Child Hospital Research Articles

Patient Engagement’s Influence On Brand Image As A Mediator To Strengthen Revisit Intention

The transformation of medical services in Indonesia from a disease-centered model to a patient-centered model has created intense competition among medical institutions. At one of the Maternal and Child Hospitals in Jakarta, a decline in visits from Non-BPJS patients indicates the need for a deeper understanding of the factors influencing patients' intentions to revisit. This study aims to analyze the influence of patient involvement and patient experience on the intention to revisit the hospital, with the mediation of the hospital's brand image. A quantitative approach with a cross-sectional design was used in this study. Data were collected through questionnaires from 119 Non-BPJS patients in the Outpatient Unit. Data analysis was conducted using PLS-SEM with the Smart-PLS program. The results showed that patient involvement and patient experience significantly influenced the intention to revisit, with the hospital's brand image serving as a strong mediator. Enhancing patient involvement, positive experiences, and a strong brand image can significantly increase patients' intention to return to the Maternal and Child Hospital in Jakarta.

Hemodynamic Differences in Patients Undergoing Cesarean Section with ERACS and Non-ERACS Methods Using Spinal Anesthesia at Siti Hawa Mother and Child Hospital Padang

Cesarean section is a surgical procedure to terminate pregnancy through an abdominal incision, which often causes hemodynamic changes, such as hypotension and increased heart rate due to spinal anesthesia. The Enhanced Recovery After Cesarean Section (ERACS) protocol was developed to reduce these complications through a perioperative care approach, including better pain control, early mobilization, and fluid management compared to non ERACS methods. This study aims to analyze the differences in hemodynamic parameters between ERACS and non ERACS methods in cesarean section patients with spinal anesthesia at Siti Hawa Mother and Child Hospital Padang. This is an observational analytic study using a cross-sectional approach. The sample consisted of 72 cesarean section patients, with 36 samples for each group. Data collection was conducted prospectively from September to November 2024. The instrument used was primary data obtained through observation and recording of hemodynamic parameters on the patient’s vital sign monitor. The results of this study showed significant differences in the average systolic pressure, diastolic pressure, and mean arterial pressure between the preoperative and intraoperative stages at 5, 10, and 15 minutes after sub arachnoid block (SAB) in both ERACS and non ERACS methods (p-value > 0.05). Meanwhile, heart rate showed a significant difference only at 15 minutes intraoperatively after spinal anesthesia (p-value < 0.05). The conclusion is that there is a difference in hemodynamics in patients undergoing cesarean section, with the ERACS method showing better hemodynamic stability compared to the non-ERACS method. Keywords: cesarean section, ERACS, non ERACS, hemodynamics, spinal anesthesia

A randomized controlled, trial on effects of mobile phone text messaging in combination with motivational interviewing versus standard infant feeding counselling on breastfeeding and child health outcomes, among women living with HIV

BackgroundDespite efforts to promote optimal breastfeeding practices, the practice of exclusive breastfeeding is low in South Africa. We conducted a trial to determine whether text messaging plus motivational interviewing prolonged exclusive breastfeeding during the first six months of life and improved child health outcomes.MethodsWe conducted a randomized parallel group-controlled trial between July 2022 and May 2024, at a secondary-level healthcare facility. Mothers living with HIV, 18 years or older, initiating breastfeeding, on combination antiretroviral therapy (cART) and their infants were enrolled. The primary endpoint was exclusive breastfeeding from birth through week 24, based on the consecutive 24-hour food recall interviews. We compared differences in exclusive breastfeeding rates using a proportion test. Mothers who completely stopped breastfeeding were asked an open-ended question on reasons for stopping breastfeeding.ResultsUsing block randomization mother-child pairs (n = 276) were randomly allocated to receive intervention (n = 138) or standard infant feeding counselling (n = 138), of whom 105 and 101 mother-child pairs in the intervention group and standard care group, respectively, completed all four study visits. Exclusive breastfeeding rate at 24 weeks in the intervention group was 6% (6/105) and 7% (7/101) in the standard care group, rate difference − 1% (95% CI -6–4%). Sixty-two of 276 mothers completely stopped breastfeeding, of whom 25% (34/138) and 20% (28) were in the intervention group and standard care group, respectively. The most common reasons for stopping breastfeeding were the mother needing to return to work or look for work, 66% (n = 41). We also found that early breastfeeding cessation increased risk of child hospitalization or death compared to any form of breastfeeding to week 24, 10% (5/48) versus 3% (5/158), p = 0.055.ConclusionsWe found no effect of the intervention on exclusive breastfeeding rates. Early cessation of breastfeeding was prevalent and maternal employment characteristics are important social determinants of breastfeeding behaviour. There is need for further research evaluating the effect of interventions that include financial incentives on breastfeeding practices among socioeconomically disadvantaged mothers. HIV services should reliably offer cART, consistently monitor viral load, and support mothers cART adherence, in settings where mixed feeding is common.Trial registrationThe trial was registered on ClinicalTrials.gov (NCT05063240) and Pan African Clinical Trial Registries (PACTR202110870407786) before recruitment of the first subject.

Factors Influencing the Willingness of Hospitalized Children's Parents to Engage in Patient Safety: A Cross-Sectional Study.

Hospitalized children's patient safety incidents can have a significant long-term impact on their physical, psychological, cognitive, and social development. Family-centered care emphasizes engaging parents, and parental involvement is an effective way to ensure child safety. This study aims to identify the factors influencing parents of children with hospitalization experiences in their willingness to engage in patient safety. In this cross-sectional study, we surveyed 210 parents whose children had been hospitalized within the past one year in South Korea. We used a structured questionnaire including patient safety knowledge, patient safety literacy, children's hospitalization experience, and the willingness to engage in patient safety. The collected data were analyzed using descriptive statistics, t-test, chi-square test, analysis of variance, correlational analysis, and regression analysis. The willingness to engage in patient safety had significant positive correlations with patient safety knowledge (r=0.36,p<0.001) and patient safety literacy (r=0.24,p<0.001). The variables that had a statistically significant influence on the willingness to engage in patient safety were the birth order of the hospitalized child (β=0.41, p=0.014), patient safety knowledge (β=0.25, p<0.001), communication with the child (β= -0.25, p=0.018), and attention to safety and comfort (β=0.21, p=0.026). This study found that the birth order of the hospitalized child, patient safety knowledge, and children's hospitalization experience are important factors in parents' willingness to engage in patient safety. The findings indicated the need to develop patient safety education programs for parents, considering the facilitators of and barriers to their willingness to engage in patient safety.

The Effect of the Implementation of Finger Print Attendance, Punishment with Discipline Rewards as an Intervening Variable on the Discipline of Employees of the Tinatapura Maternal and Child Hospital (RSIA)

Employee discipline is a crucial factor in improving the quality of services in the health sector. The Tinatapura Maternal and Child Hospital (RSIA) faces challenges in maintaining employee discipline, which has a direct impact on the quality of patient service. This study aims to analyze the effect of the implementation of finger print attendance, punishment system, and reward on employee discipline at RSIA Tinatapura, with discipline as an intervening variable. The method used in this study is Structural Equation Modeling Partial Least Squares (PLS-SEM), which is processed using SmartPLS 4 software. The research data was obtained from 160 respondents with various characteristics, such as length of work, gender, education level, and age. This study examines the relationship between finger print attendance, punishment, reward, and employee discipline. The results showed that finger print attendance had a significant influence on rewards, while punishment had a direct effect on increasing rewards. Rewards were shown to have a significant influence on employee discipline, while the direct relationship between finger print attendance and employee discipline was not significant, which suggests that the influence was mediated by rewards. This research provides practical implications for RSIA Tinatapura in developing policies based on modern attendance technology, as well as balanced reward and punishment policies to improve employee discipline. This policy not only improves operational efficiency, but also contributes to improving the quality of maternal and child health services in hospitals.

Wernicke Encephalopathy Related to Hyperemesis Gravidarum: A Retrospective Study of 12 Cases

Objective: Wernicke encephalopathy (WE) related to hyperemesis gravidarum (HG) is a devastating neuropsychiatric syndrome that remains frequently undiagnosed in pregnant women. Although many cases have been published, more studies are required to establish guidelines for the early detection and treatment of this condition.Material and Methods: We conducted a retrospective study to analyze the available data concerning 12 cases of WE complicating HG in the Mother and Child Hospital’s Obstetric Intensive Care Unit, belonging to Mohamed VI University Hospital of Marrakesh.Results: Twelve out of 76 HG admitted cases developed WE. Pregnant WE patients became depleted after 11 weeks of vomiting at median gestational weeks of 16.2. They had a severe weight loss of more than 5% of their body and had all presented prodromal signs of WE before the actual onset of the clinical triad. WE diagnosis was clinically made based on Caine’s operational criteria as they allow early identification of the disease. A good tool that could also aid diagnosis is an encephalic MRI; however, it should not delay treatment with prompt administration of high doses of thiamin of &gt; 500 mg/day. Chronic sequelae in this study occurred in 45.5% and death in one case.Conclusion: In HG, thiamin rapidly depletes which can lead to WE with adverse outcomes for the mother and fetus. Therefore, physicians must be vigilant in detecting early signs of WE to promptly provide a high dose of thiamin with targeted multimodal therapies as this could be lifesaving.

Association between Corrected QT Interval, QT Dispersion and Clinico-biochemical Severity of Diabetic Ketoacidosis in Children Aged 1-12 Years: A Prospective Cohort Study

Introduction: Diabetic Ketoacidosis (DKA) is a serious complication in children with type 1 diabetes, characterised by hyperglycaemia, metabolic acidosis and ketosis. It often leads to cardiac arrhythmias due to electrolyte imbalances and prolonged corrected QT interval (QTc). Aim: To investigate the frequency of QTc prolongation and QT dispersion (QTd) in paediatric DKA patients and their relationship with serum electrolytes and pH. Materials and Methods: A prospective cohort study was conducted over a one-year period (August 2022 to August 2023) in the paediatric Intensive Care Unit (ICU) of the Institute of Child Health and Hospital for Children, Egmore, Chennai, Tamil Nadu, India. The study included 150 children aged 1 to 12 years diagnosed with DKA. Electrocardiograms (ECGs) were recorded both at presentation and after recovery from DKA, with QTc and QTd evaluated using a 12-lead ECG. The Mann-Whitney U test was employed to compare medians and Interquartile Ranges (IQR) between two groups, while Spearman’s correlation coefficient was used to assess relationships between variables, with results illustrated through a scatter plot. A p-value &lt;0.05 was considered statistically significant. Results: Significant correlations were found between prolonged QTc intervals and severe acidosis, with affected patients exhibiting lower bicarbonate levels and higher anion gaps and blood ketone levels. After treatment, both QTc intervals and QTd significantly decreased, indicating improved cardiac repolarisation. Strong positive correlations were noted between QTc intervals and both the anion gap and blood ketone levels. Conclusion: The study highlights the QTc prolongation and QTd in children with DKA, which are closely linked to metabolic derangements. Routine ECG monitoring is essential for the early detection of QT prolongation, aiding in the prevention of life-threatening arrhythmias and improving patient outcomes.

Extreme Heat Stress and Unplanned Hospital Admissions.

The burden and health impact of heat stress on child hospitalization is limited. This study aims to investigate associations between extreme heat stress exposure based on a Universal Thermal Climate Index (UTCI), emergency department (ED) visits, and ED visits that translate into unplanned hospital admissions. This population-based case-crossover study included all ED visits and unplanned hospital admissions among children and adolescents aged 0 to 18years from New South Wales, Australia, from July 2001 to June 2020. Heat stress was measured by heatwave days defined as 2 consecutive days or more with daily maximum UTCI in the 95th percentile or higher. Distributed lag nonlinear regression models with a quasi-Poisson distribution were applied, and the relative risks from the models were presented. Totals of 8 240 170 ED visits and 1 427 736 unplanned hospital admissions were recorded. Compared with nonheatwave days, heatwave days were associated with an increased risk of ED visits and hospital admissions due to infectious diseases and infectious enteritis by 5% to 17% and heat-related illness by 78% to 104%. Findings were consistent for subgroup analyses. Children aged younger than 1year and those from the most disadvantaged areas were more vulnerable to heat-related illness on heatwave days. Effects on hospitalization were attenuated using ambient temperature only. This study provides evidence of the effectiveness of UTCI to more completely demonstrate the harmful impact of extreme heat stress on increased infection and heat-related hospitalizations among children, which were not fully captured by using ambient temperature alone. Findings can inform targeted area-based strategies, particularly among vulnerable groups to mitigate the effects of extreme heat events.

The Relationship Between Nursing Work Environment and Breastfeeding Prevalence During Child Hospitalization: A Multicenter Study

Background/Objectives: Breastfeeding during pediatric hospitalization is often challenging, especially in a setting where nursing work environments can affect breastfeeding support. This study examines the relationship between nursing work environments and the prevalence of breastfeeding during child hospitalization, focusing on aspects such as nursing workload, stress levels, and quality of work life (QoWL). Methods: A cross-sectional multicenter study was conducted in Italian pediatric hospitals from October 2023 to January 2024. Each ward head nurse completed a form daily for 30 consecutive days to record the number of children breastfed. Nurses’ workload, stress, and QoWL were measured using validated self-report questionnaires. Multivariate regression was employed to examine the associations between organizational variables and breastfeeding prevalence. Results: A total of 256 nurses from low- and medium-intensity pediatric wards completed the survey (86.7% female, mean age = 39.2, SD = 9.96). Nurses reported low stress levels (M = 2.74; SD = 0.54) and a good QoWL (M = 3.03; SD = 0.50) despite high workloads (M = 3.34; SD = 0.95). The breastfeeding prevalence mean was 1.12 (SD = 1.38), which was highest in surgical units. Regression analysis revealed that higher breastfeeding prevalence was associated with nurses’ female gender (β = 0.17), clinical setting, and higher levels of nurses’ QoWL (β = 0.14) (R2 = 0.23; p &lt; 0.001). Conclusions: To enhance breastfeeding support during child hospitalizations, healthcare policies should address workload management, stress reduction, and work–life balance. Future longitudinal research should expand to other clinical settings and include detailed patient data to understand these relationships.

An individualised mobile app was beneficial for the mothers of infants with severe congenital heart defects.

This national study focused on the individualised Heart Observation (HOBS) mobile phone app, which helps the parents of infants with severe congenital heart disease (CHD) with discharge preparations and decision making at home. We enrolled two groups of parents from 2021 to 2023, during their child's initial hospitalisation at Oslo University Hospital, Norway. Measurements were carried out at baseline and one and four months after discharge. The study examined 73 mothers, who assessed the usefulness and stress-related impact of either printed materials or the HOBS app, as the fathers' responses were insufficient. The HOBS app was significantly more useful than the printed information, with regard to discharge preparations, follow up at home and ongoing decision making, particularly if the infants had sustained cardiac impairment. The average total usefulness scores were 23.9/35 (95% CI 21.6-26.1) versus 17.0/35 (95% CI 14.1-20.0), respectively. Initial stress significantly decreased from baseline in both groups and elevated awareness of deterioration did not increase stress in the HOBS group. Mothers who used the HOBS app found it significantly more useful than the controls who received printed information, particularly if their infant had sustained cardiac impairment. Elevated awareness of deterioration did not increase stress.

Parents' Anxiety During Children’s Hospitalization

Illness and hospitalization of a child are very difficult and most often unpredictable situations in the family life cycle. The stress level of the parents of the child who is hospitalized dependson many factors, such as the psychological characteristics of children and parents, children health conditions, and support from family and medical personnel. The purpose of this study was to identify parents' anxiety in dealing with their child's hospitalization. The research design used is descriptive research with a qualitative approach. The population of this study were all parents of children aged 3-6 years who were hospitalized. The sample in this study were 43 parents of children. Sampling was carried out non-probability with a purposive sampling approach with inclusion criteria: parents were biological fathers and mothers of children who were hospitalized, preschool age 3- 6 years old who has a diagnosis of Hyperthermia, DHF, Diarrhea and Vomiting, ARI, Asthma, Traffic Accidents, parents who are willing to sign an informed consent. he results show that the anxiety of parents facing hospitalization is that the dominant child has mild anxiety (62.8%). This study hopes that parents can be involved during treatment.

FINANCIAL PLANNING ANALYSIS AT THE PRINCIPAL CLINIC OF ANNISA BLORA TRANSITIONING TO MOTHER AND CHILD HOSPITAL

Objective – The research aims to assess the income, health facility levels, potential new funding sources, and financial planning policies at a Principal Clinic transitioning to a Mother and Child Hospital.Design/Methodology/Approach – This qualitative descriptive case study will be conducted from November 2023 to March 2024.Findings – The analysis indicates plans to collaborate with BPJS for funding. The income will be allocated for medical equipment procurement, and NPV analysis yielded a positive value of IDR 985,286,391, with a 4-year and 1.5-month payback period.Conclusion and Implications – Limited existing research on financial planning analysis for transitioning clinics into hospitals is noted, whereas this research is influenced by differing socio-demographic conditions in each case. Keywords: Financial Planning, Transitioning, Mother and Child Hospital

VIOLENCE AU TRAVAIL EN MILIEU DE SANTE : EFFET DU GENRE ET DEXPERIENCE PROFESSIONNELLE DU PERSONNEL INFIRMIER MAROCAIN

The objective of this study is to explore the nature of workplace violence among nursing staff at the Mother and Child Hospital - CHU of Fès. This study could provide a better understanding of how gender and years of professional experience influence nurses perceptions of experiences of violence, whether verbal or physical, in the workplace. The study was conducted using a self-administered questionnaire completed by 182 individuals working in various departments of the Mother and Child Hospital - CHU of Fès. The sample consists of 14% male respondents (25 male nurses) and 86% female respondents (157 female nurses). The average age is 34.24, and the average seniority is 11.32 years.The results reveal that the types of violence encountered by nurses may take different forms, ranging from systematic isolation at work to changes in professional duties, as well as person-oriented violence and degrading treatment in the workplace. Furthermore, we showed that the number of years of professional experience has a negative and statistically significant effect on the exposure of nursing staff to workplace violence.

Direct medical costs of polyarthritis in a pediatric hospital in Mexico.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. The polyarticular course (polyarthritis) represents 63-66% of patients with JIA. The aim was to determine the direct medical costs (DMC) of JIA of the polyarthritis type in pediatric patients of a tertiary hospital in Mexico. An analysis of the disease costs was developed from the perspective of the Instituto de Seguridad Social del Estado de México y Municipios Maternal and Child Hospital (HMI). The time horizon was 12 years. All patients diagnosed with JIA with polyarticular course treated by the pediatric rheumatology service of the HMI from January to September 2022 and with an active clinical record were included. Different costing techniques were used. The cost components were consultations, medications, hospitalization, and office and laboratory studies. The costs are reported in USD 2021. Twenty-six records of patients with polyarticular arthritis from the HMI were analyzed, with a mean of 4,555.2 USD (standard deviation [SD] = 1,456.7) and a median of 3,828 USD (SD = 1,492) in the first 10 years of treatment. The components of DMC were medications (82.7%), office and laboratory studies (8.4%), hospitalization (8.0%), and consultations (1.8%). Biological disease-modifying drugs (bDMARDs) accounted for 95.3% of the drug component cost. The cost of bDMARDs represented the most critical cost of polyarticular JIA, reflected in the 2nd year of treatment. Including generic bDMARDs and reviewing purchase prices by health institutions in Mexico is necessary.

ETIOLOGICAL AND RESISTANCE PROFILE OF BACTERIA ISOLATED FROM PRIMARY BLOOD STREAM INFECTIONS ASSOCIATED WITH PERIPHERALLY INSERTED CENTRAL CATHETER IN NEONATES

Introduction: The Peripherally Inserted Central Catheter (PICC) is a peripherally inserted intravenous device with central venous access characteristics, with bloodstream infection being the main complication associated with the presence of this catheter. The main pathogens involved are: Candida sp., gram-positive cocci of the genus Staphylococcus coagulase-negative and gram-negative bacilli. Objective: To identify the main risk factors for neonates reported with laboratory-confirmed Primary Bloodstream Infection (PBSI) associated with PICC, as well as the etiological profile and resistance of the most prevalent bacteria. Methodology: Descriptive study with a quantitative approach carried out from January/2015 to December/2016 in the ICU of a maternal and child hospital. The sample consisted of reported cases with PICC-associated BSI. Data collection was performed using notification forms, blood culture results and antibiograms attached to the medical records. Data were tabulated and analyzed using descriptive statistics. Results: The main risk factors associated with bloodstream infection were: prematurity, prolonged hospitalization, catheter indwelling time, use of antibiotics and parenteral nutrition. Regarding the microbiological profile, S. epidermidis predominated, with 71% of strains resistant to oxacillin. Conclusion: Care planning by the interdisciplinary team for adequate management of the PICC, as well as monitoring, evaluation and discussion of the rates of PICC-associated infections will enable the adaptation of practices that minimize the rates of hospital infections.

The Correlation between Occupation and Birth Interval in Primary Postpartum Hemorrhage

ntroduction: Postpartum hemorrhage stands as one of the major contributors to maternal mortality globally. Postpartum hemorrhage is a rapid heavy vaginal bleeding that can cause signs and symptoms of hypovolemic shock. Many factors cause postpartum hemorrhage classified into indirect causes, namely type of delivery, age, parity, birth spacing, family income, education, and occupation. Objective: This study aims to determine the correlation between occupation and birth spacing with primary postpartum hemorrhage. Method: This study uses a case-control approach with a purposive sampling technique. The sample for this study included multigravida mothers and mothers diagnosed with primary postpartum hemorrhage at Ananda Maternity and Child Hospital, Makassar, in 2021. The total sample was 174 consisting of 84 cases and 84 control samples. The research instrument data is in the form of secondary data, namely medical records. Data analysis employed the chi-square test for bivariate analysis and multiple logistic regression for multivariate analysis, with a significance level of 0.05 Result: The results of the bivariate analysis showed a relationship between occupation (p-value: 0.000) and delivery distance (p-value: 0.000). Working mothers are 6 times at risk for experiencing primary postpartum hemorrhage (OR= 5.833) while mothers whose delivery interval is &lt; 2 years or &gt; 5 years have 4 times the risk (OR= 3.719). The results of the multivariate analysis show that the work and pregnancy distance is significantly related to the risk of postpartum hemorrhage (value P: 0,000) where the odds ratio for work (OR = 6,178) is higher than the distance of pregnancy (OR = 4.008). Conclusion: Occupational factors and birth spacing are significantly associated with primary postpartum hemorrhage, working mothers have a higher risk of experiencing primary postpartum hemorrhage. Pregnant women and women of childbearing age should receive more education about postpartum hemorrhage and its influencing factors to help prevent and identify it early.

An online survey of perspectives towards the impact of the covid-19 pandemic amongst caregivers of adolescents with ASD

BackgroundThe coronavirus disease (COVID-19) pandemic has had a negative impact on the health and mental health of adolescents and adolescents with autism spectrum disorders (ASD) and their caregivers, have been disproportionally affected. The purpose of this study was to investigate the impact of COVID-19 on Thai caregivers and adolescents with ASD.MethodsThis study used an online survey with closed and free text questions to investigate how the pandemic had impacted on social skills development and psychological variables, and perceived needs for support. The survey link was shared to parents via the Yuwaprasart Withayopathum Child and Adolescent Hospital and the social media platforms of known ASD stakeholder networks in Thailand. Binary logistic regression was used to investigate the relationships between sociodemographic characteristics, service use, and social skills problems experienced by adolescents during the pandemic. Content analysis was applied to analyse free-text data.ResultsA total of 376 caregivers of adolescents with ASD aged 10–19 years completed the survey, of which 364 were included in the analysis. In total, 38.7% of caregivers reported that during the pandemic the social skills of their adolescent family member had worsened. Most families reported that they were able to continue to access support from healthcare and educational services, albeit in different ways than pre-pandemic, during the acute stages of the pandemic which benefited the maintenance of ASD symptoms and social skills. Factors identified as reducing the odds of a worsening in social skills during the pandemic included; regular access to treatment for adolescents (odds ratio [OR] = 0.55, confidence interval 95% (CI) 0.32–0.98, p = 0.044), caregivers feeling that they had sufficient support from hospitals (OR = 0.46, 95% CI 0.26–0.81, p = 0.007) and older age of adolescents (OR = 0.53, CI 0.29–0.99, p = 0.047). The qualitative free text comments showed that the caregivers felt that greater information on managing adolescent behaviours, opportunities for adolescents to practice social skills, and the provision of greater emotional support and material assistance from healthcare professionals during the pandemic would have helped them to care for the adolescents with ASD.ConclusionRegular access to services, support from hospitals during the pandemic and older age in adolescence may have helped prevent the worsening of the social skills problems of adolescents with ASD.

Analysis of Risk Factors for the Incidence of Hyperemesis Gravidarum at RSIA Fatimah and at RSUD Haji Makassar

Background: 32.26% of pregnant women in South Sulawesi in 2018 experienced disorders or complications during their pregnancy, 24.3% of them experienced disorders in the form of continuous vomiting / diarrhea. If nausea and vomiting occurs more than 5 times a day, it is called hyperemesis gravidarum. One of the risk factors for hyperemesis gravidarum is education. a person's education greatly affects the ability to think and the level of understanding and acceptance of something that is conveyed. Objective: This study aims to analyze the risk factors for the occurrence of hyperemesis gravidarum in pregnant women at the Fatimah Mother and Child Hospital and at the Regional General Hospital Haji Makassar. Method: This type of research is an observational analytic research with a case control approach. The population and sample used are all pregnant women who are recorded in the register book for 2020-2022 at RSIA Fatimah Makassar and RSUD Haji Makassar with a sample of 75 cases and controls that met the inclusion criteria. Result: The results showed that the prevalence of hyperemesis gravidarum at RSIA Fatimah Makassar and RSU Haji Makassar 2020-2022 was 50% (n = 75). The results of statistical analysis were mother's age OR 0.389 (95% CI = 0.174-0.870), Parity OR 0.469 (95% CI = 0.244-0.901), Education OR 3.083 (95% CI = 1.536-6.190), Occupation OR 1.158 ( CI 95% = 0.547-2.451), The results of bivariate analysis, namely maternal education OR 3.083 (95% CI = 1.536-6.190) is a risk factor for the occurrence of hyperemesis gravidarum. Conclusion: Maternal education is a risk factor for hyperemesis gravidarum with an OR value of 3.083 &gt; 1 and a p-value = 0.002 &lt;0.05.

Abstract 4135928: Externally Validated Deep Learning Model for Patent Ductus Arteriosus Detection by Echocardiography in Preterm Infants

Introduction: Patent ductus arteriosus (PDA) is a common form of congenital heart disease in premature infants and a source of significant morbidity. Echocardiography is the mainstay modality for diagnosis and monitoring but is resource-intensive and requires expertise for interpretation. Aims: To develop and externally validate a deep learning model to identify PDA in preterm infants by echocardiography. Methods: We trained, validated, and tested a convolutional neural network to detect PDA in raw echocardiogram clips from infants (gestational age &lt;37 weeks) with and without PDAs and no significant additional congenital heart disease at the Medical University of South Carolina (MUSC). For training and validation, we employed a 12-fold cross-validation procedure. Experienced cardiologists defined the ground truth labels. We assessed classification performance on an internal model naïve dataset using the area under the receiver operator curve (AUROC), sensitivity, specificity, positive predictive value, and negative predictive value. For external multicenter testing, we used studies from Children’s Hospital of Orange County (CHOC) and Boston Children’s Hospital (BCH), both of which utilize a different ultrasound system vendor. Results: Training and validation were completed using 1,145 color/color-compare clips (661 clips with PDA and 484 no PDA) from 66 patients. The internal test dataset consisted of 142 clips from 16 patients. The external CHOC and BCH cohorts consisted of 146 clips from 50 patients and 294 clips from 68 patients, respectively. Model performance was similar for internal and external testing (Table 1). Conclusions: Our deep learning model detected the presence of PDA with acceptable performance. This performance generalized well across multiple institutions and ultrasound vendors. This work shows promise for the future development of an automated tool for PDA diagnosis enabling the democratization of pediatric cardiology resources.

Validation of the SCOFF as a Simple Screening Tool for Eating Disorders in an Inpatient Sample Before and During COVID-19.

Eating disorders (EDs) represent a significant public health concern, with a high prevalence among adolescent girls. The COVID-19 pandemic has led to a marked increase in EDs, underlining the need for a brief screening tool in clinical settings. The present study compared ICD-10-based ED-diagnoses with SCOFF-identified at-risk female patients in a clinical setting and assessed the tool's reliability. Routine data (n = 955 participants) from a child and adolescent psychiatric hospital were evaluated regarding the incidence of ED-diagnoses before (n = 312) and during the pandemic (n = 643) and compared with SCOFF results. The SCOFF's sensitivity and specificity were examined. ED-diagnoses significantly increased, almost doubling from before to during the pandemic. The number of at-risk patients identified by the SCOFF likewise differed between the two time points. The SCOFF showed high sensitivity at cut-offs of 2 (pre-pandemic) and 3 (peri-pandemic) but low specificity. Internal consistency was poor. The findings align with previous research indicating an elevated rate of admission to clinical care for ED-diagnoses during the pandemic, a trend also reflected in the SCOFF results. However, the SCOFF's low specificity and poor internal consistency raise concerns about its applicability among adolescent psychiatric inpatients.