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Introduction:  The birth of a newborn is a great moment and amazing physical changes occur soon after birth. Newborns who do not start breathing on their own by one minute after birth should receive positive pressure ventilation with room air by a self-inflating bag and mask.
Physical Examination: A brief, physical examination is performed to check for obvious signs that the baby is healthy.
Recurrent fever: Recurrent fevers are defined as three or more febrile episodes in a six-month period, occurring at least seven days apart, with no causative medical illness.
Patients with cyclic neutropenia (CN) suffer from fevers lasting 4-5 days every 2-3 weeks, slightly more frequently than PFAPA patients. Patients with malignancies can have recurrent fevers but these are typically not periodic and the child does not grow and develop normally between attacks. Diagnosis: The diagnosis of recurrent fever depends on a good history, physical findings and the appropriate laboratory workup.
It is a type of skin disorder in which there is a loss of skin pigment or color which leads to white patches all over the body. The exact reason what causes vitiligo to develop is still unknown but research shows that certain factors like autoimmune disorder, stressful event, harm to skin due to sunburn or cut, exposure to certain chemicals or a viral cause may be involved.
Melanocytes are the cells located deep within the epidermis and are responsible for producing melanin which gives gives skin its color and helps protect it from the sun. Vitiligo can be focal and localized to one area, or it may affect several different areas on the body. Although kids of all races are affected equally, spots tend to be more visible on those with darker skin. Sometimes kids with vitiligo have other symptoms, such as premature graying of the hair or a loss of pigment on the lips, since pigment cells are found in these places, too. This website uses cookies to enhance your user experience, please see how we use cookies for more information. How do you save a course?It's simple, just look for the 'save this course' buttons when viewing course search results, listings or details.What can you do with saved courses?Saving courses allow you to compare them, it also allows you to create a permanent list of 'favourites' that will always be there when you visit our site.
Partnered with providers: The Faculty has a strong focus on the training of health and education professionals and we're growing our life sciences portfolio.
The School of Health Sciences was established in 2014 to accommodate our growing biomedical science and sports courses portfolio. The School of Education has a long and established history when it comes to delivering initial teacher training (ITT), education, childhood and youth courses in Birmingham. We are one of the largest and most diverse providers of health and social care education in the country and our departments comprise of Operating Department Practice and Paramedics, Public and Community Health, Radiography, and Speech and Language Therapy. 100% Our courses offer excellent potential for career development and typically achieves a 100% employment record for graduates.
The Defence School of Healthcare Education, Department of Healthcare Education (formerly the Defence School of Health Care Studies and the Defence School of Postgraduate Medical Studies) is the Armed Forces' provider of healthcare education to Defence Medical Services personnel. We are one of the leading providers of employees to the NHS, offering first-class learning facilities including state-of-the-art lecture theatres and seminar rooms, mock wards, birthing rooms, operating theatres and virtual reality software. This form describes the procedures and possible benefits and risks to you and your baby when filing for prenatal care. A crying baby and a momentary loss of control by a frustrated parent or caregivercan end in the death of the baby or life-long permanent and severe neurological damage.
The increasing incidence of infant victims of Shaken Baby Syndrome (SBS) is a tragedy for the child, the family and the community.
The San Francisco Shaken Baby Syndrome (SBS) Prevention Work Group formed in May 2005 when pediatricians and health department workers in San Francisco noted an increase in the number of Shaken Baby Syndrome cases in San Francisco.
Although the San Francisco Department of Human Services’ Foster Care reports an increase in SBS, it is difficult to locate accurate data.
Around the same time that the SBS Prevention Work Group began meeting, a study was published demonstrating an effective model for SBS prevention, Dr.
The SBS Prevention Work Group proposes a hospital-based parent education intervention based on the Dias study. This program proposes to educate all parents and caregivers of newborns in the most basic child abuse prevention strategies. The delivery hospital intervention will not cover the entire at-risk population of children.
The training component of this program will provide SBS prevention training for obstetrical and pediatric providers, governmental and community-based agencies to reach those who did not receive the educational intervention in a San Francisco delivery hospital. A public awareness campaign will be planned, implemented, and evaluated to inform the general public, who would not necessarily be informed at the delivery hospital, but who may be responsible for caring for a newborn or small child.
The San Francisco Shaken Baby Syndrome Prevention Project has made significant strides this past year in developing our program including hiring a part time training coordinator through a collaboration with the UCSF National Center of Excellence in Women’s Health, and developing training and health education materials.
As you will see below, we have accomplished a great deal of work in part from the tremendous amount of in-kind work that has been done by the SBS Prevention Work Group members and through the funds raised. We have worked hard to raise funds to support the SBS prevention project activities and are continually fundraising to achieve full implementation of the entire proposed SBS project. After extensive research on other national SBS prevention projects, our training curriculum and PowerPoint presentation have been developed and tailored to meet the unique needs of each delivery hospital.
Thanks to all our SBS work group members in-kind support, we have finalized the English, Spanish, and Chinese brochures.
As of December 2008, 218 nurses from SFGH, UCSF and CPMC and 42 staff members from Talk Line and various family resources throughout San Francisco have been trained.
As we train the 500 nurses at the five delivery hospitals, we will continue to raise funds so we are able to implement the second tier of the SBS project.
The newborn is completely dependent on others for feeding, warmth, and comfort. Labour, birth and the immediate postnatal period are the most critical for newborn and maternal survival.
A score of 4 to 6 may indicate that the baby needs some resuscitation measures (oxygen) and careful monitoring. Parents will often be able to predict within several days the onset of the next fever attack.The syndrome usually occurs in children younger than five years who present with regular fevers and cervical adenopathy. Interestingly, symptoms of PFAPA and CN are very similar including oral aphthae, cervical adenopathy, and pharyngitis. In the majority of cases, the affected areas remain affected for the rest of the person’s life.
We offer high quality courses at both undergraduate and postgraduate degree level that are tailored to meet the needs of the professions.
Our departments cover Adult Nursing, Mental Health and Learning Disabilities, Midwifery and Child Health, and Social Work. Harvey Karp, a pediatrian and author of "The Happiest Baby On The Block" discusses his work relating to Shaken Baby Syndrome and models of care of infants and children and means for caregivers to better cope during periods of a baby's prolonged crying. Shaken Baby Syndrome is a collection of signs and symptoms resulting from violently shaking an infant or child.
A score of 3 or below indicates that the baby requires immediate resuscitation and lifesaving techniques. Aphthous ulcers, which are usually small and relatively painless, are the symptom most likely to be missed. Children with PFAPA syndrome are well between episodes and relatively well even during episodes.
Fever without any other sign or symptom is more common with viral infections than with bacterial infections. Initially the effected skin gets lighter in color but eventually it spreads to cover a much larger area producing depigmented spots. There is very little health systems research that disaggregates data by sex, and where there is such research, they lack further analysis. Before birth, the lungs are not used to exchange oxygen and carbon dioxide, and need less blood supply.
For instance, while differences between men and women will be reported, these differences are not explained. The fetal circulation sends most of the blood supply away from the lungs through special connections in the heart and the large blood vessels.
Inflammatory or autoimmune diseases, including inflammatory bowel disease, juvenile rheumatoid arthritis, and Behcet’s disease, as well as hereditary periodic fevers, lymphoma, and factitious fever, should be considered. Luke’s, San Francisco General Hospital, UCSF), the SF Child Abuse Council, San Francisco Department of Public Health (SFDPH) Maternal and Child Health, Public Health Nursing, Child Health and Disability Prevention Program (CHDP), WIC, Blue Cross and San Francisco Health Plan. A nurturing mother is important but an inattentive or abusive father can still be damaging. When a baby begins to breathe air at birth, the change in pressure in the lungs helps close the fetal connections and redirect the blood flow. However, it is important to consider gender power relations and how they shape inequalities, and aspects and dynamics of health systems.Health systems terminology is often used in gender neutral ways, however, health systems are not gender neutral. This study found that use of a separate educational piece on Shaken Baby Syndrome played a significant role in the reducing the incidence of SBS.


Analysis of gender related needs, roles and power relations that shape experiences is often the missing component in health systems research. Interventions to achieve the best early nurturing and stimulation for a child should aim to include the father to avoid perpetuating this. This also extends to other aspects of health systems research, such as health financing.Therefore, calls for health systems research need to include gender analysis as a required component, while providing support to build the capacity of researchers to incorporate such analysis is also essential. There are traditional, social and cultural norms creating barriers to addressing this but that should not stop us from looking at the issue.
Stimulating the baby to cry by massage and stroking the skin can help bring the fluid up where it can be suctioned from the nose and mouth. A fatherhood project in South Africa has seen some success.This is one of the many points that could be picked up on in the huge area of ECD.
The topic guide does well to include evidence on many issues such as antenatal preparation, breast feeding, newborn care, infant nutrition, community-based day care, pre-school, school readiness, WASH and many more.
It reviews existing literature, examining carefully what the current knowledge is, where the important issues or problems lie and a€?what worksa€?.
The author of the guide, Martin Woodhead, suggests that we should be integrated in our vision.
It is divided into ten sections.This guide was produced as a result of a reading week held for the UK Department for International Development (DFID) advisers in mid-2012. Implementation of a scheme covering all elements of ECD is likely to be cumbersome and ineffective. The topics and readings were chosen by experts in the field but are not a comprehensive review of all family planning literature. This topic guide is an update and based on the key readings selected for this week plus updated materials. As part of this topic guide we have assessed the strength of the evidence that we have used. We work together to support the use of evidence and expert advice in policymaking.HEART helps time-pressured decision-makers better understand, interpret and apply health, nutrition and education evidence. Maybe it is time for a global campaign Reply Teklu GemechuDecember 23, 2014 at 11:59 amPermalink The social and economic situations in industrialized countries are different from that of third world countries. Strong evidence should be of central importance in informing policy and programming decisions. Division of labor based on gender is more common in low income countries than in industrialized countries. As men are are usually engaged in outdoor activities and field works, women are mostly responsible for indoor activities and household chores and early child care practices.
Mothers and grandmothers are given the role of looking after children (caring & feeding). We used part two of the DFID paper, and the tables on page 9 and 15 to guide our method for this. Hence, this difference should be taken into account when developing a manual to involve both parents in effort to enhance child care practices across different social and economic contexts. In order to use the single study assessment, please see the key in the appendix which outlines the use of acronyms for each part. Social and economic situations differ around the world but the joy of children is universal.
Ideally, this is based on the assessment of all the individual studies that constitute a body of evidence but due toA limitations inA time and to show the quality of evidence used for this guide, we have based this on the evidence that is used for each section. It is often the case in less developed countries that fathers are away from the household working long hours.
Therefore this assessment is based on the body of evidence used for this paper, not all the literature.
And what better way to spend any time at home than reaping the rewards of interacting with their children.
Mothers may be encouraged to seek work outside the home to contribute financially so fathers don’t have to miss out so much. Suitable employment opportunities for women is, of course, a challenge which needs addressing as part of this. A couple typically had five or six births but only two, on average, survived to adulthood, sufficient to maintain a stable population size but no more (Dyson, 2010). By 1950, life expectancy had risen modestly to 30 years but thereafter the pace of change accelerated dramatically. By 1960, expectancy had leapt to 48 years and has continued to improve to reach 69 years by 2005-10 (UN DESA, 2013).
At the global level, it is projected to reach 76 years in 2045-2050 and 82 years in 2095-2100. By the end of the century, people in developed countries could live on average around 89 years, compared to about 81 years in developing regions (UN DESA, 2013).Birth rates in most of Asia, Latin America and Africa in the 1950s and 1960s remained high and thus the inevitable result of declining mortality was a rapid population growth.
The era of peak growth has now passed but a further increase of more than two billion is expected between 2010 and 2050 (UN DESA, 2013). Demographic projections are outlined in section 2.Two key publications provided the initial rationale for state promotion of contraception. The first was an economic analysis, concluding that rapid population growth and its associated high dependency ratio represented a serious barrier to socio-economic progress because national and domestic funds have to be diverted from investment in manufacturing and the modernisation of agriculture to the support of an ever growing number of children (Coale and Hoover, 1958).
The ability and freedom of individuals and couples to choose when and how often to become pregnant is rightly regarded as a fundamental human right (Baird 1965).
In the absence of contraception, a woman’s prime adult years are dominated by incessant cycles of pregnancy, breastfeeding and child care. Growing population together with rapid increases in consumption have led to a realisation that humanity is approaching limits to our exploitation of the planet.
Global warming, due to CO2 emissions, ocean acidification, unsustainable depletion of aquifers, land use change and its effects on bio-diversity, are among the concerns. Of course rich nations bear the prime responsibility for these trends; poor countries, where further population increase will be concentrated, have contributed little to CO2 emissions or ocean acidification. However, population growth is the main driver of increased demand for food and the likely consequences of this increased demand include further loss of bio-diversity and natural habitats, degradation of fragile ecosystems due to over-cropping and grazing, and acute problems of fresh water availability (Royal Society, 2012).Among medical interventions, family planning is unique in its breadth of benefits. It contributes directly or indirectly to the achievement of all the Millennium Development Goals and should be regarded as a central component of development strategy. Moreover, as shown in section 10, it is an extremely cost-effective intervention.Go to topDriven by these considerations, family planning programmes flourished in the era 1960-2000 and many lessons have been learnt. Their key purpose is to reduce the barriers to contraceptive adoption and sustained use, discussed in section 6, and the principles underlying an effective programme can be summarised succinctly. A favourable climate of opinion should be established and this requires high level political commitment and harnessing the support of key constituencies, such as religious and community leaders.
Health concerns about use of contraceptive methods need to be addressed by medical and paramedical staff.
In some countries, for example, India, decisions were made to popularise sterilisation or long acting methods, such as intrauterine devices (IUDs) in Egypt.
In others, sub-Saharan Africa, for example, the emphasis was placed on pills or injectables.
Once a method becomes familiar, it becomes the desirable choice and this synergy between policy decisions and social influence accounts for the fact that the method-mix in many countries is dominated by one or two methods and method-mix has a major influence on service delivery (Sullivan et al., 2006). For instance, oral contraceptives and condoms, are ideally suited for distribution through commercial outlets, usually at prices that are subsidised by social marketing.
Conversely, sterilisations, implants and IUD insertions are usually performed in medical facilities.A narrow method-mix has considerable disadvantages.
In India, the unpopularity of effective reversible methods is responsible for the fact that short inter-birth intervals, that pose a risk to the health and survival of the newborn, remain extremely common (Rutstein, 2011). In Kenya, where use is dominated by pills and injectables, half of women with an unmet need have tried and stopped one or both of these methods, typically because of side effects and related health concerns (Machiyama and Cleland, 2013). The case for widening choice in these two countries, and many others, is compelling and should be a priority. However, it is not straightforward, because it demands simultaneous attention to supply chains, provider training, and demand-creation. Voucher schemes, discussed in section 8, linked to new methods might make an important contribution to widening method-mix.Historically, periodic abstinence, other traditional methods and condoms, have rarely been promoted for married couples in family planning programmes because of their high failure rate and difficulty of adherence. The advent of medical abortion (see section 9) and its increasing, albeit often illegal, availability at pharmacies may result in a re-consideration of their roles.
Use of these methods, with abortion as back-up, can be an effective way of achieving small family sizes, as shown by the fertility decline in Europe between 1880 and 1930.
There is intriguing survey evidence from Ghana, the forerunner of fertility decline in West Africa, that well educated women in the capital city, Accra, are preferring periodic abstinence and condoms over more effective pills and injectables, presumably because they are perceived to pose less of a risk to health (Ghana Statistical Service et al., 2009). Abortion laws in Ghana are liberal and no doubt terminations are easily accessible to women in Accra.


The current world population, as of July 2013, is 7.2 billion, which is 648 million higher than in was in 2005, an increase of 81 million people per year. In contrast, the population of the developed world is expected to change minimally and remain at around 1.3 billion (UN DESA, 2013).
Growth is expected to be most rapid in the 49 least developed counties which are projected to double from 900 million in 2013 to 1.8 billion in 2050 (UN DESA, 2013)Population growth and fertility rates have substantial effects on the economic circumstances of individual regions and countries, partly because they determine the ratio of the working age population to the dependent young and old population. The new UN figures have also adjusted fertility levels upwards as new information has become available. In 15 high-fertility countries of sub-Saharan Africa, the estimated average number of children per woman has been adjusted upwards by more than 5 per cent (UN DESA, 2013). An evaluation of the success of family planning programmes can be found in section 7 of this guide. Small differences in the trajectory of fertility during the next decades will have major consequences for population size, structure and distribution in the long term.
The a€?low-varianta€? projection, where women have half a child less, on average, than under the medium variant, would produce a population of 8.3 billion in 2050. Nevertheless, a sustained decrease in fertility will promote further demographic transition and eventually result in population stabilisation (figure 2). Source: Population Reference Bureau, 2004Family planning is considered a tool to reduce population growth and effect demographic change, and many countries have adopted population policies to encourage this. In Mali, a population reduction policy was adopted in 2003 as part of a poverty reduction strategy (UN DESA, 2009). Likewise, Mauritania seeks to reduce fertility to 4 births per woman by 2015 as a measure to reduce widespread poverty (UN DESA, 2009). Gender inequity significantly impacts sexual and reproductive health outcomes, including contraceptive use, unwanted and unintended pregnancies and gender-based violence. At the same time high fertility rates and poor family planning lead to reduced opportunities for girls to attend school and for women to join the labour force, which enable them to contribute at both the household and macroeconomic levels.
Important obstacles to gender equality include cultural attitudes and expectations around marriage and family roles and dominant concepts of masculinity.Decreases in fertility deliver defined socio-economic benefits (Eastwood and Lipton, 2012). The rise in prosperity that was seen in the developed world following the industrial revolution was also due to a simultaneous rapid capital accumulation. However, in the least developed countries of the world, population is increasing rapidly without necessarily any increase in capital accumulation (Pritchett, 1996).
The population in the least developed countries is still young, with children under 15 accounting for 40 per cent of the population (UN DESA, 2011). The increase in economic prosperity occurred in the wake of rapid demographic transition that began in the 1950s.
A dramatic decrease in child and infant mortality in 1965-1970 led to a rapid expansion in the proportion of young dependents in the population, and by 1980 the dependency ratio peaked at 80% of the total population. Post-1980, the dependency ratio fell to less than 50% in 2010 and there was significant growth in labour, human capital per head of population, and the savings ratio. The majority of these women are from Europe, North America, Latin America, Asia and North Africa (Singh and Darroch, 2012). Sub-Saharan Africa lags behind and has the lowest prevalence rates of 18% (in 2010) (Singh and Darroch, 2012). The complex barriers that prevent women from using modern contraceptives are discussed in detail in section 4 of this guide. Women with unmet contraceptive needs have 1 in 180 lifetime risk of dying during pregnancy (Singh and Darroch, 2012).
Using a revised definition, evidence suggests unmet need is slightly higher compared to the original definition. An assessment of the demand for family planning programmes can be found in section 6 of this guide. The regions with the highest prevalence are North America and Latin America and the Caribbean (73% and 67%, respectively), and the lowest prevalence is seen in Africa (22%; figures 4 and 5). Prevalence varies within each region and by individual characteristics,A for example, wealth, education and age (UNFPA, 2012).
The highest levels in Europe are seen in Norway and other Northern European countries and the lowest levels are seen in the countries of the former Yugoslav Republic (UN DESA, 2011). In Latin America and the Caribbean, the highest levels are seen in Brazil and the lowest in Haiti. A strong link exists between high unmet need, low use of modern contraceptives, and poverty.
In many countries, one or two methods account for the majority of use (Sullivan et al., 2006). Widening method choice is a priority but requires considerable investment in logistics, training and demand-creation, expanding access to safe, effective and affordable contraception and making information about different methods readily available.
For example, sterilisation has been used in a coercive or persuasive manner at state level, for example in China, and also been used to target women with disabilities, on low income, and other disadvantaged groups. There are potential side effects associated with the use of some hormonal contraceptives, including irregular or heavy vaginal bleeding (implants), a delayed return to fertility (progesterone only pills) and an increased risk of cardiovascular disease (combined oral contraceptives); combined oral pills are also contraindicated during breastfeeding (WHO, 2010). The highest prevalence is seen in Hong Kong (50%), Japan (41%), Greece (34%) and Russian Federation (30%) (UN DESA, 2011).
It is also the most common method used by sexually-active single women in sub-Saharan Africa and Latin America.
Unlike other contraceptive methods discussed above, which are taken before intercourse, the EC pill is usually taken after intercourse to reduce the risk of pregnancy.
The use of this method remains relatively low, in part due to a persistent poor understanding of fertility, contraception and pregnancy risk in both the developed and developing worlds (Westley and Glasier, 2010). However, women are also prevented from accessing emergency contraception in the developed and developing worlds by political and social ideologies. For example, the United States currently has age restrictions on the sale of emergency contraception, despite legal rulings compelling their removal (Centre for Reproductive Rights, 2010; FDA, 2013). Many couples do not switch promptly to an alternative method, leaving them at risk of an unintended pregnancy.
Traditional methods of contraception include withdrawal and rhythm or calendar or fertility awareness methods. Jointly, these account for 6% of all contraceptive use globally, with highest use observed in Albania (59%), Azerbaijan (38%) and Greece (30%) (UN DESA, 2011). These methods have high failure rates and have not been included in any of the figures for modern contraceptives (Singh and Darroch, 2012).
Prevalence of contraceptive method by region.Data taken from the UN World Contraceptive Use 2011.
Permanent and long-acting contraceptives such as male and female sterilisation, IUDs and hormonal implants have the highest CYP values, whilst short-acting and single-use methods such as the oral contraceptive pill and condoms have low CYPs (USAID, 2011).
Barriers to family planning occur at multiple levels in government, society and the health system (WHO, 2012). Social disapproval, expressed by women as opposition to family planning, together with lack of information, tends to be more important when contraceptive use is low.
Effective and targeted actions are urgently needed to improve contraceptive choice and access for women and families globally. There is also usually a correlation between travel time from a woman’s home to any health clinic and the likelihood that she will use a contraceptive. It is important to remember that women are not a homogenous group, and that different population groups such as the disabled and ethnic minorities experience different barriers to choice and access, and may face additional barriers to those experienced by other women (UNFPA, 2012).Financial costs The prices of contraceptives vary widely in different markets and between branded and generic products. The financial cost of contraceptives may influence choice of method and adoption (Campbell et al., 2006).
Fertility preferences can be derived from the social and economic status gained by conforming to cultural expectations about motherhood rather than through personal choice, for example by having large families, sons or proving fertility by having children straight after marriage (Sills et al., 2012). As well as this, unplanned pregnancies increase the risk of intimate partner violence and violence increases the risk of unplanned pregnancies (Koenig et al., 2003). They may think that their husbands oppose family planning which can be a factor discouraging contraceptive practice in a wide variety of settings, including Egypt, Guatemala, India, the Philippines and Nepal.
Fears about being thought of as sexually promiscuous have also been mentioned as barriers to using condoms in some settings in the Middle East (Kulczycki, 2004).Medical and legal restrictionsPractices, derived at least partly from a medical rationale, which result in a scientifically unjustifiable impediment to, or denial of, contraception. For example, women being subjected to unnecessary medical procedures as a prerequisite for gaining access to contraceptive methods may act as a barrier (Campbell et al., 2006).



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