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Lindgren Penn posted an update 6 months, 1 week ago
may be due to weaknesses in the policies’ design, leading to a lack of effectiveness, but they may also be due to failures of implementation and evaluation. These failures appear to have led to insufficient or no policy learning and governments proposing similar or identical policies repeatedly over many years. Governments should learn from their earlier policy failures. They should prioritize policies that make minimal demands on individuals and have the potential for population-wide reach so as to maximize their potential for equitable impacts. Policies should be proposed in ways that readily lead to implementation and evaluation.
Although circulatory impairment during the transitional circulation associates morbidity and mortality, its treatment remains controversial. In a pilot trial on circulatory impairment defined as low superior vena cava (SVC) flow, dobutamine (Db) versus placebo (PL) showed a trend towards improved short-term outcomes. The purpose of this study was to report on the long-term outcome of the infants who were observed for SVC flow patterns.
Among the 126 infants <31 weeks of gestation prospectively scanned from birth, 28 presented low SVC flow within the first 24 h after birth and received Db (n=16) or PL (n=12). Follow-up of survivors included motor assessment and Bayley Scales II or III at 2 years, and the Reynolds Intellectual Assessment Scale at 6 years. Neurodevelopmental impairment (NDI) was defined as cerebral palsy (Gross Motor Function Classification System ≥ level 2), or a cognitive function score < -2 standard deviations; or moderate or severe hearing or visual impairment. Db group, PL group and normal-flow group were compared.
Eighteen infants died (Db 5; PL 2; normal flow group 11, P=0.1). Follow-up in survivors was accomplished in 80% and 55% of the cohort at 2 years and 6 years, respectively. No significant difference in the combined outcome (mortality or NDI) was found between the groups (42% Db, 36% PL, 30% normal flow group).
This exploratory analysis did not show any differences in the long-term outcome of infants according to SVC flow patterns or its treatment early after birth.
This exploratory analysis did not show any differences in the long-term outcome of infants according to SVC flow patterns or its treatment early after birth.
This prospective study evaluated and correlated the impact of ocular prostheses on quality of life and stress with socioeconomic level and clinical characteristics. The clinical difficulties and perceptions of patients after ocular rehabilitation were evaluated.
Anophthalmic patients (at least 18 years of age) who were not users of ocular prostheses were recruited. The Medical Outcomes Short-Form Health Survey (SF-36) and Perceived Stress Scale (PSS-10) questionnaires were administered before and after 3 and 6 months of prosthesis installation. Clinical characteristics, difficulties, and perceptions were evaluated by quantitative and descriptive analysis (7 days, 3 months, 6 months). Data were analyzed by the Friedman test and Pearson Correlation test (α = 0.05).
The final sample consisted of 26 patients. Quality of life showed improvement in the “Bodily Pain” and “General Health” domains. Wearing the prosthesis did not influence perceived stress. The clinical evaluation showed clinical discharge over 6scharge was continuous.
Exposure to maternal postpartum depression (PPD) increases the risk for emotion regulatory and psychiatric problems in offspring. This study aimed to determine if maternal cognitive behavioral therapy (CBT) for PPD improves infant emotion regulatory capacity.
Participants were 40 infants of mothers with a primary diagnosis of major depressive disorder matched 11-40 healthy control infants of nondepressed mothers on infant age, sex, and socioeconomic status. Mothers with PPD received nine weeks of group CBT. Dyads were tested at two time points. Congo Red Visit 1 occurred following the first CBT session (baseline visit for control infants). Visit 2 took place after CBT (nine weeks post-baseline for controls). At both visits, infant emotion regulation was assessed using resting-state frontal electroencephalography alpha asymmetry (FAA), heart rate variability (HRV), and maternal and partner ratings of orientation or regulation behaviors (infant behavior questionnaire-revised ). Changes in maternal characteristics (depression, bonding, and emotion regulation) from pretreatment to posttreatment were examined to determine if they explained infant changes.
At Visit 1, infants of women with PPD exhibited poorer emotion regulation relative to the healthy control infants. At Visit 2, following maternal PPD treatment, infants exhibited improved emotion regulation (shifted from right to left FAA , increased HRV , mother and partner reported orientation or regulation behaviors) such that they no longer differed from the healthy control infants. Changes in maternal characteristics did not appear to account for these changes.
Treating PPD may promote adaptive changes in physiological and behavioral systems underlying infant emotion regulation.
Treating PPD may promote adaptive changes in physiological and behavioral systems underlying infant emotion regulation.
This study explores the role of the public health advocacy coalition in alcohol policy development in Ireland. Compared with industry actors, much less is known about the membership, activities and influence of public health advocates in alcohol policymaking. To address this gap, this paper identifies several advocacy strategies, drawn from the advocacy coalition framework and other policy theories, and then analyses them in the context of recent Irish developments.
The study used theory-building process-tracing to construct a record of the public health advocacy coalition and its campaign to promote the Public Health (Alcohol) Act 2018 in Ireland. Specifically, we drew upon 131 primary documents produced by advocates, 464 newspaper articles and 18 semi-structured interviews with key advocates, public health experts and elected officials to undertake a thematic analysis.
Public health advocates in Ireland have developed sophisticated political strategies to foster major alcohol policy change. First, public health advocates led the formation of a broad-based advocacy coalition that helped members to effectively pool their limited resources as well as coordinate their strategy and messaging.