Conectar
Examine the meaning of ‘successful feeding’ for parents of infants at risk for feeding difficulties and how this meaning evolved from 1 to 24 months post-term age.
Secondary analysis of responses to an open-ended question from a U.S. longitudinal mixed methods study.
At 1-, 6-, 12-, 18-, and 24-months post-term, parents completed surveys which included the question: What is ‘successful feeding’ to you? Using conventional content analysis, 864 responses from parents of 254 infants were coded into the following categories: Child Behaviour, Positive Response, Intake, and Time. Themes characterizing each category were identified.
Child Behaviour, Positive Response, and Intake were common at all time points. Responses related to Time (e.g., eating in a timely manner) were least frequent at 1, 6, and 12 months and were no longer mentioned thereafter. Demonstrating feeding skill/ability and satiety were common themes at all time points. Adequate quantity of food and no adverse response (e.g., emesis, choking) were common themes at 1 month; both decreased thereafter. The perception that the child was engaged in eating and eating nutritionally adequate food increased as children aged.
Parents' perspectives of successful feeding focused on indicators of their child's development and emotional and physical well-being. As their children aged, ate increasingly complex foods, and developed physiologic stability, the meaning of success focused less on the amount of intake and avoidance of an adverse response and more on child well-being.
Nurses and feeding specialists can incorporate parents' views of success as they provide feeding support.
Children having a positive behavioural and affective response to eating, and adequate intake provide evidence to parents of their success in achieving feeding goals. Understanding issues of importance to parents is an essential component of family-centered care of children with feeding difficulties.
No Patient or Public Contribution.
The authors have adhered to the Standards for reporting qualitative research.
by Brandon Hergert, Kristin M. Whitworth, Devorah C. Goldman, Lisa Moreau, Kelsey McQueen, Kalindi Parmar, Alan D’Andrea, Melissa S. Samuel, Kevin D. Wells, Randall S. Prather, Craig Dorell, Markus Grompe, William H. Fleming
Although small animal models of Fanconi anemia (FA) are useful, they do not faithfully replicate many of the clinical features seen in FA patients. We reasoned that a porcine model of FA with its similar physiology and a relatively long lifespan would produce a phenotype more similar to human FA. Targeting FANCA in domestic swine resulted in skeletal abnormalities and extreme sensitivity to interstrand DNA cross-linking agents. In addition, FANCA disruption followed by mitomycin C treatment resulted in a > 10-fold increase in chromosomal radials, a finding that is considered diagnostic for human FA. Bone marrow derived, hematopoietic progenitor cells from a FANCA null pig showed a 75% reduction in colony forming activity compared to wild type. Evaluation of steady state hematopoiesis in the peripheral blood revealed the gradual development of red cell macrocytosis and a reduction in circulating neutrophils. Targeting of FANCD2 failed to produce any biallelic animals demonstrating the loss of FANCD2 function is embryonic lethal in pigs. These results indicate that a porcine model of FANCA holds promise for the development of strategies to prevent the development of bone marrow failure and malignancies in patients with FA.Rapid urbanisation in Bangladesh has posed significant challenges to the urban health system, particularly in the delivery of primary healthcare (PHC). The country’s PHC system is fragmented, involving public, non-government organization (NGO), private and informal providers, leading to inequitable access, high out-of-pocket expenditure and inefficiencies. Strategic purchasing, which links resource allocation to health priorities and outcomes, offers a potential pathway to strengthening urban PHC systems. This study aims to assess the current urban PHC system, examine stakeholders’ perspectives on the feasibility of strategic purchasing, understand community health needs and preferences and develop a policy framework for strategically purchasing PHC services in urban settings.
This study will follow a sequential mixed-methods approach, integrating qualitative and quantitative data. A scoping review will be conducted to assess the characteristics and funding modalities of the existing urban PHC purchasing mechanisms. Key informant interviews with stakeholders, including policy makers and health experts, will explore the strengths and challenges of the current urban PHC system and the feasibility of implementing strategic purchasing. Community healthcare needs and preferences will be examined through in-depth interviews (IDIs), focus group discussions (FGDs) and a discrete choice experiment (DCE) survey in urban informal settlements. Insights from IDIs and FGDs will inform the DCE survey, which will present hypothetical scenarios to participants to identify the most important attributes for improving PHC services. Qualitative data will be coded deductively and inductively, and DCE data will be analysed using latent class models, with sensitivity analyses conducted using the multinomial logit model. Findings will contribute to the development of a strategic purchasing framework, validated through consultation workshops with health system stakeholders.
Ethical approval has been obtained from the ethics committees in both Bangladesh and the UK. Findings will be disseminated through workshops, peer-reviewed publications, policy briefs and conference presentations.
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