Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. ...Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs. This time frame immediately post birth may represent a 'sensitive period' for programming future physiology and behavior.
To assess the effects of immediate or early SSC for healthy newborn infants compared to standard contact on establishment and maintenance of breastfeeding and infant physiology.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (17 December 2015), made personal contact with trialists, consulted the bibliography on kangaroo mother care (KMC) maintained by Dr Susan Ludington, and reviewed reference lists of retrieved studies.
Randomized controlled trials that compared immediate or early SSC with usual hospital care.
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Quality of the evidence was assessed using the GRADE approach.
We included 46 trials with 3850 women and their infants; 38 trials with 3472 women and infants contributed data to our analyses. Trials took place in 21 countries, and most recruited small samples (just 12 trials randomized more than 100 women). Eight trials included women who had SSC after cesarean birth. All infants recruited to trials were healthy, and the majority were full term. Six trials studied late preterm infants (greater than 35 weeks' gestation). No included trial met all criteria for good quality with respect to methodology and reporting; no trial was successfully blinded, and all analyses were imprecise due to small sample size. Many analyses had statistical heterogeneity due to considerable differences between SSC and standard care control groups. Results for womenSSC women were more likely than women with standard contact to be breastfeeding at one to four months post birth, though there was some uncertainty in this estimate due to risks of bias in included trials (average risk ratio (RR) 1.24, 95% confidence interval (CI) 1.07 to 1.43; participants = 887; studies = 14; I² = 41%; GRADE: moderate quality). SSC women also breast fed their infants longer, though data were limited (mean difference (MD) 64 days, 95% CI 37.96 to 89.50; participants = 264; studies = six; GRADE:low quality); this result was from a sensitivity analysis excluding one trial contributing all of the heterogeneity in the primary analysis. SSC women were probably more likely to exclusively breast feed from hospital discharge to one month post birth and from six weeks to six months post birth, though both analyses had substantial heterogeneity (from discharge average RR 1.30, 95% CI 1.12 to 1.49; participants = 711; studies = six; I² = 44%; GRADE: moderate quality; from six weeks average RR 1.50, 95% CI 1.18 to 1.90; participants = 640; studies = seven; I² = 62%; GRADE: moderate quality).Women in the SCC group had higher mean scores for breastfeeding effectiveness, with moderate heterogeneity (IBFAT (Infant Breastfeeding Assessment Tool) score MD 2.28, 95% CI 1.41 to 3.15; participants = 384; studies = four; I² = 41%). SSC infants were more likely to breast feed successfully during their first feed, with high heterogeneity (average RR 1.32, 95% CI 1.04 to 1.67; participants = 575; studies = five; I² = 85%). Results for infantsSSC infants had higher SCRIP (stability of the cardio-respiratory system) scores overall, suggesting better stabilization on three physiological parameters. However, there were few infants, and the clinical significance of the test was unclear because trialists reported averages of multiple time points (standardized mean difference (SMD) 1.24, 95% CI 0.76 to 1.72; participants = 81; studies = two; GRADE low quality). SSC infants had higher blood glucose levels (MD 10.49, 95% CI 8.39 to 12.59; participants = 144; studies = three; GRADE: low quality), but similar temperature to infants in standard care (MD 0.30 degree Celcius (°C) 95% CI 0.13 °C to 0.47 °C; participants = 558; studies = six; I² = 88%; GRADE: low quality). Women and infants after cesarean birthWomen practicing SSC after cesarean birth were probably more likely to breast feed one to four months post birth and to breast feed successfully (IBFAT score), but analyses were based on just two trials and few women. Evidence was insufficient to determine whether SSC could improve breastfeeding at other times after cesarean. Single trials contributed to infant respiratory rate, maternal pain and maternal state anxiety with no power to detect group differences. SubgroupsWe found no differences for any outcome when we compared times of initiation (immediate less than 10 minutes post birth versus early 10 minutes or more post birth) or lengths of contact time (60 minutes or less contact versus more than 60 minutes contact).
Evidence supports the use of SSC to promote breastfeeding. Studies with larger sample sizes are necessary to confirm physiological benefit for infants during transition to extra-uterine life and to establish possible dose-response effects and optimal initiation time. Methodological quality of trials remains problematic, and small trials reporting different outcomes with different scales and limited data limit our confidence in the benefits of SSC for infants. Our review included only healthy infants, which limits the range of physiological parameters observed and makes their interpretation difficult.
Winter wheat (Triticum aestivum, L.) production in the semi-arid US Northern High Plains (NHP) is challenged by frequent droughts and water-limited, low fertility soils. Composted cattle manure ...(compost) and cover crops (CC) are known to provide agroecosystem services such as improved soil health, and in the CC case, increased plant diversity, and competition with weedy species. The main concern of planting CC in winter wheat fallow rotation in regions that are more productive than the NHP, however, is the soil moisture depletion. It is unknown however, whether addition of CC to compost-amended soils in the NHP will improve soil properties and agroecosystem health without compromising already low soil water content. The main objective of this study was to assess the effects of four CC treatments amended with compost (45 Mg ha.sup.-1) or inorganic fertilizer (IF) (.09 Mg ha.sup.-1 mono-ammonium phosphate, 11-52-0 and 1.2 Mg ha.sup.-1 ammonium sulfate, 21-0-0) on the presence of weeds, soil and plant total carbon (C), nitrogen (N), and biological dinitrogen (N.sub.2) fixation (BNF). Mycorrhizal Mix (MM), Nitrogen Fixer Mix (NF), Soil Building Mix (SB), a monoculture of phacelia (Phacelia tanacetifolia Benth L.) (PH), and a no CC control (no CC) were grown in native soil kept at 7% soil moisture in a greenhouse for a period of nine weeks. When amended with compost, MM was the most beneficial (48 g m.sup.-2 BNF and 1.7% soil C increase). SB had the highest germination, aboveground biomass, and decreased weed biomass by 60%. It also demonstrated the second highest amount of BNF (40 g m.sup.-2) and soil C increase by 1.5%. On contrary, IF hindered BNF by almost 70% in all legume-containing CC treatments and reduced soil C by 15%.
To determine the reliability and validity of the upper extremity function and pain scales of the Pediatric Outcomes Data Collecton Instrument (PODCI UEF and PODCI P) as an outcome measure in ...adolescents with Hypermobility Spectrum Disorder (HSDs).
An observational study using a cross-section design was conducted. A convenience sample of 83 adolescents (age 11-18 years) with HSDs were recruited. Test-retest reliability of the PODCI UEF and PODCI P was examined using Lin's concordance correlation coefficient (ρ
c
). Concurrent validity was established by comparing the PODCI UEF to the PROMIS Pediatric Upper Extremity-Short Form (PROMIS PUE-SF) and comparing the PODCI P to Numeric Rating Scale (NRS) using Spearman rho correlations.
There was high test-retest reliability for the PODCI UEF, ρ
c
= 0.81 (p < 0.001) and moderate test-retest reliability for the PODCI P, ρ
c
= 0.68 (p < 0.001). There was a strong correlation between the PODCI UEF and the PROMIS PUE-SF, r
s
= 0.80 (p < 0.001) and a moderate inverse relationship r
s
= −0.73 (p < 0.001) between PODCI P and NRS scores (n = 150).
The PODCI UEF and PODCI P may be a valid and reliable outcome measure in adolescents with HSDs.
Implications for rehabilitation
Adolescents with joint hypermobility can have chronic pain, fatigue, and decreased participation in daily activities.
Clinical use of valid and reliable outcome measures to measure change may assist in planning care and identifying best practice for the management of HSDs.
The PODCI was designed to be used as an outcome measure for chronic musculoskeletal conditions and has demonstrated test-retest reliability, validity, and responsiveness to change in other pediatric populations.
The PODCI may be a valid and reliable outcome measure in adolescents with HSDs.
Flexible gallium nitride (GaN) thin films can enable future strainable and conformal devices for transmission of radio‐frequency (RF) signals over large distances for more efficient wireless ...communication. For the first time, strainable high‐frequency RF GaN devices are demonstrated, whose exceptional performance is enabled by epitaxial growth on 2D boron nitride for chemical‐free transfer to a soft, flexible substrate. The AlGaN/GaN heterostructures transferred to flexible substrates are uniaxially strained up to 0.85% and reveal near state‐of‐the‐art values for electrical performance, with electron mobility exceeding 2000 cm2 V−1 s−1 and sheet carrier density above 1.07 × 1013 cm−2. The influence of strain on the RF performance of flexible GaN high‐electron‐mobility transistor (HEMT) devices is evaluated, demonstrating cutoff frequencies and maximum oscillation frequencies greater than 42 and 74 GHz, respectively, at up to 0.43% strain, representing a significant advancement toward conformal, highly integrated electronic materials for RF applications.
Flexible gallium nitride (GaN) thin films and devices are described that enable amplification of radio‐frequency signals in future conformal and wearable electronics. Flexible GaN is realized through lift‐off using a 2D boron nitride release layer and can accommodate strains up to 0.43%, while exhibiting electron mobility and small signal frequency performance rivaling high‐performing, rigid GaN materials.
Purpose
The purpose of this article is to examine the roles family members play in shaping young children’s food preferences and habits, as well as the extent to which these effects endure into ...adulthood.
Design/methodology/approach
Drawing on research in public health, marketing, nutrition and psychology, this paper examines how intergenerational influences (IGs) are manifested in the dietary domain.
Findings
Evidence suggests that the influence of early socialization is substantial, and that such impacts constitute an interesting yet sometimes overlooked set of forces that can help to guide our consumption behaviors as adults.
Originality/value
A detailed agenda for future research is proposed.
Market based institutional reforms across the globe have led to massive improvements in business conditions and have contributed to unprecedented rates of cross-border business activities. Scholars ...have tried to understand the implications of such reforms and have amassed a significant body of work in this area, but analysis of this literature highlights some deficiencies limiting its impact. A primary issue is the fragmentation of this work across different disciplines and the use of different terminology even in the business literature, leading to disconnected conversations and limited progress on the topic. The purpose of this article is two-fold: (1) provide a systematic review of the literature on the effect of market based institutional reforms on firm strategy and performance, and (2) propose a future research agenda. We argue that employing an aggregate perspective, as opposed to one focusing on individual reform subcomponents, provides a more comprehensive understanding of their systemic implications. We use this approach to analyze extant work on the implications of reforms including both direct effects on firm strategy and performance and various contingences such as location, time, institutional legacies, and global organizations. To summarize our two objectives, we develop two graphical models – one depicting the current state of the literature and the other highlighting possible theoretical additions for future research.
Childhood obesity is a serious global health challenge. Families and consumption are at the nexus of the problem, as childhood weight issues depend significantly on family-related influences (genetic ...predispositions, physical activities, and household food consumption practices). This article focuses on how a family socializes a child toward or away from obesity. It advances a family consumer socialization framework to characterize key elements and processes. Biological predispositions, parent/family inputs, elements of child development, parent-child interactions, and intergenerational transfer are all major contributors to weight status and life course potentials. Time is also a crucial component, here represented in two forms—linear and cyclical. Drawing on extensive research from other disciplines and related consumer research, five “foundational properties” are distilled, representing fundamental tenets underpinning the family’s role in this problem. Each property is then used to chart promising opportunities for consumer researchers and others interested in advancing knowledge on this pressing concern.
Each year, approximately 200,000 patients in the United States will receive partial- or whole-brain irradiation for the treatment of primary or metastatic brain cancer. Early and delayed radiation ...effects are transient and reversible with modern therapeutic standards; yet, late radiation effects (≥6 months postirradiation) remain a significant risk, resulting in progressive cognitive impairment. These risks include functional deficits in memory, attention, and executive function that severely affect the patient's quality of life. The mechanisms underlying radiation-induced cognitive impairment remain ill defined. Classically, radiation-induced alterations in vascular and neuroinflammatory glial cell clonogenic populations were hypothesized to be responsible for radiation-induced brain injury. Recently, preclinical studies have focused on the hippocampus, one of two sites of adult neurogenesis within the brain, which plays an important role in learning and memory. Radiation ablates hippocampal neurogenesis, alters neuronal function, and induces neuroinflammation. Neuronal stem cells implanted into the hippocampus prevent the decrease in neurogenesis and improve cognition after irradiation. Clinically prescribed drugs, including PPARα and PPARγ agonists, as well as RAS blockers, prevent radiation-induced neuroinflammation and cognitive impairment independent of improved neurogenesis. Translating these exciting findings to the clinic offers the promise of improving the quality of life of brain tumor patients who receive radiotherapy.
Official development aid – monetary transfers to developing countries to promote social and economic development – reached more than $140 billion in 2016. However, traditional forms of government ...bilateral aid continue to decline, while private aid is rising. Nevertheless, the impact of this aid, including its potential to stimulate economic development through new business formation, remains uncertain. In this study, we examine the impact of three sources of monetary aid flows on formal and informal entrepreneurship. Drawing from the international political economy literature we argue that bilateral aid and private aid are associated with higher levels of informal entrepreneurship, while multilateral aid is accompanied by lower levels. Moreover, we show that bilateral and private aid are linked with lower levels of formal entrepreneurship, while multilateral aid has no impact. The analyses of a panel of 313 observations from 49 countries provide robust support for these arguments.
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