1.
Effectiveness of a hospital-based postnatal parent education intervention about pain management during infant vaccination: a randomized controlled trial.
Taddio, A, Shah, V, Bucci, L, MacDonald, NE, Wong, H, Stephens, D
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2018;(42):E1245-E1252
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Abstract
BACKGROUND Parents have reported that they want to learn how to reduce pain in infants during vaccinations. Our objective was to compare different levels of intensity of postnatal education about pain mitigation on parental self-reported use of interventions at future infant vaccinations. METHODS We conducted a longitudinal, 3-group parallel, add-on, randomized controlled trial on the postnatal ward of a hospital. New mothers, unaware of the hypothesis, were randomly assigned to 1 of 3 intervention groups and 3 follow-up groups (i.e., 9 groups, 3 × 3). The 3 intervention groups were control (general immunization information), pain pamphlet (pain mitigation information), and pain pamphlet and pain video (pain mitigation information). Both pain mitigation education groups also received general immunization information. The 3 follow-up groups were 2-, 4- and 6-month infant vaccinations. Mothers reported use of breastfeeding, sucrose and topical anesthetics during infant vaccinations in a telephone survey. RESULTS Of 3420 participants, follow-up was available for 2549 (75%): 36.1%, 34.2% and 29.7% reported on pain mitigation practices at 2-, 4- and 6-month vaccinations, respectively (p = 0.9). Maternal characteristics did not differ (p > 0.05): mean age, 33.6 years; 58% were primipara. Utilization of any intervention (breastfeeding, sucrose or topical anesthetics) was 53.2%, 61.4% and 63.0% for control, pain pamphlet, and pain pamphlet and pain video groups, respectively (p < 0.001); both pain education groups had higher utilization than the control group, but did not differ from one another. Uptake differed among intervention groups at 2 and 4 months but not at 6 months. INTERPRETATION Hospital-based postnatal education increased parental use of pain interventions at infant vaccinations and can be added to existing education. TRIAL REGISTRATION ClinicalTrials.gov, no. NCT01937143.
2.
Addressing the anti-vaccination movement and the role of HCWs.
Tafuri, S, Gallone, MS, Cappelli, MG, Martinelli, D, Prato, R, Germinario, C
Vaccine. 2014;(38):4860-5
Abstract
Over the last two decades, growing numbers of parents in the industrialized world are choosing not to have their children vaccinated. Trying to explain why this is occurring, public health commentators refer to the activities of an anti-vaccination movement. The aim of this paper is to review the literature about the anti-vaccination movements and to highlight the knowledge and the skills needed for HCWs to fight against their ideas. The main theoretical structures of anti-vaccination ideology in the 19th and 20th centuries are: vaccines cause idiopathic illness; opponents against vaccines accused vaccine partisans to be afraid of the "search after truth," they fear unveiling errors; the vaccination law not only insults every subject of the realm, but also it insults every human being; vaccine immunity is temporary; an alternative healthy lifestyle, personal hygiene and diet stop diseases. Proponents against vaccination now have additional means to communicate their positions to the general public, the Internet in particular. Doctors and HCWs constantly have to face parents and patients who search information about vaccination. A lot of these people have previously found data about vaccinations from a lot of sources, such as papers, media or in websites and in these sources most contents come from anti-vaccine movements. For these reasons doctors and HCWs need to have updated knowledge about the vaccinations and to know the contents proposed by vaccine sceptics. Educating the general public cannot be fully effective unless there is a corresponding provision, enthusiasm and commitment by trained HCWs.
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Stress and support for parents of youth with bipolar disorder.
Nadkarni, RB, Fristad, MA
The Israel journal of psychiatry and related sciences. 2012;(2):104-10
Abstract
BACKGROUND This article reviews stress related to parenting a youth with bipolar disorder (BD), maladaptive coping, immunologic and physical functioning related to chronic stress; presents preliminary findings about the association between immune parameters and health conditions, mental health indices and interpersonal functioning in parents of children with mood disorders; and provides recommendations for stress management based on clinical trials of family-based psychoeducational psychotherapy (PEP). DATA Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), Epstein Barr Virus (EBV), nutritional markers and measures of physical health, mental health and interpersonal functioning were collected from 26 parents of mood disordered children. Higher CRP was associated with more perceived stress, more depression, increased incidence of illness/ physical conditions, and lower albumin levels. Elevated IL-6 was associated with higher nicotine use. LIMITATIONS Sample size and demographics were restricted, limiting generalizability. CONCLUSION Pilot data are consistent with literature from adult caregivers, and suggest caregivers who are more stressed also evidence some signs of immune abnormality. Evidence-based strategies to support parents are discussed.
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Health care in the first year after international adoption.
Schulte, EE, Springer, SH
Pediatric clinics of North America. 2005;(5):1331-49, vii
Abstract
After international adoption, routine screenings for infectious and nutritional diseases, lead exposure, and vision and hearing difficulties are early priorities for children's postadoptive health care. Specific health concerns raised before adoption should also be reviewed after children arrive home with their families. Once appropriate postadoptive screenings and immunizations have been initiated, the challenge for the primary care provider is to determine the intervals and content of future follow-up visits. Clinical decision making is influenced by a specific child's age, acute medical needs, and developmental assessments.
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Office laboratory procedures, office economics, parenting and parent education, and urinary tract infection.
McBride, SC
Current opinion in pediatrics. 2003;(6):641-9
Abstract
Four areas of pediatric office practice are again reviewed: office laboratory procedures, office economics, parenting and parent education, and urinary tract infection. Screening for celiac disease and the use of rapid antigen testing for extrapharyngeal group A Streptococcus infections are included in office laboratory procedures. Utilization of health care among patients with public insurance, electronic medical records, billing among pediatric residents, and satisfaction surveys are reviewed in office economics. Challenges related to breastfeeding, obesity management and timely immunizations are covered within parenting and parent education. Finally, the use of an augmented urinalysis and a discussion of imaging for first febrile urinary tract infections are included in the area of urinary tract infection.