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Support and guide parents on infants problems with home visits and a focus on maternal mental health

Por: Namnabati · M.

Commentary on: Olsen AL, Ammitzboll J, Olsen EM, et al. Problems of feeding, sleeping and excessive crying in infancy: a general population study. Arch Dis Child 2019;104:1034–41.

Implications for practice and research

  • This study identified some regulatory problems such as feeding, sleeping and excessive crying during three periods of infancy through a set of preprogrammed home visits.

  • Parental health has been found to be closely related to infant feeding and sleeping patterns.

  • Providing parents with a strategy to cope with problems with infant feeding and sleeping patterns can reduce parental stress and improve the health of infants.

  • Future research can focus on understanding problems in early and late infancy to provide specific support for parents and develop guidelines for policymakers.

  • Context

    The most common problems among infants are excessive crying, and feeding and sleeping problems, which may occur individually or together. These...

    Statins used for secondary prevention in patients with stroke reduce the risk of further ischaemic strokes and cardiovascular events

    Por: Hill · J. · Hare · M.

    Commentary on: Tramacere, I, Boncoraglio, GB, Banzi, R, et al. Comparison of statins for secondary prevention in patients with ischemic stroke or transient ischemic attack: a systematic review and network meta-analysis. BMC Med 2019;17:67. doi:10.1186/s12916-019-1298-5.

    Implications for practice and research

  • The secondary use of statins is effective in reducing the absolute risk of ischaemic stroke and cardiac events in patients who previously have had an ischaemic stroke or transient ischaemic attack (TIA).

  • Further research is required to ascertain which statin is the most effective.

  • Context

    Stroke is one of the major causes of worldwide death and disability, with one in four people predicted to experience a stroke within their lifetime.1 After a stroke or a TIA, there remains a substantial long-term risk of recurrent stroke.2 It is recommended that statins should be used to reduce the risk of recurrent stroke...

    Mindfulness training for primary care patients promotes chronic disease self-management behaviours

    Por: Kearney · D. J.

    Commentary on: Gawande R, To MN, Pine E, et al. Mindfulness training enhances self-regulation and facilitates health behaviour change for primary care patients: a randomized controlled trial. J Gen Intern Med 2019;34:293–302

    Implications for practice and research

  • Referral of primary care patients to mindfulness training programmes can lead to improved depression and anxiety and increased likelihood of initiating an effective self-management strategy.

  • Longer term studies of behavioural change following mindfulness training are needed.

  • Context

    It is increasingly recognised that chronic physical illnesses (eg, arthritis, diabetes, chronic pain, irritable bowel syndrome and fibromyalgia) commonly co-occur with mental health conditions (eg, depression, anxiety and post-traumatic stress disorder). When mental illness is comorbid with chronic physical illness, outcomes are generally poorer, in part due to impaired self-management. This study by Gawande and colleagues studied the impact of mindfulness training for primary care patients on self-management by assessing...

    Duration of antibiotic treatment for common infections frequently exceeds recommended guidelines, potentially impacting antimicrobial resistance

    Por: Zhang · N.

    Commentary on: Pouwels KB, Hopkins S, Llewelyn MJ, et al. Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines. BMJ 2019;364:l440. doi: 10.1136/bmj.l440

    Implications for research and practice

  • Adherence to clinical prescribing guidelines for common infections stands to significantly decrease the number of days that patients take antibiotics. This could potentially have significant impacts on antimicrobial resistance.

  • Further research could explore the relationship of adherence to guidelines and antimicrobial resistance, and ultimately explore antimicrobial stewardship programmes to increase compliance with guidelines.

  • Context

    The realisation that antibiotic overuse can be harmful has shaped modern global movements of antibiotic prophylaxis and stewardship. Furthermore, nursing has had an established role in this movement.1 As a result, adherence to guidelines for antibiotic treatment for numerous common infections is a serious clinical concern. There is an established relationship...

    Making visible the invisible: the brilliance study

    Por: Russell · S.

    Commentary on: Collier A, Hodgins M, Crawford G, et al. What does it take to deliver brilliant home-based palliative care? Using positiveorganisational scholarship and video reflexive ethnography to explore the complexities of palliative care at home. Palliat Med 2018:269216318807835. doi: 10.1177/0269216318807835.

    Implications for practice and research

  • Presents credible arguments that good practice is reinforced and encouraged through making everyday interactions visible.

  • Explains and demonstrates the research methodology of  Positive Organisational Scholarship in Healthcare (POSH, study of that which is positive, flourishing and life-giving in organisations) and video-reflexive ethnography (VRE) to support generalisability of these methods for research.

  • Context

    Despite the increasing number of people worldwide requiring palliative care at home, there is limited evidence on how such care is best practised. Care can improve symptom management, quality of life and prevent hospitalisation at the end of life. There is significant variation in how it is delivered....

    Increased risk of recurrent Clostridium difficile infection among older adults taking antibiotics and acid reducing medications

    Por: Kean · T.

    Commentary on: Haran JP, Bradley E, Howe E, et al. Medication exposure and risk of recurrent Clostridium difficile infection in community-dwelling older people and nursing home residents. J Am Geriatr Soc 2018; 66(2):333–338.

    Implications for practice and research

  • Increased rates of Clostridium difficile in healthcare facilities and in the community mandates comprehensive infection prevention and control (IPAC) strategies including deprescribing proton pump inhibitors and antibiotic stewardship.

  • Research to examine frailty as a predictive marker of recurrent C. difficile infections (rCDI) among older adults who take acid-reducing agents, antibiotics, and corticosteroids may provide greater clarity on the influence of the living environment.

  • Context

    Recognised as the leading cause of antibiotic-associated diarrhoea worldwide,1–3C. difficile disproportionately affects older adults and confers substantial health and economic burden. The study by Haran et al draws necessary attention to rCDI among older adults who...

    Australian study reveals challenges faced by maternal and child health nurses in caring for refugee families

    Por: McKnight · P.

    Commentary on: Willey SM, Cant RP, Williams, et al. Maternal and child health nurses work with refugee families: perspectives from regional Victoria, Australia. J Clin Nurs 2018;27:3387–96.

    Implications for practice and research

  • Families from a refugee background face significant barriers to accessing healthcare, including communication, underlying health needs and cultural differences.

  • Further professional development is needed to ensure nurses and midwives have the required skills to provide care for refugee and asylum-seeking families.

  • Future research should take account of the legal frameworks governing asylum seekers’ entitlement to health.

  • Context

    As a signatory to the United Nations High Commission for Refugees Convention1, Australia has a long history of resettling asylum-seeking families and refugees. Access to universal healthcare is available to all refugees with a permanent protection visa and some asylum seekers dependent on visa status, which includes maternal and child health services (MCH). Families from...

    Nurse-led cognitive behavioural group treatment intervention for insomnia successfully reduces daytime symptomatology

    Por: Scott · L. · Bawden · J.

    Commentary on: Sandlund C, et al. Impact of group treatment for insomnia on daytime symptomatology: Analyses from a randomized controlled trial in primary care. Int J Nurs Stud 2018;85:126–35

    Implications for practice and research

  • Nurse-led initiatives can be successfully applied to group treatment for insomnia in primary care settings.

  • Future research should continue to explore the impact of daytime symptomatology of insomnia (fatigue, mood, health related quality of life and daytime functioning) on subgroups of patients and should be considered when designing a treatment intervention.

  • Context

    The burden of insomnia is significant in primary care.1 Standard care often involves hypnotic medications. Previous research has focused on improvement in sleep outcomes. This article discusses how extensive daytime symptomatology is attributed to sleep difficulties and how these symptoms have a negative impact on quality of life and mental health. Cognitive processes contribute to developing...