Metformin Plus Insulin For Preexisting Diabetes Or Gestational Diabetes In Early Pregnancy: The Mompod Randomized Clinical Trial, Kim A Boggess, Arielle Valint, Jerrie S Refuerzo, Noelia Zork, Ashley N Battarbee, Kacey Eichelberger, Gladys A Ramos, Gayle Olson, Celeste Durnwald, Mark B Landon, Kjersti M Aagaard, Kedra Wallace, Christina Scifres, Todd Rosen, Wadia Mulla, Amy Valent, Sherri Longo, Laura Young, M Alison Marquis, Sonia Thomas, Ashley Britt, Diane Berry

Student and Faculty Publications

IMPORTANCE: Insulin is recommended for pregnant persons with preexisting type 2 diabetes or diabetes diagnosed early in pregnancy. The addition of metformin to insulin may improve neonatal outcomes.

OBJECTIVE: To estimate the effect of metformin added to insulin for preexisting type 2 or diabetes diagnosed early in pregnancy on a composite adverse neonatal outcome.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial in 17 US centers enrolled pregnant adults aged 18 to 45 years with preexisting type 2 diabetes or diabetes diagnosed prior to 23 weeks' gestation between April 2019 and November 2021. Each participant was treated with insulin and …

Hospital Adhering To The Ten Steps To Successful Breastfeeding Predicts Exclusive Breastfeeding In Latinx Mothers., Ana Linares, Diana Cartagena, Marialda Moreira Christoffel

Nursing Faculty Publications

Introduction: Assessing how well a hospital adheres to the Ten Steps to Successful Breastfeeding is the key to outlining necessary modifications in mother breastfeeding support. This study aimed to assess Latinx mothers’ perception of how well a hospital adheres to the Ten Steps to Successful Breastfeeding and its influence on exclusive breastfeeding (EBF) rates at hospital discharge.

Methods: Secondary analysis of two longitudinal studies. The combined sample (N = 74) of Latinx pregnant women residing in the US. We modified, translated, and evaluated reliability of the Questionnaire for the Breastfeeding Mother (QBFM), which was applied to evaluate mothers’ …

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guidelines Update – X – Breastfeeding A Baby With Cow's Milk Allergy, Vicki Mcwilliam, Merryn Netting, Evelyn Volders, Debra Palmer, Ignacio Ansotegui, Stefania Arasi, Amal H. Assa'ad, Sami L. Bahna, Antonio Bognanni, Rose Kamenwa

Paediatrics and Child Health, East Africa

Cow’s milk allergy is rare in exclusively breastfed infants. To support the continuation of breastfeeding an infant after diagnosis with a cow’s milk allergy, it is critical to examine the evidence for and against any form of cow’s milk elimination diet for lactating mothers. In this narrative review, we highlight the lack of high-quality evidence, hence subsequent controversy, regarding whether the minuscule quantities of cow’s milk proteins detectable in human milk cause infant cow’s milk allergy symptoms. Current clinical practice recommendations advise a 2–4 week trial of maternal cow’s milk dietary elimination for: a) IgE-mediated cow’s milk allergy only if …

Effectiveness Of Individualized Counseling On The Duration Of Exclusive Breastfeeding: Study Protocol For A Multicenter, Randomized, Parallel, And Open Clinical Trial., Mariana Torreglosa Ruiz, Elisa Da Conceição Rodrigues, Karine Emanuelle Peixoto Oliveira Da Silva, Cynthya Viana De Resende, Michele Curcino Cavalcanti, Luciano Marques Dos Santos, Monika Wernet, Ana Letícia Monteiro Gomes, Marialda Moreira Christoffel, Maria Beatriz Guimarães Raponi, Jéssica Aparecida Da Silva, Jacqueline Faria De Oliveira, Divanice Contim, Ana Linares

Nursing Faculty Publications

BACKGROUND: Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care.

METHODS: Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and …

Pediatric Streptococcal Pharyngitis Testing And Treatment Practices, Amanda Welch

Dissertations

Objective: The purpose of this pilot quality improvement study was to implement SmartPhrases and assess its impact on adherence to the Infectious Disease Society of America (IDSA) guideline for Group A Streptococcus (GAS) pharyngitis testing and treatment in pediatric patients ages 1-16 years old. The aim was to use SmartPhrases to improve adherence with the IDSA guideline by 30% for GAS pharyngitis swabbing and 10% for appropriate antibiotic prescribing in three months.

Methods: A retrospective data analysis approach was used, in reviewing SmartPhrases data from the electronic health records (EHR) in a metropolitan Urgent Care. This data were collected from …

Association Between Early Prostacyclin Therapy And Extracorporeal Life Support Use In Patients With Congenital Diaphragmatic Hernia, Akila B Ramaraj, Samuel E Rice-Townsend, Carrie L Foster, Delphine Yung, Emma O Jackson, Ashley H Ebanks, Matthew T Harting, Rebecca A Stark, Congenital Diaphragmatic Hernia Study Group

Student and Faculty Publications

IMPORTANCE: Prostacyclin (PGI2) is a therapeutic option to treat congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension in neonates. Its use may decrease the need for extracorporeal life support (ECLS).

OBJECTIVE: To evaluate the association of early PGI2 therapy with ECLS use and outcomes among patients with CDH.

DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study from the CDH Study Group (CDHSG) registry of patients born from January 2007 to December 2019. Patients were from 88 different tertiary pediatric referral centers worldwide that contributed data to the CDHSG. Patients were included in the study if they were admitted within the first …

Provision Of Formal Education To Nursing Staff: Kangaroo Mother Care Within Maternal-Child Units, Jessica Holly

Doctor of Nursing Practice Scholarly Project

Kangaroo mother care (KMC) is an evidence-based intervention that improves neonatal outcomes and reduces mortality in infants. KMC is not fully integrated into local hospital maternal-child departments and nursing professionals do not have a standard education offering concerning KMC. While the use of KMC is not entirely absent, nursing knowledge and understanding of its correct execution leads to lesser occurrences of KMC initiation. This scholarly project addresses nursing knowledge as a practice quality improvement. A literature review was completed, including searches through CINAHL, Merck Manuals, MEDLINE Plus Health Information, ProQuest, and UpToDate. A pretest, educational video, and posttest were then …

Tiny Tusks Internship: The Marketing Of Infant Formula, Valeria De La Torre

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Less than half of the world’s infants and young children are breastfed despite the major benefits and recommendations by WHO. Commercial milk formula has been advertised so intensely that it has produced many misleading marketing styles that lead parents to believe commercial milk formula has better benefits than breastmilk. The United States is one of the few countries that have yet to act on WHO’s International Code of Marketing for Breastmilk to decrease the aggressive marketing styles in place. By only placing pictures of happy babies on the formula cans, it leads parents to believe that their baby would be …

Structural Basis Of Impaired Disaggregase Function In The Oxidation-Sensitive Skd3 Mutant Causing 3-Methylglutaconic Aciduria, Sukyeong Lee, Sang Bum Lee, Nuri Sung, Wendy W Xu, Changsoo Chang, Hyun-Eui Kim, Andre Catic, Francis T F Tsai

Student and Faculty Publications

Mitochondria are critical to cellular and organismal health. To prevent damage, mitochondria have evolved protein quality control machines to survey and maintain the mitochondrial proteome. SKD3, also known as CLPB, is a ring-forming, ATP-fueled protein disaggregase essential for preserving mitochondrial integrity and structure. SKD3 deficiency causes 3-methylglutaconic aciduria type VII (MGCA7) and early death in infants, while mutations in the ATPase domain impair protein disaggregation with the observed loss-of-function correlating with disease severity. How mutations in the non-catalytic N-domain cause disease is unknown. Here, we show that the disease-associated N-domain mutation, Y272C, forms an intramolecular disulfide bond with Cys267 and …

A National, Electronic Health Record-Based Study Of Perinatal Hemorrhagic And Ischemic Stroke, Stuart Fraser, Samantha M Levy, Yashar Talebi, Sean I Savitz, Alicia Zha, Gen Zhu, Hulin Wu

Student and Faculty Publications

BACKGROUND: Perinatal stroke occurs in approximately 1 in 1100 live births. Large electronic health record (EHR) data can provide information on exposures associated with perinatal stroke in a larger number of patients than is achievable through traditional clinical studies. The objective of this study is to assess prevalence and odds ratios of known and theorized comorbidities with perinatal ischemic and hemorrhagic stroke.

METHODS: The data for patients aged 0-28 days with a diagnosis of either ischemic or hemorrhagic stroke were extracted from the Cerner Health Facts Electronic Medical Record (EMR) database. Incidence of birth demographics and perinatal complications were recorded. …

Substance Use Among Persons With Syphilis During Pregnancy - Arizona And Georgia, 2018-2021, Jeffrey M Carlson, Ayzsa Tannis, Kate R Woodworth, Megan R Reynolds, Neha Shinde, Breanne Anderson, Keivon Hobeheidar, Aisha Praag, Kristen Campbell, Cynthia Carpentieri, Teri Willabus, Elizabeth Burkhardt, Elizabeth Torrone, Kevin P O'Callaghan, Kathryn Miele, Dana Meaney-Delman, Suzanne M Gilboa, Emily O'Malley Olsen, Van T Tong

Student and Faculty Publications

Despite universal prenatal syphilis screening recommendations and availability of effective antibiotic treatment, syphilis prevalence during pregnancy and the incidence of congenital syphilis have continued to increase in the United States (1,2). Concurrent increases in methamphetamine, injection drug, and heroin use have been described in women with syphilis (3). CDC used data on births that occurred during January 1, 2018-December 31, 2021, from two states (Arizona and Georgia) that participate in the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET) to describe the prevalence of substance use among pregnant persons with syphilis by congenital syphilis pregnancy outcome (defined …

Educating Acute Care And Emergency Nurses On Infant Safe Sleep Practices, Kimberly Catherine Mackeil-White

Walden Dissertations and Doctoral Studies

Rates of infant deaths due to sudden infant death syndrome, asphyxia, and sudden unexplained infant death dropped significantly during the original marketing and education push for infant safe sleep practices during the 1990s following the recommendations from the Center for Disease Control and the American Academy of Pediatrics, but a plateau has occurred with no further recent decreases. Safe sleep practices are inconsistent in the practicum site and guidelines for safe sleep practices do not exist. Although aware of the concepts, staff do not consistently educate families about maintaining the practices within the hospital environment, as evidenced by non-compliance with …

Virtual Home Visits During Covid-19 Pandemic: Mothers' And Home Visitors' Perspectives, Abdullah Al-Taiar, Michele A. Kekeh, Stephanie Ewers, Amy L. Prusinski, Kimberly J. Alombro, Nancy Welch

Community & Environmental Health Faculty Publications

Background

The experiences of mothers enrolled in Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with virtual home visiting (VHV) during the pandemic remain mostly unknown. This study aimed to describe in detail the experience of home visitors and mothers with VHV during COVID-19 pandemic. This is a prerequisite for guiding future efforts to optimize MIECHV services that are provided through virtual operation.

Methods

Focus groups discussion were conducted with home visitors (n = 13) and mothers (n = 30) who were enrolled in BabyCare program in Virginia from January 2019 to June 2022. This included mothers who received …

Effect Of Breastfeeding Support Initiative On Knowledge, Breast Engorgement, And Newborn Feeding Behavior Among Post-Cesarean Mothers, Smitha M V Dr, Priyadarshini T, Sandhya Kashyap, Jyoti Sambharwal, Angel Joy, Ashitha Korothan, Premlata Sabarni, Sabarni Banerjee

Manipal Journal of Nursing and Health Sciences

Effect of Breastfeeding Support Initiative on knowledge, Breast engorgement, and Newborn feeding behavior among post-cesarean mothers

ABSTRACT:

Background:

Delayed breastfeeding, improper breastfeeding techniques such as difficulties in holding the baby, posture, and sucking, and poor knowledge and skills on breastfeeding leads to breast engorgement and poor feeding. The breastfeeding support initiative is a unique program encouraging lactation to improve breastfeeding and prevent complications

Objectives:

To determine the effect of the breastfeeding support initiative on the knowledge of breastfeeding, breast engorgement, and newborn feeding behavior among post-cesarean mothers.

Methods:

We conducted a Quasi-experimental study among 60 post-cesarean mothers at a selected …

Exclusive Breastfeeding Versus Formula Feeding: Evaluating The Development Of Childhood Allergies, Jasmine Olshin, Anna Kousky, Lily Williams, Michael Mark

Non-Thesis Student Work

Allergies such as dietary, allergic rhinitis, allergy-related asthma, and atopic dermatitis have become increasingly prevalent in childhood and pose a public health concern – especially as severe allergic reactions, such as anaphylaxis, are rising among children. Exclusive breastfeeding and formula feeding are two common infant feeding practices, but their role in influencing the development of childhood allergies are not entirely understood. Thus, the question is raised as to whether infants who are exclusively breastfed are at a decreased risk for developing childhood allergies, compared to infants who are formula fed. A literature search was conducted utilizing relevant databases PubMed, BioMed …

Infant Safe Sleep Initiative, Heather Kuisle

Regis University Student Publications (comprehensive collection)

Abstract

Background: Sudden Unexpected Infant Death (SUID), which includes sudden infant death syndrome (SIDS), is one of the leading causes of infant deaths in the United States and a significant health issue. Although there has not been a distinct single cause found for SIDS, it has been determined that there are several risk factors identified that increase the risk of an infant dying from SIDS. Infant Safe Sleep Education as recommended by the American Academy of Pediatrics is essential for healthcare professionals to educate new families on infant safe sleep.

Objective: The objective of this project was to create and …

Population-Based Linked Longitudinal Surveillance Of Pregnant People And Their Infants: A Critical Resource For Emerging, Re-Emerging, And Persistent Threats, Van T Tong, Kate R Woodworth, Erin Blau, Neha Shinde, Amanda Akosa, Suzanne M Gilboa, Dana Meaney-Delman

Student and Faculty Publications

Public health emergencies, from Zika to COVID-19, have underscored the importance of addressing the needs of pregnant people and their infants. Recent events have underlined the critical role of mother-infant-linked longitudinal surveillance to characterize and assess the impacts of emerging, re-emerging, and persistent threats, including infectious diseases, on these populations. In partnership with state, local, and territorial health departments, CDC's National Center on Birth Defects and Developmental Disabilities activated the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) to capture information about pregnant people with laboratory-confirmed infection with SARS-CoV-2 (the virus that causes COVID-19) and their infants. SET-NET …