ABSTRACT
The objective of this study is to evaluate the effectiveness of a cue-based feeding protocol in improving time to nipple feed and time to discharge in very low birth weight infants in a Level III Neonatal Intensive Care Unit. Demographic, feeding, and discharge data were recorded and compared between the two cohorts. The pre-protocol cohort included infants born from August 2013 through April 2016 and the post-protocol cohort included infants born from January 2017 through December 2019. 272 infants were included in the pre-protocol cohort and 314 infants in the post-protocol cohort. Both cohorts were statistically comparable in gestational age, gender, race, birthweight, prenatal care, antenatal steroid use, and rates of maternal diabetes. There were statistically significant differences between the pre- versus post-protocol cohorts in median post-menstrual age (PMA) in days at first nipple feed (PO) (240 vs 238, p = 0.025), PMA in days at full PO (250 vs 247, p = 0.015), and length of stay in days (55 vs 48, p = 0.0113). Comparing each year in the post-protocol cohort, for each outcome measure, a similar trend was noted in 2017 and 2018, but not in 2019. In conclusion, the cue-based feeding protocol was associated with a decrease in the time to first PO, time to full nipple feeds, and the length of stay in very-low-birthweight infants.
Subject(s)
Cues , Nipples , Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Infant, Very Low Birth Weight , Patient Discharge , MaleABSTRACT
BACKGROUND: Child psychopathology involves inappropriate or biased attributions of others' mental states (mentalizing), and parents' assessment of their children's mentalizing significantly predicts the latter's psychosocial outcomes. Behavioral difficulties are frequent in children with epilepsy (CWE) yet biased mentalizing and parental accuracy in understanding their child's mental states reasoning have not been addressed. METHODS: This study compared the performance of 34 CWE aged 9 to 16â¯years with 67 language age-matched controls on a biased mentalizing task. The task required children to infer on the mental states of peers in stories involving social scenarios. Responses were scored as positive, negative, or rational mentalizing attributions. To measure parental accuracy, a parent version was administered in the patient group that required a parent to identify their child's responses correctly. Relationships with the child's cognitive, behavioral, and epilepsy-related factors were examined. RESULTS: Patients made greater negative mental states attributions compared with control children. This negative mentalizing bias was accurately identified by parents and was associated with children's behavioral problems. Parental accuracy was reduced for patients with lower cognitive abilities. Parents did not accurately identify an overly positive (OP) bias in their child's mental states attributions. Children's positive response bias correlated with their lower executive function (EF) skills. Epilepsy factors predicted cognitive deficits but not biased mentalizing or behavioral problems. CONCLUSION: Biased mentalizing characterizes social cognition in CWE with behavioral problems. Further investigation of the mentalizing biases and parental awareness of children's mental states reasoning is required to fully understand the greater psychosocial and behavioral difficulties found in CWE.
Subject(s)
Epilepsy/psychology , Epilepsy/therapy , Mentalization , Parent-Child Relations , Parents/psychology , Social Perception , Adolescent , Child , Epilepsy/diagnosis , Female , Humans , Male , Mentalization/physiology , Social BehaviorABSTRACT
A common endeavor shared by physicians practicing in specialty fields of Radiology and Obstetrics and Gynecology is the comprehensive care and diagnosis of women with breast problems and breast disease. Because each specialty provides its respective clinical expertise in breast health, each also shares a concern, which is the high risk of litigation associated with a missed or delayed diagnosis of breast cancer. This shared concern is well documented for both specialties. Instead, it is argued that physicians are better prepared by engaging in the practice of evidence-based breast care in their respective specialties.
