• Title/Summary/Keyword: High risk Infant

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Analysis of Studies on High-Risk Infants and Quality Assessment of Intervention Studies (국내 고위험신생아 연구 분석 및 중재 연구의 질 평가)

  • Lee, Hyejung;Kim, Anna;Maeng, Anna;Kim, Gayeong
    • Child Health Nursing Research
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    • v.22 no.2
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    • pp.153-162
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    • 2016
  • Purpose: It is critical that evidence from research is applied to everyday nursing practice to improve the quality of care and health outcomes. Aims of this study were to review high-risk infant related studies published in major nursing and non-nursing journals in Korea and to assess the quality of intervention studies. Methods: Through the Korean literature search engine of RISS.KR the authors identified 132 studies, and two researchers evaluated each of these studies using the analysis criteria. The quality of intervention studies was assessed using the van Tulder Scale. Results: Among the studies, 40.2% were either thesis or dissertation and 86.4% were quantitative studies. Convenience sampling was the most commonly used sampling method. All experimental studies were quasi-experiment except one pre-experiment study. Sensory stimulation and kangaroo care were the most common interventions for high-risk infants. Over half of the intervention studies were assessed to be "low risk of bias" but both randomization and blinding processes were not adequately satisfied in most of the studies. Conclusion: Findings of this study suggest that high-risk infants are more likely to be recruited for experimental studies but types of interventions were very limited. To provide evidence-based care for high-risk infants, rigorously conducted experimental studies should be encouraged.

Application of a Documentary about High-risk Newborns in Nursing Education: An Exploratory Study (고위험신생아 간호교육에서의 다큐멘터리 활용에 대한 탐색적 연구)

  • Kang, Hyun-Ju;Yu, Juyoun
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.173-180
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    • 2020
  • Purpose: The purpose of this study was to explore nursing students' recognition and understanding of the clinical environment of high-risk neonatal nursing care after watching a documentary about the neonatal intensive care unit (NICU), where high-risk newborns are treated. Methods: This study was a qualitative content analysis. In total, 151 nursing students' personal essays describing their reactions to a documentary about the NICU were analyzed using the NVivo 12 program. Results: Nursing students' experiences of engaging with a documentary about the NICU were structured into four thematic categories: 'actual observations of the imagined NICU', 'observation and recognition of nursing knowledge', 'empathy with people related to the baby', and 'establishing attitudes and values as a nurse'. Conclusion: Based on the results of this study, it is suggested that documentaries can be applied in nursing education about high-risk newborns.

Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia

  • Sutriana, Vivi Ninda;Sitaresmi, Mei Neni;Wahab, Abdul
    • Clinical and Experimental Pediatrics
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    • v.64 no.11
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    • pp.588-595
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    • 2021
  • Background: Acute respiratory infections (ARIs), especially pneumonia, remain a major cause of infant mortality worldwide. In Indonesia, pneumonia is the second most common cause of infant and toddler deaths. Exclusive breastfeeding and basic immunization can protect infants and children from contracting pneumonia. Purpose: Our goal was to assess the risk factors for childhood pneumonia in regions with a high prevalence of pneumonia in Indonesia. Methods: This case-control study was conducted between March and April 2019. A total of 176 infants and toddlers aged 10-59 months were enrolled and selected from among patients who visited the community health center. Cases of pneumonia were diagnosed clinically based on the World Health Organization guidelines, and the control was nonpneumonia. Results: The risk factors for the diagnosis of pneumonia included no or nonexclusive breastfeeding (odds ratio [OR], 7.95; 95% confidence interval [CI], 3.52-17.94), incomplete basic immunizations (OR, 4.47; 95% CI, 2.22-8.99), indoor air pollution (OR, 7.12; 95% CI, 3.03-16.70), low birth weight (OR, 3.27; 95% CI, 1.19-8.92), and a high degree of wasting (OR, 2.77; 95% CI, 1.06-7.17). Other variables such as nutritional status (height-for-age z score), age, sex, and educational status of the mother were not risk factors for pneumonia. Conclusion: No or nonexclusive breastfeeding, incomplete basic immunizations, indoor air pollution, a history of low birth weight, and severe malnutrition were risk factors for childhood pneumonia. Breastfeeding was the dominant factor, while sex modified the relationship between exclusive breastfeeding and the incidence of pneumonia.

The Effects of the Systemic Follow up Health Care Program on the Health Promotion and the Risk Reduction in Premature Infants and Their Mothers (체계적 건강관리프로그램이 모성과 미숙아의 건강증진 및 질병예방에 미치는 영향에 관한 연구)

  • Ahn Young-Mee
    • Journal of Korean Academy of Nursing
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    • v.34 no.6
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    • pp.1129-1142
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    • 2004
  • Purpose: This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers. Method: The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional NICU education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively. Result: All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar. Conclusion: A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.

The Study of Cognition Comparative on SIDS (영아돌연사증후군(SIDS)에 대한 인식 비교에 관한 연구)

  • Kim, Og-Sim
    • Journal of Families and Better Life
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    • v.28 no.1
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    • pp.1-11
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    • 2010
  • The purpose of this study is to compare the cognition of SIDS as the first step for decreasing the SIDS death rate for the infant and for activity of infant-care in Korea. Participants were 409 child care center directors and 146 parents from 500 child care center directors and 200 parents who using child care center facilities for their children in Seoul. For analysis of research questions, frequencies, Cronbach $\alpha$, t-test,One-way ANOVA, Scheffee test were used with SPSSWIN 15.0. Through this study, we find the child care center directors have good cognition for it, but their effort for SIDS prevention is limited, because they don't have any official prevention education from authorized training center. Even though the parents have a low awareness for SIDS prevention than child care center directors, but they have high score in endeavor for SIDS precaution. Both child care center directors and parents want to receive systematic information from government side. Our infant should have a opportunity to grow up health and stability from reducing the risk of SIDS. In western countries such as U.S.A., U.K. and Japan have studied to decrease the SIDS death rate from thirty years ago, they have already government and social organization for preventing the SIDS. Nowadays, as you know well, our country birth-rate is falling by 1.08, therefore, it is important to decrease the infant death rate for keeping with our population. Also, it is relevant to the child-welfare and the child-safety and more better the child-care.

A Contrast Nephropathy in a Preterm Infant Following Preoperative Embolization of Giant Sacrococcygeal Teratoma

  • Lee, Byong Sop
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.26-30
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    • 2017
  • Newborn infants with huge and highly vascular sacrococcygeal teratoma (SCT) are frequently subjected to renal hypoperfusion secondary to high-output cardiac failure. Any underlying renal dysfunction is a significant risk factor for the development of contrast-induced nephropathy (CIN). However, reports on CIN in infants are rare. I report here a case of a premature infant born at 28 weeks and 3 days of gestation with a huge SCT who survived preoperative embolization and surgical resection but presented with persistent non-oliguric renal failure that was suggestive of CIN. During radiological intervention, a contrast medium had been administered at about 10 times the manufacturer-recommended dose for pediatric patients. Despite hemodynamic stabilization and normalization of urine output immediately following surgery, the patient's serum creatinine and cystatin-C levels did not return to baseline until 4 months after birth. No signs of reflux nephropathy were observed in follow-up imaging studies. Dosing guidelines for the use of a contrast medium in radiological interventions should be provided for infants or young patients.

Dietary Diversity during Early Infancy Increases Microbial Diversity and Prevents Egg Allergy in High-Risk Infants

  • Bo Ra Lee;Hye-In Jung;Su Kyung Kim;Mijeong Kwon;Hyunmi Kim;Minyoung Jung;Yechan Kyung;Byung Eui Kim;Suk-Joo Choi;Soo-Young Oh;Sun-Young Baek;Seonwoo Kim;Jaewoong Bae;Kangmo Ahn;Jihyun Kim
    • IMMUNE NETWORK
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    • v.22 no.2
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    • pp.17.1-17.14
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    • 2022
  • We aimed to investigate associations of dietary diversity (DD) with gut microbial diversity and the development of hen's egg allergy (HEA) in infants. We enrolled 68 infants in a high-risk group and 32 infants in a control group based on a family history of allergic diseases. All infants were followed from birth until 12 months of age. We collected infant feeding data, and DD was defined using 3 measures: the World Health Organization definition of minimum DD, food group diversity, and food allergen diversity. Gut microbiome profiles and expression of cytokines were evaluated by bacterial 16S rRNA sequencing and real-time reverse transcriptase-polymerase chain reaction. High DD scores at 3 and 4 months were associated with a lower risk of developing HEA in the high-risk group, but not in the control group. In the high-risk group, high DD scores at 3, 4, and 5 months of age were associated with an increase in Chao1 index at 6 months. We found that the gene expression of IL-4, IL-5, IL-6, and IL-8 were higher among infants who had lower DD scores compared to those who had higher DD scores in high-risk infants. Additionally, high-risk infants with a higher FAD score at 5 months of age showed a reduced gene expression of IL-13. Increasing DD within 6 months of life may increase gut microbial diversity, and thus reduce the development of HEA in infants with a family history of allergic diseases.

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

  • Lee, Jae Wook;Cho, Bin
    • Clinical and Experimental Pediatrics
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    • v.60 no.5
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    • pp.129-137
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    • 2017
  • The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.

Exposure and Risk Assessment of Melamine in Representative Korean Foods for Infants and Children (WHO 내용일일섭취량을 고려한 우리나라 영유아 어린이의 식품을 통한 멜라민 노출 및 위해 평가)

  • Oh, Chang-Hwan
    • Journal of Dairy Science and Biotechnology
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    • v.27 no.1
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    • pp.1-12
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    • 2009
  • In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.

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Early Life Factors Influencing the Risk of Obesity

  • Lifschitz, Carlos
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.217-223
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    • 2015
  • The obesity epidemic is a worldwide problem. Factors predisposing to obesity include genetics, race, socioeconomic conditions, birth by cesarean section, and perinatal antibiotic use. High protein (HP) content in infant formulas has been identified as a potential culprit predisposing to rapid weight gain in the first few months of life and leading to later obesity. In a large multicountry study the effects of lower protein (LP) formula (1.77 and 2.2 g protein/100 kcal, before and after the 5th month, respectively) were compared to those of higher protein (2.9 and 4.4 g protein/100 kcal, respectively). Results indicated that at 24 months, the weight-for-length z score of infants in the LP formula group was 0.20 (0.06, 0.34) lower than that of the HP group and was similar to that of the breastfed reference group. The authors concluded that a HP content of infant formula is associated with higher weight in the first 2 years of life but has no effect on length. LP intake in infancy might diminish the later risk of overweight and obesity. At 6 years of age HP children had a significantly higher body mass index (by 0.51; 95% confidence interval [CI], 0.13-0.90; p=0.009) and a 2.43 (95% CI, 1.12-5.27; p=0.024) fold greater risk of becoming obese than those who received the LP. In conclusion, several factors may influence development of metabolic syndrome and obesity. Breastfeeding should always be encouraged. An overall reduction of protein intake in formula non breastfed infants seems to be an additional way to prevent obesity.