Papers by Susan Ludington
Nursing Reports, 2020
Objectives: were to (a) determine incidence of postpartum hemorrhage (PPH) in all women deliverin... more Objectives: were to (a) determine incidence of postpartum hemorrhage (PPH) in all women delivering between 2009 and 2015, and (b) determine the amount of Estimated Blood Loss (EBL) and duration of the third stage of labor in each subgroup for women with or without PPH, and (c) compare EBL and duration of 3rd stage of labor between subgroups in groups of women with or without PPH. Design: A retrospective chart review conducted using codes for atonic PPH. Setting: Records from a University based tertiary setting, 264 charts were reviewed and data from 154 charts were analyzed. One-way ANOVAs followed with post-hocs and a 2-way ANOVA were conducted. Results: PPH rate increased by 47.50% from 2009–2015. For women with PPH, EBL was lower in skin to skin contact (SSC) + Breastfeeding (BF) subgroup. For women without PPH, EBL was lower in SSC only subgroup. Third stage of labor duration was longer in women with PPH. Conclusions: Study confirmed the increasing trends of PPH due to uterine a...
Journal of data science, Mar 14, 2021
Childhood obesity is a major health concern. The associated health risks dramatically reduce life... more Childhood obesity is a major health concern. The associated health risks dramatically reduce lifespan and increase healthcare costs. The goal was to develop methodology to identify as early in life as possible whether or not a child would become obese at age five. This diagnostic tool would facilitate clinical monitoring to prevent and or minimize obesity. Obesity is measured by Body Mass Index (BMI), but an improved metric, the ratio of weight to height (or length) (WOH), is proposed from this research for detecting early obesity. Results of this research demonstrate that WOH performs better than BMI for early detection of obesity in individuals using a longitudinal decision analysis (LDA), which is essentially an individuals type control chart analysis about a trend line. Utilizing LDA, the odds of obesity of a child at age five is indicated before the second birthday with 95% sensitivity and 97% specificity. Further, obesity at age five is indicated with 75% specificity before two months and with 84% specificity before three months of age. These results warrant expanding this study to larger cohorts of normal, overweight, and obese children at age five from different healthcare facilities to test the applicability of this novel diagnostic tool.
Neonatal Network, Aug 1, 2001
Purpose:To determine the safety and efficacy of allowing kangaroo mother care (KMC) one hour per ... more Purpose:To determine the safety and efficacy of allowing kangaroo mother care (KMC) one hour per day during the course of phototherapy using a fiberoptic phototherapy panel.Sample:Thirty premature infants, 30–35 weeks gestation, <2,500 gm, who required phototherapy. Infants were randomized into three groups: (1) infants who received traditional bank or spotlight phototherapy 24 hours per day, (2) infants who received traditional phototherapy 23 hours per day and for the 24th hour lay prone on a fiberoptic phototherapy panel, and (3) infants who received traditional phototherapy 23 hours per day and for the 24th hour were given KMC with a fiberoptic phototherapy panel held against their back.Outcome Variables:Nonparametric statistics were used for between-group comparisons on number of days of phototherapy, daily bilirubin decrement, and bilirubin profiles over the course of phototherapy.Results:Groups did not differ in the number of days of phototherapy or in daily mean bilirubin decrement. The bilirubin profile for the KMC group showed a more shallow descent than did the profiles for the other groups, but a significant difference in decline was present only on day 4 of treatment (p= .05).Conclusion:This pilot work suggests that KMC using a fiberoptic panel during phototherapy may be safe, but further study is needed.
Journal of perinatology : official journal of the California Perinatal Association, 1991
Twelve stable premature infants in open-air cribs acted as their own controls in a study designed... more Twelve stable premature infants in open-air cribs acted as their own controls in a study designed to evaluate the effect of skin-to-skin contact (SSC) with their mothers on infant heart rate, respiratory rate, oxygen saturation, and skin temperature. Measurements were taken every minute during three consecutive interfeeding periods (2 to 3 hours each): pre-SSC, SSC, and post-SSC. Skin-to-skin contact in the upright position between maternal breasts underneath a velour blouse occurred in the continuing care nursery of secondary level NICUs and was compared with infants lying in open-air cribs. All physiologic measures remained within normal limits, suggesting that SSC had no adverse effects. Statistically significant increases in heart rate and skin and rectal temperatures during SSC were also within normal limits. Skin-to-skin contact can occur between hospitalized stable premature infants and their mothers without physiologic compromise and heat loss to the infant. Practice implica...
Journal of Educational Television, 1988
A multimediated self‐instructional program was developed to introduce new concepts and techniques... more A multimediated self‐instructional program was developed to introduce new concepts and techniques in an emerging area of nursing education. Two field testings of this instructional program were conducted with nursing students enrolled in a university. The results indicated that cognitive achievement did not differ between students taught by multimediated self‐instruction and lecture‐discussion. Students were able to effectively learn new nursing content through both teaching methods. There was no significant relationship found between students’ opinions about the instructional method experienced and their cognitive achievement. Students expressed some unfavourable feelings towards multimediated self‐instruction, possibly related to their general lack of prior experience with independent study or videotaped instruction. The effective use of multimediated self‐instruction is discussed.
Journal of Obstetric, Gynecologic & Neonatal Nursing, 1996
Kangaroo care (skin-to-skin holding) is an intervention that meets development care criteria by f... more Kangaroo care (skin-to-skin holding) is an intervention that meets development care criteria by fostering neurobehavioral development. The five dimensions of neurobehavioral development are autonomic, motor, state, attention/interaction, and self-regulation. Kangaroo care promotes stability of heart and respiratory function, minimizes purposeless movements, improves behavioral state profiles, offers maternal proximity for attention/interaction episodes, and permits self-regulatory behavior expression. Kangaroo care satisfies in part the handling, self-consoling/soothing, nonnutritive sucking, and parenting interventions recommended by the National Association of Neonatal Nurses' Infant and FamilyCentered Developmental Care Gutdelines. JOGNN, 25,691-703; 1996. angaroo care (KC) is a synonym for skin-to-skin K ontact in which the preterm infant, wearing only This article discusses the research-based linkages be-Relationsb@ Between Kc and Autonomic Kangaroo care has been found to provide a milieu that supports autonomic stability and fosters improvement in basic physiologic functions (Table 1). Clearly, when implemented in the selected populations tested to date, KC promotes cardiorespiratory stabilization, as shown by decreased variation in heart and respiratory rates (Fig. l), Neurobehavioral Organization improved oxygenation, less bradycardia, fewer and shorter apneic episodes, and fewer episodes of periodic The goal of developmental care is to support and promote the premature infant's adaptability to external envi-breathing. "Events such as apnea and bradycardia can trigger or involve associated changes in cerebral autoreg
Josanpu zasshi = The Japanese journal for midwife, 1978
The maternal role incorporates new attitudes, beliefs, responsibilities, and relationships, all r... more The maternal role incorporates new attitudes, beliefs, responsibilities, and relationships, all revolving around a child. The new role involves reorganization. Reorganization of the household is a simple matter; reorganizatiop of a woman's identity from woman and wife to woman, wife, and mother is considerably more complicated. Differentiation has to be made between two maternal components. The first is the emotion manifested by "motherliness." Just what is meant by "motherliness" is arbitrary. Professionals describe this emotional component in various terms: bond, attachment, tie, affection, dependency. The nursing profession has developed a list of nursing diagnoses, but a diagnosis for the emotional component of the maternal role has eluded us. Yet, maternal-child nursing is in desperate need of a diagnostic term, one that can be used by all maternal-child nurses
The American Journal of Nursing, 1977
... SUSAN M. LUDINGTON-HOE, RN, Ph.D., is an as-sistant professor in maternal-child nursing at Ba... more ... SUSAN M. LUDINGTON-HOE, RN, Ph.D., is an as-sistant professor in maternal-child nursing at Bay-lor University School of Nursing, Dallas, Texas. with uniform understanding of its meaning. ...Touch progression may be considered an index of developing maternicity. ...
Acta Paediatrica, 2005
The components of the Kangaroo Mother Care (KMC) intervention, their rational bases, and their cu... more The components of the Kangaroo Mother Care (KMC) intervention, their rational bases, and their current uses in low-, middle-, and high-income countries are described. KMC was started in 1978 in Bogotá (Colombia) in response to overcrowding and insufficient resources in neonatal intensive care units associated with high morbidity and mortality among low-birthweight infants. The intervention consists of continuous skin-to-skin contact between the mother and the infant, exclusive breastfeeding, and early home discharge in the kangaroo position. In studies of the physiological effects of KMC, the results for most variables were within clinically acceptable ranges or the same as those for premature infants under other forms of care. Body temperature and weight gain are significantly increased, and a meta-analysis showed that the kangaroo position increases the uptake and duration of breastfeeding. Investigations of the behavioral effects of KMC show rapid quiescence. The psychosocial effects of KMC include reduced stress, enhancement of mother-infant bonding, and positive effects on the family environment and the infant's cognitive development. Conclusion: Past and current research has clarified some of the rational bases of KMC and has provided evidence for its effectiveness and safety, although more research is needed to clearly define the effectiveness of the various components of the intervention in different settings and for different therapeutic goals.
Acta Paediatrica, 2010
Since Kangaroo Mother Care (KMC) was developed in Colombia in the 1970s, two trends in clinical a... more Since Kangaroo Mother Care (KMC) was developed in Colombia in the 1970s, two trends in clinical application emerged. In low income settings, the original KMC model is implemented. This consists of continuous (24 h ⁄ day, 7 days ⁄ week) and prolonged mother ⁄ parent-infant skin-to-skin contact; early discharge with the infant in the kangaroo position; (ideally) exclusive breastfeeding; and, adequate follow-up. In affluent settings, intermittent KMC with sessions of one or a few hours skin-to-skin contact for a limited period is common. As a result of the increasing evidence of the benefits of KMC for both infants and families in all intensive care settings, KMC in a high-tech environment was chosen as the topic for the first European Conference on KMC, and the clinical implementation of the KMC model in all types of settings was discussed at the 7th International Workshop on KMC. Kangaroo Mother Care protocols in high-tech Neonatal Intensive Care Units (NICU) should specify criteria for initiation, kangaroo position, transfer to ⁄ from KMC, transport in kangaroo position, kangaroo nutrition, parents' role, modification of the NICU environment, performance of care in KMC, and KMC in case of infant instability. Conclusion: Implementation of the original KMC method, with continuous skin-to-skin contact whenever possible, is recommended for application in high-tech environments, although scientific evaluation should continue.
Objectives The purpose of the study was to compare a heel stick conducted during skin-to-skin con... more Objectives The purpose of the study was to compare a heel stick conducted during skin-to-skin contact with the mother to a heel stick in an incubator in reducing premature infant physiologic and behavioral pain responses.
Nursing for Women's Health
The objective of this pilot study was to determine women's perceptions of their levels of materna... more The objective of this pilot study was to determine women's perceptions of their levels of maternal role competence at discharge from a Baby-Friendly hospital. A convenience sample of 30 women completed two self-reported questionnaires: a demographic questionnaire and the Perceived Maternal Parenting Self-Efficacy scale. Women reported that they perceived high levels of maternal role competence with a mean total score of 69.80 (standard deviation = 6.86) out of 80. As women experience breastfeeding in Baby-Friendly hospitals, maternal role competence may develop with appropriate support.
Journal of …, 1992
RefDoc, THE reference in scientific document supply / Refdoc, la référence en fourniture de docum... more RefDoc, THE reference in scientific document supply / Refdoc, la référence en fourniture de documents scientifiques ...
Journal of Nursing Measurement, 1995
Instrumentation capable of handling 12 continuous hours of nine-channel real-time physiologic dat... more Instrumentation capable of handling 12 continuous hours of nine-channel real-time physiologic data sampled at 10Hz was needed to test within and between subject variability and preterm infant responses to skin-to-skin contact with the mother. A review of basic electrical components, electrical principles related to physiologic monitoring, and electrophysiology concepts generic to physiologic monitoring is presented. The development, specifications and applications of a new instrument to monitor premature infant cardiorespiratory adaptations are discussed.
Josanpu zasshi = The Japanese journal for midwife, 1978
The maternal role incorporates new attitudes, beliefs, responsibilities, and relationships, all r... more The maternal role incorporates new attitudes, beliefs, responsibilities, and relationships, all revolving around a child. The new role involves reorganization. Reorganization of the household is a simple matter; reorganizatiop of a woman's identity from woman and wife to woman, wife, and mother is considerably more complicated. Differentiation has to be made between two maternal components. The first is the emotion manifested by "motherliness." Just what is meant by "motherliness" is arbitrary. Professionals describe this emotional component in various terms: bond, attachment, tie, affection, dependency. The nursing profession has developed a list of nursing diagnoses, but a diagnosis for the emotional component of the maternal role has eluded us. Yet, maternal-child nursing is in desperate need of a diagnostic term, one that can be used by all maternal-child nurses
Kangaroo care (KC), skin-to-skin contact between mother and infant, is a promising method for blu... more Kangaroo care (KC), skin-to-skin contact between mother and infant, is a promising method for blunting pain responses. This crossover pilot tested KC effects on biobehavioral responses to heel stick in preterm infants (30–32 weeks ’ gestational age, 2–9 days old) measured by Premature Infant Pain Profile (PIPP) and salivary and serum cortisol. Mother–infant dyads were ran-domly assigned to KC heel stick (KCH) first or incubator heel stick (IH) first. Study 1 (80-min study, N 18) tested the effect of 80 min of KC before and throughout the heel stick procedure versus incubator care. Study 2 (30-min study,N 10) tested 30 min of KC before and throughout the heel stick versus incubator care. KCH and IH began during a premeasurement phase and continued through four data collection phases: baseline, heel warming, heel stick, and recovery. PIPP responses were measured every 30 s during data collection; salivary cortisol was measured at the end of baseline and recovery; and serum cortisol wa...
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Papers by Susan Ludington