Publications by authors named "George Little"

Objective: This review examined the quantitative relationship between group care and overall maternal satisfaction compared with standard individual care.

Data Sources: We searched CINAHL, Clinical Trials, The Cochrane Library, PubMed, Scopus, and Web of Science databases from the beginning of 2003 through June 2023.

Study Eligibility Criteria: We included studies that reported the association between overall maternal satisfaction and centering-based perinatal care where the control group was standard individual care.

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Objective: The aim of this study is to determine the odds of caesarean section in all births in teaching hospitals as compared with non-teaching hospitals.

Setting: Over 3600 teaching and non-teaching hospitals in 22 countries. We searched CINAHL, The Cochrane Library, PubMed, sciELO, Scopus and Web of Science from the beginning of records until May 2020.

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The Helping Babies Breathe Global Development Alliance (GDA) was a public-private partnership created simultaneously with the launch of the educational program Helping Babies Breathe to accelerate dissemination and implementation of neonatal resuscitation in low- and middle-income countries with the goal of reducing the global burden of neonatal mortality and morbidity related to birth asphyxia. Representatives from 6 organizations in the GDA highlight the recognized needs that motivated their participation and how they built on one another's strengths in resuscitation science and education, advocacy, frontline implementation, health system strengthening, and implementation research to achieve common goals. Contributions of time, talent, and financial resources from the community, government, and private corporations and foundations powered an initiative that transformed the landscape for neonatal resuscitation in low- and middle-income countries.

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Helping Babies Breathe (HBB) changed global education in neonatal resuscitation. Although rooted in the technical and educational expertise underpinning the American Academy of Pediatrics' Neonatal Resuscitation Program, a series of global collaborations and pivotal encounters shaped the program differently. An innovative neonatal simulator, graphic learning materials, and content tailored to address the major causes of neonatal death in low- and middle-income countries empowered providers to take action to help infants in their facilities.

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Bubble CPAP (bCPAP) is used for respiratory distress (RD) in neonates. The leading causes of neonatal mortality can lead to severe RD. Many neonatal deaths are preventable using evidence-based interventions like bCPAP as part of a comprehensive approach.

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Article Synopsis
  • * It found that while most very low birth weight (VLBW) infants were admitted to NICUs, there was significant variation in admissions and care among late preterm infants across different hospitals and regions, even after adjusting for health risks.
  • * The findings suggest that differences in NICU use do not fully depend on the severity of illnesses, indicating different practices among hospitals, and questioning the overall efficiency and effectiveness of the current care models.
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Background: Helping Babies Breathe (HBB), a skills-based program in neonatal resuscitation for birth attendants in resource-limited settings, has been implemented in over 80 countries since 2010. Implementation studies of HBB incorporating low-dose high-frequency practice and quality improvement show substantial reductions in fresh stillbirth and first-day neonatal mortality. Revision of the program aimed to further augment provider and facilitator skills and address gaps in implementation with the goal of improving neonatal survival.

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A 30-year-old man suffered post-traumatic hypothermic cardiac arrest. On arrival in the emergency department, rectal core temperature was 23°C. Manual cardiopulmonary resuscitation (CPR) was continued as no mechanical chest compression device was available, and active and passive rewarming was undertaken.

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Background: The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities.

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Objectives: To develop an educational program designed to train health care providers in resource limited settings to carry out neonatal resuscitation. We analyzed facilitator and learner perceptions about the course, examined skill performance, and assessed the quality of instruments used for learner evaluation as part of the formative evaluation of the educational program Helping Babies Breathe.

Methods: Multiple stakeholders and a Delphi panel contributed to program development.

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Objective: To assess the developmental impact of surviving a sibling who dies in the neonatal intensive care unit (NICU).

Study Design: Fourteen (13 adults, 1 adolescent) siblings of infants who died in Dartmouth-Hitchcock Medical Center's NICU between 1980 and 1990 were interviewed. The interviews were recorded and transcribed verbatim, and prominent themes were coded.

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Background: Despite high per capita health care expenditure, the United States has crude infant survival rates that are lower than similarly developed nations. Although differences in vital recording and socioeconomic risk have been studied, a systematic, cross-national comparison of perinatal health care systems is lacking.

Objective: To characterize systems of reproductive care for the United States, Australia, Canada, and the United Kingdom, including a detailed analysis of neonatal intensive care and mortality.

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Background: There is marked regional variation in the availability of neonatal intensive care in the United States. We conducted a study to determine whether a greater supply of neonatologists or neonatal intensive care beds is associated with lower neonatal mortality.

Methods: We used the 1996 master files of the American Medical Association and the American Osteopathic Association and 1998 and 1999 surveys of neonatal intensive care units to calculate the supply of neonatologists and neonatal intensive care beds in 246 neonatal intensive care regions.

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We report and illustrate a case of fetal demise at 31 weeks caused by fulminant herpes simplex virus (HSV) infection. The 15-year-old mother reported no past history or symptoms of an HSV infection during pregnancy. Autopsy revealed extensively ulcerated skin and necrosis of the liver, adrenal glands, brain, and placental membranes.

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Foliar sprays of potato plants with phosphonic acid (partially neutralised with potassium hydroxide to pH 6.4) substantially reduced infection of the tubers by Phytophthora infestans, the cause of late blight, in glasshouse and field experiments over a 4-year period. Healthy tubers of blight-susceptible cultivars removed from treated plants and artificially inoculated by spraying with sporangial/zoospore suspensions of P infestans did not develop disease symptoms, demonstrating that the phosphonate applications had directly reduced the susceptibility of tubers to infection, probably as a result of translocation into tuber tissue.

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