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2008 Niday Perinatal Database quality audit: report of a quality assurance project.

https://arctichealth.org/en/permalink/ahliterature128969
Source
Chronic Dis Inj Can. 2011 Dec;32(1):32-42
Publication Type
Article
Date
Dec-2011
Author
S. Dunn
J. Bottomley
A. Ali
M. Walker
Author Affiliation
Better Outcomes Registry and Network (BORN Ontario), Ottawa, Ontario, Canada. sadunn@ohri.ca
Source
Chronic Dis Inj Can. 2011 Dec;32(1):32-42
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Canada
Data Collection - standards
Databases, Factual - standards
Humans
Medical Records
Perinatal care
Quality Control
Abstract
This quality assurance project was designed to determine the reliability, completeness and comprehensiveness of the data entered into Niday Perinatal Database.
Quality of the data was measured by comparing data re-abstracted from the patient record to the original data entered into the Niday Perinatal Database. A representative sample of hospitals in Ontario was selected and a random sample of 100 linked mother and newborn charts were audited for each site. A subset of 33 variables (representing 96 data fields) from the Niday dataset was chosen for re-abstraction.
Of the data fields for which Cohen's kappa statistic or intraclass correlation coefficient (ICC) was calculated, 44% showed substantial or almost perfect agreement (beyond chance). However, about 17% showed less than 95% agreement and a kappa or ICC value of less than 60% indicating only slight, fair or moderate agreement (beyond chance).
Recommendations to improve the quality of these data fields are presented.
PubMed ID
22153174 View in PubMed
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Abstracts of Perinatal Medicine 2011. June 15-17, 2011. Harrogate, United Kingdom.

https://arctichealth.org/en/permalink/ahliterature101038
Source
Arch Dis Child Fetal Neonatal Ed. 2011 Jun;96 Suppl 1:Fa1-144
Publication Type
Conference/Meeting Material
Article
Date
Jun-2011
Source
Arch Dis Child Fetal Neonatal Ed. 2011 Jun;96 Suppl 1:Fa1-144
Date
Jun-2011
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Animals
Female
Humans
Infant, Newborn
Infant, Newborn, Diseases
Perinatal care
Perinatology
Pregnancy
PubMed ID
21682005 View in PubMed
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Accessibility, continuity and appropriateness: key elements in assessing integration of perinatal services.

https://arctichealth.org/en/permalink/ahliterature183622
Source
Health Soc Care Community. 2003 Sep;11(5):397-404
Publication Type
Article
Date
Sep-2003
Author
Danielle D'Amour
Lise Goulet
Jean-François Labadie
Liette Bernier
Raynald Pineault
Author Affiliation
Faculté des sciences infirmières and Groupe de recherche interdisciplinaire en santé (GRIS), Université de Montréal, Montreal, Quebec, Canada. Danielle.damour@umontreal.ca
Source
Health Soc Care Community. 2003 Sep;11(5):397-404
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Continuity of Patient Care - statistics & numerical data
Delivery of Health Care, Integrated - statistics & numerical data
Female
Health Care Rationing - statistics & numerical data
Health Services Accessibility - statistics & numerical data
House Calls - statistics & numerical data
Humans
Infant, Newborn
Length of Stay
Patient Education as Topic - standards
Perinatal Care - statistics & numerical data
Postnatal Care - statistics & numerical data
Pregnancy
Quebec
Regional Health Planning - methods
Telemedicine - statistics & numerical data
Abstract
A trend toward the reduction in the length of hospital stays has been widely observed. This increasing shift is particularly evident in perinatal care. A stay of less than 48 hours after delivery has been shown to have no negative effects on the health of either the mother or the baby as long as they receive an adequate follow-up. This implies a close integration between hospital and community health services. The present article addresses the following questions: To what extent are postnatal services accessible to mothers and neonates? Are postnatal services in the community in continuity with those of the hospital? Are the services provided by the appropriate source of care? The authors conducted a telephone survey among 1158 mothers in a large urban area in the province of Quebec, Canada. The results were compared to clinical guidelines widely recognised by professionals. The results show serious discrepancies with these guidelines. The authors found a low accessibility to services: less than half of the mothers received a home visit by a nurse. In terms of continuity of care, less than 10% of the mothers received a follow-up telephone call within the recommended time frame and only 18% benefited from a home visit within the recommended period. Finally, despite guidelines to the contrary, hospitals continue to intervene after discharge. This results in a duplication of services for 44.7% of the new-borns. On the other hand, 40.7% are not seen in the recommended period after hospital discharge at all. These results raise concerns about the integration of services between agencies. Following earlier work, the present authors have grouped explanatory factors under four dimensions: the strategic dimension, particularly leadership; the structural dimension, including the size of the network; the technological dimension, with respect to information transmission system; and the cultural dimension, which concerns the collaboration process and the development of relationships based on trust.
PubMed ID
14498836 View in PubMed
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Application of the baby friendly hospital initiative to neonatal care: suggestions by Swedish mothers of very preterm infants.

https://arctichealth.org/en/permalink/ahliterature92578
Source
J Hum Lact. 2008 Aug;24(3):252-62
Publication Type
Article
Date
Aug-2008
Author
Nyqvist Kerstin Hedberg
Kylberg Elisabeth
Author Affiliation
Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden.
Source
J Hum Lact. 2008 Aug;24(3):252-62
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adult
Female
Guideline Adherence
Health Knowledge, Attitudes, Practice
Hospitals, Maternity - standards
Humans
Infant Care - standards
Infant, Newborn
Infant, Premature - growth & development
Mothers - psychology
Perinatal Care - standards
Social Support
Sweden
Abstract
The aim of this study was to obtain suggestions from mothers of very preterm infants regarding modification of the Baby Friendly Hospital Initiative (BFHI) 10 Steps to Successful Breastfeeding. Thirteen mothers were interviewed 2 to 6 months after their infants' discharge from the hospital. The interviews generated 13 steps, which partly agree with the BFHI steps. The new steps address respect for mothers' individual decisions about breastfeeding, education of staff in specific knowledge and skills, antenatal information about lactation in the event of preterm birth, skin-to-skin (kangaroo mother) care, breast milk expression, early introduction of breastfeeding, facilitation of mothers' 24-hour presence in the hospital, preference for mother's own milk, semi-demand feeding before transition to demand breastfeeding, special benefits of pacifier sucking, alternative strategies for reduction of supplementation, use of bottle-feeding when indicated, a family-centered and supportive physical environment, support of the father's presence, and early transfer of infants' care to parents.
PubMed ID
18689712 View in PubMed
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Are Canadian hospitals providing family-centered maternity and newborn care?

https://arctichealth.org/en/permalink/ahliterature212669
Source
Leadersh Health Serv. 1996 Mar-Apr;5(2):16-20, 46
Publication Type
Article
Author
L. Hanvey
C. Levitt
G. Chance
Source
Leadersh Health Serv. 1996 Mar-Apr;5(2):16-20, 46
Language
English
Publication Type
Article
Keywords
Canada
Cesarean Section
Communication
Delivery, obstetric - statistics & numerical data
Family
Female
Hospital-Patient Relations
Humans
Infant Care - statistics & numerical data
Infant, Newborn
Labor, Obstetric
Mother-Child Relations
Obstetrics and Gynecology Department, Hospital - organization & administration - statistics & numerical data
Organizational Policy
Perinatal Care - organization & administration - statistics & numerical data
Pregnancy
Questionnaires
Rooming-in Care - statistics & numerical data
Abstract
A philosophy of family-centered maternity and newborn care requires that there be open communication between a woman, her family and health professionals; that the woman be able to choose people to support her, and have those people present during labour and birth; and that the mother and infant remain in close contact whenever possible following birth. Using data from a 1993 survey, the authors conclude that Canadian hospitals still have a long way to go before putting these ideals into practice.
PubMed ID
10156772 View in PubMed
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Are Canadian women achieving a fit pregnancy? A pilot study.

https://arctichealth.org/en/permalink/ahliterature144465
Source
Can J Public Health. 2010 Jan-Feb;101(1):87-91
Publication Type
Article
Author
Tamara R Cohen
Hugues Plourde
Kristine G Koski
Author Affiliation
School of Dietetics and Human Nutrition, McGill University (Macdonald Campus), Ste Anne de Bellevue, QC.
Source
Can J Public Health. 2010 Jan-Feb;101(1):87-91
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Body mass index
Canada
Energy intake
Energy Metabolism
Female
Food Habits
Health Status Indicators
Health Surveys
Humans
Logistic Models
Mental Recall
Odds Ratio
Perinatal care
Physical Fitness
Pilot Projects
Pregnancy
Questionnaires
Weight Gain
Abstract
Canadian recommendations exist for energy intake (EI), physical activity (PA) and gestational weight gain (GWG) to help pregnant women avoid excessive GWG and attain "fit pregnancies". Our objectives were: 1) to measure daily EI, PA and GWG to observe whether pregnant women were meeting recommendations, 2) to explore the impact of health care provider advice on PA and GWG, and 3) to determine behaviours associated with recommended weekly GWG.
Women (n = 81) were recruited from prenatal classes. Current weight and self-reported pre-pregnancy weight were documented. Current PA levels and provider advice for PA and GWG were surveyed using questionnaires. Dietary recalls and pedometer steps were recorded for three and seven days respectively.
The majority of our women were classified as having average pre-pregnancy body mass indices (BMI) of 23.3 +/- 4 kg/m2, average EI of 2237 kcal/d and energy expenditure (EE) of 2328 kcal/d, but with weekly rates of GWG in excess of current recommendations despite having received advice about GWG (74%) and PA (73%). Most were classified as sedentary ( 8.5 MET-hr/wk.
Health care providers need to provide appropriate PA and GWG guidelines to pregnant women. Development of pregnancy step and MET-hr/wk recommendations are warranted in order to promote greater PA during pregnancy.
PubMed ID
20364546 View in PubMed
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Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

https://arctichealth.org/en/permalink/ahliterature31468
Source
BJOG. 2002 Jun;109(6):677-82
Publication Type
Article
Date
Jun-2002
Author
Birgitta Essén
Birgit Bödker
N O Sjöberg
Jens Langhoff-Roos
Gorm Greisen
Saemundur Gudmundsson
P O Ostergren
Author Affiliation
Department of Obstetrics and Gynaecology, Malmö University Hospital, Lund University, Sweden.
Source
BJOG. 2002 Jun;109(6):677-82
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Adult
Africa - ethnology
Cohort Studies
Emigration and Immigration
Female
Humans
Infant mortality
Infant, Newborn
Medical Audit
Perinatal Care - standards
Quality of Health Care
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Abstract
OBJECTIVE: To test the hypothesis that suboptimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, when compared with Swedish mothers. DESIGN: A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women. POPULATION AND SETTING: Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990-1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified. MAIN OUTCOME MEASURES: Suboptimal factors in perinatal care services, categorised as maternal, medical care and communication. RESULTS: The rate of suboptimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the odds ratio (OR) was 6.2 (95% CI 1.9-20); the OR for intrapartal deaths was 13 (95% CI 1.1-166); and the OR for neonatal deaths was 18 (95% CI 3.3-100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of intrauterine growth restriction (IUGR), inadequate medication, misinterpretation of cardiotocography (CTG) and interpersonal miscommunication. CONCLUSIONS: Suboptimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the suboptimal performance of certain health care routines in the Swedish perinatal care system.
PubMed ID
12118647 View in PubMed
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Assessment of newborn resuscitation skills of physicians with a simulator manikin.

https://arctichealth.org/en/permalink/ahliterature137839
Source
Arch Dis Child Fetal Neonatal Ed. 2011 Sep;96(5):F383-9
Publication Type
Article
Date
Sep-2011
Author
Liisa Rovamo
Minna-Maria Mattila
Sture Andersson
Per Rosenberg
Author Affiliation
Children's Hospital, Jorvi Hospital, Helsinki University Hospital, Finland. liisa.rovamo@hus.fi
Source
Arch Dis Child Fetal Neonatal Ed. 2011 Sep;96(5):F383-9
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Clinical Competence
Cohort Studies
Delivery Rooms
Education, Medical, Continuing
Educational Measurement - methods
Finland
Humans
Infant, Newborn
Manikins
Neonatology - education
Perinatal Care - standards
Resuscitation - education - standards
Abstract
Education of medical staff according to Neonatal Resuscitation Program guidelines improves outcome of delivery room resuscitation. Regular assessment of skills is important for reliable performance of neonatal resuscitation. We assessed the practical resuscitation skills of clinicians in a standard scenario in a newborn simulation.
Observational cohort study.
The resuscitation skills of 6 consultant neonatologists, 11 paediatricians and 11 anaesthesiologists were assessed in a simulation. The standard test scenario was a newborn infant with asphyxia. A 30-item checklist was used for scoring technical skills, while non-technical skills were scored using a nine-item checklist. The pass/fail score was 18.66 for technical skills. Scoring was carried out by a neonatologist/anaesthesiologist team in real time.
Two paediatricians and two anaesthesiologists failed the test. The average score was 25 for neonatologists, 22 for paediatricians and 20 for anaesthesiologists. Technical scores were compiled into four clusters for assessment of items in the same category. The scores in the ventilation cluster were lower the later the participants started ventilation, the longer they maintained pauses in ventilation, the older the baby at the time of intubation and the longer the time they used for intubation. The time intervals were checked from the video recordings. The neonatologists had better non-technical skills than the other groups. Good group-working skills correlated with high technical scores.
Many clinicians exhibited inadequate skills to resuscitate a newborn infant in a standard scenario. The neonatologists, as clinical experts, performed best in both technical and non-technical skills testing.
PubMed ID
21242245 View in PubMed
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[Assisted insemination--a risk factor in perinatal health care]

https://arctichealth.org/en/permalink/ahliterature58535
Source
Tidsskr Nor Laegeforen. 2002 Jan 30;122(3):317-8
Publication Type
Article
Date
Jan-30-2002

Association of Perinatal Risk Factors With Obsessive-Compulsive Disorder: A Population-Based Birth Cohort, Sibling Control Study.

https://arctichealth.org/en/permalink/ahliterature282263
Source
JAMA Psychiatry. 2016 Nov 01;73(11):1135-1144
Publication Type
Article
Date
Nov-01-2016
Author
Gustaf Brander
Mina Rydell
Ralf Kuja-Halkola
Lorena Fernández de la Cruz
Paul Lichtenstein
Eva Serlachius
Christian Rück
Catarina Almqvist
Brian M D'Onofrio
Henrik Larsson
David Mataix-Cols
Source
JAMA Psychiatry. 2016 Nov 01;73(11):1135-1144
Date
Nov-01-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Apgar score
Birth weight
Breech Presentation
Case-Control Studies
Cesarean Section
Cohort Studies
Epigenesis, Genetic
Female
Gene-Environment Interaction
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases - epidemiology - genetics
Male
Obsessive-Compulsive Disorder - epidemiology - etiology - genetics
Perinatal care
Pregnancy
Prenatal Exposure Delayed Effects
Retrospective Studies
Risk factors
Siblings
Sweden
Tobacco Smoke Pollution - adverse effects
Young Adult
Abstract
Perinatal complications may increase the risk of obsessive-compulsive disorder (OCD). Previous reports were based on small, retrospective, specialist clinic-based studies that were unable to rigorously control for unmeasured environmental and genetic confounding.
To prospectively investigate a wide range of potential perinatal risk factors for OCD, controlling for unmeasured factors shared between siblings in the analyses.
This population-based birth cohort study included all 2?421?284 children from singleton births in Sweden from January 1, 1973, to December 31, 1996, who were followed up through December 31, 2013. From the 1?403?651 families in the cohort, differentially exposed siblings from the 743?885 families with siblings were evaluated; of these, 11?592 families included clusters of full siblings that were discordant for OCD. Analysis of the data was conducted from January, 26, 2015, to September, 5, 2016.
Perinatal data were collected from the Swedish Medical Birth Register and included maternal smoking during pregnancy, labor presentation, obstetric delivery, gestational age (for preterm birth), birth weight, birth weight in relation to gestational age, 5-minute Apgar score, and head circumference.
Previously validated OCD codes (International Statistical Classification of Diseases and Health Related Problems, Tenth Revision, code F42) in the Swedish National Patient Register.
Of 2?421?284 individuals included in the cohort, 17?305 persons were diagnosed with OCD. Of these, 7111 were men (41.1%). The mean (SD) age of individuals at first diagnosis of OCD was 23.4 (6.5) years. An increased risk for OCD remained after controlling for shared familial confounders and measured covariates (including sex, year of birth, maternal and paternal age at birth, and parity), for smoking 10 or more cigarettes per day during pregnancy (hazard ratio [HR], 1.27; 95% CI, 1.02-1.58), breech presentation (HR, 1.35; 95% CI, 1.06-1.71), delivery by cesarean section (HR, 1.17; 95% CI, 1.01-1.34), preterm birth (HR, 1.24; 95% CI, 1.07-1.43), birth weight 1501 to 2500 g (HR, 1.30; 95% CI, 1.05-1.62) and 2501 to 3500 g (HR, 1.08; 95% CI, 1.01-1.16), being large for gestational age (HR, 1.23; 95% CI, 1.05-1.45), and Apgar distress scores at 5 minutes (HR, 1.50; 95% CI, 1.07-2.09). Gestational age and birth weight followed inverse dose-response associations, whereby an increasingly higher risk for OCD was noted in children with a shorter gestational age and lower birth weight. We also observed a dose-response association between the number of perinatal events and increased OCD risk, with HRs ranging from 1.11 (95% CI, 1.07-1.15) for 1 event to 1.51 (95% CI, 1.18-1.94) for 5 or more events.
A range of perinatal risk factors is associated with a higher risk for OCD independent of shared familial confounders, suggesting that perinatal risk factors may be in the causal pathway to OCD.
PubMed ID
27706475 View in PubMed
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206 records – page 1 of 21.