Please select the eligibility criteria that correspond to the clinical trial below.
Title: Co-Bedding as a Comfort Measure for Twins Undergoing Painful Procedures
Brief Summary: A rising number of preterm twins, at high risk of undergoing repeated medical procedures often without adequate pain relief, are being admitted to Neonatal Intensive Care Units. Skin-to-skin contact between mothers and their infants during painful procedures has been shown to decrease pain and help them stabilize more quickly afterwards. The main question of this study is whether the contact of a twin could provide a similar form of comfort. Sixty-four twin pairs will have an equal chance of undergoing a medically necessary heel stick while being cared for together (co-bedding) or separately. Primary outcome will be physiologic and behavioral pain response. If found to be beneficial, changes to neonatal care practices to include co-bedding may help twins tolerate and recover from painful procedures. Findings will help care providers make recommendations for at risk twins experiencing procedural pain and add to existing theoretical models with respect to the exact mechanism of comfort through touch.


Options:
A: Inclusion Criteria:

* Written informed consent.
* Gestational age of 37 0/7 to 41 6/7 weeks.
* Patients cared in rooming-in, with post-natal age of 12 to 72 hours of life.
* Adequate for gestational age and healthy infants.
* No other painful stimuli before study except for Vitamine K injection soon after birth.
* Interval from last feeding between 30 and 60 minutes.

Exclusion Criteria:

* Mothers that used opioid at gestation labor or birth.
* Delivery under general anesthesia.
* Apgar score less than seven in the 1st or 5th minute of life.
* Neonates that received any venous, arterial, capillary or spinal puncture.
* Any congenital malformation or CNS abnormality.
B: Inclusion Criteria:

* infants with a gestational age between 32-42 weeks at delivery and post-natal age of less than 20 weeks old

Exclusion Criteria:

* acetaminophen or ibuprofen administration within 4 hours prior to immunization, current neurological disorder, known genetic anomaly, moderate to severe illness with or without fever at the time of vaccination, anaphylactic reaction to previous dose of vaccine, or if infant was previously enrolled in the study at 2 months.
C: Inclusion Criteria:

* All medically stable twin infants admitted to the NICU who are:

  1. Free from infection; and
  2. Breathing room air or receiving oxygen via nasal prongs.
* Twins may be receiving feeds via gavage tubes, IV therapy via peripheral or central line, and may be experiencing periods of apnea.

Exclusion Criteria:

* Weigh less than 1000 grams;
* Receiving ventilator support;
* Have chest tubes or umbilical catheter in situ;
* Have major congenital anomalies or chromosomal aberrations; OR
* If only one of the twins require overhead phototherapy.
D: Inclusion Criteria:

* unilateral inguinal hernia
* age age \> 4 months, \<16 years
* fully descended testes
* study consent signed

Exclusion Criteria:

* previous abdominal or inguinal surgery
* testes not fully descended
* not healthy enough for day surgery
* age \< 4months or \>16 years
* study consent not signed

Answer: C