Breastfeeding has been widely studied as a factor that improves maternal and newborn health outcomes. Immediate or early skin-to-skin contact interventions have been proposed in health care services to increase breastfeeding or exclusive breastfeeding rates following caesarean births although the findings are inconclusive. This systematic review and meta-analysis aimed to synthesize the available evidence on early or immediate skin-to-skin contact and breastfeeding in women and newborns following caesarean birth. A systematic search was performed using in the MEDLINE, EMBASE, Cochrane Library and Web of Science databases from inception to June 2024. The effects of early or immediate skin-to-skin contact were reported as relative risks (RRs) with 95 % confidence intervals (CIs) provided by the original articles. Pooled estimates were calculated using the DerSimonan and Laird methods. The intervention groups received early or immediate skin-to-skin contact and the control group received standard care after caesarean birth. The risk of the bias of the randomized controlled trials was assessed using the Cochrane risk of bias tool for randomized controlled trials (RoB 2) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) assessment tool for nonrandomized studies. Publication bias was assessed with funnel plot asymmetry and Egger's test. Zotero reference manager and Stata 17 software were used. Eight randomized controlled trials and three quasiexperimental studies involving a total of 1.990 participants were included. The findings indicate that skin-to-skin contact decreased the time to first attachment by 51.73 min (95 % CI: -68.54 to -34.91; I2: 85.3), increased the breastfeeding rates in the first 2 h after birth (RR: 4.86; 95 % CI: 2.71 to 7.01; I2: 44.1) and the exclusive breastfeeding rate at discharge (RR: 1.69; 95 % CI 1.36 to 2.01; I2: 13.7), but not the exclusive breastfeeding rate at one month from birth or later (RR: 1.13; 95 % CI 0.73 to 1.54; I2: 0.0). This study revealed that early or immediate skin-to-skin contact after caesarean birth improved breastfeeding rates and exclusive breastfeeding rates during the health care stay. Trials with longer follow-up times are needed to assess whether interventions based on early or immediate skin-to-skin contact maintain their effectiveness over time and to clarify whether early or immediate skin-to-skin contact is safe for preterm newborns or women with certain health conditions.
1 January 2020 in Revista Latino-Americana de Enfermagem
Objective: to construct and validate a tool for the evaluation of responders in tactical casualty care simulations. Method: three rubrics for the application of a tourniquet, an emergency bandage and haemostatic agents recommended by the Hartford Consensus were developed and validated. Validity and reliability were studied. Validation was performed by 4 experts in the field and 36 nursing participants who were selected through convenience sampling. Three rubrics with 8 items were evaluated (except for the application of an emergency bandage, for which 7 items were evaluated). Each simulation was evaluated by 3 experts. Results: an excellent score was obtained for the correlation index for the 3 simulations and 2 levels that were evaluated (competent and expert). The mean score for the application of a tourniquet was 0.897, the mean score for the application of an emergency bandage was 0.982, and the mean score for the application of topical haemostats was 0.805. Conclusion: this instrument for the evaluation of nurses in tactical casualty care simulations is considered useful, valid and reliable for training in a prehospital setting for both professionals who lack experience in tactical casualty care and those who are considered to be experts.
La gestión de información actual y fiable en el ámbito científico es imprescindible para el ejercicio de las diferentes profesiones. El objetivo principal es identificar el impacto de la formación impartida por el personal de la Biblioteca de la UAH vinculado a la adquisición de competencias informacionales por parte del estudiante universitario. La metodología se basa en un estudio analítico pre-post. La intervención se realizó con estudiantes de 1º Grado (curso 2015-16) y al final de sus estudios (siendo el último en el curso 2020-21). El ámbito del estudio fueron ocho titulaciones de Ciencias y Ciencias de la Salud de la UAH. La medición se realizó mediante un cuestionario anónimo administrado a los estudiantes, basado en el instrumento de encuesta previamente validada y adaptada. Conclusión: el estudiantado mejora en las competencias informacionales al finalizar los estudios, aunque con cierta variabilidad según el tiempo y profundidad dedicada a dichas competencias.
Background/Objectives: The establishment of strong prenatal bonding is a key determinant of perinatal well-being, influencing maternal psychological adaptation and infant development. Numerous studies have examined risk factors and psychopathology during pregnancy, but limited research has explored the role of positive psychological constructs, such as positive mental health (PMH). This study aimed to assess whether anxiety mediates the relationship between PMH and the quality of prenatal bonding. Methods: A total of 90 pregnant women participated. PMH was assessed using the Abbreviated Positive Mental Health Questionnaire; anxiety using the Hospital Anxiety and Depression Scale; and prenatal bonding using the Prenatal Assessment Scale for Pregnant Women (EVAP). A simple mediation model was tested, with anxiety as a mediator between PMH (predictor) and prenatal bonding (outcome), controlling the analysis for previous miscarriages, relationship stability, high-risk pregnancy, and employment. Results: The model revealed partial mediation (F = 16.617, p < 0.001). Higher PMH was associated with lower anxiety (B = −0.297, SE = 0.062, p < 0.001) and stronger prenatal bonding (B = 0.777, SE = 0.091, p < 0.001). Interestingly, anxiety emerged as an adaptive response, which could improve maternal sensitivity and communication with the unborn child (B = 0.316, SE = 0.145, p = 0.032). The model explained 56% of the variance in prenatal bonding, even after accounting for relevant covariates. Conclusions: These findings underscore the importance of considering contextual and psychosocial factors when assessing the role of emotions such as anxiety during pregnancy. Rather than being inherently maladaptive, anxiety may play a functional role in facilitating maternal engagement with the baby, especially when grounded in PMH. Given the limited research, our findings support the integration of positive psychology frameworks into perinatal health interventions.