126 results on '"O'Brien, Karel"'
Search Results
2. Supporting parents as essential care partners in neonatal units during the SARS-CoV-2 pandemic.
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van Veenendaal, Nicole R, Deierl, Aniko, Bacchini, Fabiana, O'Brien, Karel, Franck, Linda S, and International Steering Committee for Family Integrated Care
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International Steering Committee for Family Integrated Care ,Humans ,Parents ,Infant ,Newborn ,Caregivers ,Pandemics ,COVID-19 ,SARS-CoV-2 ,family centred care ,family integrated care ,neonatal ,parent ,Pediatrics ,Paediatrics and Reproductive Medicine - Abstract
AimTo review the evidence on safety of maintaining family integrated care practices and the effects of restricting parental participation in neonatal care during the SARS-CoV-2 pandemic.MethodsMEDLINE, EMBASE, PsycINFO and CINAHL databases were searched from inception to the 14th of October 2020. Records were included if they reported scientific, empirical research (qualitative, quantitative or mixed methods) on the effects of restricting or promoting family integrated care practices for parents of hospitalised neonates during the SARS-CoV-2 pandemic. Two authors independently screened abstracts, appraised study quality and extracted study and outcome data.ResultsWe retrieved 803 publications and assessed 75 full-text articles. Seven studies were included, reporting data on 854 healthcare professionals, 442 parents, 364 neonates and 26 other family members, within 286 neonatal units globally. The pandemic response resulted in significant changes in neonatal unit policies and restricting parents' access and participation in neonatal care. Breastfeeding, parental bonding, participation in caregiving, parental mental health and staff stress were negatively impacted.ConclusionThis review highlights that SARS-CoV-2 pandemic-related hospital restrictions had adverse effects on care delivery and outcomes for neonates, families and staff. Recommendations for restoring essential family integrated care practices are discussed.
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- 2021
3. Neonatal and Early Childhood Outcomes of Twin and Singleton Infants Born Preterm
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Shah, Prakesh S., Beltempo, Marc, Kanungo, Jaideep, Wong, Jonathan, Stavel, Miroslav, Sherlock, Rebecca, Mehrem, Ayman Abou, Toye, Jennifer, Ting, Joseph, Fajardo, Carlos, Bodani, Jaya, Strueby, Lannae, Seshia, Mary, Louis, Deepak, Alvaro, Ruben, Mukerji, Amit, Da Silva, Orlando, Augustine, Sajit, Lee, Kyong-Soon, Ng, Eugene, Lemyre, Brigitte, Daboval, Thierry, Khurshid, Faiza, Bizgu, Victoria, Barrington, Keith, Lapointe, Anie, Ethier, Guillaume, Drolet, Christine, Piedboeuf, Bruno, Claveau, Martine, St-Hilaire, Marie, Bertelle, Valerie, Masse, Edith, Mehdizadeh-Hakak, Hamid, Makary, Hala, Ojah, Cecil, Hudson, Jo-Anna, Afifi, Jehier, Aslam, Ameer, Lee, Shoo K., Abenhaim, Haim, Andrews, James, Armson, Anthony, Audibert, Francois, Aziz, Khalid, Ballantyne, Marilyn, Barrett, Jon, Berard, Anick, Blais, Lucie, Bocking, Alan, Burrows, Jason, Butt, Kimberly, Canning, Roderick, Carson, George, Chaillet, Nils, Chandra, Sue, Church, Paige, Cieslak, Zenon, Coughlin, Kevin, Crane, Joan, Creighton, Dianne, Dahlgren, Leanne, Daspal, Sibasis, de Cabo, Cecilia, Deshpandey, Akhil, Dow, Kimberly, Dunn, Michael, Helou, Salhab el, El-Chaar, Darine, El-Naggar, Walid, Foster, Jonathan, Gagnon, Robert, Gratton, Rob, Han, Victor, Harrison, Adele, Hasan, Shabih, Helewa, Michael, Hicks, Matthew, Joseph, K.S., Kajetanowicz, Andrzej, Kalapesi, Zarin, Khairy, May, Lacaze-Masmonteil, Thierry, Lodha, Abhay, Luu, Thuy Mai, Ly, Linh, Majnemer, Annette, Marc, Isabelle, McDonald, Sarah D., McMillan, Doug, Melamed, Nir, Metcalfe, Amy, Moddemann, Diane, Monterrosa, Luis, Morais, Michelle, Mundle, William, Murphy, Lynn, Murphy, Kellie, Nuyt, Anne-Monique, Nwaesei, Chuks, O'Brien, Karel, Offringa, Martin, Ouellet, Annie, Pasquier, Jean-Charles, Pechlivanoglou, Petros, Pelausa, Ermelinda, Portales-Casamar, Elodie, Premji, Shahirose, Puligandla, Pramod, Pullenayegum, Eleanor, Reichert, Amber, Robson, Kate, Schneider, Carol, Shah, Vibhuti, Shivananda, Sandesh, Singhal, Nalini, Skarsgard, Erik, Skoll, Amanda, Smith, Graeme, Synnes, Anne, Thériault, Katherine, Tough, Suzanne, Ubhi, Jagdeep, Vincer, Michael, Whittle, Wendy, Whyte, Hilary, Wilson, Doug, Wood, Stephen, Ye, Philip, Yee, Wendy, Zwicker, Jill, Pillay, Thevanisha, Synnes’, Anne, Colby, Lindsay, Anson, Shelagh, Moodley, Anitha, Hendson, Leonora, Ricci, M. Florencia, McKnight, Sarah, Kelly, Edmond, Raghuram, Kamini, Thomas, Karen, Banihani, Rudaina, Nguyen, Kim-Anh, Mandel, Ruth, Morin, Alyssa, Bélanger, Sylvie, Weitzner, Omer, and Yang, Junmin
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- 2023
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4. Hospitalising preterm infants in single family rooms versus open bay units: A systematic review and meta-analysis of impact on parents.
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van Veenendaal, Nicole R, van Kempen, Anne AMW, Franck, Linda S, O'Brien, Karel, Limpens, Jacqueline, van der Lee, Johanna H, van Goudoever, Johannes B, and van der Schoor, Sophie RD
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AA ,at admission ,BA ,before-after study ,BDI ,Beck Depression Inventory ,CI ,confidence interval ,EPDS ,Edinburgh Postnatal Depression Scale ,FCC ,Family-Centred Care ,FCCS ,Family-Centred Care Survey ,MPAS ,Maternal Postnatal Attachment Scale ,Mo ,months ,NA ,not applicable ,NICU ,Neonatal Intensive Care Unit ,NR ,not reported ,NRPI ,non-randomised prospective intervention study ,NRRI ,non-randomised retrospective intervention study ,OBU ,Open Bay Unit ,PES ,Parent Expectations Scale ,PG ,Press Ganey NICU Survey ,PRISMA ,Preferred Reporting Items for Systematic Reviews and Meta-analysis ,PROSPERO ,International Prospective Register of Systematic Reviews ,PSI ,Parental Stress Index ,PSS-NICU ,Parental Stressor Scale – NICU ,RCT ,Randomised Controlled Trial ,ROBINS-I ,Risk of Bias in Non-randomised Studies of Interventions ,RoB ,Risk of Bias ,SD ,standard deviation ,SFR ,Single Family Room ,SMD ,standardised mean difference ,SPSQ ,Swedish Parental Stress Index ,STAI ,State-Trait Anxiety Inventory ,Wks ,weeks ,AA ,at admission ,BA ,before-after study ,BDI ,Beck Depression Inventory ,CI ,confidence interval ,EPDS ,Edinburgh Postnatal Depression Scale ,FCC ,Family-Centred Care ,FCCS ,Family-Centred Care Survey ,MPAS ,Maternal Postnatal Attachment Scale ,Mo ,months ,NA ,not applicable ,NICU ,Neonatal Intensive Care Unit ,NR ,not reported ,NRPI ,non-randomised prospective intervention study ,NRRI ,non-randomised retrospective intervention study ,OBU ,Open Bay Unit ,PES ,Parent Expectations Scale ,PG ,Press Ganey NICU Survey ,PRISMA ,Preferred Reporting Items for Systematic Reviews and Meta-analysis ,PROSPERO ,International Prospective Register of Systematic Reviews ,PSI ,Parental Stress Index ,PSS-NICU ,Parental Stressor Scale – NICU ,RCT ,Randomised Controlled Trial ,ROBINS-I ,Risk of Bias in Non-randomised Studies of Interventions ,RoB ,Risk of Bias ,SD ,standard deviation ,SFR ,Single Family Room ,SMD ,standardised mean difference ,SPSQ ,Swedish Parental Stress Index ,STAI ,State-Trait Anxiety Inventory ,Wks ,weeks - Abstract
BackgroundMany parents develop stress-related symptoms and depression when their preterm infant is hospitalised in the neonatal intensive care unit (NICU) after birth. We reviewed the evidence of parent well-being with preterm infants hospitalised in single family rooms (SFRs) or in open bay neonatal units (OBUs).MethodsFor this systematic review and meta-analysis, we searched MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Clinicaltrials.gov, and International Clinical Trials Registry Platform (ICTRP) databases from inception through 22 November 2019 using controlled terms and text words related to prematurity and NICU-design. We included randomised and non-randomised studies comparing outcomes in parents with preterm infants admitted to SFRs or OBUs. Methodological quality was assessed using Cochrane Collaboration's Risk of Bias Tool for randomised controlled trials and the Risk of Bias Tool for Non-Randomised Studies of Interventions (ROBINS-I). Outcomes included: parental stress, satisfaction, participation (presence/involvement/skin-to-skin care), self-efficacy, parent-infant-bonding, depression, anxiety, post-traumatic stress, empowerment, and degree of family-centred care. Summary estimates were calculated using random effects models with standardised mean differences (SMDs). PROSPERO registration: CRD42016050643.FindingsWe identified 614 unique publications. Eleven study populations (1, 850 preterm infants, 1, 549 mothers and 379 fathers) were included. All but one study were at serious to critical risk of bias. SFRs were associated with higher levels of parental presence, involvement, and skin-to-skin care. Upon discharge, SFRs were associated with lower stress levels (n = 828 parents, SMD-0·30,95%CI -0·50;-0·09, p
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- 2020
5. Facilitators and constraints to family integrated care in low‐resource settings informed the adaptation in Uganda.
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Kabajassi, Olive, Reiter, Anna, Tagoola, Abner, Kenya‐Mugisha, Nathan, O'Brien, Karel, Wiens, Matthew O., Feeley, Nancy, and Duby, Jessica
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RESOURCE-limited settings ,MEDICAL personnel ,TASK shifting ,NEONATAL intensive care units ,HIGH-income countries - Abstract
Aim: Family Integrated Care (FICare) was developed in high‐income countries and has not been tested in resource‐poor settings. We aimed to identify the facilitators and constraints that informed the adaptation of FICare to a neonatal hospital unit in Uganda. Methods: Maternal focus groups and healthcare provider interviews were conducted at Uganda's Jinja Regional Referral Hospital in 2020. Transcripts were analysed using inductive content analysis. An adaptation team developed Uganda FICare based on the identified facilitators and constraints. Results: Participants included 10 mothers (median age 28 years) and eight healthcare providers (seven female, median age 41 years). Reducing healthcare provider workload, improving neonatal outcomes and empowering mothers were identified as facilitators. Maternal stress, maternal difficulties in learning new skills and mistrust of mothers by healthcare providers were cited as constraints. Uganda FICare focused on task‐shifting important but neglected patient care tasks from healthcare providers to mothers. Healthcare providers learned how to respond to maternal concerns. Intervention material was adapted to prioritise images over text. Mothers familiar with FICare provided peer‐to‐peer support to other mothers. Conclusion: Uganda FICare shares the core values of FICare but was adapted to be feasible in low‐resource settings. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Rates and Determinants of Mother’s Own Milk Feeding in Infants Born Very Preterm
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Abenhaim, Haim, Afifi, Jehier, Alvaro, Ruben, Andrews, James, Armson, Anthony, Audibert, Francois, Aziz, Khalid, Ballantyne, Marilyn, Barrett, Jon, Beltempo, Marc, Berard, Anick, Bertelle, Valerie, Blais, Lucie, Bocking, Alan, Bodani, Jaya, Burrows, Jason, Butt, Kimberly, Canning, Roderick, Carson, George, Chaillet, Nils, Chandra, Sue, Church, Paige, Cieslak, Zenon, Coughlin, Kevin, Crane, Joan, Creighton, Dianne, Da Silva, Orlando, Daboval, Thierry, Dahlgren, Leanne, Daspal, Sibasis, de Cabo, Cecilia, Deshpandey, Akhil, Dow, Kimberly, Drolet, Christine, Dunn, Michael, el Helou, Salhab, El-Chaar, Darine, El-Naggar, Walid, Fajardo, Carlos, Foster, Jonathan, Gagnon, Robert, Gratton, Rob, Han, Victor, Harrison, Adele, Hasan, Shabih, Helewa, Michael, Hicks, Matthew, Joseph, K.S., Kajetanowicz, Andrzej, Kalapesi, Zarin, Khairy, May, Lacaze-Masmonteil, Thierry, Lee, Kyong-Soon, Lemyre, Brigitte, Lodha, Abhay, Louis, Deepak, Mai Luu, Thuy, Ly, Linh, Majnemer, Annette, Makary, Hala, Marc, Isabelle, Masse, Edith, McDonald, Sarah D., McMillan, Doug, Melamed, Nir, Metcalfe, Amy, Moddemann, Diane, Monterrosa, Luis, Morais, Michelle, Mukerji, Amit, Mundle, William, Murphy, Lynn, Murphy, Kellie, Nuyt, Anne-Monique, Nwaesei, Chuks, O’Brien, Karel, Offringa, Martin, Ojah, Cecil, Ouellet, Annie, Pasquier, Jean-Charles, Pechlivanoglou, Petros, Pelausa, Ermelinda, Piedboeuf, Bruno, Portales-Casamar, Elodie, Premji, Shahirose, Puligandla, Pramod, Pullenayegum, Eleanor, Reichert, Amber, Schneider, Carol, Seshia, Mary, Shah, Prakesh S., Shah, Vibhuti, Sherlock, Rebecca, Shivananda, Sandesh, Singhal, Nalini, Skarsgard, Erik, Skoll, Amanda, Smith, Graeme, Synnes, Anne, Thériault, Katherine, Ting, Joseph, Tough, Suzanne, Toye, Jennifer, Ubhi, Jagdeep, Vincer, Michael, Whittle, Wendy, Whyte, Hilary, Wilson, Doug, Wood, Stephen, Ye, Philip, Yee, Wendy, Zwicker, Jill, Dharel, Dinesh, Wood, Christel, Bacchini, Fabiana, Ye, Xiang Y., and Alshaikh, Belal
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- 2021
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7. Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth
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Abenhaim, Haim, Afifi, Jehier, Alvaro, Ruben, Andrews, James, Armson, Anthony, Audibert, Francois, Aziz, Khalid, Ballantyne, Marilyn, Barrett, Jon, Berard, Anick, Bertelle, Valerie, Blais, Lucie, Bocking, Alan, Bodani, Jaya, Burrows, Jason, Butt, Kimberly, Canning, Roderick, Carson, George, Chaillet, Nils, Chandra, Sue, Church, Paige, Cieslak, Zenon, Crane, Joan, Creighton, Dianne, Da Silva, Orlando, Daboval, Thierry, Dahlgren, Leanne, Daspal, Sibasis, de Cabo, Cecilia, Deshpandey, Akhil, Dow, Kimberly, Drolet, Christine, Dunn, Michael, Salhab el Helou, El-Chaar, Darine, El-Naggar, Walid, Fajardo, Carlos, Gagnon, Robert, Gratton, Rob, Han, Victor, Harrison, Adele, Hasan, Shabih, Helewa, Michael, Hicks, Matthew, Joseph, K.S., Kajetanowicz, Andrzej, Kalapesi, Zarin, Khairy, May, Lacaze-Masmonteil, Thierry, Lee, Kyong-Soon, Lemyre, Brigitte, Lodha, Abhay, Mai Luu, Thuy, Ly, Linh, Majnemer, Annette, Makary, Hala, Marc, Isabelle, Masse, Edith, McDonald, Sarah D., McMillan, Doug, Melamed, Nir, Metcalfe, Amy, Moddemann, Diane, Monterrosa, Luis, Morais, Michelle, Mundle, William, Murphy, Lynn, Murphy, Kellie, Nuyt, Anne-Monique, Nwaesei, Chuks, O’Brien, Karel, Offringa, Martin, Ojah, Cecil, Ouellet, Annie, Pasquier, Jean-Charles, Pelausa, Ermelinda, Piedboeuf, Bruno, Portales-Casamar, Elodie, Puligandla, Pramod, Pullenayegum, Eleanor, Reichert, Amber, Robson, Kate, Schneider, Carol, Seshia, Mary, Shah, Prakesh S., Sherlock, Rebecca, Shivananda, Sandesh, Singhal, Nalini, Skarsgard, Erik, Skoll, Amanda, Smith, Graeme, Synnes, Anne, Thériault, Katherine, Ting, Joseph, Tough, Suzanne, Toye, Jennifer, Ubhi, Jagdeep, Vincer, Michael, Whittle, Wendy, Whyte, Hilary, Wilson, Doug, Wood, Stephen, Ye, Philip, Yee, Wendy, Zwicker, Jill, Jaideep Kanungo, Mehrem, Ayman Abou, Sankaran, Koravangattu, Adie, Mohammad, Khurshid, Faiza, Barrington, Keith, Lapoint, Anie, Ethier, Guillaume, Claveau, Martine, Emberley, Julie, Rios, Juan D., Beltempo, Marc, Louis, Deepak, Mukerji, Amit, Premji, Shahirose, Shah, Vibhuti, Lee, Shoo K., and Pechlivanoglou, Petros
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- 2021
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8. Skin-to-skin care (SSC) for term and preterm infants.
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Altit, Gabriel, Hamilton, Danica, and O'Brien, Karel
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INFECTION prevention ,BREASTFEEDING ,MEDICAL protocols ,PARENTS ,CARDIOPULMONARY system physiology ,HYPOTHERMIA ,MENTAL health ,INFANT mortality ,BODY temperature regulation ,NEURAL development ,POSTNATAL care ,BREAST milk ,HUMAN microbiota ,INFANT care ,REACTIVE oxygen species ,OXYGEN in the body ,HEART beat ,SURGICAL complications ,PAIN ,PSYCHOLOGICAL stress ,PARENT-infant relationships ,IMMUNITY ,NEURAL tube defects - Abstract
Skin-to-skin care (SSC) is an important part of parent and infant care during the neonatal period and into infancy. SSC should be initiated immediately after birth and practiced as a standard of care in all settings, as well as in the home. There is strong evidence that SSC has a positive effect on breastfeeding and human milk feeding in both term and preterm infants, as well as on mortality, cardiopulmonary stability, and thermoregulation. SSC reduces pain and infant stress, enhances parent–infant bonding, has neurodevelopmental benefits, and has positive effects on parental mental health. The safety and feasibility of providing SSC has been established in term and preterm infants, and SSC is recommended as best practice for all infants. The benefits of SSC outweigh the risks in most situations, and despite challenges, care providers should implement procedures and accommodations to ensure that SSC occurs as a safe and positive experience for the parent, family, infant, and health care team. This statement includes all families as defined and determined by themselves, and recognizes that health communication, language, and terminology must be individualized to meet specific family needs by the health care team. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Les soins peau-à-peau chez les nourrissons à terme et prématurés.
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Altit, Gabriel, Hamilton, Danica, and O'Brien, Karel
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Les soins peau-à-peau (SPP) sont un aspect important des soins au parent et au nourrisson pendant la période néonatale et la première enfance. Ils doivent être entrepris immédiatement après la naissance et faire partie des soins standards dans tous les milieux, y compris à la maison. Selon de solides données probantes, les SPP ont un effet positif sur l'allaitement et l'alimentation par du lait humain, tant chez les nourrissons à terme que prématurés, de même que sur la mortalité, la stabilité cardiorespiratoire et la thermorégulation. Les SPP réduisent la douleur et le stress chez les nourrissons, accroissent l'attachement entre le parent et son nourrisson et ont des effets bénéfiques sur le neurodéveloppement de l'enfant ainsi que sur la santé mentale des parents. Le caractère sécuritaire et la faisabilité des SPP sont établis chez les nourrissons à terme et prématurés, et ces soins sont recommandés dans le cadre d'une pratique exemplaire auprès de tous les nourrissons. Les avantages des SPP sont supérieurs aux risques dans la plupart des situations, et malgré les défis qui y sont associés, les dispensateurs de soins devraient adopter des protocoles et prévoir des adaptations pour s'assurer que les SPP soient une expérience positive et sécuritaire pour le parent, la famille, le nourrisson et l'équipe soignante. Le présent document de principes s'adresse à toutes les familles, telles qu'elles se définissent et se déterminent elles-mêmes, et tiennent compte de l'importance de personnaliser la communication, le langage et la terminologie en matière de santé pour que l'équipe soignante réponde aux besoins particuliers de la famille. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Family Integrated Care for Preterm Infants
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Franck, Linda S., Waddington, Chandra, and O’Brien, Karel
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- 2020
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11. Hospitalising preterm infants in single family rooms versus open bay units: A systematic review and meta-analysis of impact on parents
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van Veenendaal, Nicole R., van Kempen, Anne A.M.W., Franck, Linda S., O'Brien, Karel, Limpens, Jacqueline, van der Lee, Johanna H., van Goudoever, Johannes B., and van der Schoor, Sophie R.D.
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- 2020
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12. Early-Onset Invasive Candidiasis in Extremely Low Birth Weight Infants: Perinatal Acquisition Predicts Poor Outcome
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Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC), Barton, Michelle, Shen, Alex, O'Brien, Karel, Robinson, Joan L., Davies, H. Dele, Simpson, Kim, Asztalos, Elizabeth, Langley, Joanne, Le Saux, Nicole, Sauve, Reginald, Synnes, Anne, Tan, Ben, de Repentigny, Louis, Rubin, Earl, Hui, Chuck, Kovacs, Lajos, Yau, Yvonne C. W., and Richardson, Susan E.
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- 2017
13. Healthcare professionals' perceptions of pain in infants at risk for neurological impairment
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Breau, Lynn M, McGrath, Patrick J, Stevens, Bonnie, Beyene, Joseph, Camfield, Carol S, Finley, G Allen, Franck, Linda, Howlett, Alexandra, O'Brien, Karel, and Ohlsson, Arne
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Chronic Pain ,Infant Mortality ,Clinical Research ,Pediatric ,Perinatal Period - Conditions Originating in Perinatal Period ,Neurosciences ,Pain Research ,Neurological ,Adult ,Analysis of Variance ,Attitude of Health Personnel ,Canada ,Empathy ,Female ,Health Knowledge ,Attitudes ,Practice ,Humans ,Infant Care ,Infant ,Newborn ,Intensive Care Units ,Neonatal ,Judgment ,Male ,Middle Aged ,Nervous System Diseases ,Pain ,Pain Measurement ,Personnel ,Hospital ,Risk Assessment ,Workforce ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
BackgroundTo determine whether healthcare professionals perceive the pain of infants differently due to their understanding of that infant's level of risk for neurological impairment.MethodNeonatal Intensive Care Units (NICU's) at two tertiary pediatric centers. Ninety-five healthcare professionals who practice in the NICU (50 nurses, 19 physicians, 17 respiratory therapists, 9 other) participated. They rated the pain (0-10 scale and 0-6 Faces Pain Scale), distress (0-10), effectiveness of cuddling to relieve pain (0-10) and time to calm without intervention (seconds) for nine video clips of neonates receiving a heel stick. Prior to each rating, they were provided with descriptions that suggested the infant had mild, moderate or severe risk for neurological impairment. Ratings were examined as a function of the level of risk described.ResultsProfessionals' ratings of pain, distress, and time to calm did not vary significantly with level of risk, but ratings of the effectiveness of cuddling were significantly lower as risk increased [F (2,93) = 4.4, p = .02]. No differences in ratings were found due to participants' age, gender or site of study. Physicians' ratings were significantly lower than nurses' across ratings.ConclusionProfessionals provided with visual information regarding an infants' pain during a procedure did not display the belief that infants' level of risk for neurological impairment affected their pain experience. Professionals' estimates of the effectiveness of a nonpharmacological intervention did differ due to level of risk.
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- 2004
14. Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants
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Schmidt, Barbara, D'Ilario, Judy, Cairnie, Janice, Dix, Joanne, Adams, Beth Anne, Warriner, Erin, Marie Kim, Mee-Hai, Anderson, Peter, Davis, Peter, Doyle, Lex, Argus, Brenda, Callanan, Catherine, Davis, Noni, Duff, Julianne, McDonald, Marion, Asztalos, Elizabeth, Hohn, Denise, Lacy, Maralyn, Haslam, Ross, Barnett, Christopher, Goodchild, Louise, Lontis, Rosslyn Marie, Fraser, Simon, Keng, Julie, Saunders, Kerryn, Opie, Gillian, Kelly, Elaine, Woods, Heather, Marchant, Emma, Turner, Anne-Marie, Magrath, Emma, Williamson, Amanda, Bairam, Aida, Bélanger, Sylvie, Fraser, Annie, Blayney, Marc, Lemyre, Brigitte, Frank, Jane, Solimano, Alfonso, Synnes, Anne, Grunau, Ruth E., Hubber-Richard, Philippa, Rogers, Marilyn, Mackay, Margot, Petrie-Thomas, Julianne, Butt, Arsalan, van Wassenaer, Aleid, Nuytemans, Debbie, Houtzager, Bregje, van Sonderen, Loekie, Regev, Rivka, Itzchack, Netter, Arnon, Shmuel, Chalaf, Adiba, Ohlsson, Arne, O'Brien, Karel, Hamilton, Anne-Marie, Chan, May Lee, Sankaran, Koravangattu, Proctor, Pat, Golan, Agneta, Goldsch-Lerman, Esther, Reynolds, Graham, Dromgool, Barbara, Meskell, Sandra, Parr, Vanessa, Maher, Catherine, Broom, Margaret, Kecskes, Zsuzsoka, Ringland, Cathy, McMillan, Douglas, Spellen, Elizabeth, Sauve, Reginald S., Christianson, Heather, Anseeuw-Deeks, Deborah, Creighton, Dianne, Heath, Jennifer, Alvaro, Ruben, Chiu, Aaron, Porter, Ceceile, Turner, Gloria, Moddemann, Diane, Granke, Naomi, Penner, Karen, Bow, Jane, Mulder, Antonius, Wassenberg, Renske, van der Hoeven, Markus, Clarke, Maxine, Parfitt, Judy, Parker, Kevin, Nwaesei, Chukwuma, Ryan, Heather, Saunders, Cory, Schulze, Andreas, Wermuth, Inga, Hilgendorff, Anne, Flemmer, Andreas W., Herlenius, Eric, Legnevall, Lena, Lagercrantz, Hugo, Matthew, Derek, Amos, Wendy, Tulsiani, Suresh, Tan-Dy, Cherrie, Turner, Marilyn, Phelan, Constance, Shinwell, Eric S., Levine, Michael, Juster-Reicher, Ada, Khairy, May, Grier, Patricia, Vachon, Julie, Perepolkin, Larissa, Barrington, Keith J., Sinha, Sunil Kumar, Tin, Win, Fritz, Susan, Walti, Herve, Royer, Diane, Halliday, Henry, Millar, David, Mayes, Clifford, McCusker, Christopher, McLaughlin, Olivia, Fahnenstich, Hubert, Tillmann, Bettina, Weber, Peter, Wariyar, Unni, Embleton, Nicholas, Swamy, Ravi, Bucher, Hans U., Fauchere, Jean-Claude, Dietz, Vera, Harikumar, Chidambara, Anderson, Peter J., Asztalos, Elizabeth V., Davis, Peter G., Dewey, Deborah, Doyle, Lex W., Roberts, Robin S., Gent, Michael, Fraser, William, Hey, Edmund, Perlman, Max, Thorpe, Kevin, Gray, Shari, Chambers, Carole, Costantini, Lorrie, Yacura, Wendy, McGean, Erin, and Scapinello, Lori
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- 2015
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15. Building Connections with Families: Implementation of a Video-Messaging Service in the Neonatal Intensive Care Unit.
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Bott, Stephanie, Dantas Fernandez, Nicole, Narciso, Janet, MacAlpine, Janet, Quain, Nicole, Rettie, Julia, Sharpe, Lia, Diambomba, Yenge, Al Bizri, Ayah, O'Brien, Karel, and Shah, Vibhuti
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PARENT attitudes ,NEONATAL intensive care ,SCIENTIFIC observation ,ACADEMIC medical centers ,CONFIDENCE intervals ,COMPUTERS ,WORK ,ATTITUDES of medical personnel ,NEONATAL intensive care units ,MEDICAL personnel ,TERTIARY care ,HUMAN services programs ,PATIENTS' families ,WORKFLOW ,INSTANT messaging ,EXPERIENTIAL learning ,QUESTIONNAIRES ,SCALE analysis (Psychology) ,DESCRIPTIVE statistics ,RESEARCH funding ,DATA analysis software ,LOGISTIC regression analysis ,ODDS ratio ,VIDEO recording ,PORTABLE computers ,VOLUNTEER service - Abstract
Background: Family involvement is vital to optimize the care of infants in the neonatal intensive care unit (NICU). Various technologies have been used to support communication with parents in the NICU. The purpose of this study was to evaluate the parent and staff experience and perception of the use of a cloud-based video-messaging service in our NICU. Methods: This study was a single center observational study conducted at Mount Sinai Hospital, Toronto, Canada. Following the implementation of a video-messaging service, parent and staff surveys were distributed to evaluate their experience and perception. Results: Parent responses were positive with respect to how the service helped them feel: closer to their infant (100%) and reassured about their infant's care (100%). Nursing staff responses indicated that they perceived a benefit to parents (100%) and to their building a relationship with families (79%). However, they also identified time constraints (85%) and the use of the technology hardware (24%) as challenges. Conclusions: The use of an asynchronous video-messaging service was perceived as beneficial to both parents and staff in the NICU. Complaints pertained to the impact of the technology on nursing workflow and the difficulty using the hardware provided for use of the service. [ABSTRACT FROM AUTHOR]
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- 2023
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16. A Pilot Study of Family-Integrated Care (FICare) in Critically Ill Preterm and Term Infants in the NICU: FICare Plus.
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Ansari, Najmus Sehr, Franck, Linda S., Tomlinson, Christopher, Colucci, Anna, and O'Brien, Karel
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PILOT projects ,SAFETY ,PREMATURE infants ,NEONATAL intensive care ,AUGMENTED reality ,MENTAL health ,NEONATAL intensive care units ,HEALTH outcome assessment ,PARENTING ,FAMILY-centered care ,RESEARCH funding ,DESCRIPTIVE statistics ,CHI-squared test ,INTEGRATED health care delivery ,LONGITUDINAL method ,COVID-19 pandemic ,PSYCHOSOCIAL factors - Abstract
Family-integrated care (FICare) is associated with improved developmental outcomes and decreased parental mental health risks in stable preterm infants. However, less is known about its application in critically ill infants who are at greater risk for adverse outcomes. The objective of this study was to assess the safety and feasibility of implementation of an augmented FICare program, FICare Plus, in critically ill infants in the first few weeks of life. Resources were specifically developed for staff and parents to support earlier parental engagement in infant care. Infant health outcomes and standardized measures of parental stress, anxiety and parenting self-efficacy were also collected using standardized questionnaires: State -Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS: NICU), Perceived Parenting Self-Efficacy Tool and Family Centered Care Survey. The t-test or Wilcoxon rank-sum test were used to compare continuous variables, while the Chi-square or Fisher exact test were used for categorical variables, respectively. In this prospective cohort study, 41 critically ill infants were enrolled: 17 in standard care (SC) and 24 in the FICare Plus group. The tools and procedures developed for FICare Plus successfully supported greater engagement in the care of their infants with no increase in adverse events and no increase in parental stress. Parents in the FICare Plus cohort felt confident to participate in their infant's care. The staff also found this model of care acceptable and well adopted. Preliminary measures of infant efficacy were similar in both groups. Total anxiety scores were high among all parents at enrollment (87 (67–94) vs. 70.5 (66–86); p-value 0.22). However, the scores prior to discharge were lower in FICare Plus group (78 (71–90) vs. 63 (52–74.5); p-value 0.02). This pilot study showed that it is feasible and safe to implement family-integrated care in critically ill infants. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Social Variables Predict Gains in Cognitive Scores across the Preschool Years in Children with Birth Weights 500 to 1250 Grams
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Schmidt, Barbara, D'Ilario, Judy, Cairnie, Janice, Dix, Joanne, Anne Adams, Beth, Warriner, Erin, Kim, Mee-Hai Marie, Anderson, Peter, Davis, Peter, Doyle, Lex, Argus, Brenda, Callanan, Catherine, Davis, Noni, Duff, Julianne, McDonald, Marion, Asztalos, Elizabeth, Hohn, Denise, Lacy, Maralyn, Haslam, Ross, Barnett, Christopher, Goodchild, Louise, Lontis, Rosslyn Marie, Fraser, Simon, Keng, Julie, Saunders, Kerryn, Opie, Gillian, Kelly, Elaine, Woods, Heather, Marchant, Emma, Turner, Anne-Marie, Magrath, Emma, Williamson, Amanda, Bairam, Aida, Bélanger, Sylvie, Fraser, Annie, Blayney, Marc, Lemyre, Brigitte, Frank, Jane, Solimano, Alfonso, Synnes, Anne, Grunau, Ruth E., Hubber-Richard, Philippa, Rogers, Marilyn, Mackay, Margot, Petrie-Thomas, Julianne, Butt, Arsalan, van Wassenaer, Aleid, Nuytemans, Debbie, Houtzager, Bregje, van Sonderen, Loekie, Regev, Rivka, Itzchack, Netter, Arnon, Shmuel, Chalaf, Adiba, Ohlsson, Arne, O'Brien, Karel, Hamilton, Anne-Marie, Chan, May Lee, Sankaran, Koravangattu, Proctor, Pat, Golan, Agneta, Goldsch-Lerman, Esther, Reynolds, Graham, Dromgool, Barbara, Meskell, Sandra, Parr, Vanessa, Maher, Catherine, Broom, Margaret, Kecskes, Zsuzsoka, Ringland, Cathy, McMillan, Douglas, Spellen, Elizabeth, Sauve, Reginald S., Christianson, Heather, Anseeuw-Deeks, Deborah, Creighton, Dianne, Heath, Jennifer, Alvaro, Ruben, Chiu, Aaron, Porter, Ceceile, Turner, Gloria, Moddemann, Diane, Granke, Naomi, Penner, Karen, Bow, Jane, Mulder, Antonius, Wassenberg, Renske, van der Hoeven, Markus, Clarke, Maxine, Parfitt, Judy, Parker, Kevin, Nwaesei, Chukwuma, Ryan, Heather, Saunders, Cory, Schulze, Andreas, Wermuth, Inga, Hilgendorff, Anne, Flemmer, Andreas W., Herlenius, Eric, Legnevall, Lena, Lagercrantz, Hugo, Matthew, Derek, Amos, Wendy, Tulsiani, Suresh, Tan-Dy, Cherrie, Turner, Marilyn, Phelan, Constance, Shinwell, Eric S., Levine, Michael, Juster-Reicher, Ada, Khairy, May, Grier, Patricia, Vachon, Julie, Perepolkin, Larissa, Barrington, Keith J., Sinha, Sunil Kumar, Tin, Win, Fritz, Susan, Walti, Herve, Royer, Diane, Halliday, Henry, Millar, David, Mayes, Clifford, McCusker, Christopher, McLaughlin, Olivia, Fahnenstich, Hubert, Tillmann, Bettina, Weber, Peter, Wariyar, Unni, Embleton, Nicholas, Swamy, Ravi, Bucher, Hans U., Fauchere, Jean-Claude., Dietz, Vera, Harikumar, Chidambara, Anderson, Peter J., Asztalos, Elizabeth V., Davis, Peter G., Dewey, Deborah, Doyle, Lex W., Roberts, Robin S., Gent, Michael, Fraser, William, Hey, Edmund, Perlman, Max, Thorpe, Kevin, Gray, Shari, Chambers, Carole, Costantini, Lorrie, Yacura, Wendy, McGean, Erin, Scapinello, Lori, Manley, Brett J., Böhm, Birgitta, and van Wassenaer-Leemhuis, Aleid G.
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- 2015
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18. Understanding the Family Context: A Qualitative Descriptive Study of Parent and NICU Clinician Experiences and Perspectives.
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Dahan, Maya, Rotteau, Leahora, Higazi, Shelley, Kwayke, Ophelia, Lai, Giselle, Moulsdale, Wendy, Sampson, Lisa, Stannard, Jennifer, Church, Paige Terrien, and O'Brien, Karel
- Subjects
FAMILIES & psychology ,PARENT attitudes ,NEONATAL intensive care ,WORK ,RESEARCH methodology ,NEONATAL intensive care units ,PHYSICIANS' attitudes ,MEDICAL personnel ,INTERVIEWING ,FAMILY attitudes ,PATIENTS' families ,QUALITATIVE research ,EXPERIENTIAL learning ,COMMUNICATION ,DECISION making ,RESEARCH funding ,THEMATIC analysis - Abstract
Enabling individualized decision-making for patients requires an understanding of the family context (FC) by healthcare providers. The FC is everything that makes the family unique, from their names, preferred pronouns, family structure, cultural or religious beliefs, and family values. While there is an array of approaches for individual clinicians to incorporate the FC into practice, there is a paucity of literature guiding the process of collecting and integrating the FC into clinical care by multidisciplinary interprofessional teams. The purpose of this qualitative study is to explore the experience of families and Neonatal Intensive Care Unit (NICU) clinicians with information sharing around the FC. Our findings illustrate that there are parallel and overlapping experiences of sharing the FC for families and clinicians. Both groups describe the positive impact of sharing the FC on building and sustaining relationships and on personalization of care and personhood. The experience by families of revolving clinicians and the risks of miscommunication about the FC were noted as challenges to sharing the FC. Parents described the desire to control the narrative about their FC, while clinicians described seeking equal access to the FC to support the family in the best way possible related to their clinical role. Our study highlights how the quality of care is positively impacted by clinicians' appreciation of the FC and the complex relationship between a large multidisciplinary interprofessional team and the family in an intensive care unit, while also highlighting the difficulties in its practical application. Knowledge learned can be utilized to inform the development of processes to improve communication between families and clinicians. [ABSTRACT FROM AUTHOR]
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- 2023
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19. Family Integrated Care in Uganda: a feasibility study.
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Duby, Jessica, Kabajaasi, Olive, Muteteri, Judith, Kisooka, Efulansi, Barth, Delaney, Feeley, Nancy, O'Brien, Karel, Nathan, Kenya-Mugisha, Tagoola, Abner, and Wiens, Matthew O.
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NEONATAL nursing ,NEONATAL mortality ,MECONIUM aspiration syndrome ,FAMILY support ,HOSPITAL care quality - Abstract
Objective: To determine the feasibility of adapting Family Integrated Care to a neonatal hospital unit in a low-income country.Design: Single-centre, pre/post-pilot study of an adapted Family Integrated Care programme in Uganda (UFICare).Setting: Special Care Nursery at a Ugandan hospital.Patients: Singleton, inborn neonates with birth weight ≥2 kg.Interventions: As part of UFICare, mothers weighed their infant daily, assessed for severe illness ('danger signs') twice daily and tracked feeds.Main Outcome Measures: Feasibility outcomes included maternal proficiency and completion of monitoring tasks. Secondary outcomes included maternal stress, discharge readiness and post-discharge healthcare seeking.Results: Fifty-three mother-infant dyads and 51 mother-infant dyads were included in the baseline and intervention groups, respectively. Most mothers were proficient in the tasks 2-4 days after training (weigh 43 of 51; assess danger signs 49 of 51; track feeds 49 of 51). Mothers documented their danger sign assessments 82% (IQR 71-100) of the expected times and documented feeds 83% (IQR 71-100) of hospital days. In the baseline group, nurses weighed babies 29% (IQR 18-50) of hospitalised days, while UFICare mothers weighed their babies 71% (IQR 57-80) of hospitalised days (p<0.001). UFICare mothers had higher Readiness for Discharge scores compared with the baseline group (baseline 6.8; UFICare 7.9; p<0.001). There was no difference in maternal stress scores or post-discharge healthcare seeking.Conclusions: Ugandan mothers can collaborate in the medical care of their hospitalised infant. By performing tasks identified as important for infant care, mothers felt more prepared to care for their infant at discharge. [ABSTRACT FROM AUTHOR]- Published
- 2023
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20. Motivated by Money? The Impact of Financial Incentive for the Research Team on Study Recruitment
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Unger, Sharon, Wylie, Lesley, Fallah, Shafagh, Heinrich, Lee, and O'Brien, Karel
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- 2010
21. Influence of risk of neurological impairment and procedure invasiveness on health professionals’ management of procedural pain in neonates
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Stevens, Bonnie, McGrath, Patrick, Ballantyne, Marilyn, Yamada, Janet, Dupuis, Annie, Gibbins, Sharyn, Franck, Linda, Allen Finley, G., Howlett, Alexandra, Johnston, Celeste, O’Brien, Karel, and Ohlsson, Arne
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- 2010
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22. Family Integrated Care reduces NICU length of stay and improves medical outcomes across China
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O'Brien, Karel K.
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- 2021
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23. Gravens by Design: Family Integrated Care: An Evidence-Based and Inclusive Model for Delivering on Your NICU's Commitment to Family-Centered Care.
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Franck, Linda S. and O'Brien, Karel
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EVALUATION of medical care , *NEONATAL intensive care , *PATIENT participation , *EVIDENCE-based medicine , *CONFERENCES & conventions , *FAMILY-centered care , *COMPASSION , *HUMAN services programs , *PSYCHOLOGY of caregivers , *INTERPERSONAL relations , *COMMITMENT (Psychology) - Abstract
The article focuses on promoting family-centered care in neonatal intensive care units (NICUs) and the implementation of the Family Integrated Care (FICare) model. It emphasizes that safe and high-quality neonatal care is best provided when the parents or primary caregivers are actively involved. It also highlights the negative consequences for infants, parents, healthcare professionals, and healthcare delivery systems when family- and community-centered neonatal care is not provided.
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- 2023
24. Parents as primary caregivers in the neonatal intensive care unit
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Lee, Shoo K. and O’Brien, Karel
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- 2014
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25. Development and validation of a risk scoring tool to predict respiratory syncytial virus hospitalization in premature infants born at 33 through 35 completed weeks of gestation
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Sampalis, John S., Langley, Joanne, Carbonell-Estrany, Xavier, Paes, Bosco, O'Brien, Karel, Allen, Upton, Mitchell, Ian, Figueras Aloy, Jose, Pedraz, Carmen, and Michaliszyn, Andrea F.
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Health risk assessment -- Management -- Research -- Health aspects ,Infants (Premature) -- Research -- Health aspects ,Respiratory syncytial virus -- Diagnosis -- Research -- Risk factors -- Health aspects ,Health ,Company business management ,Management ,Diagnosis ,Research ,Risk factors ,Health aspects - Abstract
Keywords: hospitalization; prematurity; respiratory syncytial virus; risk assessment; risk factors; scoring tool. 471 Risk Factor AssessmentDevelopment and Validation of a Risk Scoring Tool to Predict Respiratory Syncytial Virus Hospitalization in [...]
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- 2008
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26. Determining behavioural and physiological responses to pain in infants at risk for neurological impairment
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Stevens, Bonnie, McGrath, Patrick, Gibbins, Sharyn, Beyene, Joseph, Breau, Lynn, Camfield, Carol, Finley, Allen, Franck, Linda, Howlett, Alexandra, Johnston, Celeste, McKeever, Patricia, O’Brien, Karel, Ohlsson, Arne, and Yamada, Janet
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- 2007
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27. Complications Associated With Surgically Placed Central Venous Catheters In Low Birth Weight Neonates
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Pandit, Paresh B, Pandit, Florence A, Govan, Jairaj, and O’Brien, Karel
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- 1999
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28. Indicators of pain in neonates at risk for neurological impairment
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Stevens, Bonnie, McGrath, Patrick, Dupuis, Annie, Gibbins, Sharyn, Beyene, Joseph, Breau, Lynn, Camfield, Carol, Allen Finley, Gordon, Franck, Linda S., Howlett, Alexandra, Johnston, Celeste, McKeever, Patricia, O’Brien, Karel, Ohlsson, Arne, and Yamada, Janet
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- 2009
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29. Family integrated care: very preterm neurodevelopmental outcomes at 18 months.
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Synnes, Anne R., Petrie, Julie, Grunau, Ruth E., Church, Paige, Kelly, Edmond, Moddemann, Diane, Xiang Ye, Shoo K. Lee, O'Brien, Karel, Ye, Xiang, Lee, Shoo K, Canadian Neonatal Network Investigators, and Canadian Neonatal Follow-Up Network Investigators
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NEONATAL nursing ,PARENT attitudes ,SCHOOL children ,NEURAL development ,NEONATAL necrotizing enterocolitis ,PARENTING ,RESEARCH ,NEONATAL intensive care ,PSYCHOLOGY of parents ,CHILD development ,RESEARCH methodology ,NEONATAL intensive care units ,DEVELOPMENTAL disabilities ,EVALUATION research ,WORD deafness ,WEIGHT gain ,COMPARATIVE studies ,RANDOMIZED controlled trials ,BREASTFEEDING ,HEALTH care teams ,QUESTIONNAIRES ,PARENT-child relationships ,LONGITUDINAL method ,PSYCHOLOGICAL stress - Abstract
Objective: To examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months' corrected age.Design/methods: Prospective cohort study of infants born <29 weeks' gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.Results: Of 756 infants <29 weeks' GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significantly higher incidence of intraventricular haemorrhage (IVH) (19.5% vs 11.7%, p=0.024) and higher proportion of employed mothers (76.6% vs 73.6%, p=0.043). There was no significant difference in the odds of the primary outcome (adjusted OR: 0.92 (0.59 to 1.42) FiCare vs Control) on multivariable analyses adjusted for GA, IVH and maternal employment. However, Bayley-III Motor scores (adjusted difference in mean (95% CI) 3.87 (1.22 to 6.53) and body mass index 0.67 (0.36 to 0.99) were higher in the FICare group.Conclusions: Very preterm infants exposed to FICare had no significant difference in incidence of cognitive or language delay but had better motor development.Trial Registration Number: Participants in this cohort study were previously enrolled in a registered trial: NCT01852695. [ABSTRACT FROM AUTHOR]- Published
- 2022
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30. Alpha1-proteinase inhibitor therapy for the prevention of chronic lung disease of prematurity: a randomized, controlled trial
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Stiskal, Joseph A., Dunn, Michael S., Shennan, Andrew T., O'Brien, Karel K.E., Kelly, Edmond N., Koppel, Robert I., Cox, Diane W., Ito, Shinya, Chappel, S. Lesley, and Rabinovitch, Marlene
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Alpha 1-antitrypsin -- Health aspects ,Lung diseases -- Prevention ,Infants (Premature) -- Care and treatment - Abstract
Treating premature infants with alpha1-proteinase inhibitor (A1PI) may hinder the evolution of chronic lung disease (CLD) and reduce the risk of bleeding in the lungs. Of 106 low-birth-weight infants at high risk for this inflammatory lung disease, 53 were given four intravenous doses of A1PI between days 0 and 14, while the others received a placebo. No significant difference was seen between the groups with respect to CLD, measured as requiring oxygen therapy at day 28. The treated group showed improved outcomes in the reduction of pulmonary hemorrhage and days of oxygen therapy required., Background. An imbalance between increased neutrophil elastase and a decreased antiprotease shield has been suggested as a factor contributing to the development of chronic lung disease (CLD). We hypothesized that administration of [[Alpha].sub.1]-proteinase inhibitor (A1PI), also known as [[Alpha].sub.1]-antitrypsin, to premature neonates would prevent CLD. Design. A randomized, placebo-controlled, prospective study of A1PI supplementation was performed. Neonates [is less than] 24 hours of age with birth weights 600-1000 g on respiratory support, and 1001-1250 g with respiratory distress syndrome (RDS) were eligible. Intravenous A1PI (60 mg/kg) or placebo was infused on days 0, 4, 7, and 14. Primary outcome was CLD in survivors, defined as the need for supplemental oxygen on day 28. Results. A total of 106 patients were recruited. There were no significant differences between groups in birth weight or incidence of RDS. The incidence of CLD in survivors was lower in the treated group, but the difference did not reach statistical significance (relative risk [RR], 0.79; confidence interval [CI], 0.60-1.02). This beneficial trend persisted at 36 weeks corrected gestational age (RR, 0.48; CI, 0.23-1.00). The incidence of pulmonary hemorrhage was lower in the treated group (RR, 0.22; CI, 0.05-0.98). Other complications were not significantly different between groups. Conclusions. In this, the first trial of a protease inhibitor for the prevention of CLD in premature infants, the infusions were well-tolerated. A1PI therapy may impede the development of CLD and appears to reduce the incidence of pulmonary hemorrhage in some neonates born prematurely. Pediatrics 1998;101:89-94; [[Alpha].sub.1]-proteinase inhibitor, bronchopulmonary dysplasia, infant, randomized, controlled trials; serine proteinase inhibitors:, ABBREVIATIONS. CLD, chronic lung disease; RDS, respiratory distress syndrome; A1PI, [[Alpha].sub.1]-proteinase inhibitor. Chronic lung disease (CLD) or bronchopulmonary dysplasia is the end result of unresolved neonatal acute lung injury.[1] Affected [...]
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- 1998
31. A parent‐administered sensorimotor intervention for oral feeding in infants born preterm: A randomized clinical study.
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Fucile, Sandra, Snider, Laurie, O'Brien, Karel, Smith, Lorraine, and Dow, Kimberly
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NEONATAL intensive care units , *PREMATURE infants , *HOSPITAL admission & discharge , *DEVELOPMENTAL programs , *GESTATIONAL age - Abstract
Aim Method Results Interpretation To evaluate the effect of a parent‐administered sensorimotor intervention (PASI) program on developmental outcomes of infants born preterm during their stay in the neonatal intensive care unit (NICU).A randomized clinical study was conducted with 94 infants (mean gestational age 31 weeks [SD 2.2 weeks]; 1658 g [SD 478 g]; 49 males, 45 females) initially enrolled and randomly assigned to an experimental or a control group. Infants in the experimental group received a PASI, consisting of tactile input to oral structures, trunk/limbs, and non‐nutritive sucking for 15 minutes, once a day, for 10 days. Infants in the control group received standard care. Outcomes included attainment of complete oral feeds, occurrence of direct breastfeeding at hospital discharge, and motor function assessed using the Test of Infant Motor Performance (TIMP).A total of 80 infants completed the study. Infants in the experimental group achieved complete oral feeds sooner (11.9 [SD 4.3] vs 15.3 [SD 6.5] days, p = 0.013), and a greater number of them received direct breastfeeds (22 vs 12, p = 0.010) than controls. Infants in both groups had equivalent motor functions scores on the TIMP (46.9 [SD 4.8], 46.8 [SD 8.4], p = 0.961).A PASI program may enhance an infant's oral feeding skills. These findings provide evidence to advocate for the institution of PASI in NICUs. [ABSTRACT FROM AUTHOR]
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- 2024
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32. Procedural pain in newborns at risk for neurologic impairment
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Stevens, Bonnie, McGrath, Patrick, Gibbins, Sharyn, Beyene, Joseph, Breau, Lynn, Camfield, Carol, Finley, Allen, Franck, Linda, Howlett, Alixe, McKeever, Patricia, O'Brien, Karel, Ohlsson, Arne, and Yamada, Janet
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- 2003
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33. Supporting parents as essential care partners in neonatal units during the SARS-CoV-2 pandemic.
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Veenendaal, Nicole R., Deierl, Aniko, Bacchini, Fabiana, O'Brien, Karel, Franck, Linda S., van Veenendaal, Nicole R, and International Steering Committee for Family Integrated Care
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COVID-19 pandemic ,NEONATAL nursing ,PARENTS ,MEDICAL personnel ,PARENTING ,SARS-CoV-2 - Abstract
Aim: To review the evidence on safety of maintaining family integrated care practices and the effects of restricting parental participation in neonatal care during the SARS-CoV-2 pandemic.Methods: MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched from inception to the 14th of October 2020. Records were included if they reported scientific, empirical research (qualitative, quantitative or mixed methods) on the effects of restricting or promoting family integrated care practices for parents of hospitalised neonates during the SARS-CoV-2 pandemic. Two authors independently screened abstracts, appraised study quality and extracted study and outcome data.Results: We retrieved 803 publications and assessed 75 full-text articles. Seven studies were included, reporting data on 854 healthcare professionals, 442 parents, 364 neonates and 26 other family members, within 286 neonatal units globally. The pandemic response resulted in significant changes in neonatal unit policies and restricting parents' access and participation in neonatal care. Breastfeeding, parental bonding, participation in caregiving, parental mental health and staff stress were negatively impacted.Conclusion: This review highlights that SARS-CoV-2 pandemic-related hospital restrictions had adverse effects on care delivery and outcomes for neonates, families and staff. Recommendations for restoring essential family integrated care practices are discussed. [ABSTRACT FROM AUTHOR]- Published
- 2021
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34. Family integrated care: Supporting parents as primary caregivers in the neonatal intensive care unit.
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Waddington, Chandra, Veenendaal, Nicole R., O'Brien, Karel, and Patel, Neil
- Abstract
Family integrated care (FICare) is a collaborative model of neonatal care which aims to address the negative impacts of the neonatal intensive care unit (NICU) environment by involving parents as equal partners, minimizing separation, and supporting parent‐infant closeness. FICare incorporates psychological, educational, communication, and environmental strategies to support parents to cope with the NICU environment and to prepare them to be able to emotionally, cognitively, and physically care for their infant. FICare has been associated with improved infant feeding, growth, and parent wellbeing and self‐efficacy; important mediators for long‐term improved infant neurodevelopmental and behavioural outcomes. FICare implementation requires multi‐disciplinary commitment, staff motivation, and sufficient time for preparation and readiness for change as professionals relinquish power and control to instead develop collaborative partnerships with parents. Successful FICare implementation and culture change have been applied by neonatal teams internationally, using practical approaches suited to their local environments. Strategies such as parent and staff meetings and relational communication help to break down barriers to change by providing space for the co‐creation of knowledge, the negotiation of caregiving roles and the development of trusting relationships. The COVID‐19 pandemic highlighted the vulnerability within programs supporting parental presence in neonatal units and the profound impacts of parent‐infant separation. New technologies and digital innovations can help to mitigate these challenges, and support renewed efforts to embed FICare philosophy and practice in neonatal care during the COVID‐19 recovery and beyond. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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35. Outcome following pulmonary haemorrhage in very low birthweight neonates treated with surfactant
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Pandit, Paresh B, O'Brien, Karel, Asztalos, Elizabeth, Colucci, Enza, and Dunn, Michael S
- Published
- 1999
36. Infant flow biphasic nasal continuous positive airway pressure (BP- NCPAP) vs. infant flow NCPAP for the facilitation of extubation in infants' ≤ 1,250 grams: a randomized controlled trial
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O'Brien Karel, Campbell Craig, Brown Leanne, Wenger Lisa, and Shah Vibhuti
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Infant-newborn ,Non-invasive ventilation ,Continuous positive airway pressure ,Extubation failure ,Pediatrics ,RJ1-570 - Abstract
Abstract Background The use of mechanical ventilation is associated with lung injury in preterm infants and therefore the goal is to avoid or minimize its use. To date there is very little consensus on what is considered the "best non-invasive ventilation mode" to be used post-extubation. The objective of this study was to compare the effectiveness of biphasic nasal continuous positive airway pressure (BP-NCPAP) vs. NCPAP in facilitating sustained extubation in infants ≤ 1,250 grams. Methods We performed a randomized controlled trial of BP-NCPAP vs. NCPAP in infants ≤ 1,250 grams extubated for the first time following mechanical ventilation since birth. Infants were extubated using preset criteria or at the discretion of the attending neonatologist. The primary outcome was the incidence of sustained extubation for 7 days. Secondary outcomes included incidence of adverse events and short-term neonatal outcomes. Results Sixty-seven infants received BP-NCPAP and 69 NCPAP. Baseline characteristics were similar between groups. The trial was stopped early due to increased use of non-invasive ventilation from birth, falling short of our calculated sample size of 141 infants per group. The incidence of sustained extubation was not statistically different between the BP-NCPAP vs. NCPAP group (67% vs. 58%, P = 0.27). The incidence of adverse events and short-term neonatal outcomes were similar between the two groups (P > 0.05) except for retinopathy of prematurity which was noted to be higher (P = 0.02) in the BP-NCPAP group. Conclusions Biphasic NCPAP may be used to assist in weaning from mechanical ventilation. The effectiveness and safety of BP-NCPAP compared to NCPAP needs to be confirmed in a large multi-center trial as our study conclusions are limited by inadequate sample size. Clinical Trials Registration # NCT00308789 Source of support Grant # 06-06, Physicians Services Incorporated Foundation, Toronto, Canada. Summit technologies Inc. provided additional NCPAP systems and an unrestricted educational grant. Abstract presented at The Society for Pediatric Research Meeting, Baltimore, USA, May 2nd-5th, 2009 and Canadian Paediatric Society Meeting, June 23rd-29th, Ottawa, 2009.
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- 2012
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37. Lessons from SARS: A retrospective study of outpatient care during an infectious disease outbreak
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O'Brien Karel, Nasef Nehad, Wylie Lesley, and Unger Sharon
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Pediatrics ,RJ1-570 - Abstract
Abstract Background During severe acute respiratory syndrome (SARS) outbreak in Toronto, outpatient clinics at SickKids Hospital were closed to prevent further disease transmission. In response, a decision was made by the neonatal neuro-developmental follow up (NNFU) clinic staff to select patients with scheduled appointments to have a mail/telephone assessment using Ages and Stages Questionnaire (ASQ) or to postpone/skip their visit. The objective of this study was to compare the developmental assessment and its outcome in two groups of NNFU clinic patients, SARS versus non-SARS, over three standard clinic appointments. Methods We compared the diagnostic accuracy (identification of developmental delay), and patient management (referral for therapy or communication of a new diagnosis) of the strategies used during SARS, April/May 2003, to the standard assessment methods used for patients seen in April/May 2005 (non-SARS). In all cases data were obtained for 3 patient visits: before, during and after these 2 months and were compared using descriptive statistics. Results There were 95 patients in the SARS group and 99 non-SARS patients. The gestational age, sex, entry diagnosis and age at the clinic visit was not different between the groups. The NNFU clinic staff mailed ASQ to 27 families during SARS, 17 (63%) were returned, and 8 of the 17 were then contacted by telephone. Criteria used to identify infants at risk selected for either mailed ASQ or phone interviews were not clearly defined in the patients' charts. There was a significant under identification of developmental delay during SARS (18% versus 45%). Of those who responded to the mailed questionnaire, referrals for therapy rates were similar to non-SARS group. The lost to follow up rate was 24% for the SARS group compared with 7% for non-SARS. There was no difference in the overall rate of developmental delay in the two groups as identified at the 'after' visit. Conclusions Poor advanced planning led to a haphazard assessment of patients during this infectious disease outbreak. Future pandemic plans should consider planning for outpatient care as well as in hospital management of patients.
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- 2010
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38. alpha sub 1 -Proteinase Inhibitor Therapy for the Prevention of Chronic Lung Disease of Prematurity: A Randomized, Controlled Trial
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Stiskal, Joseph A., Dunn, Michael S., Shennan, Andrew T., O'Brien, Karel K. E., Kelly, Edmond N., Koppel, Robert I., Cox, Diane W., Ito, Shinya, Chappel, S. Lesley, and Rabinovitch, Marlene
- Published
- 1998
39. Congenital diaphragmatic hernia: lung-to-head ratio and lung volume for prediction of outcome
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Alfaraj, Malikah A., Shah, Prakesh S., Bohn, Desmond, Pantazi, Sophia, O'Brien, Karel, Chiu, Priscilla P., Gaiteiro, Rose, and Ryan, Greg
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- 2011
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40. Characteristics and outcome of infants with candiduria in neonatal intensive care - a Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study
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Langley Joanne M, Hui Charles, Le Saux Nicole, Rubin Earl, Synnes Anne, Asztalos Elizabeth, Simpson Kim, O'Brien Karel, Barton Michelle, Davies H Dele, Robinson Joan L, Sauve Reg, de Repentigny Louis, Kovacs Lajos, Tan Ben, and Richardson Susan E
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Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background There is limited information in the literature on the presentation and prognosis of candidal urinary tract infection (UTI) in infants in the neonatal intensive care unit (NICU). Methods This was a prospective cohort study performed in 13 Canadian NICUs. Infants with candidal UTI without extra-renal candidal infection at presentation were enrolled. Results Thirty infants fit the study criteria. Median birth weight and gestational age were 2595 grams (range 575-4255) and 35 weeks (range 24-41) with 10 infants being < 30 weeks gestation. The most common primary underlying diagnosis was congenital heart disease (n = 10). The median age at initial diagnosis was 16 days (range 6-84 days). Renal ultrasonography findings were compatible with possible fungal disease in 15 of the 26 infants (58%) in whom it was performed. Treatment was variable, but fluconazole and either amphotericin B deoxycholate or lipid-based amphotericin B in combination or sequentially were used most frequently. Extra-renal candidiasis subsequently developed in 4 infants. In 2 of these 4 infants, dissemination happened during prolonged courses of anti-fungal therapy. Three of 9 deaths were considered to be related to candidal infection. No recurrences of candiduria or episodes of invasive candidiasis following treatment were documented. Conclusion Candidal UTI in the NICU population occurs both in term infants with congenital abnormalities and in preterm infants, and is associated with renal parenchymal disease and extra-renal dissemination. A wide variation in clinical approach was documented in this multicenter study. The overall mortality rate in these infants was significant (30%). In one third of the deaths, Candida infection was deemed to be a contributing factor, suggesting the need for antifungal therapy with repeat evaluation for dissemination in infants who are slow to respond to therapy.
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- 2009
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41. Evaluating the effect of Family Integrated Care on maternal stress and anxiety in neonatal intensive care units.
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Cheng, Chelsea, Franck, Linda S., Ye, Xiang Y., Hutchinson, Sarah A., Lee, Shoo K., and O'Brien, Karel
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ANXIETY prevention ,PREVENTION of psychological stress ,NEONATAL intensive care ,ATTITUDES of mothers ,CONFIDENCE intervals ,FAMILY medicine ,NEONATAL intensive care units ,GESTATIONAL age ,TREATMENT effectiveness ,PARENTING ,COMPARATIVE studies ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,INTEGRATED health care delivery ,CLUSTER analysis (Statistics) ,SECONDARY analysis ,EVALUATION - Abstract
Objective: To identify how Family Integrated Care (FICare) affected maternal stress and anxiety. Study Design: This secondary analysis of the FICare cluster randomised controlled trial included infants born between 1 April 2013 and 31 August 2015 at ≤33 weeks' gestation. Mothers completed the PSS:NICU and STAI questionnaires at enrolment and study day 21. Results: 1383 mothers completed the surveys at one or both time-points. The mean PSS:NICU and STAI scores at day 21 were significantly lower in the FICare mothers than controls (PSS:NICU mean [standard deviation] FICare 2.32 [0.75], control 2.48 [0.78], p = 0.0005; STAI FICare 70.8 [20.0], control 74.2 [19.6], p = 0.0004). The sights and sounds, looks and behaviour, and parental role PSS:NICU subscales and the state and trait STAI subscales were all significantly different between FIC are and controls at day 21. The magnitude of change in all stress and anxiety subscales was greater in the FICare group than controls. These differences remained significant after adjustment for confounders with the greatest change in the parental role (least-squares mean [95% confidence interval] FICare −0.65 [−0.72, 0.57], control −0.31 [−0.38, −0.24], p < 0.0001) and state anxiety subscales. Conclusion: FICare is effective at reducing NICU-related maternal stress and anxiety. [ABSTRACT FROM AUTHOR]
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- 2021
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42. Familial fetal pleural effusions
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Fox, Grenville F. and O'Brien, Karel K.
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- 1996
43. Identification of pain indicators for infants at risk for neurological impairment: A Delphi consensus study
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Camfield Carol, Breau Lynn, Beyene Joseph, Gibbins Sharyn, Yamada Janet, McGrath Patrick, Stevens Bonnie, Finley Allen, Franck Linda, Howlett Alexandra, Johnston Celeste, McKeever Patricia, O'Brien Karel, and Ohlsson Arne
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Pediatrics ,RJ1-570 - Abstract
Abstract Background A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at risk for neurological impairments (NI). The objective of this study was to establish consensus about which behavioural, physiologic and contextual indicators best characterize pain in infants at high, moderate and low levels of risk for NI. Methods A 39- item, self-administered electronic survey that included infant physiologic, behavioral and contextual pain indicators was used in a two round Delphi consensus exercise. Fourteen pediatric pain experts were polled individually and anonymously on the importance and usefulness of the pain indicators for the 3 differing levels of risk for NI. Results The strength of agreement between expert raters was moderate in Round 1 and fair in Round 2. In general, pain indicators with the highest concordance for all three groups were brow bulge, facial grimace, eye squeeze, and inconsolability. Increased heart rate from baseline in the moderate and severe groups demonstrated high concordance. In the severe risk group, fluctuations in heart rate and reduced oxygen saturation were also highly rated. Conclusion These data constitute the first step in contributing to the development and validation of a pain measure for infants at risk for NI. In future research, we will integrate these findings with the opinions of (a) health care providers about the importance and usefulness of infant pain indicators and (b) the pain responses of infants at mild, moderate and high risk for NI.
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- 2006
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44. Healthcare professionals' perceptions of pain in infants at risk for neurological impairment
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Camfield Carol S, Beyene Joseph, Stevens Bonnie, McGrath Patrick J, Breau Lynn M, Finley G Allen, Franck Linda, Howlett Alexandra, O'Brien Karel, and Ohlsson Arne
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Pediatrics ,RJ1-570 - Abstract
Abstract Background To determine whether healthcare professionals perceive the pain of infants differently due to their understanding of that infant's level of risk for neurological impairment. Method Neonatal Intensive Care Units (NICU's) at two tertiary pediatric centers. Ninety-five healthcare professionals who practice in the NICU (50 nurses, 19 physicians, 17 respiratory therapists, 9 other) participated. They rated the pain (0–10 scale and 0–6 Faces Pain Scale), distress (0–10), effectiveness of cuddling to relieve pain (0–10) and time to calm without intervention (seconds) for nine video clips of neonates receiving a heel stick. Prior to each rating, they were provided with descriptions that suggested the infant had mild, moderate or severe risk for neurological impairment. Ratings were examined as a function of the level of risk described. Results Professionals' ratings of pain, distress, and time to calm did not vary significantly with level of risk, but ratings of the effectiveness of cuddling were significantly lower as risk increased [F (2,93) = 4.4, p = .02]. No differences in ratings were found due to participants' age, gender or site of study. Physicians' ratings were significantly lower than nurses' across ratings. Conclusion Professionals provided with visual information regarding an infants' pain during a procedure did not display the belief that infants' level of risk for neurological impairment affected their pain experience. Professionals' estimates of the effectiveness of a nonpharmacological intervention did differ due to level of risk.
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- 2004
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45. Family integrated care: State of art and future perspectives.
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Moreno‐Sanz, Bárbara, Alferink, Milène Tirza, O'Brien, Karel, and Franck, Linda S.
- Abstract
Family integrated care (FICare) represents a contemporary approach to health care that involves the active participation of families within the healthcare team. It empowers families to acquire knowledge about the specialised care required for their newborns admitted to neonatal intensive care unit (NICU) and positions them as primary caregivers. Healthcare professionals in this model act as mentors and facilitators during the hospitalisation period. This innovative model has exhibited notable enhancements in both short‐ and long‐term health outcomes for neonates, alongside improved psychological well‐being for families and heightened satisfaction among healthcare professionals. Initially designed for stable premature infants and their families, FICare has evolved to include critically ill premature and full‐term infants. Findings from recent studies affirm the safety and feasibility of FICare as a NICU‐wide model of care, benefiting all infants and families. The envisioned expansion of FICare focusses on sustainability and extending its implementation, recognising the necessity for tailored adaptations to suit varying diverse cultural and socio‐economic contexts. [ABSTRACT FROM AUTHOR]
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- 2024
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46. Parents Are Not Visiting. Parents Are Parenting.
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Bracht, Marianne, Franck, Linda S., O'Brien, Karel, and Bacchini, Fabiana
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- 2023
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47. The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care.
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Franck, Linda S. and O'Brien, Karel
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There is increasing recognition that parents play a critical role in promoting the health outcomes of low birthweight and preterm infants. Despite a large body of literature on interventions and models to support family engagement in infant care, parent involvement in the delivery of care for such infants is still restricted in many neonatal intensive care units (NICUs). In this article, we propose a taxonomy for classifying parent‐focused NICU interventions and parent‐partnered care models to aid researchers, clinical teams, and health systems to evaluate existing and future approaches to care. The proposed framework has three levels: interventions to support parents, parent‐delivered interventions, and multidimensional models of NICU care that explicitly incorporate parents and partners in the care of their preterm or low birthweight infant. We briefly review the available evidence for interventions at each level and highlight the strong level of research evidence to support the parent‐delivered intervention of skin‐to‐skin contact (also known as the Kangaroo Care position) and for the Kangaroo mother care and family integrated care models of NICU care. We suggest directions for future research and model implementation to improve and scale‐up parent partnership in the care of NICU infants. [ABSTRACT FROM AUTHOR]
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- 2019
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48. Opinion—Words Matter: The Implications of COVID-19 on Family-Centered Care in the NICU.
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Bracht, Marianne, Franck, Linda S., O'Brien, Karel, and Bacchini, Fabiana
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VISITING the sick ,NEONATAL intensive care ,NEONATAL intensive care units ,MEDICAL personnel ,FAMILY-centered care ,PATIENTS' families ,PATIENT-family relations ,COVID-19 pandemic - Published
- 2022
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49. A Neonate with Blisters.
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Erdle, Stephanie C and O'Brien, Karel
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- 2020
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50. The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families.
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Shah, Prakesh S., McDonald, Sarah D., Barrett, Jon, Synnes, Anne, Robson, Kate, Foster, Jonathan, Pasquier, Jean-Charles, Joseph, K.S., Piedboeuf, Bruno, Lacaze-Masmonteil, Thierry, O'Brien, Karel, Shivananda, Sandesh, Chaillet, Nils, and Pechlivanoglou, Petros
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PREMATURE labor ,RESEARCH protocols ,PREMATURE infants - Abstract
Background: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. Methods: Our national cohort will include 24 maternal--fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care. Interpretation: These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative research and quality-improvement platform that supports programs, projects and partnerships focused on improving outcomes of preterm neonates. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
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