Campbell University
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Neonatal Thrush Is Not Associated with Mode of Delivery
PURPOSE: Thrush is an opportunistic infection of the buccal cavity by the organism . It is most commonly seen in infants and becomes relatively uncommon between 6 to 9 months of age implying the infection is possibly dictated by risk factors present at or around the time of birth. The objective of this study is to determine if there is an association between the development of thrush and cesarean delivery, as we hypothesize. METHODS: Neonatal records were obtained through retrospective chart review of the past 10 years from an outpatient clinic and hospital records in Sandusky Ohio. ICD 9 and 10 codes for thrush and well child visit were used to identify patients. Statistical analysis performed on the data included: multivariable logistic regression, χ test of association, and nonparametric χ test of goodness-of-fit. RESULTS: A total of 636 patient records were reviewed, with 127 having a diagnosis of thrush and 509 without the diagnosis. A multivariable logistic regression indicated that during the first year of life, children born by cesarean section were no more likely to develop thrush compared with those born by vaginal delivery, controlling for age and sex of the neonate as well as parity and group B streptococcus status of the mother. CONCLUSION: This study demonstrated that there is no significant correlation between the mode of delivery and the development of thrush. It is reasonable to conclude that of the many factors associated with neonatal thrush development, mode of delivery is likely not one of them
A Parental Report of Youth Transition Readiness: The Parent STARx Questionnaire (STARx-P) and Re-evaluation of the STARx Child Report
PURPOSE:
The STARx Questionnaire is a self-report measure of health care transition (HCT) readiness in youth with chronic diseases. We aimed to improve reliability and generalizability of the STARx and report initial reliability data on the STARx-P Questionnaire, a self-reportmeasure of parent perspective on their child\u27s HCT readiness. METHODS:
Participants were recruited in several clinics from a large academic hospital in the southeastern USA and via the therapeutic summer camp for children with chronic disease. Children with chronic conditions responded to the 18-question STARx Questionnaire and their parents responded to the parent version, the STARx-P Questionnaire. RESULTS:
IRB-approved consents were obtained from 341 parents (89.4% mothers) and 455 children (Mean age 12.28±2.53; 36.9% Males; 68.6% Caucasian; 22.6% African-American). The most common diagnoses were kidney disease, inflammatory bowel disease, diabetes, cerebral palsy, sickle cell, and cystic fibrosis. Principal component analysis of the STARx-P Questionnaire identified three major subscales in both the child and parent-report: Disease Knowledge, Self-management and Provider Communication. Internal reliability was moderate to good (α=0.545-0.759). CONCLUSIONS:
The STARx-P Questionnaire and STARx Version 4 Questionnaire have demonstrated initial reliability in this multi-institution study. It is the first HCT readiness questionnaire that includes a parent-proxy report which is needed in studies of non-verbal and/or developmentally delayed children. Parent-report can also give unique insights not obtained from self-reports