2 results
Evaluation of a “tummy time” intervention to improve motor skills in infants after cardiac surgery
- Part of
- Karen Uzark, Cynthia Smith, Sunkyung Yu, Ray Lowery, Christopher Tapley, Jennifer C. Romano, Jennifer Butcher
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- Journal:
- Cardiology in the Young / Volume 32 / Issue 8 / August 2022
- Published online by Cambridge University Press:
- 27 September 2021, pp. 1210-1215
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- Article
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Background:
Infants who require open heart surgery are at increased risk for developmental delays including gross motor impairments which may have implications for later adaptive skills and cognitive performance. We sought to evaluate the feasibility and efficacy of a tummy time intervention to improve motor skill development in infants after cardiac surgery.
Methods:Infants <4 months of age who underwent cardiac surgery were randomly assigned to tummy time with or without outpatient reinforcement or standard of care prior to hospital discharge. The Alberta Infant Motor Scale (AIMS) was administered to each infant prior to and 3 months after discharge. Groups were compared, and the association between parent-reported tummy time at home and change in motor scores at follow-up was examined.
Results:Parents of infants (n = 64) who had cardiac surgery at a median age of 5 days were randomly assigned to tummy time instruction (n = 20), tummy time + outpatient reinforcement (n = 21) or standard of care (n = 23). Forty-nine (77%) returned for follow-up. At follow-up, reported daily tummy time was not significantly different between groups (p = 0.17). Fifteen infants had <15 minutes of tummy time daily. Infants who received >15 minutes of tummy time daily had a significantly greater improvement in motor scores than infants with <15 minutes of tummy time daily (p = 0.01).
Conclusion:In infants following cardiac surgery, <15 minutes of tummy time daily is associated with increased motor skill impairment. Further research is needed to elucidate the best strategies to optimise parental compliance with tummy time recommendations.
Health Equity Funds Implemented by URC and Supported by USAID
- from APPENDIX
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- By Tapley Jordanwood, University Research Co. (URC), Cambodia, Maurits van Pelt, University Research Co. (URC), Cambodia, Christophe Grundmann, University Research Co. (URC), Cambodia
- Edited by Hossein Jalilian, Vicheth Sen
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- Book:
- Improving Health Sector Performance
- Published by:
- ISEAS–Yusof Ishak Institute
- Published online:
- 21 October 2015
- Print publication:
- 12 September 2011, pp 387-419
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- Chapter
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Summary
INTRODUCTION
Cambodia has been experimenting with health equity funds (HEFs) for almost a decade. University Research Co., LLC (URC) has been supporting the implementation of HEFs since 2003 as part of the “Health Systems Strengthening in Cambodia” (USAID-HSSC 2002–08) and the “Better Health Services” (URC-BHS 2009–13) projects funded by USAID. HEFs are a pro-poor health financing scheme, operated by national NGOs, which identify the poor households in an area and then provide financial support to those poor in procuring public health services. This is done by purchasing health services on behalf of these poor, providing them with reimbursements for transport to health facilities, and providing the patients’ caretakers with money to cover food expenses.
Since their first introduction, the number of HEFs has increased significantly. Figure A.1 illustrates this growth, showing that of the thirty-two HEF schemes in place by 2007, half are two years old or less. Some HEF schemes have not run continuously since implementation and several schemes have changed donors. For simplicity, colours represent current donor and breaks are not shown.
HEF schemes are popular with many stakeholders. Almost all poor people using the scheme report that they appreciate the assistance and say they would use the same service again in the future (MoH Monitoring Group Reports 2007 and 2008). Moreover, many public health service providers welcome the HEF scheme in their facility because it generates regular income for their facility and staff.
Cambodia's public health system is managed by the Ministry of Health, with authority delegated to twenty-four provincial and municipal health departments (PHDs), which are further divided into seventy-six operational districts (ODs). Each of these ODs operates public health centres and most manage a district referral hospital. The PHD manages a provincial referral hospital and the central MoH manages tertiary national referral hospitals.
Cambodia's public health service is underutilized. Those who can afford to frequently use private services, while the poor, who in many cases would like to use public health services, are prevented by a variety of barriers. HEFs are meant to help remove the barriers so that the poor can use public health services to the same extent as the non-poor.