patients. In the next section we describe how 3DP, POCUS, and virtual modeling improve care delivery in neonatology and other fields of medicine.

Imaging and modeling in simulation-based education and training

Imaging, modeling and other emerging technologies are used in the education of healthcare professionals and patients, families, and other home caregivers. 3DAMs have been shown to improve performance and promote competency-based education. The benefits of 3DP in education include on demand reproducibility, the possibility to model different physiologic and pathologic anatomy from an endless dataset of images, and the possibility to share 3D models among different institutions.56 3DP has

Conclusion

In conclusion, imaging and modeling technologies have significantly advanced healthcare, including neonatal care. These technologies have enhanced education and training for all levels and types of learners, enabled better preparation and rehearsal for complex care, augmented diagnosis and applications of personalized treatment plans, and improved patient outcomes. From ultrasound to physical models to sophisticated virtual models, these tools provide invaluable insights into the delicate care.

Source:https://www.sciencedirect.com/science/article/abs/pii/S0146000523001283?via%3Dihub

Casey Insights

Mar 7, 2023 VIENNA

MRI can be a powerful tool for diagnosing problems in newborns, but transferring infants to the radiology department for scanning creates a number of issues. Aspect Imaging has developed Embrace, a 1-telsa MRI scanner that can be installed in the neonatal intensive care unit (NICU) to enable MRI to be used at the bedside. Aspect Imaging demonstrated the Embrace scanner at the 2023 European Congress of Radiology (ECR) meeting.

Innovation and Comfort in the NICU: Enhancing the Neonatal Experience:

In the fast-paced world of neonatal care, where infants face immense challenges from their earliest moments, a wave of innovation is transforming the NICU into a place of both healing and joy. Amidst the beeping monitors and hushed whispers, new technologies and thoughtful touches are bringing smiles to the faces of families and healthcare professionals alike.

Imagine, for a moment, the introduction of point-of-care MRI machines, compact enough to fit beside a newborn’s crib yet powerful enough to provide detailed images without the need for transport. Picture tiny headphones delicately placed on the ears of our smallest patients, playing gentle melodies to soothe and comfort them during procedures. In these small yet significant advancements, the NICU transcends its clinical setting, becoming a sanctuary of warmth and reassurance.

But the innovation doesn’t end there. Enter virtual reality (VR), once reserved for gaming enthusiasts, now offering parents a momentary escape to tranquil beaches or serene forests, providing a much-needed respite from the sterile surroundings. Meanwhile, specialized mobile apps empower parents to track their baby’s progress, celebrate milestones, and inject a touch of whimsy into their daily routines with photo filters that adorn their infants with superhero capes or astronaut helmets.

This harmonious blend of technology and compassionate care paints a future where laughter and joy are as integral to the NICU experience as medical treatment. It’s a future where parents find solace and moments of levity amidst the uncertainty, and where our smallest patients are given every opportunity not just to survive, but to thrive.

As we embrace these innovations, we usher in a new era of neonatal care—one filled with hope, imagination, and the promise of brighter beginnings for our tiniest heroes and their families.

By Yi-Jin Yu – February 19, 2024

An Indiana mother was inspired to change careers after her second child was diagnosed with congenital heart defects and spent nearly two months in a neonatal intensive care unit.

With February being Heart Month, Calley Burnett is sharing her personal story to raise awareness about congenital heart defects, something she had no idea her son Spencer would have when he was born on July 26, 2016.

Burnett, who previously worked for a family business, is now a NICU nurse at Riley Hospital for Children in Indianapolis, the same hospital where Spencer was sent for further care days after his birth.

Calley Burnett was inspired to become a nurse after her second son, Spencer, was born with congenital heart defects.

Burnett’s positive experience with the Riley nurses and doctors who cared for Spencer left an indelible mark on her and in 2019, the mom of two decided to go back to nursing school and become a registered nurse.

“Spencer was born with congenital heart defects and that led my way into the nursing program after just being bedside for several weeks with Spencer at Riley,” the 39-year-old told “Good Morning America.”

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Burnett said even though it was a “very scary” time for her while Spencer was in the NICU, she and her family had a team of caring health providers who were dedicated to helping Spencer through his many treatments and hurdles.

Spencer had to spend nearly two months in the neonatal intensive care unit at Riley Hospital for Children in Indiananpolis, Indiana.

Spencer had to be treated for multiple heart defects, including coarctation of the aorta, ventricular septal defect, and patent ductus arteriosus. This meant a part of Spencer’s aorta was narrower than usual, he had an unclosed hole in his aorta and he also had a hole in the wall separating the two ventricles of his heart.

According to Burnett, Spencer needed to have a closed-heart surgery in August 2016 before he was discharged. Nearly a year later, the boy also had an open-heart surgery in July 2017, all to treat the various heart issues he was born with.

“We had just phenomenal nurses there that I still talk to today … Their bedside manner and how they made me feel and the trust that I had and the bond that we had, it just opened my eyes to say, ‘You know what, I think that this is something that I would love to do,'” Burnett explained.

It took Burnett, who had to take prerequisite classes, about two years to complete nursing school. The working mom said although it was “tough,” the sacrifices and the hard work were “very well worth it.”

After graduating, Burnett first took a job at another hospital but she knew she wanted to return to Riley, where the staff meant so much to her and Spencer.

“I knew immediately that I wanted to be with the babies. There’s just something about being at Riley and being with kids and tiny little infants that I just knew that’s where my heart was going to be as soon as I hit nursing school,” Burnett said.

Today, Spencer is an active second grader who plays basketball and soccer.

“He is a very spunky 7-year-old. He’s very athletic. He’s always on the go, always making me laugh. He is just loving life,” his mother told “GMA.”

Burnett says she’s staying on her toes as a NICU nurse at Riley, which she said “feels like home.”

“It’s a phenomenal feeling to be able to help the parents because I feel like I’ve been there. I can tell these moms and dads, ‘Hey, I’ve been where you are and I understand.’ And I just love it,” she said.

For others inspired to take a turn in their own careers or to go into nursing themselves, Burnett said she encourages them to take the leap.

“If that is your passion. I would 100% follow [it]. It’s worth it,” she said. ‘The journey is worth it. It’s tough. But what you get back from it is a hundred times better.”

Source: https://www.goodmorningamerica.com/living/story/mom-inspired-become-nurse-after-sons-diagnosis-heart-107269214

Mama Sing My Song  715 views Jan 19, 2024

“My Little Fighter – NICU Baby Song” by @mamasingmysong AS SEEN ON SHARK TANK! https://www.mamasingmysong.com

🦸‍♂️💜Children’s Book Read Aloud: SUPREEMIE: KYLO’S JOURNEY THROUGH THE NICU by Nico Avery + Shanel

nightyniteswithneli

On this episode of Nighty Nights with Miss Neli, we join our friend Kylo on his journey to grow big and strong so that he can go home with his family from the NICU. Book Description: This book takes readers on a journey with a micro premature baby named Kylo. Born weighing just 1 pound 3 ounces, Kylo may be small but that doesn’t stop him from being super. He’ll have to stay in the NICU (Neonatal Intensive Care Unit), which is way different from mommy’s belly until he’s big and strong enough to go home. But adventure and growth await him during his hospital stay. This story follows Kylo on his journey to grow stronger and bigger. SUPREEMIE KYLO’S JOURNEY THROUGH THE NICU

NOVA | Performance Paragliders Oct 28, 2014 #FLYnova #parapente #paragliding

A group of professional test pilots explore the remote and rarely visited Island of Socotra off the coast of Yemen in the heart of the Middle East. Join them as they thermal up to 1000m over the Indian Ocean, battle 40 km/h winds, and fly from the longest caves in the orient. A 37 minute documentary including spectacular aerial footage from one of the few remaining flying secrets left on earth. #NOVAparagliders #NOVAwings #FLYnova #Gleitschirm #paragliding #parapente #parapendio #paragleiter #ForgottenIsland