Julie Weston

• Business Manager at University of Toronto

To describe sleep quantity, sleep patterns, fatigue, and sleepiness for parents of critically ill hospitalized children. Prospective observational study. Quaternary academic PICU. One hundred eighteen parents of 91 children recruited during their child's PICU stay. None. For 5 days and nights, parents wore an actigraph to determine objective sleep-...

Objectives: Parents may have their infant sleep with them in the same bed (bed sharing [BS]), in the same room, but a separate bed (room sharing [RS]), or a separate room in a separate bed (solitary sleeping [SS]); prevalence estimates of these choices are limited. Little is known regarding the effects of infant sleep location (ISL) on infant or ma...

Objective To evaluate the effectiveness of a behavioural-educational sleep intervention delivered in the early postpartum in improving maternal and infant sleep. Design Randomised controlled trial. Setting Postpartum units of two university affiliated hospitals. Participants 246 primiparous women and their infants randomised while in hospital with...

Appendix: TIPS booklet

Background. Caesarean birth rates in North America continue to rise, in the absence of benefit for mothers and babies. One reason may be that hospitalized labouring women spend most of their labours in recumbent or semi-recumbent positions. Although hands-and-knees position has theoretical advantages, efforts to encourage its adoption in practice a...

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Objective: A previous multisite, randomized, controlled trial of peer support compared with usual care for prevention of postpartum depression demonstrated a reduction in depression symptoms at 12 weeks postbirth. Our objective was to determine the cost-effectiveness of this intervention. Study design: Prospectively planned economic evaluation a...

To evaluate the effectiveness of a behavioural-educational sleep intervention delivered in the early postpartum in improving maternal and infant sleep. Randomised controlled trial. Postpartum units of two university affiliated hospitals. 246 primiparous women and their infants randomised while in hospital with an internet based randomisation servic...

Objectives: Parents may have their infant sleep with them in the same bed (bed sharing (BS)), in the same room, but a separate bed (room sharing (RS)), or a separate room in a separate bed (solitary sleeping (SS)); prevalence estimates of these choices are limited. Little is known regarding the effects of infant sleep location (ISL) on infant or ma...

Historically, women have been attended and supported by other women during labour. However in hospitals worldwide, continuous support during labour has become the exception rather than the routine. Primary: to assess the effects of continuous, one-to-one intrapartum support compared with usual care. Secondary: to determine whether the effects of co...

Alternative institutional settings have been established for the care of pregnant women who prefer and require little or no medical intervention. The settings may offer care throughout pregnancy and birth, or only during labour; they may be part of hospitals or freestanding entities. Specially designed labour rooms include bedroom-like rooms, ambie...

Refractory angina is a debilitating disease characterized by persistent cardiac pain resistant to all conventional treatments for coronary artery disease. Percutaneous myocardial laser revascularization (PMLR) has been proposed to improve symptoms in these patients. We used meta-analysis to assess the effectiveness of PMLR versus optimal medical th...

Background: Studies consistently show a relationship between social disadvantage and low birthweight. Many countries have programs offering special assistance to women thought to be at risk for giving birth to a low birthweight infant. These programs may include advice and counseling (about nutrition, rest, stress management, alcohol, and recreati...

Nearly all hospitalized laboring women spend most of the time in bed. We made simple but radical modifications to a hospital labor room, which included the removal of the standard hospital bed and the addition of equipment to promote relaxation, mobility, and calm. We designed a pilot study, the objectives of which were to test the feasibility of a...

Hands-and-knees position has shown promise as an intervention to improve labor and birth outcomes, but no reports exist that examine its use with women laboring with epidural analgesia. Concerns of safety, effects on analgesia, and acceptability of use may limit use of active positioning during labor with regional analgesia. This article presents a...

Objective: To determine if a complex nursing and midwifery intervention in hospital labour assessment units would increase the likelihood of spontaneous vaginal birth and improve other maternal and neonatal outcomes. Design: Multicentre, randomised controlled trial with prognostic stratification by hospital. Setting: 20 North American and UK h...

To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression. Multisite randomised controlled trial. Seven health regions across Ontario, Canada. 701 women in the first two weeks postpartum identified as high risk for postnatal depression with the Edinburgh postnatal depression scale and randomised with an...

To determine if a complex nursing and midwifery intervention in hospital labour assessment units would increase the likelihood of spontaneous vaginal birth and improve other maternal and neonatal outcomes. Multicentre, randomised controlled trial with prognostic stratification by hospital. 20 North American and UK hospitals. 5002 nulliparous women...

Hands-and-knees positioning during labor has been recommended on the theory that gravity and buoyancy may promote fetal head rotation to the anterior position and reduce persistent back pain. A Cochrane review found insufficient evidence to support the effectiveness of this intervention during labor. The purpose of this study was to evaluate the ef...

North American cesarean delivery rates have risen dramatically since the 1960s, without concomitant improvements in perinatal or maternal health. A Cochrane Review concluded that continuous caregiver support during labor has many benefits, including reduced likelihood of cesarean delivery. To evaluate the effectiveness of nurses as providers of lab...

The Term Breech Trial (TBT) is a multicenter, international randomized trial that compared a policy of planned cesarean section with a policy of planned vaginal birth for selected pregnancies with a fetus in breech presentation at term. The TBT involved 121 centers in 26 countries that recruited 2088 women between January 9, 1997 and April 21, 2000...

The Term Breech Trial (TBT) is a multicenter, international randomized trial that compared a policy of planned cesarean section with a policy of planned vaginal birth for selected pregnancies with a fetus in breech presentation at term. The TBT involved 121 centers in 26 countries that recruited 2088 women between January 9, 1997 and April 21, 2000...

Our objective was to determine significant predictors for the development of neonatal infection in infants born to patients with premature rupture of membranes at term. Multivariate analysis was used to determine the significant predictors of neonatal infection in infants born to women with premature rupture of the membranes who were enrolled in th...

Induction of labor has become common practice in many Western countries, but few studies have assessed women's views. A randomized, controlled trial was conducted at 72 hospitals in six countries. Five thousand forty-one women meeting eligibility criteria, with no contraindications for induction of labor or expectant management, were randomly assig...

As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. Recently the TERMPROM (Term Prelabor Rupture of the Membranes) Study Group reported the results of a randomized controlled trial comparing 4 management strategies: induction with oxytocin (IwO), induction with pros...

Our purpose was to determine significant predictors for the development of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Logistic regression analysis with odds ratios and 95% confidence intervals was used to determine the significant predictors of clinical chorioamnionitis and postpartum feve...

Background Induction of labor has become common practice in many Western countries, but few studies have assessed women's views. Methods A randomized, controlled trial was conducted at 72 hospitals in six countries. Five thousand forty‐one women meeting eligibility criteria, with no contraindications for induction of labor or expectant management,...

Our purpose was to determine the effect of induction of labor on neonatal infection if mothers are group B streptococci positive and have prelabor rupture of membranes at term. In the TermPROM study 5041 women were randomized to induction with intravenous oxytocin, induction with vaginal prostaglandin E2 gel, or expectant management with induction,...

The study objective was to evaluate the effect of a patient information video during the informed consent process of a perinatal trial. Ninety women, between 19 and 33 weeks gestation, were randomised to receive written information about this perinatal trial and watch an information video or to receive written information only. Participants complet...

OBJECTIVES: Recently we reported the results of a RCT comparing 4 strategics of management for women with PROM at term induction with oxytocin (I/o), induction with prostaglandins (I/p), expectant management with induction with oxytocin (E/o) or with prostaglandins (E/p) if complications developed.1 There were no significant differences in neonatal...

OBJECTIVES: We wished to determine the association between maternal variables and the development of clinical chorioamnionitis for women with PROM at term. STUDY DESIGN: The TermPROM Study included 5041 women with prelabor rupture of membranes at term, who were randomized to 1 of 4 groups: induction with IV oxytocin (I/o), induction with vaginal PG...

OBJECTIVES: We wislied to determine the association between maternal variables and subsequent neonatal infection for women with PROM at terui. STUDY DESIGN: The TermPROM Stud> included 3041 women with prelabor rupture of membranes at term, who were randomized to 1 of 4 groups: induction with IV oxytocin (Io), induction with vaginal PGE, gel (Ip), o...

OBJECTIVES: Women and their fetuses may be at greater risk of infection if genital tract cultures are positive for GBS. The objective of this secondary analysis of the TermPROM Study was to determine if a policy of induction of labor with either IV oxytocin or vaginal prostaglandin E2 (PGE2) gel would decrease the risk of neonatal infection if moth...

Background: As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. It is not known whether inducing labor will reduce this risk or whether one method of induction is better then another. Methods: We studied 5041 women with prelabor rupture of the membranes at term....

Background Early amniotomy has been advocated as a means of preventing dystocia, but its efficacy has not been studied prospectively. The purpose of this multicenter study was to determine whether routine early amniotomy reduces the risk of dystocia for nulliparous women in spontaneous labor. Methods We studied 925 nulliparous women in labor, who w...