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Corrigendum. 勘误表。
IF 1.5 Pub Date : 2018-12-27 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518800765

[This corrects the article DOI: 10.1177/1179556518784300.].

[这更正了文章DOI: 10.1177/1179556518784300.]。
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引用次数: 0
Bronchopulmonary Dysplasia: An Update of Current Pharmacologic Therapies and New Approaches. 支气管肺发育不良:当前药物疗法和新方法的最新进展。
IF 1.5 Pub Date : 2018-12-11 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518817322
Zoe Michael, Fotios Spyropoulos, Sailaja Ghanta, Helen Christou

Bronchopulmonary dysplasia (BPD) remains the most prevalent long-term morbidity of surviving extremely preterm infants and is associated with significant health care utilization in infancy and beyond. Recent advances in neonatal care have resulted in improved survival of extremely low birth weight (ELBW) infants; however, the incidence of BPD has not been substantially impacted by novel interventions in this vulnerable population. The multifactorial cause of BPD requires a multi-pronged approach for prevention and treatment. New approaches in assisted ventilation, optimal nutrition, and pharmacologic interventions are currently being evaluated. The focus of this review is the current state of the evidence for pharmacotherapy in BPD. Promising future approaches in need of further study will also be reviewed.

支气管肺发育不良(BPD)仍然是极早产儿存活后最常见的长期发病率,并与婴儿期及以后大量使用医疗服务有关。新生儿护理领域的最新进展提高了极低出生体重儿(ELBW)的存活率;然而,在这一脆弱人群中,新型干预措施并未对 BPD 的发病率产生实质性影响。BPD 的病因是多方面的,因此需要多管齐下的预防和治疗方法。目前正在评估辅助通气、最佳营养和药物干预方面的新方法。本综述的重点是 BPD 药物治疗的证据现状。此外,还将对需要进一步研究的未来可行方法进行综述。
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引用次数: 0
Neonatal Cholestasis: A Pandora's Box. 新生儿胆汁淤积症:潘多拉的盒子。
IF 1.5 Pub Date : 2018-12-06 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518805412
Aakash Pandita, Vishal Gupta, Girish Gupta

Neonatal cholestasis (NC) is a diagnostic dilemma frequently countered in a neonatal care unit. Early diagnosis is vital for achieving an optimal patient outcome as many causes of cholestasis such as biliary atresia are time-sensitive and amenable to treatment if analyzed and treated early. Nonetheless, it is not generally simple to analyze these cases right on time as some of them are regularly missed due to the presence of pigmented stools, lack of newborn metabolic screening, and named as instances of prolonged jaundice. In this manner, we prescribe to explore all reasons for prolonged jaundice stretching out past 14 days in neonates. Besides, we suggest that stool card ought to be a piece of release rundown for all newborn children being released from the nursery. This is of most extreme significance in the nation like India where guaranteeing customary follow-up is as yet a tough assignment. These stool cards will help in the early determination of patients with NC particularly biliary atresia and guarantee their auspicious cure. Another reason which needs exceptional say is parenteral nutrition-associated liver illness, as the proportion of preterm babies is getting greater and greater with better neonatal care. These extreme preterm infants are in the requirement for prolonged (>14 days) total parenteral nourishment because of which they are at high hazard for NC contrasted with their more developed peers. In this survey, we will give an understanding of clinical approach, differential diagnosis, and clinical review of NC.

新生儿胆汁淤积症(NC)是一个诊断困境,经常反击在新生儿护理单位。早期诊断对于获得最佳患者结果至关重要,因为胆汁淤积症的许多原因(如胆道闭锁)是时间敏感的,如果及早分析和治疗,可以进行治疗。然而,及时分析这些病例通常并不简单,因为其中一些病例由于存在色素粪便而经常被遗漏,缺乏新生儿代谢筛查,并被命名为长期黄疸的实例。以这种方式,我们规定探讨所有原因延长黄疸延伸过去14天的新生儿。此外,我们建议大便卡应该是所有新生儿从托儿所出院时的一张出院清单。这对于像印度这样的国家来说是最重要的,因为保证习惯性的后续行动是一项艰巨的任务。这些大便卡将有助于早期确定NC患者,特别是胆道闭锁,并保证他们的吉祥治愈。另一个需要特别说明的原因是肠外营养相关的肝脏疾病,随着新生儿护理的改善,早产儿的比例越来越大。这些极度早产儿需要长时间(>14天)的全肠外营养,因为与发育较好的同龄人相比,他们患NC的风险很高。在这个调查中,我们将给出临床方法的理解,鉴别诊断和临床回顾NC。
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引用次数: 10
Evaluating Accessible Sleep Health Information in Rural and Urban Contexts: Delivery Face-to-Face or Online? 评估农村和城市环境下可获得的睡眠健康信息:面对面还是在线传递?
IF 1.5 Pub Date : 2018-11-29 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518815168
Joanne M Osborne, Sarah Blunden

Objective: New parents need education about infant sleep but is not universally available especially not in regional and rural areas. We delivered sleep education both face-to-face and online to test sleep knowledge acquisition for parents wherever they reside. Best practice delivery of accessible sleep health information for new families needs to be investigated more carefully in order for specialist services to be universally available.

Methods: Pre- and post-information session questionnaires (n = 32) assessed levels of knowledge acquisition and comparisons tested differences between face-to-face seminars compared with an online webinar.

Results: Sleep knowledge across participants was low (69% scoring < 50%). Sleep knowledge significantly increased for both the webinar delivery group (P = .002) and face-to-face delivery group (P = .001). No significant differences in knowledge acquisition were found between face-to-face vs online delivery (P = .170), suggesting both modes of delivery were sufficient to improve parental sleep knowledge.

Conclusions: Parental sleep knowledge, while low, increased with education. Online delivery was similar to face-to-face delivery suggesting ease of access for rural and remote communities needing specialist sleep information.

Implications for public health: Information delivered online is effective and offers a health delivery solution to regional and remote parents unable to access sleep services and rendering sleep service accessibility more equitable.

目的:新生儿父母需要进行婴儿睡眠教育,但这种教育并不普遍,特别是在农村地区。我们提供面对面和在线的睡眠教育,以测试父母的睡眠知识获取情况。需要更仔细地调查为新家庭提供可获得的睡眠健康信息的最佳做法,以便普遍提供专业服务。方法:信息会议前后问卷(n = 32)评估知识获取水平,比较测试面对面研讨会与在线网络研讨会之间的差异。结果:所有参与者的睡眠知识都很低(69%得分< 50%)。网络研讨会组(P = .002)和面对面讲座组(P = .001)的睡眠知识显著增加。面对面授课与在线授课在知识获取方面没有显著差异(P = 0.170),这表明两种授课方式都足以提高父母的睡眠知识。结论:父母睡眠知识水平虽低,但随着教育程度的提高而提高。在线交付与面对面交付相似,这表明需要专业睡眠信息的农村和偏远社区更容易获得。对公共卫生的影响:在线提供的信息是有效的,为无法获得睡眠服务的区域和偏远父母提供了保健服务解决方案,并使获得睡眠服务的机会更加公平。
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引用次数: 4
Factors Associated with Prescribing Broad-Spectrum Antibiotics for Children with Upper Respiratory Tract Infections in Ambulatory Care Settings. 在门诊护理环境中为上呼吸道感染儿童开具广谱抗生素处方的相关因素。
IF 1.5 Pub Date : 2018-07-02 DOI: 10.1177/1179556518784300
Mohammad S Alzahrani, Mary K Maneno, Monika N Daftary, La'Marcus Wingate, Earl B Ettienne

Objectives: Broad-spectrum antibiotics are frequently prescribed for children with upper respiratory tract infections (URI). Excessive use of broad-spectrum antibiotics leads to the emergence of resistant bacteria. This study aimed to identify factors associated with prescribing broad-spectrum antibiotics among children younger than 18 years presenting with URI in outpatient settings.

Methods: We conducted a cross-sectional analysis of the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey-Outpatient Departments (NHAMCS-OPD) between 2006 and 2010. Descriptive statistics of visits from children with URI were estimated. Simple and multiple logistic regression analyses were used to identify socio-demographic and clinical characteristics associated with broad-spectrum antibiotic prescribing. We also completed a stratified analysis by age (⩽2 vs >2).

Results: A total of 4013 outpatient visits for children with URI from both NAMCS and NHAMCS-0PD data were examined. Broad-spectrum antibiotics were prescribed in 39% of the visits, accounting for an estimated 6.8 million visits annually. Multivariable analysis showed that visits in the South region (odds ratio [OR] = 2.38; 95% confidence interval [CI]: 1.38-4.10) compared with the West region and visits with diagnoses of acute sinusitis (OR = 2.77; 95% CI: 1.65-4.63) and acute otitis media (OR = 1.90; 95% CI: 1.32-2.74) compared with those with acute pharyngitis were associated with greater odds of broad-spectrum antibiotic prescribing.

Conclusions: The prescribing of broad-spectrum antibiotics is common for children with URI in ambulatory care settings. Diagnosis and management of URI remain a critical area for awareness campaigns promoting judicious use of antibiotics.

目的:广谱抗生素经常用于儿童上呼吸道感染(URI)。过度使用广谱抗生素会导致耐药细菌的出现。本研究旨在确定18岁以下儿童使用广谱抗生素的相关因素 在门诊环境中使用URI的年数。方法:我们对2006年至2010年间的全国门诊医疗调查(NAMCS)和全国医院门诊医疗调查门诊部(NHAMCS-OPD)进行了横断面分析。估计了URI儿童就诊的描述性统计数据。使用简单和多元逻辑回归分析来确定与广谱抗生素处方相关的社会人口统计学和临床特征。我们还完成了按年龄进行的分层分析(⩽2 vs>2)。结果:根据NAMCS和NHAMCS-0PD数据,共检查了4013例URI儿童门诊就诊。39%的就诊中使用了广谱抗生素,估计占6.8 每年访问量达百万人次。多变量分析显示,在南部地区就诊(比值比[OR] = 2.38;95%置信区间[CI]:1.38-4.10)与西部地区相比,以及诊断为急性鼻窦炎(OR = 2.77;95%可信区间:1.65-4.63)和急性中耳炎(OR = 1.90;95%可信区间:1.32-2.74)与急性咽炎患者相比,与更大的广谱抗生素处方几率相关。结论:在门诊护理环境中,对URI儿童开具广谱抗生素处方很常见。URI的诊断和管理仍然是促进明智使用抗生素的宣传活动的关键领域。
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引用次数: 17
Parents' Expressions of Concerns and Hopes for the Future and Their Concomitant Assessments of Disability in Their Children. 父母对未来的关注和希望的表达及其对子女残疾的评估。
IF 1.5 Pub Date : 2018-06-27 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518784948
Niels Ove Illum, Mette Bonderup, Kim Oren Gradel

Aim: To assess parents' ability to express their concerns and hopes for the future in their children with disability and assess their children's disability as well as to analyse these data for consistency.

Method: Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours were asked to freely express their concerns and hopes for the future and to assess disability in their own children by employing a set of 26 International Classification of Functioning, Disability and Health, Children and Youth Version (ICF-CY) body function (b) codes and activity and participation (d) codes. A grounded theory approach was employed to systematize parents' expressions of concerns and hopes; then, parents scored qualifiers on a 5-step qualitative Likert scale. Parents assessed their children's disability in the same way using the ICF-CY 5-step qualifier scale.

Results: Altogether, 119 parents freely expressed their concerns and hopes, and 101 of them also assessed their children's disability using the 26 ICF-CY codes. A total of 475 expressions of concern and hopes (issues) were expressed and categorized into 34 areas of concern and hopes (subsections). The most frequently mentioned issues were education; understanding, goodwill, and communication between parents; and community support. Qualitative data on both 5-step qualifier scales showed good reliability. Rasch analysis maps on concerns and hopes for children as well as on the ICF-CY assessment demonstrated good alignment and a clinically relevant progression from the least to the most disabled children.

Conclusion: Parents can express valid and reliable data on their concerns and hopes for the future and can reliably assess disability in their own children.

目的:评估父母对残疾孩子表达他们对未来的关注和希望的能力,评估孩子的残疾情况,并分析这些数据的一致性。方法:162名患有脊柱裂、脊髓性肌萎缩症、肌肉失调、脑瘫、视力障碍、听力障碍、精神残疾或脑肿瘤后残疾的儿童的父母被要求自由表达他们对未来的关注和希望,并采用一套26版国际功能、残疾和健康分类来评估他们自己孩子的残疾情况。儿童和青少年版本(ICF-CY)身体功能(b)代码和活动和参与(d)代码。一种扎根理论的方法被用来系统化父母的关心和希望的表达;然后,父母们用5步定性李克特量表给合格者打分。父母以同样的方式使用ICF-CY 5步限定量表评估孩子的残疾。结果:总共有119名家长自由表达了他们的担忧和希望,其中101名家长也使用了26个ICF-CY代码来评估他们孩子的残疾。共表达了475项关切和希望(问题),并将其分为34个关切和希望领域(小节)。最常提到的问题是教育;父母之间的理解、善意、沟通;还有社区支持。两种5步限定量表的定性数据均具有良好的信度。Rasch对儿童的关注和希望以及ICF-CY评估的分析图显示出良好的一致性和从最轻残疾儿童到最严重残疾儿童的临床相关进展。结论:父母可以表达他们对未来的关注和希望的有效和可靠的数据,可以可靠地评估自己孩子的残疾。
{"title":"Parents' Expressions of Concerns and Hopes for the Future and Their Concomitant Assessments of Disability in Their Children.","authors":"Niels Ove Illum,&nbsp;Mette Bonderup,&nbsp;Kim Oren Gradel","doi":"10.1177/1179556518784948","DOIUrl":"https://doi.org/10.1177/1179556518784948","url":null,"abstract":"<p><strong>Aim: </strong>To assess parents' ability to express their concerns and hopes for the future in their children with disability and assess their children's disability as well as to analyse these data for consistency.</p><p><strong>Method: </strong>Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours were asked to freely express their concerns and hopes for the future and to assess disability in their own children by employing a set of 26 International Classification of Functioning, Disability and Health, Children and Youth Version (ICF-CY) body function (b) codes and activity and participation (d) codes. A grounded theory approach was employed to systematize parents' expressions of concerns and hopes; then, parents scored qualifiers on a 5-step qualitative Likert scale. Parents assessed their children's disability in the same way using the ICF-CY 5-step qualifier scale.</p><p><strong>Results: </strong>Altogether, 119 parents freely expressed their concerns and hopes, and 101 of them also assessed their children's disability using the 26 ICF-CY codes. A total of 475 expressions of concern and hopes (issues) were expressed and categorized into 34 areas of concern and hopes (subsections). The most frequently mentioned issues were education; understanding, goodwill, and communication between parents; and community support. Qualitative data on both 5-step qualifier scales showed good reliability. Rasch analysis maps on concerns and hopes for children as well as on the ICF-CY assessment demonstrated good alignment and a clinically relevant progression from the least to the most disabled children.</p><p><strong>Conclusion: </strong>Parents can express valid and reliable data on their concerns and hopes for the future and can reliably assess disability in their own children.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2018-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556518784948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36345403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Fit "N" Cool Kids: The Effects of Character Modeling and Goal Setting on Children's Physical Activity and Fruit and Vegetable Consumption. 适合“N”酷孩子:性格塑造和目标设定对儿童体育活动和果蔬消费的影响。
IF 1.5 Pub Date : 2018-06-25 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518784296
Jessyka N Larson, Timothy A Brusseau, Heidi Wengreen, Stuart J Fairclough, Maria M Newton, James C Hannon

Efforts to decrease the risk of overweight and obesity should focus on children's physical activity (PA) and fruit and vegetable (FV) consumption. Within school-based interventions, there is insufficient evidence on the effectiveness of the use of character modeling and goal setting to determine changes in step counts, MVPA, and FV consumption. Study participants were 187 students in grades 4 and 5 from 2 Title 1 elementary schools in the Southwest United States. The intervention was a quasi-experimental character modeling and goal setting program. New Lifestyles NL-1000 activity monitors were used to assess number of steps taken and MVPA by the participants. Fruit and vegetable consumption was measured by direct observation. School day steps, MVPA, and FV consumption were recorded at baseline, intervention, and during a 10-week follow-up. There were not differences between groups at baseline. Steps and MVPA were statistically significantly (P < .05; Δ = ~2500 steps and ~5 minutes of MVPA) greater in the intervention compared with the control group over time. Fruit and vegetable consumption was not significantly (P = .308) greater in the intervention compared with the control group over time. Students in the intervention school were significantly more active than students in the control school during the intervention phase and at follow-up. The findings reported here would suggest that character modeling and goal setting can increase PA among elementary aged children but did not increase FV consumption.

降低超重和肥胖风险的努力应该集中在儿童的体育活动(PA)和水果蔬菜(FV)消费上。在基于学校的干预措施中,没有足够的证据表明使用性格建模和目标设定来确定步数、MVPA和FV消耗的变化的有效性。研究参与者是美国西南部两所一级小学四年级和五年级的187名学生。干预是一个准实验性的性格建模和目标设定程序。新生活方式NL-1000活动监测器用于评估参与者所采取的步骤数量和MVPA。水果和蔬菜的消耗量是通过直接观察来测量的。在基线、干预和10周随访期间记录上学日步数、MVPA和FV消耗。在基线时各组之间没有差异。Steps和MVPA有统计学意义(P P = .308)随着时间的推移在干预中比对照组更大。在干预阶段和随访中,干预学校的学生明显比对照学校的学生更活跃。本文报道的研究结果表明,性格建模和目标设定可以增加小学年龄儿童的PA,但不会增加FV的消耗。
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引用次数: 0
Perceptions of Acute Malnutrition and Its Management in Infants Under 6 Months of Age: A Qualitative Study in Rural Bangladesh. 对 6 个月以下婴儿急性营养不良及其管理的看法:孟加拉国农村地区的定性研究。
IF 1.5 Pub Date : 2018-05-03 eCollection Date: 2018-01-01 DOI: 10.1177/1179556518771698
Yasir Arafat, M Munirul Islam, Nicki Connell, Golam Mothabbir, Marie McGrath, James A Berkley, Tahmeed Ahmed, Marko Kerac

Background: World Health Organization guidelines advise community-based care (CBC) for "uncomplicated" severe acute malnutrition (SAM) infants <6 months old (u6m), whereas current national protocols refer to inpatient care. Our aim was to inform and shape future management strategies by understanding caregivers' and different stakeholders' perceptions on malnutrition among infants u6m on barriers/facilitators to future CBC.

Methods: The methods used in this study are as follows: in-depth interviews and focus group discussions (FGDs) in southern Bangladesh, thematic analysis of transcripts, and sample size by data saturation.

Results: We conducted 5 FGDs with 29 caregivers, 4 with 29 health care workers, 4 key informant interviews each with community leaders and health supervisors. Five themes emerged. 1) Identification of SAM infants and care-seeking behavior: malnutrition was not noticed until severe, caregivers focused on clinical symptoms. Both allopathic and traditional healers were consulted. (2) Perceived causes of infant malnutrition: underlying illness, poor feeding practices, poverty, and local superstitions. (3) Views and preferences on treatment: hospitals and doctors were perceived as offering the best treatment, health care workers were also important, and respondents highlighted the need care of the caregiver/mother along with the infant. (4) Perceived benefits and risks of CBC: lower cost and greater accessibility were appreciated but worried about quality. (5) Community networks: wider family and social support networks were considered important aspects of care.

Conclusions: There is considerable potential for CBC but needs to be better and earlier identification of at-risk infants, strengthening of health systems to avoid community options being perceived as "second best," engagement with families and communities to tackle "upstream" determinants of SAM, and care for mother-infant pairs.

背景:世界卫生组织的指导方针建议对 "无并发症 "的严重急性营养不良(SAM)婴儿进行社区护理:本研究采用的方法如下:在孟加拉国南部进行深入访谈和焦点小组讨论(FGDs),对笔录进行主题分析,并根据数据饱和度确定样本量:我们与 29 名护理人员进行了 5 次 FGD,与 29 名医护人员进行了 4 次 FGD,与社区领导和卫生监督员各进行了 4 次关键信息提供者访谈。得出了五个主题1) SAM 婴儿的识别和寻求护理的行为:营养不良直到严重时才被发现,护理人员只关注临床症状。对症疗法和传统疗法都有咨询。(2)对婴儿营养不良原因的看法:潜在疾病、不良喂养方式、贫困和当地迷信。(3) 对治疗的看法和偏好:医院和医生被认为能提供最好的治疗,医护人员也很重 要,受访者强调照顾者/母亲和婴儿都需要照顾。(4) 对 CBC 的好处和风险的看法:低成本和更容易获得受到赞赏,但担心质量。(5) 社区网络:更广泛的家庭和社会支持网络被认为是护理的重要方面:CBC 有很大的潜力,但需要更好、更早地识别高危婴儿,加强卫生系统以避免社区选择被视为 "次优",让家庭和社区参与解决 SAM 的 "上游 "决定因素,并为母婴提供护理。
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引用次数: 0
A Review of the Factors Associated With the Timely Initiation of Breastfeeding and Exclusive Breastfeeding in the Middle East. 中东地区及时开始母乳喂养和纯母乳喂养相关因素综述
IF 1.5 Pub Date : 2017-12-17 eCollection Date: 2017-01-01 DOI: 10.1177/1179556517748912
Riyadh A Alzaheb

Background: Breastfeeding supplies all the nutrients that infants need for their healthy development. Breastfeeding practice is multifactorial, and numerous variables influence mothers' decisions and ability to breastfeed. This review identifies the factors potentially affecting the timely initiation of breastfeeding within an hour after birth and exclusive breastfeeding in the first 6 months in Middle Eastern countries.

Methods: The Medline, ScienceDirect, and Web of Science databases were keyword-searched for primary studies meeting the following inclusion criteria: (1) publication in the English language between January 2001 and May 2017, (2) original research articles reporting primary data on the factors influencing the timely initiation of breastfeeding and/or exclusive breastfeeding, (3) the use of World Health Organization definitions, and (4) Middle Eastern research contexts. A random effect model was used to establish the average prevalence of the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East.

Results: The review identified 19 studies conducted in Saudi Arabia (7), Iran (3), Egypt (2), Turkey (2), Kuwait (1), the United Arab Emirates (1), Qatar (1), Lebanon (1), and Syria (1). The meta-analysis established that 34.3% (confidence interval [CI]: 20.2%-51.9%) of Middle Eastern newborns received breastfeeding initiated within an hour of birth, and only 20.5% (CI: 14.5%-28.2%) were fed only breast milk for the first 6 months. The 8 studies exploring breastfeeding initiation most commonly associated it with the following: delivery mode, maternal employment, rooming-in, and prelacteal feeding. The 17 studies investigating exclusive breastfeeding most frequently linked it to the following: maternal age, maternal education, maternal employment, and delivery mode.

Conclusions: Middle Eastern health care organizations should fully understand all the determinants of breastfeeding identified by this review to provide suitable practical guidance and advice to help new mothers to overcome barriers where possible and to contribute to improving infant and maternal health in the region.

背景:母乳喂养提供婴儿健康发育所需的所有营养。母乳喂养实践是多因素的,许多变量影响母亲的决定和母乳喂养的能力。本综述确定了可能影响中东国家出生后1小时内及时开始母乳喂养和前6个月纯母乳喂养的因素。方法:对Medline、ScienceDirect和Web of Science数据库中符合以下纳入标准的主要研究进行关键字搜索:(1)2001年1月至2017年5月期间以英文发表的研究;(2)报告影响及时开始母乳喂养和/或纯母乳喂养因素的主要数据的原创研究文章;(3)使用世界卫生组织定义;(4)中东研究背景。采用随机效应模型建立中东地区及时开始母乳喂养和纯母乳喂养的平均流行率。结果:本综述确定了在沙特阿拉伯(7)、伊朗(3)、埃及(2)、土耳其(2)、科威特(1)、阿拉伯联合酋长国(1)、卡塔尔(1)、黎巴嫩(1)和叙利亚(1)进行的19项研究。荟萃分析确定34.3%(置信区间[CI]: 20.2%-51.9%)的中东新生儿在出生后一小时内开始母乳喂养,只有20.5% (CI: 14.5%-28.2%)的新生儿在前6个月只喂母乳。8项关于母乳喂养开始的研究通常将其与以下方面联系起来:分娩方式、母亲就业、同居和泌乳前喂养。调查纯母乳喂养的17项研究最常将其与以下因素联系起来:产妇年龄、产妇教育程度、产妇就业和分娩方式。结论:中东卫生保健组织应充分了解本次审查确定的所有母乳喂养决定因素,以提供适当的实际指导和建议,帮助新妈妈在可能的情况下克服障碍,并为改善该地区的婴儿和孕产妇健康作出贡献。
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引用次数: 85
Hypoglycemia: When to Treat? 低血糖症:何时治疗?
IF 1.5 Pub Date : 2017-12-15 eCollection Date: 2017-01-01 DOI: 10.1177/1179556517748913
Venkat Reddy Kallem, Aakash Pandita, Girish Gupta

Hypoglycemia is the most common metabolic disorder encountered in neonates. The definition of hypoglycemia as well as its clinical significance and management remain controversial. Most cases of neonatal hypoglycemia are transient, respond readily to treatment, and are associated with an excellent prognosis. Persistent hypoglycemia is more likely to be associated with abnormal endocrine conditions, such as hyperinsulinemia, as well as possible neurologic sequelae. Manifestations of hypoglycemia include seizures which can result in noteworthy neuromorbidity in the long haul. Thus, hypoglycemia constitutes a neonatal emergency which requires earnest analytic assessment and prompt treatment. In this review, we have tried to cover the pathophysiology, the screening protocol for high-risk babies, management, long-term neurologic sequelae associated with neonatal hypoglycemia, with evidence-based answers wherever possible, and our own practices.

低血糖是新生儿最常见的代谢紊乱。低血糖的定义、临床意义和处理方法仍存在争议。大多数新生儿低血糖症是一过性的,对治疗反应迅速,预后良好。持续性低血糖更可能与高胰岛素血症等内分泌异常以及可能的神经系统后遗症有关。低血糖的表现包括癫痫发作,长期发作会导致值得注意的神经系统疾病。因此,低血糖是一种新生儿急症,需要认真分析评估和及时治疗。在这篇综述中,我们试图涵盖与新生儿低血糖相关的病理生理学、高危婴儿筛查方案、管理、长期神经系统后遗症,并尽可能提供循证答案和我们自己的实践。
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引用次数: 0
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Clinical Medicine Insights-Pediatrics
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