COMPARATIVE Investigation Involving SYSTEM Hours Healthcare IN THE NORTH White National DISTRICT

The UNICEF Community-based Infant and Young Child Feeding Counseling Package (C-IYCFCP) currently has limited responsive feeding (RF) content, thus limiting dissemination of RF messages within infant and young child feeding (IYCF) counseling.
This project
) developed counseling cards based on existing evidence-based RF guidelines and
) tested their feasibility in Ghana.
Five RF counseling cards were developed focusing on eating with family; introducing new foods; hunger/satiety cues; food texture; and calming a child. Four focus group discussions (FGDs) were conducted with adult mothers and fathers of children younger than 3 y of age to assess the cultural appropriateness of the cards and accompanying key messages. The feasibility of including cards as part of IYCF counseling was tested via
) systematic observation of 8 group education sessions utilizing the cards with the same target audience and
) in-depth interviews with health care providers involved in IYCF training and/or counseling.
FGD findings guided changes to all cards to ensure comprehension and cultural appropriateness. The group education sessions suggested that the counseling cards provided important RF messages that are specific, clear, and feasible to implement. Health care providers strongly endorsed the need for and utility of the RF counseling cards and felt they were feasible and important to integrate into the C-IYCFCP currently being used to deliver IYCF training and counseling in Ghana.
The counseling cards have a strong potential to add key RF dimensions to IYCF training and counseling in Ghana.
The counseling cards have a strong potential to add key RF dimensions to IYCF training and counseling in Ghana.
Early-life exposure to traffic-related air pollution may decrease fetal growth and increase childhood obesity risk. Our objective was to evaluate the relationship of early-life exposure to traffic-related air pollution with birthweight in term newborns and obesity at age 7-8 years in two prospective birth cohorts in Cincinnati, OH (the Health Outcomes and Measures of the Environment (HOME) Study and Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS)).
We estimated elemental carbon attributable to traffic (ECAT) exposure at residential addresses during pregnancy with a validated land use regression model. We assessed birthweight among term infants using birth records or parent report (HOME Study n= 333 and CCAAPS n=590). We measured children's weight and height at 7-8 years, and calculated age- and sex-specific BMI z-scores (HOME Study n= 198 and CCAAPS n=459). Using multivariable linear regression, we estimated the difference in term birthweight and BMI z-score per interquartile range (IQR) increase in ECAT concentrations in each cohort separately and in the pooled sample.
In adjusted models, ECAT exposure was not associated with lower birthweight (pooled sample β 30g; 95% CI -6, 66), or with higher BMI z-score (pooled sample β -0.04; 95% CI -0.15, 0.08). Infant sex modified the association between ECAT and birthweight (p=0.05). Among male newborns, higher ECAT concentrations were associated with higher birthweight (β 61g; 95% CI 9, 113), but we observed no association among female newborns (β -9g; 95% CI -58, 41).
In contrast to some prior studies, early-life traffic-related air pollution exposure was not associated with lower birthweight or increased childhood adiposity in these two cohorts.
In contrast to some prior studies, early-life traffic-related air pollution exposure was not associated with lower birthweight or increased childhood adiposity in these two cohorts.
To assess olfactory and clinical morbidity in primary (idiopathic)-type atrophic rhinitis and its course following treatment.
Prospective nonrandomized controlled cohort study with follow-up.
Department of Otorhinolaryngology and Head and Neck Surgery of a university hospital (tertiary heath care center).
Sixty-one patients with atrophic rhinitis underwent assessment of clinical severity with baseline olfaction with the Brief Smell Identification test, while the improvement of their status following surgical versus nonsurgical treatment was further assessed.
Olfaction was universally deranged with bimodal age presentation and female predominance (61%). Clinical improvement was significantly associated with surgical treatment but did not reveal any relation with up-front severity of disease. A near-significant association of age with severity did not reveal significance when stratified by age group. Saracatinib chemical structure Baseline olfaction or its change following treatment did not reveal any significance with severity of tion. Accordingly, olfaction was affected early and recovered slowly (or not at all), independent of clinical morbidity, which in turn is affected rather late but recovers early. Olfactory dysfunction at the initial stage may be a surrogate marker of potential worsening clinical condition, since bacteria often superinfect underlying susceptible nasal environment. While surgery mainly improved clinical parameters without affecting olfaction directly, a true improvement would include recovery of both.
Racial disparities of surgical outcomes have been demonstrated for a variety of operations. We sought to determine whether minority status is associated with disparate care for adrenalectomy.
This study is a retrospective database review of the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) from January 1, 2014 through April 30, 2018. Primary outcome was complication rate. Secondary outcomes were length of stay and surgeon experience. Minority status was defined as Black or Hispanic and outcomes were compared with White patients.
For the study period, 1141 patients who underwent adrenalectomies were included, of whom 69.9% were White and 22.6% minority. The minority patients were significantly younger with higher rates of diabetes mellitus. Minority patients had higher rates of complication and longer length of stay. Minority patients were more likely to have an adrenalectomy by a low-volume surgeon. In multivariate logistic regression, minority status remained associated with complication rate.