مجله دانشکده پزشکی اصفهان
پیاپی 590 (هفته دوم آبان 1399)

Safe inter-hospital transfer of high-risk neonate is a part of hospital care. Due to the high rate of inter-hospital transport and the importance of family presence as a key element in infant care (family-centered care), this study aimed to determine the extent of carrying out family-centered care during the inter-facility transport of high risk neonates.

In this descriptive cross-sectional study, 150 parents of neonates transferred from the hospitals of the Mazandaran Province, Iran, to neonatal intensive care unit (NICU) of the only children's subspecialty center in this province, and 150 members of the neonatal transport team were selected using non-random sampling convenient method in 2018. The data were collected using a researcher-made questionnaire about the implementation of family-centered care during the inter-facility transport with 8 questions for transport team and 12 for parents with yes or no answer, and analyzed using SPSS software.

 88% of transport team members (132 case) and 66.7% of the parents (100 case) stated that family-centered care during the transport of neonates was desirable; and there was a significant difference between them (P = 0.001). In contrast, 30 parents (20%), 91 members of the transport team (60.7%) acknowledged that it was possible for the parents to make skin to skin contact during and before the transfer of the baby; the imbalance of responses in the parent group and transport team was significant, too (P = 0.001).</div>

Although from the viewpoint of most the members of the transport team and the parents, family-entered care during the inter-hospital transport was optimal, but both groups stated that the skin contact between the parents and the baby was not well provided; this need more education.

As published in literature, vitamin D deficiency lead to increased morbidity and mortality rate in patients who hospitalized in intensive care units (ICUs). The present study conducted to evaluate the effect of vitamin D supplement on outcomes in patients with traumatic injuries hospitalized in ICU.

 In a clinical trial study, 55 patients with low levels of vitamin D (less than 30 ng/ml) and 55 patients with normal levels of vitamin D were selected from the patients admitted to the ICU of Alzahra hospital, Isfahan, Iran. The patients suffering hypovitaminosis D (interventional group) received 300,000 units of vitamin D intramuscularly. Patients who had adequate vitamin D levels were considered as control group. The patients’ recovery from the ICU was evaluated and compared by the Sequential Organ Failure Assessment (SOFA) index.

 SOFA scores were significantly higher in vitamin D deficiency group in first 2 weeks after hospitalization. Serum vitamin D levels at the end of the 3rd</sup> week had no statistical different between the two groups. The discharge rate in vitamin D deficiency group in first 2 weeks were lower than control group significantly. But at the end of the third week, the difference between the two groups was not significant.</div>

The results of our study showed that vitamin D supplement increased discharge rate of traumatic patients hospitalized in ICU.

Autism spectrum disorder is one of the most common developmental disorders among children that emerges in early childhood. These children have disturbances in self-regulation at various levels including physical, sensory, mental, emotional, and social levels. However, there is a clear link between self-regulation and language as well as learning and overall development. Therefore, before we can target a child's developmental skills, we need to know how the child is regulated. This article aimed to review the resources to study interventions for the treatment of self-regulated disorders in children with autism spectrum disorder.

 This was a narrative review study. To find studies related to the purpose of the research, a search was performed on English databases of Ot seeker, Google Scholar, Pubmed, using the keywords autism, intervention, and self-regulation management, and Persian data base of Scientific Information Database (SID) using autism and self-regulation Persian keywords. Finally, 18 related studies were selected based on the inclusion criteria.

 The literature review showed that interventions related to the treatment of self-regulation disorders in these children include drug therapy, interventions based on sensory processing and sensory integration, behavioral and cognitive-behavioral therapies, types specialized in massages, horseback riding therapy, group interventions, and Chinese medicine.

It seems that the selection and application of a specific type of intervention for each child with autism spectrum disorder is dependent on his/her mental age, severity of autism, and the child's environment. Factors related to the individual, interaction, and environment affect the child's ability to self-regulation.