1,668 research outputs found
Avoidance of bottles during the establishment of breast feeds in preterm infants
No full textBackground: Preterm infants start milk feeds by gavage tube. As they mature, sucking feeds are gradually introduced. Women who choose to breast feed their preterm infant are not always able to be in hospital with their baby and need an alternative approach to feeding. Most commonly, milk (expressed breast milk or formula) is given by bottle. Whether using bottles during establishment of breast feeds is detrimental to breast feeding success is a topic of ongoing debate. Objectives: To identify the effects of avoidance of bottle feeds during establishment of breast feeding on the likelihood of successful breast feeding, and to assess the safety of alternatives to bottle feeds. Search methods: We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 2), MEDLINE via PubMed (1966 to July 2016), Embase (1980 to July 2016) and CINAHL (1982 to July 2016). We also searched databases of clinical trials and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Selection criteria: Randomised and quasi-randomised controlled trials comparing avoidance of bottles with use of bottles in women who have chosen to breast feed their preterm infant. Data collection and analysis: Two review authors independently assessed trial quality and extracted data. When appropriate, we contacted study authors for additional information. Review authors used standard methods of The Cochrane Collaboration and the Cochrane Neonatal Review Group. Main results: We included seven trials with 1152 preterm infants. Five studies used a cup feeding strategy, one used a tube feeding strategy and one used a novel teat when supplements to breast feeds were needed. We included the novel teat study in this review, as the teat was designed to more closely mimic the sucking action of breast feeding. The trials were of small to moderate size, and two had high risk of attrition bias. Adherence with cup feeding was poor in one of the studies, indicating dissatisfaction with this method by staff and/or parents; the remaining four cup feeding studies provided no such reports of dissatisfaction or low adherence. Meta-analyses provided evidence of low to moderate quality indicating that avoiding bottles increases the extent of breast feeding on discharge home (full breast feeding typical risk ratio (RR) 1.47, 95% confidence interval (CI) 1.19 to 1.80; any breast feeding RR 1.11, 95% CI 1.06 to 1.16). Limited available evidence for three months and six months post discharge shows that avoiding bottles increases the occurrence of full breast feeding and any breast feeding at discharge and at six months post discharge, and of full (but not any) breast feeding at three months post discharge. This effect was evident at all time points for the tube alone strategy and for all except any breast feeding at three months post discharge for cup feeding. Investigators reported no clear benefit when the novel teat was used. No other benefits or harms were evident, including, in contrast to the previous (2008) review, length of hospital stay. Authors' conclusions: Evidence of low to moderate quality suggests that supplementing breast feeds by cup increases the extent and duration of breast feeding. Current insufficient evidence provides no basis for recommendations for a tube alone approach to supplementing breast feeds.Carmel T Collins, Jennifer Gillis, Andrew J McPhee, Hiroki Suganuma, Maria Makride
Avoidance of bottles during the establishment of breast feeds in preterm infants
No full textCopyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.BackgroundPreterm infants start milk feeds by gavage tube. As they mature, sucking feeds are gradually introduced. Women who choose to breast feed their preterm infant are not always available and an alternative approach to feeding is needed. Most commonly, milk (expressed breast milk or formula) is given by bottle. There is some controversy about whether using bottles during the establishment of breast feeds is detrimental to breastfeeding success.ObjectivesTo determine the effect of avoidance of bottle feeds during the establishment of breastfeeding on the likelihood of successful breastfeeding and to determine if alternatives to bottle feeds are safe.Search strategyWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL and EMBASE in any language. The search was updated in July 2008.Selection criteriaRandomised or quasi randomised controlled trials comparing avoidance of bottles with use of bottles in women who have chosen to breast feed their preterm infant.Data collection and analysisTwo review authors independently assessed trial quality and extracted data. When appropriate, we contacted study authors for additional information. Standard methods of the Cochrane Collaboration and the Cochrane Neonatal Review Group were used.Main resultsFive trials of 543 infants were included. Four trials used a cup feeding strategy and one trial used a tube feeding strategy when supplements to breast feeds were needed. The single study of tube feeding had a high risk of bias. In the analysis of all five trials, significant heterogeneity was evident in two of the primary outcomes. This was reduced when the tube feeding trial was removed from analyses.Cup feeding significantly decreased 'no breastfeeding or only partial breast feeding' on discharge home (summary RR 0.75, 95% CI 0.61 to 0.91). However, cup feeding significantly increased length of hospital stay by 10 days (95% CI 3.87 to 16.29). There was a high degree of noncompliance in the largest study of cup feeding indicating dissatisfaction with this method by staff and/or parents.The one trial of a tube alone approach significantly reduced 'no breastfeeding or only partial breastfeeding' and 'no breastfeeding at all' at all time periods but the results need to be interpreted with caution due to the high risk of bias.Authors' conclusionsSupplementing breast feeds by cup confers no breastfeeding benefit beyond discharge home and delays discharge considerably. There is currently insufficient evidence on which to base recommendations for a tube alone approach to supplementing breast feeds. Further research is needed to evaluate a tube alone approach.CT Collins, M Makrides, J Gillis, AJ McPhe
Multiphase flow modelling of explosive volcanic eruptions using an adaptive unstructured mesh-based approach
No full textEarly discharge with home support of gavage feeding for stable preterm infants who have not established full oral feeds
No full textCopyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.BackgroundEarly discharge of stable preterm infants still requiring gavage feeds has the potential benefits of uniting families sooner and reducing health care and family costs compared to discharge home when on full sucking feeds. Potential disadvantages include the increased burden for the family and the possibility of complications related to gavage feeding.ObjectivesTo determine the effects of a policy of early discharge of stable preterm infants with home support of gavage feeding compared with a policy of discharge of such infants when they have reached full sucking feeds.Search strategyThe standard search strategy of the Cochrane Neonatal Review Group was used together with additional searches of the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), CINAHL (1982 to April week 1 2003), EMBASE (1980 to 2003 week 15) and MEDLINE (1966 to April week 1 2003).Selection criteriaAll randomised and quasi-randomised trials among infants born Data collection and analysisTwo reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group.Main resultsData from one quasi-randomised trial, with 88 infants from 75 families, were included in the review. Infants in the early discharge program with home gavage feeding had a mean hospital stay that was 9.3 days shorter [MD -9.3 (-18.49 to -0.11)] than infants in the control group. Infants in the early discharge program also had a lower risk of clinical infection during the home gavage period compared with the corresponding time in hospital for the control group [RR 0.35 (0.17 to 0.69)]. There were no significant differences between groups in duration and extent of breast feeding, weight gain, re-admission within the first 12 months post discharge from the home gavage program or from hospital, scores reflecting parental satisfaction, or health service use.Reviewer's conclusionsExperimental evidence to evaluate the benefits and risks in preterm infants of early discharge from hospital with home gavage feeding compared with later discharge upon attainment of full sucking feeds is limited to the results of one small quasi-randomised controlled trial. High quality trials with concealed allocation, complete follow-up of all randomised infants and adequate sample size are needed before practice recommendations can be made.Collins CT, Makrides M, McPhee A
Maternal prenatal and/or postnatal n-3 fish oil supplementation for preventing allergies in early childhood
No full textThis is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effect of n-3 LCPUFA supplementation in mothers during pregnancy or lactation on allergy outcomes in their children.Anoja W Gunaratne, Maria Makrides, Carmel T Collin
Multiphase flow modelling of volcanic ash particle settling in water using adaptive unstructured meshes
No full text17.06.13 KB. Ok to add the published version for this journal. OUPSmall-scale experiments of volcanic ash particle settling in water have demonstrated that ash particles can either settle slowly and individually, or rapidly and collectively as a gravitationally unstable ash-laden plume. This has important implications for the emplacement of tephra deposits on the seabed. Numerical modelling has the potential to extend the results of laboratory experiments to larger scales and explore the conditions under which plumes may form and persist, but many existing models are computationally restricted by the fixed mesh approaches that they employ. In contrast, this paper presents a new multiphase flow model that uses an adaptive unstructured mesh approach. As a simulation progresses, the mesh is optimized to focus numerical resolution in areas important to the dynamics and decrease it where it is not needed, thereby potentially reducing computational requirements. Model verification is performed using the method of manufactured solutions, which shows the correct solution convergence rates. Model validation and application considers 2-D simulations of plume formation in a water tank which replicate published laboratory experiments. The numerically predicted settling velocities for both individual particles and plumes, as well as instability behaviour, agree well with experimental data and observations. Plume settling is clearly hindered by the presence of a salinity gradient, and its influence must therefore be taken into account when considering particles in bodies of saline water. Furthermore, individual particles settle in the laminar flow regime while plume settling is shown (by plume Reynolds numbers greater than unity) to be in the turbulent flow regime, which has a significant impact on entrainment and settling rates. Mesh adaptivity maintains solution accuracy while providing a substantial reduction in computational requirements when compared to the same simulation performed using a fixed mesh, highlighting the benefits of an adaptive unstructured mesh approach
C.T. Vivian, Joseph E. Lowery, and Tom Brown, circa 1980
No full textSouthern Christian Leadership Conference President Joseph E. Lowery is shown standing outside with C.T. Vivian (left) and Tom Brown (right) at Paschal's Motor Hotel.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Joseph & Evelyn Lowery Institute for Justice and Human Rights, the Joseph Echols Lowery Irrevocable Trust, and other donors in supporting the processing and digitization of Morehouse College's Joseph Echols and Evelyn Gibson Lowery Collection
Recommended from our members
Image 350 of Theo Brown Diaries, 1933
No full text340
WEDNESDAY DECEMBER 6
Clear
All day at A.S.A.E. again today.
In morning slipped away long enough
to see Harold Rockwell at Northern Trust Co.
Lunch at Chicago Club with Charlie Wiman.
Collins of Ames and Harold White there too.
Collins showed us some photos of lister with
damingattachment.
Left for home at 6 P.M.
Collins mentioned 2 patents we should look into
if interested indaming lister rows.
1814848 C.T. PEACOCK ARRIBA COLORADO
1892002 " " " "
A preliminary investigation into the risk factors associated with cellulitis of the lower limb
No full textCellulitis is an infective/inflammatory skin condition costing 426,000 bed days per year. The legs are most frequently affected and 18-20% of patients suffer from recurrent attacks. Bacteria are thought to be causal but are rarely identified, therefore antibiotic treatment is empirical and currently the only means of prophylaxis. Previous studies have cited athlete’s foot, skin vulnerability and oedema as risk factors for cellulitis and there may also be a relationship with the immune response. This preliminary study was designed to evaluate these risk factors and identify areas for further investigation.Patients were matched with controls (N = 12 + 12 controls) by age, sex and mobility. Participants attended twice (during treatment and again 6 weeks after clinical resolution). Foot scrapings were cultured to examine the flora and blood samples taken to determine white cell types and numbers, cytokine levels and markers specific to fungal infection. Physiological measurement techniques were used to assess skin function. Psychological stress levels were evaluated and medical history recorded.Fewer dermatophytes were grown from the feet of patients as compared to matched controls. Amongst patients blood profiling showed evidence of increased neutrophil count post episode and levels of IL-12 and IL-8 also reached near significance in this group. Physiological tests for skin blood flow, water loss and pH produced results consistent with cellulitic skin but persisting oedema was significantly higher in the patient group and characterised by loss of structure in the dermal tissues. Ipsilateral injuries, allergies, history of other bacterial infections, excessive life time prescription of antibiotics and levels of psychological stress, evaluated by a questionnaire, were also found to be significantly higher in the patient group. No evidence was produced to show any differences between acute and recurrent populations.This preliminary study into the potential risk factors for cellulitis indicates that some factors merit further investigation. Larger studies are required to substantiate results
Pectin - Xyloglucan linkages in type I primary cell walls of plants
No full textEvidence for covalent pectin - xyloglucan linkages in the cell wall of growing cells and maturing tissues has been reported. In-vitro studies using isolated Golgi membranes, and pulse-labelling studies in vivo, indicate that pectin - xyloglucan linkages form in the Golgi apparatus. The structure and biological significance of these complexes are discussed. © 2005 Società Botanica Italiana.Abdel-Massih RM, 2003, PLANTA, V216, P502, DOI 10.1007-s00425-002-0861-y; Brett C.T., 1996, PHYSL BIOCH PLANT CE; BRETT CT, 2004, 10 CELL WALL M 2004, P66; Femenia A, 1999, CARBOHYD POLYM, V39, P151, DOI 10.1016-S0144-8617(99)00003-X; KEEGSTRA K, 1973, PLANT PHYSIOL, V51, P188, DOI 10.1104-pp.51.1.188; MCCANN MC, 1990, J CELL SCI, V96, P323; POPPER ZA, 2004, 10 CELL WALL M 2004, P85; Thompson JE, 2000, PLANTA, V211, P275, DOI 10.1007-s004250000287; Vincken JP, 2003, PLANT PHYSIOL, V132, P1781, DOI 10.1104-pp.103.022350; WALDRON KW, 1992, PHYTOCHEMISTRY, V31, P1931, DOI 10.1016-0031-9422(92)80336-D89
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