Effect of Premature Infant Oral Motor Intervention on Oral Feeding and Weight Gain: A Systematic Review and Meta-Analysis.

Background: Sucking and swallowing coordination did not achieve until 32-34 weeks of gestation in premature infants. Oral motor stimulations improve oral motor musculature and neurobehavioral synergism which improves the rate of oral feeding readiness and weight gain and ultimately reduces the duration of hospitalization. Premature Infant Oral Motor Interventions (PIOMI) is a specific oral motor therapy effective in improving the clinical outcomes among premature infants. Earlier no review had been conducted specifically to assess the effectiveness of PIOMI on oral feeding progression, weight gain, and Length of hospital Stay (LOS) among premature infants. So, the present review had been planned. Materials and Methods: Review was conducted by searching databases like PubMed/Medline, Embase, Ovid, Clinical Key and Academia, Google and Google Scholar (from PIOMI inception to October 2020). Published articles on RCTs and clinical trials were included. Results: Six studies, with a total of 301 premature infants, were included in Meta Analysis (MA). PIOMI was found effective in early attainment of feeding progression (Mean Difference (MD) = -4.63 days at 95% Confidence Interval (CI) = -4.97 to - 4.29, p < 0.001) and shifting from gavage to independent oral feeding (MD = -2.54 days at 95% CI = -3.13 to - 1.95, p < 0.001), shows weight gain at discharge (MD = 51.61 grams at 95% CI = 19.84 to 83.38, p = 0.001), and reduces LOS (MD = -2.81 days at 95% CI = -3.51 to - 2.10, p < 0.001). Conclusions: Review shows shows the effectiveness of PIOMI in improving oral feeding progression and early attainment of gavage to independent oral feedings, and it also showed weight gain at discharge and reduced LOS.

Perception, perceived scope, and potential barriers towards developing nurse practitioners cadre among health care providers and beneficiaries: A pilot study from Northern India.

BACKGROUND: The role of nurse practitioner (NP) emerged in early 1965 when general practitioners began working with nurses. Evidence across the world highlights the benefits achieved by the NP role. The Indian Nursing Council (INC) implemented a country-wide NP in critical care (NPCC) program with the approval of the ministry of health and family welfare (MoHFW) in 2017. The NP role is in its infancy in India. Hence, there is a need to assess the perception among beneficiaries and healthcare personnel. This study was conducted to assess the perception, perceived scope, and potential barriers for developing the role of NPs in India among beneficiaries and healthcare providers. MATERIAL AND METHODS: A descriptive, cross-sectional pilot study was conducted at AIIMS Rishikesh, Uttarakhand, India, among 205 participants (84 beneficiaries, 78 nurses, and 43 physicians) using a proportionate stratified random sampling technique. Likert scales and socio-demographic sheets were used to assess the perception, perceived scope of practice, and potential barriers in developing a NP cadre in India. Descriptive and inferential statistics were used for analyzing data. RESULTS: The mean age of beneficiaries was 37.98, nurses was 27.58, and physicians was 28.13 years, respectively. 121 (61%) of participants were highly favored, and 77 (38%) were in favor of developing NP cadre in India. They considered it to be necessary, feasible, and acceptable in India. The feasibility and necessity of the perception domain were highly significant (P < 0.001 and P < 0.003, respectively). Nurses (mean ± SD: 35.36 ± 3.55) considered that NPs could have a wide range of practice followed by beneficiaries (mean ± SD: 38.17 ± 3.68) than physicians (mean ± SD: 34.75 ± 5.95). Lack of awareness, the nonexistence of cadre structure, lack of acceptance of the role of physicians, and lack of clear policy were the key potential barriers to develop an NP cadre in India. CONCLUSIONS: In this study, participants had favorable views on employing NPs in India; thus, this role will improve healthcare access for beneficiaries. NPs can carry out a wide range of practices.However, a lack of awareness, no cadre structure, and a lack of a clear policy may hinder the development of the NP cadre in India.

Impact of mobile phone dependence on behavior and academic performance of adolescents in selected schools of Uttarakhand, India.

BACKGROUND: Mobile phones are one of the excellent gifts of technology in the 21st century, which is most popular among adolescents. Today, mobile phones have infinite resources that have multiple benefits and applications. Its excessive use may impact adolescents in the form of behavioral changes and diminish the academic performance. This study explores the relationship between mobile phone usage with behavioral modifications and educational achievement among adolescents. MATERIALS AND METHODS: A descriptive correlational study was conducted among adolescents (n = 285 -male-210, female-75) at selected schools of Rishikesh, Uttarakhand, India. The test of mobile dependence was used to assess the mobile phone dependence, and a behavioral Likert scale to evaluate the behavioral changes through the self-report method. The academic performance was observed by school records; percentage of the last two examination results was considered. Collected data were analyzed using descriptive and inferential statistics. RESULTS: The study shows that 156 (54.70%) participants had a low mobile dependency, 191 (67%) participants had negative behavioral changes, and 125 (43.90%) participants had shown reduced academic performance due to overuse of the mobile phone. A significant relationship was seen between mobile phone dependency with behavioral changes (P < 0.001) and academic achievement (P < 0.035) seen among adolescents. Regression analysis predicted 49% of the differences among adolescents with selected variables due to the overuse of mobile phones. CONCLUSION: The study concluded that mobile dependency changes adolescent's behavior as well as reduces their academic performance due to the overuse of the mobile phone.

Realities, scope, challenges, and facilitators for implementation of nurse practitioner's role in India: A review.

India is in dire need of an alternative to general medical practitioners to overcome a severe shortage of doctors, especially in rural and underprivileged regions. Empowering nurses through nurse practitioner (NP) role is the superlative solution to provide quality health care in primary care setting. Based on conceptions and research findings of the NP' s role, we analyzed and examined the realities, scope, and barriers for implementing the NP' s role in India and propose future strategies to create a NP cadre.