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The wrapping of the newborn in an orthopedic tubular mesh, simulating a cocoon, can allow the infant to regain the feeling of security and stability experienced in the uterus given that the movement of one of the parts of the body exerts tactile and pressure variation in others. We aimed to evaluate the influence of an orthopedic tubular mesh, simulating a cocoon, in therapeutic positioning, on the variables of the autonomous, motor, and regulatory systems of preterm newborns. A controlled and randomized clinical trial was conducted with preterm newborns positioned in dorsal decubitus and divided into two groups: (a) cocoon – newborns covered with an orthopedic tubular mesh, and (b) control – newborns positioned according to the sector's routine and without the use of an orthopedic mesh. During the follow-up, each newborn was placed in the position for 30 min and was recorded for a total of 2 min, once at the beginning and again at the end of the observation period. Variables related to the autonomous system (heart rate, respiratory rate, and peripheral oxygen saturation), motor system (general movements), and regulatory system (Neonatal Infant Pain Scale) were evaluated before and after the intervention. The videos were evaluated by a researcher blind to the purpose of the study, and the resulting data were analyzed using SPSS. Of the 40 preterm newborns evaluated (32.5 ± 1.83 weeks), 21 were female, and 20 were allocated to the cocoon group. The variables related to the autonomous, motor, and regulatory systems remained unchanged following the positioning in the cocoon, as compared to the typical positioning employed in the neonatal unit. The simulation of a cocoon, utilizing an orthopedic tubular mesh, when applied to preterm newborns admitted to a neonatal intensive care unit can contribute to maintaining low levels of stress, without altering variables of the autonomous, motor, and regulatory systems. [ABSTRACT FROM AUTHOR]

Abstract Introduction Recent publications report a decrease in the age of onset of pubertal changes in the United States and Europe. The PROSPEL study (PRemier Observatoire des Stades Pubertaire en Libéral) will provide the first French data on the age at which pubertal signs appear. Before considering this work at the national level, we wanted to assess its feasibility. Materials and methods Private pediatricians and general practitioners were recruited in Bordeaux and Toulouse. Before participating in the study, they had been trained in pubertal assessment and then evaluated. Each physician completed 1–4 weeks of inclusion during which children aged 5–18 years seen in consultation were included, except children who were adopted or had a chronic condition. Pubertal stages were assessed according to Tanner's classification and using an orchidometer for testicular volume. The causes of non-realization were documented where appropriate. Inter-individual reproducibility was analyzed by a double examination for a number of children who had previously given their consent. Results In total, 63 physicians participated in the study (35 pediatricians and 28 general practitioners). All were certified at the end of the training session. A total of 2646 children were included (1318 girls, 1328 boys) with a homogeneous age distribution. The study was carried out in 83.5% of cases. The main reason for non-realization was that physicians did not propose the study to patients who met the criteria (10.1%). Lack of time was the main reason. Inter-individual reproducibility was excellent. Discussion and conclusion Our results attest to the good feasibility of the PROSPEL study. They allowed us to validate our methodology, the training and certification of the participating physicians, and to consider extending the study to the national level. [ABSTRACT FROM AUTHOR]