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Newborn Illness

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1. Delayed illness recognition and multiple referrals: a qualitative study exploring care-seeking trajectories contributing to maternal and newborn illnesses and death in southern Tanzania. (PubMed)

Delayed illness recognition and multiple referrals: a qualitative study exploring care-seeking trajectories contributing to maternal and newborn illnesses and death in southern Tanzania. Maternal and neonatal mortality remain high in southern Tanzania despite an increasing number of births occurring in health facilities. In search for reasons for the persistently high mortality rates, we explored illness recognition, decision-making and care-seeking for cases of maternal and neonatal illness (...) and death.We conducted 48 in-depth interviews (16 participants who experienced maternal illnesses, 16 mothers whose newborns experienced illness, eight mothers whose newborns died, and eight family members of a household with a maternal death), and five focus group discussions with community leaders in two districts of Mtwara region. Thematic analysis was used for interpretation of findings.Our data indicated relatively timely illness recognition and decision-making for maternal complications. In contrast

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2019 BMC health services research

2. In-service training for health professionals to improve care of seriously ill newborns and children in low-income countries. (PubMed)

In-service training for health professionals to improve care of seriously ill newborns and children in low-income countries. A variety of in-service emergency care training courses are currently being promoted as a strategy to improve the quality of care provided to seriously ill newborns and children in low-income countries. Most courses have been developed in high-income countries. However, whether these courses improve the ability of health professionals to provide appropriate care in low (...) -income countries remains unclear. This is the first update of the original review.To assess the effects of in-service emergency care training on health professionals' treatment of seriously ill newborns and children in low-income countries.For this update, we searched the Cochrane Database of Systematic Reviews, part of The Cochrane Library (www.cochranelibrary.com); MEDLINE, Ovid SP; EMBASE, Ovid SP; the Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library

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2015 Cochrane

3. The interfacility transport of critically ill newborns

The interfacility transport of critically ill newborns The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care (...) following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns. Key Words: Interfacility transport; Intramural; Newborn; Transport medicine

2015 Canadian Paediatric Society

4. Interpretation of Genomic Sequencing Results in Healthy and Ill Newborns: Results from the BabySeq Project. (PubMed)

Interpretation of Genomic Sequencing Results in Healthy and Ill Newborns: Results from the BabySeq Project. Genomic sequencing provides many opportunities in newborn clinical care, but the challenges of interpreting and reporting newborn genomic sequencing (nGS) results need to be addressed for its broader and effective application. The BabySeq Project is a pilot randomized clinical trial that explores the medical, behavioral, and economic impacts of nGS in well newborns and those admitted (...) to a neonatal intensive care unit (NICU). Here we present childhood-onset and actionable adult-onset disease risk, carrier status, and pharmacogenomics findings from nGS of 159 newborns in the BabySeq Project. nGS revealed a risk of childhood-onset disease in 15/159 (9.4%) newborns; none of the disease risks were anticipated based on the infants' known clinical or family histories. nGS also revealed actionable adult-onset disease risk in 3/85 (3.5%) newborns whose parents consented to receive

2019 American Journal of Human Genetics

5. Perspectives of time: a qualitative study of the experiences of parents of critically ill newborns in the neonatal nursery in North Queensland interviewed several years after the admission. (PubMed)

Perspectives of time: a qualitative study of the experiences of parents of critically ill newborns in the neonatal nursery in North Queensland interviewed several years after the admission. A qualitative study informed by grounded theory principles to explore the experiences of parents who had extremely preterm or babies with antenatally diagnosed life-threatening diagnoses who were cared for in a regional tertiary neonatal unit. The study was conducted when the child was old enough

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2019 BMJ open

6. Endothelial Microvesicles and Soluble Markers of Endothelial Injury in Critically Ill Newborns (PubMed)

Endothelial Microvesicles and Soluble Markers of Endothelial Injury in Critically Ill Newborns Neonatal systemic inflammatory response and multiple organ dysfunction syndrome are the main postnatal insults influencing mortality and morbidity. Critically ill newborns with high predicted mortality are supported by extracorporeal membrane oxygenation (ECMO). Biomarkers of inflammatory response and endothelial injury can be used for early diagnosis and treatment of critical neonatal situations (...) and angiopoietin-2 (P < 0.01) in the ECMO group while VEGF in the ECMO group was significantly lower (P < 0.01). In the ECMO group, the concentration of annexin-V-positive microvesicles (total microvesicles) and endothelial microvesicles expressing mucosal vascular addressin cell adhesion molecule 1 (MadCAM1) was increased (P = 0.05). In summary, we found increased concentrations of soluble inflammatory and endothelial markers in the plasma of critically ill newborns with multiple organ dysfunction. Increased

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2018 Mediators of inflammation

7. Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial. (PubMed)

Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial. To evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship.We assessed persistent wheezing illness determined at 18-24 months corrected (...) (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis.Of 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing

2018 Journal of Pediatrics

8. Home visits by community health workers to improve identification of serious illness and care seeking in newborns and young infants from low- and middle-income countries. (PubMed)

Home visits by community health workers to improve identification of serious illness and care seeking in newborns and young infants from low- and middle-income countries. The objectives of this review were to evaluate the effect of home visits by trained community health workers (CHWs) to successfully identify newborns and young infants (up to 59 days of age) with serious illness and improve care seeking from a health facility. The authors searched the Cochrane Central Register of Controlled (...) successful identification of serious illness. Evidence from validation studies supports the implementation of home visits by trained CHWs for improving outcomes in sick newborns and young infants in resource-limited areas. Further well-designed studies evaluating the effect of home visits by CHWs on successful identification of seriously ill newborns and young infants should include verification by a 'gold standard'.

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2018 Journal of perinatology : official journal of the California Perinatal Association

9. Consistency of Integrated Management of Newborn and Childhood Illness (IMNCI) in Shire Governmental Health Institution in 2017 (PubMed)

Consistency of Integrated Management of Newborn and Childhood Illness (IMNCI) in Shire Governmental Health Institution in 2017 In an effort to reduce infant mortality and morbidity, the World Health Organization and other technical partners developed the Integrated Management of Newborn and Childhood Illness (IMNCI). This study focuses on assessment of consistency and completeness of integrated management of neonatal and child hood illness in primary health care units.A total of 384 cases were

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2018 BMC research notes

10. Illness recognition and appropriate care seeking for newborn complications in rural Oromia and Amhara regional states of Ethiopia. (PubMed)

Illness recognition and appropriate care seeking for newborn complications in rural Oromia and Amhara regional states of Ethiopia. Ethiopia has made significant progress in reducing child mortality but newborn mortality has stagnated at around 29 deaths per 1000 births. The Maternal Health in Ethiopia Partnership (MaNHEP) was a 3.5-year implementation project aimed at developing a community-oriented model of maternal and newborn health in rural Ethiopia and to position it for scale up. In 2014 (...) the newborn survived to 28 days of life, and 13 cases in which the newborn died within 28 days of life, for a total sample size of 29 cases. Narrative interview were conducted with the main caregiver and several witnesses to the event. Analysis of the data included thematic content analysis and the determination of care seeking pathways and levels and timeliness of biomedical care seeking.Mothers and other witnesses do recognize certain symptoms of newborn illness which they often mentioned in clusters

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2018 BMC Pediatrics

11. Premature newborn care

Premature newborn care Premature newborn care - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Premature newborn care Last reviewed: February 2019 Last updated: February 2019 Summary A premature infant is an infant born before 37 weeks' gestation. In addition to immediate post-birth resuscitation, efforts to reduce excessive oxygen exposure, hyperventilation, hypothermia, and hypoglycaemia must be made. Consultation (...) with a neonatologist as soon as possible is recommended to provide expertise to reduce potential morbidity. Gestational age determination done within hours of birth is important for designating further care of the premature newborn. The risk of adverse outcomes varies inversely with gestational age. The New Ballard Score uses measurements of neuromuscular and physical maturity to complement the maternal history and ultrasonographic findings to estimate gestational age, although a first-trimester ultrasound remains

2019 BMJ Best Practice

12. Rapid Targeted Genomics in Critically Ill Newborns. (PubMed)

Rapid Targeted Genomics in Critically Ill Newborns. Rapid diagnostic whole-genome sequencing has been explored in critically ill newborns, hoping to improve their clinical care and replace time-consuming and/or invasive diagnostic testing. A previous retrospective study in a research setting showed promising results with diagnoses in 57%, but patients were highly selected for known and likely Mendelian disorders. The aim of our prospective study was to assess the speed and yield of rapid (...) targeted genomic diagnostics for clinical application.We included 23 critically ill children younger than 12 months in ICUs over a period of 2 years. A quick diagnosis could not be made after routine clinical evaluation and diagnostics. Targeted analysis of 3426 known disease genes was performed by using whole-genome sequencing data. We measured diagnostic yield, turnaround times, and clinical consequences.A genetic diagnosis was obtained in 7 patients (30%), with a median turnaround time of 12 days

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2017 Pediatrics

13. What if the baby doesn't survive? Health-care decision making for ill newborns in Ethiopia. (PubMed)

What if the baby doesn't survive? Health-care decision making for ill newborns in Ethiopia. Despite efforts to improve access to and quality of care for newborns, the first month after birth remains the most dangerous period of life. Given high neonatal mortality in low-income countries, saving newborn lives is a key priority for global and national health policy agendas. However, little is known about how these policies resonate with local understandings, experiences and household priorities (...) useful members of the household alongside costly health-care services delayed decision making and care-seeking. While sickness was recognized as dangerous for the ill newborn, seeking health-care could be harmful for the economic survival of the family. In a resource-constrained setting, families' focused on productive assets in order to minimize long-term risks, and waited before seeking newborn health-care services. Until the baby had survived the first vulnerable weeks and months of life

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2017 Social Science & Medicine

14. Illness recognition and care-seeking for maternal and newborn complications in rural eastern Uganda (PubMed)

Illness recognition and care-seeking for maternal and newborn complications in rural eastern Uganda To enhance understanding of the roles of community-based initiatives in poor rural societies, we describe and explore illness recognition, decision-making, and appropriate care-seeking for mothers and newborn illnesses in two districts in eastern Uganda where in one implementation district, a facility and community quality improvement approach was implemented.This was a cross-sectional study (...) using qualitative methods. We conducted 48 event narratives: eight maternal and newborn deaths and 16 maternal and newborn illnesses. Additionally, we conducted six FGDs with women's saving groups and community leaders. Qualitative data were analyzed thematically using Atlas.ti software.Women and caretakers reported that community initiatives including the presence of community health workers and women's saving groups helped in enhancing illness recognition, decision-making, and care-seeking

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2017 Journal of health, population, and nutrition

15. Care-seeking behaviors for maternal and newborn illnesses among self-help group households in Uttar Pradesh, India (PubMed)

Care-seeking behaviors for maternal and newborn illnesses among self-help group households in Uttar Pradesh, India India has made large strides in reducing maternal mortality ratio and neonatal mortality rate, yet care-seeking behavior for appropriate care is still a challenge. We conducted a qualitative study to understand the process of recognition and care-seeking for maternal and newborn illnesses in rural India where a health intervention through women's self-help groups (SHG) to improve (...) maternal and newborn health behaviors is implemented by a non-governmental organization, the Rajiv Gandhi Mahila Vikas Pariyojana. The study aimed to understand the process of recognition and care-seeking for maternal and newborn illnesses from SHG and non-SHG households in the intervention area.Thirty-two illness narratives, 16 of maternal deaths and illness and 16 of newborn illnesses and deaths, were conducted. Women, their family members, and other caretakers who were present during the event

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2017 Journal of health, population, and nutrition

16. Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Jigawa State, Northern Nigeria (PubMed)

Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Jigawa State, Northern Nigeria Maternal mortality and newborn mortality continue to be major challenges in Nigeria, with the highest levels in the northern part of the country. The objective of this study was to explore the process and sequence of symptom recognition, decision-making, and care-seeking among families experiencing maternal and neonatal illness and deaths in 24 (...) software and a codebook developed a priori based on the study's conceptual model.Compared to maternal cases, much less care-seeking was reported for newborns, especially in cases that ended in death. Key decision-makers varied by type of case. Husbands played the lead role in maternal death and neonatal illness cases, while female relatives and traditional birth attendants were more involved in decision-making around perceived PPH, and mothers were the principal decision makers in the neonatal death

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2017 Journal of health, population, and nutrition

17. Summary findings from a mixed methods study on identifying and responding to maternal and newborn illness in seven countries: implications for programs (PubMed)

Summary findings from a mixed methods study on identifying and responding to maternal and newborn illness in seven countries: implications for programs There is a lack of systematic information documenting recognition of potentially life-threatening complications and decisions to seek care, as well as reaching care and the specific steps in that process. In response to this gap in knowledge, a multi-country mixed methods study was conducted to illuminate the dynamics driving Delays 1 and 2 (...) across seven countries for maternal and newborn illness and death.A common protocol and tools were developed, adapted by each of seven study teams depending on their local context (Ethiopia, India, Indonesia, Nigeria, Tanzania, Uganda, and Nepal). Maternal and newborn illness, and maternal and newborn death cases were included. Trained interviewers conducted event narratives to elicit and document a detailed sequence of actions, from onset of symptoms to the resolution of the problem. Event timelines

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2017 Journal of health, population, and nutrition

18. Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Sarlahi District, Nepal (PubMed)

Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Sarlahi District, Nepal Identification of maternal and newborn illness and the decision-making and subsequent care-seeking patterns are poorly understood in Nepal. We aimed to characterize the process and factors influencing recognition of complications, the decision-making process, and care-seeking behavior among families and communities who experienced a maternal complication (...) , death, neonatal illness, or death in a rural setting of Nepal.Thirty-two event narratives (six maternal/newborn deaths each and 10 maternal/newborn illnesses each) were collected using in-depth interviews and small group interviews. We purposively sampled across specific illness and complication definitions, using data collected prospectively from a cohort of women and newborns followed from pregnancy through the first 28 days postpartum. The event narratives were coded and analyzed for common

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2017 Journal of health, population, and nutrition

19. Methodology for a mixed-methods multi-country study to assess recognition of and response to maternal and newborn illness (PubMed)

Methodology for a mixed-methods multi-country study to assess recognition of and response to maternal and newborn illness Although maternal and newborn mortality have decreased 44 and 46% respectively between 1990 and 2015, achievement of ambitious Sustainable Development Goal targets requires accelerated progress. Mortality reduction requires a renewed focus on the continuum of maternal and newborn care from the household to the health facility. Although barriers to accessing skilled care (...) are documented for specific contexts, there is a lack of systematic evidence on how women and families identify maternal and newborn illness and make decisions and subsequent care-seeking patterns. The focus of this multi-country study was to identify and describe illness recognition, decision-making, and care-seeking patterns across various contexts among women and newborns who survived and died to ultimately inform programmatic priorities moving forward.This study was conducted in seven countries-Ethiopia

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2017 Journal of health, population, and nutrition

20. Effect of Anatomical and Developmental Factors on the Risk of Unplanned Extubation in Critically Ill Newborns (PubMed)

Effect of Anatomical and Developmental Factors on the Risk of Unplanned Extubation in Critically Ill Newborns 28494497 2018 11 13 1098-8785 34 12 2017 Oct American journal of perinatology Am J Perinatol Effect of Anatomical and Developmental Factors on the Risk of Unplanned Extubation in Critically Ill Newborns. 1234-1240 10.1055/s-0037-1603341 Hatch L Dupree LD Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee. Grubb Peter H PH

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2017 American journal of perinatology

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