Wellness
$1.9M grant will help protect newborns from necrotizing enterocolitis

A University of Arizona College of Nursing-led research team will use a $1.9 million Department of Health and Human Services grant to lead a nationwide effort to keep babies safe from the deadly threat of necrotizing enterocolitis, known as NEC.
According to the NEC Society, more than 3,500 babies are diagnosed with necrotizing enterocolitis in the United States each year, and at least one baby dies from NEC every day. The gastrointestinal disease involves infection and inflammation in the gut and is one of the 10 leading causes of infant death. Black and Hispanic babies die of NEC at significantly higher rates than white babies.
The grant, which was awarded by the Agency for Healthcare Research and Quality, a division of Department of Health and Human Services, will fund the widespread distribution of an NEC prevention bundle, NEC-Zero, to help neonatal intensive care units prevent and improve timely recognition of NEC.
“NEC is a devastating disease that has long-term complications and lifetime impacts on babies,” said principal investigator Sheila Gephart, PhD, RN, professor and interim chair of the Advanced Nursing Practice and Science Division at the U of A College of Nursing.
“The NEC-Zero prevention bundle helps clinicians in any location deliver excellent care to any baby.”
NEC-Zero, which was developed by Gephart, uses evidence-based interventions that are essential to reduce the risk of contracting NEC. Tactics include giving the baby the mother’s milk, using a feeding protocol, limiting antibiotic and antacid exposure, and using strategies for timely recognition of the condition.
The telehealth approach to share it with neonatal intensive care units was co-created with Kimberly Shea, PhD, RN, a clinical professor at the College of Nursing, and program coordinator Christina Wyles, PhD, RN, who is a doctoral student and U of A fellowship award recipient.
“Our approach using telehealth is like a driver’s manual to help the real heroes – clinicians who are in NICUs helping babies and parents deal with this awful disease,” Gephart said.
“Neonatal clinicians to do their very best work for every baby every day to reduce the burden of NEC in fragile infants. Our team is eager to come alongside them to support them in doing so.”
Gephart’s team will train, mentor and support health care providers on NEC-Zero using telehealth-based educational material developed in collaboration with the Arizona Telemedicine Program and the University of New Mexico’s Project ECHO. The goal is to work with as many as 30 neonatal intensive care units across the country in the next few years.
“One thing that is really special about the project is that we don’t just connect with NICU teams, we also encourage them to connect with families as partners,” Gephart said, adding that printed materials are available to assist families with babies who contract NEC.
“The support of the Agency for Healthcare Research and Quality is instrumental in allowing Dr. Gephart and her team to improve the health of infants through the invaluable resources and training provided in the NEC-Zero toolkit,” said Brain Ahn, PhD, dean of the College of Nursing.
“Research projects such as this are instrumental to the College of Nursing’s goal of significantly improving health care outcomes through nurse-led research, outreach and educational programmes.”
Adolescent health
Newly-launched Female Health Hub will support grassroots football players

A new Female Health Hub launched by the English FA will support women and girls in grassroots football in England with trusted advice on health issues affecting play.
The hub brings together expert-backed guidance, practical tools and player insights in one place, giving women and girls practical advice and reassurance on female health in football.
It has four core aims: to help women and girls better understand their bodies and how female health affects performance and participation, to educate players on key health topics and when to seek further advice or support, to provide practical strategies to help navigate common female health challenges, and to help break down taboos and normalise conversations around female health in football.
Users of the hub will also be able to hear directly from members of the England women’s national team, who share their own experiences of navigating female health matters while playing at the highest level of the game.
“Our ambition is to create a game where women and girls can thrive,” said Sue Day, the FA’s director of women’s football.
“To achieve that, it’s essential that players feel supported in environments that understand and respond to their female health needs.
“We’ve heard directly from grassroots players that they want better information and support around female health, but that they often don’t know where to find it.
“The launch of the Female Health Hub marks an important step in changing the landscape.
“We want every player to feel confident in her own skin and supported without judgment, so she can feel empowered by her body, rather than held back by it.”
The platform was launched following research conducted by the FA that highlighted the need for better education and support around female health in football.
According to the FA, 88 per cent of adult players surveyed said their menstrual cycle has an impact on their ability to train or play, but 86 per cent reported they had never received education about the menstrual cycle in relation to football performance and training.
The research also found 64 per cent of women experience issues related to sports bras or breast health while playing football, despite sports bras being considered one of the most important pieces of playing kit.
Players also expressed strong interest in learning more about injury prevention, at 87 per cent, nutrition, at 84 per cent, and mental health, at 77 per cent, in relation to female health.
The first phase of the Female Health Hub focuses on three of the most requested topics: menstrual health, breast health and injury resilience, with further content to follow, including nutrition and pelvic health guidance.
Menopause
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Pregnancy
Physicians neglecting preventive care for women with diabetes, study finds

Women with diabetes are less likely to get preventive care than those without the condition, a UCLA-led study suggests.
The findings are based on an analysis of more than 40 studies from several countries.
They highlight how physicians largely overlook the importance of these routine services for women who have diabetes mellitus, or DM, putting them at risk of preventable medical conditions such as pregnancy complications.
Lauren Wisk is associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and senior author on the study.
She said: “These findings are important because they identify that women with diabetes are not receiving recommended well-woman care, which is essential to support both managing their diabetes and their overall health.
“Providers need to be aware that they should not forget to provide these essential services for women with diabetes.”
The researchers sifted through thousands of studies, focusing on the concepts of women, diabetes and women’s health services, and settled on 44 that addressed treatment services for women aged 15 to 49 with type 1 or type 2 diabetes, excluding those with diabetes insipidus or gestational diabetes.
They looked at four preventive health service categories: contraceptive counselling and use, breast and cervical cancer screening, pre-conception counselling, and screening for sexually transmitted infections.
One study found that 48 per cent of women with diabetes received contraceptive services compared with 62 per cent of women without the disease.
Nine papers showed cervical cancer screening rates ranging from 38 to 79 per cent for women with diabetes compared with 46 to 86 per cent for those without diabetes.
Four studies found that breast cancer screening rates for women with diabetes ranged between 38 and 69 per cent compared with 54 and 82 per cent for those without diabetes.
Fourteen studies found pre-conception counselling rates of just over 1 per cent compared with 46 per cent for women with diabetes who are planning to get pregnant.
The researchers did not identify any studies on screening for sexually transmitted infections, which they said represents “a substantial gap in the literature.”
The researchers wrote: “One of the more striking findings of this review is the importance of robust coordinated care teams in ensuring access to appropriate services for women with DM.
“Several of the identified studies provide support that a co-management model, or the concept of involving endocrinology, primary care, and other specialty care providers in the care of individuals with DM, as recommended by the American Diabetes Association, is associated with greater receipt of services.”
Within the time constraints of an office visit, primary care physicians are expected to address preventative health needs as well as chronic disease management, said Dr Lisa Kransdorf, an associate clinical professor of medicine at the Geffen School and a study co-author.
She said chronic disease management will often take priority.
“In cases where the patient has other providers such as specialists and clinical pharmacists actively involved in their chronic disease management, there is opportunity for primary care physicians to attend to preventative care gaps,” the researcher added:
There are some limitations to the findings.
The search yielded only 44 studies, many of which relied on patient recall, which can be unreliable, highlighting the need for further research.
In addition, most of the studies analysed had small sample sizes or were conducted at a single site, limiting how applicable the findings might be in other settings.
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