The development of an online neonatal intensive care unit family education

Background: British Columbia’s Fraser Health Authority (FHA) neonatal intensive care units (NICUs) value family centered care (FCC). Nevertheless, there is limited evidence that FCC is actually incorporated into practice, as well as some concern that FHA NICU education is inaccessible, inconsistent, or disorganized. Purpose: The mission of this project is to support the principles of FCC throughout the development of an FHA online NICU family education guide by reflecting upon the needs of families throughout their NICU journey. Methods: A needs assessment was initially completed and included literature reviews, consultations, and an environmental scan. This data informed development of an online NICU family education guide which plots current education materials along key stages of the NICU journey: prenatal, admission, early days, growing and developing, discharge and at home. For the purposes of this practicum, only the prenatal stage was fully developed and will serve as a template for other stages following a formative evaluation. A pamphlet and revised FHA Neonatal Checkpoint will also be developed to augment teaching by health care professionals. Implementation and evaluation plans were adapted from the Center for Disease Control Framework for Program Evaluation in Public Health. Results: The needs assessment validates and directs the development, implementation, and evaluation of the online guide illustrating an FCC approach. The online guide centralizes and organizes education by selecting education topics that relate to each stage of the NICU journey. This family-directed design enables families’ access to consistent and reliable information and offers them an opportunity to learn at their own pace. Conclusion: The process of creating, implementing, and evaluating an online family education program for FHA NICUs elucidates the intricacies and the advantages of integrating FCC into NICU practice.

La antropología de Pedro Laín Entralgo, y su aplicación a la enfermería

Introduction. Current times are distinguished, among other things, by the instability of the events, facts and ideas that follow one another vertiginously. The circumstances that surround our society are extremely changing, as well as the way of understanding things and assessing recent developments. The material world dominates over human life. Productive tasks take first place. Appearances are unstable and the ephemeral confirms its power in the 21st century’s mentality. We are immersed in the aesthetics of seduction and image. And in human life, the expansion of needs in all walks of life has become part of the structure of human beings’ existence in the current world. The consumerist fever, the euphoria for new things have made the sense of life virtually insubstantial. All this hardly fits into the nature of healthcare professions. In our case, nursing science has scarce support in our society for continuing the research about the meaning of being a nurse that the reality of the profession requires...

Data Resource Profile : Aberdeen Maternity and Neonatal Databank (AMND)

Conflict of interest: None of the authors have any conflict of interest.

Prospective risk of stillbirth and neonatal complications in twin pregnancies : systematic review and meta-analysis

Peer reviewed

Programa de acogida, apoyo y orientación a los nuevos estudiantes de las titulaciones de Enfermería, Fisioterapia y Podología

Diseño y Planificación de un Programa para acoger en la Facultad a los estudiantes de nuevo ingreso en primer curso que básicamente pretende informar de qué es la Universidad, cómo es la Complutense, cómo es la Facultad y todo acerca de los recursos de todo tipo que se brindan a cada titulación de esta su Facultad a partir de ahora.

Dynamic classifiers for neonatal brain monitoring

Brain injury due to lack of oxygen or impaired blood flow around the time of birth, may cause long term neurological dysfunction or death in severe cases. The treatments need to be initiated as soon as possible and tailored according to the nature of the injury to achieve best outcomes. The Electroencephalogram (EEG) currently provides the best insight into neurological activities. However, its interpretation presents formidable challenge for the neurophsiologists. Moreover, such expertise is not widely available particularly around the clock in a typical busy Neonatal Intensive Care Unit (NICU). Therefore, an automated computerized system for detecting and grading the severity of brain injuries could be of great help for medical staff to diagnose and then initiate on-time treatments. In this study, automated systems for detection of neonatal seizures and grading the severity of Hypoxic-Ischemic Encephalopathy (HIE) using EEG and Heart Rate (HR) signals are presented. It is well known that there is a lot of contextual and temporal information present in the EEG and HR signals if examined at longer time scale. The systems developed in the past, exploited this information either at very early stage of the system without any intelligent block or at very later stage where presence of such information is much reduced. This work has particularly focused on the development of a system that can incorporate the contextual information at the middle (classifier) level. This is achieved by using dynamic classifiers that are able to process the sequences of feature vectors rather than only one feature vector at a time.

MicroRNA expression and function in neonatal hypoxic ischaemic encephalopathy

Hypoxic ischaemic encephalopathy (HIE) is a devastating neonatal condition which affects 2-3 per 1000 infants annually. The current gold standard of treatment - induced hypothermia, has the ability to reduce neonatal mortality and improve neonatal morbidity. However, to be effective it needs to be initiated within the therapeutic window which exists following initial insult until approximately 6 hours after birth. Current methods of assessment which are relied upon to identify infants with HIE are subjective and unreliable. To overcome this issue, an early and reliable biomarker of HIE severity must be identified. MicroRNA (miRNA) are a class of small non-coding RNA molecules which have potential as biomarkers of disease state and potential therapeutic targets. These tiny molecules can modulate gene expression by inhibiting translation of messenger RNA (mRNA) and as a result, can regulate protein synthesis. These miRNA are understood to be released into the circulation during cellular stress, where they are highly stable and relatively easy to quantify. Therefore, these miRNAs may be ideal candidates for biomarkers of HIE severity and may aid in directing the clinical management of these infants. By using both transcriptomic and proteomic approaches to analyse the expression of miRNAs and their potential targets in the umbilical cord blood, I have confirmed that infants with perinatal asphyxia and HIE have a significantly different UCB miRNA signature compared to UCB samples from healthy controls. Finally, I have identified and investigated 2 individual miRNAs; both of which show some potential as classifiers of HIE severity and predictors of long term outcome, particularly when coupled with their downstream targets. While this work will need to be validated and expanded in a new and larger cohort of infants, it suggests the potential of miRNA as biomarkers of neonatal pathological conditions such as HIE.

Reporting on data monitoring committees in neonatal randomised controlled trials is inconsistent

Aim: To evaluate the reported use of Data Monitoring Committees (DMCs), the frequency of interim analysis, pre-specified stopping rules and early trial termination in neonatal randomised controlled trials (RCTs). Methods: We reviewed neonatal RCTs published in four high impact general medical journals, specifically looking at safety issues including documented involvement of a DMC, stated interim analysis, stopping rules and early trial termination. We searched all journal issues over an 11-year period (2003-2013) and recorded predefined parameters on each item for RCTs meeting inclusion criteria. Results: Seventy neonatal trials were identified in four general medical journals: Lancet, New England Journal of Medicine (NEJM), British Medical Journal and Journal of American Medical Association (JAMA). 43 (61.4%) studies reported the presence of a DMC, 36 (51.4%) explicitly mentioned interim analysis; stopping rules were reported in 15 (21.4%) RCTs and 7 (10%) trials were terminated early. The NEJM most frequently reported these parameters compared to the other three journals reviewed. Conclusion: While the majority of neonatal RCTs report on DMC involvement and interim analysis there is still scope for improvement. Clear documentation of safety related issues should be a central component of reporting in neonatal trials involving newborn infants.

La profesionalización de la enfermería en Argentina : Disputas políticas e institucionales durante el peronismo

Nuestra investigación pretende visualizar el proceso de profesionalización de las enfermeras durante el peronismo desde dos ámbitos profundamente emparentados con espacios políticos peronistas: la Escuela de Enfermas de la Secretaría de Salud Pública (1947) y la Escuela de Enfermeras "7 de mayo" de la Fundación Eva Perón (1950). Conscientes de que este recorte excluye otras escuelas que funcionaron durante este período, los objetivos de este trabajo justifican el acotamiento dado que el interés está centrado en las disputas institucionales entre entidades embanderadas en las nuevas lógicas políticas peronistas

La profesionalización de la enfermería en Argentina : Disputas políticas e institucionales durante el peronismo

Nuestra investigación pretende visualizar el proceso de profesionalización de las enfermeras durante el peronismo desde dos ámbitos profundamente emparentados con espacios políticos peronistas: la Escuela de Enfermas de la Secretaría de Salud Pública (1947) y la Escuela de Enfermeras "7 de mayo" de la Fundación Eva Perón (1950). Conscientes de que este recorte excluye otras escuelas que funcionaron durante este período, los objetivos de este trabajo justifican el acotamiento dado que el interés está centrado en las disputas institucionales entre entidades embanderadas en las nuevas lógicas políticas peronistas

La profesionalización de la enfermería en Argentina : Disputas políticas e institucionales durante el peronismo

Nuestra investigación pretende visualizar el proceso de profesionalización de las enfermeras durante el peronismo desde dos ámbitos profundamente emparentados con espacios políticos peronistas: la Escuela de Enfermas de la Secretaría de Salud Pública (1947) y la Escuela de Enfermeras "7 de mayo" de la Fundación Eva Perón (1950). Conscientes de que este recorte excluye otras escuelas que funcionaron durante este período, los objetivos de este trabajo justifican el acotamiento dado que el interés está centrado en las disputas institucionales entre entidades embanderadas en las nuevas lógicas políticas peronistas

The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Quantitative analysis of methyl and propyl parabens in neonatal DBS using LC–MS/MS

Aim: Excipients are used to overcome the chemical, physical and microbiological challenges posed by developing formulated medicines. Both methyl and propyl paraben are commonly used in pediatric liquid formulations. There is no data on systemic exposure to parabens in neonates. The European Study of Neonatal Exposure to Excipients project has investigated this. Results & methodology: DBS sampling was used to collect opportunistic blood samples. Parabens were extracted from the DBS and analyzed using a validated LC-MS/MS assay.

Discussion & Conclusion: The above assay was applied to analyze neonatal DBS samples. The blood concentrations of parabens in neonates confirm systemic exposure to parabens following administration of routine medicines.

Neonatal Examination

This chapter describes the development from embryo to fetus in the various stages and the factors which can impact on normal fetal development

Neonatal Jaundice

This chapter explains the pathophysiology of bilirubin metabolism and the common causes of jaundice in neonates. It also describes the investigations and management of this condition