OBJECTIVE: There are challenges in delivering maternal and infant health (MIH) care to remote Northern Territory (NT) communities. These include fragmented care with birthing in regional hospitals resulting in cultural and geographical dislocation for Aboriginal women. Many NT initiatives are aimed at improving care. Indicators for evaluating these for remote ...

What effect do the various stressing stimuli in a neonatal intensive care unit have on the very sensitive process of synaptogenesis and apoptosis, dendritic growth and neuronal differentiation? To what degree can even minimal changes in the neuronal network of the developing cortex lead to behavioural disorders? And is there ...

OBJECTIVE: To determine the adjusted effect of hospital level of care and volume on mortality of very low birth weight (VLBW) infants in the state of California, where deregionalization of perinatal care has occurred. RESEARCH DESIGN: Secondary data analysis of California maternal-infant hospital discharge data from 1997 to 2002 was ...

OBJECTIVE: To assess the safety of surfactant administration prior to transport of premature infants. DESIGN/METHODS: We performed a retrospective review of 24- to 34-weeks premature infants admitted to the Newborn Intensive Care Unit (NICU) between July 1, 1999 and September 30, 2004. Outcome measures were the presence of hyperventilation (PCO2 ...

To compare the 5-year survival without major disability in infants born at the threshold of viability at 22-25 weeks who were actively treated in the delivery room and admitted to a NICU to that of those born at 26-27 weeks of gestation. All infants between 22(+0) and 27(+6) weeks of ...

AIM: In most cases, admission of an infant to the intensive care unit is unexpected and is stressful for their mothers. The aim of this study is to examine factors affecting anxiety level of mothers whose infant is admitted to the neonatal intensive care unit. BACKGROUND: Anxiety disorders figure among ...

OBJECTIVE: To investigate the feasibility of analyzing acylcarnitine in dry filter-paper blood spots by liquid chromatography-tandem mass spectrometry (LC-MS/MS) which could be applied to detect inborn errors of metabolism in neonates. METHODS: We obtained filter-paper blood from 26 dead infants from a neonatal intensive care unit (NICU) between October 1, ...

The results of randomized clinical trials indicate that the optimal management for infants with hypoxic ischaemic encephalopathy is therapeutic hypothermia combined with high quality standard neonatal intensive care. In addition to therapeutic hypothermia clinical management of the infant with hypoxic ischaemic encephalopathy should include the management of multiorgan dysfunction, obtaining ...

Variable approaches to the care of infants with congenital diaphragmatic hernia (CDH) by multiple providers may contribute to inconsistent care. Our institution developed a comprehensive evidence-based protocol to standardize the management of CDH infants. This report reviews patient outcomes before and after the implementation of the protocol. Retrospective chart review ...

Premature birth incidence and survival rates are increasing steadily due to advances in obstetric and neonatal intensive care. Those born at the limits of viability are highly at-risk of adverse neurocognitive function over their lifespan, leading to current controversy regarding aggressive resuscitation efforts for these extremely preterm children. However, data ...

OBJECTIVE: The objective of this study was to compare rates of survival and special health care needs (SHCN) from discharge to 18 months' corrected age between infants who were born between 22 and 24 weeks and 25 and 27 weeks and to determine predictors and persistence of SHCN. METHODS: Data ...

This paper assesses the extent to which the infant mortality rate might be treated as a "proxy" for poverty in research on cross-national variation in homicide rates. We have assembled a pooled, cross-sectional time-series dataset for 16 advanced nations over the 1993-2000 period that includes standard measures of infant mortality ...

BACKGROUND: Neuregulin (NRG1) is a developmental growth factor and homozygous C allele carriers at the NRG221533 locus are at reduced risk for developmental disability. AIMS: To explore whether 1) the NRG221533 CC genotype is associated with a decreased likelihood of neonatal intensive care unit (NICU) admission; 2) NRG1 is present ...

In a survey of staphylococcal colonization, Staphylococcus aureus was detected in 7 of 67 infants (10%). Two of the infants (3%) carried methicillin-resistant S aureus (MRSA), revealing an unsuspected transmission of MRSA within the neonatal intensive care unit. Molecular surveillance of S aureus provided useful information to improve infection control ...

Congenital tracheal stenosis (CTS) is rare. When it presents early in life, its management can be challenging. Of the surgical techniques that have been devised to correct long-segment CTS, slide tracheoplasty (ST) appears to be superior. We present our 7-year-experience of ST for the treatment of symptomatic CTS in neonates ...

OBJECTIVES: To validate maternal recognition of neonatal illnesses at home compared to assessment by community health workers (CHWs) during routine household surveillance for neonatal illness in rural Bangladesh. METHODS: Surveillance in the intervention arm of two cluster-randomized, controlled trials of newborn interventions conducted in Sylhet and Mirzapur districts of Bangladesh. ...

Transport is a move involving a change of location for a neonate. Any move, be it from one bed to another or from one hospital to another, is a transport. Each transport has one main goal, and that is to get from point A to point B with no adverse ...

AIM: To describe the epidemiology of infants admitted to Paediatric Intensive Care (PIC) with acute respiratory failure including bronchiolitis. METHODS: Data from all consecutive admissions from 2004 to 2007 in all 29 designated Paediatric Intensive Care Units (PICUs) in England and Wales were collected. Admission rates, risk-adjusted mortality, length of ...

The purpose of this study was to evaluate the demographic characteristics and outcomes of neonates who were admitted to a neonatal intensive care unit and treated with inhaled nitric oxide (iNO) during the years 2000-08. The goal of studying this group of neonates was to evaluate how iNO use has ...

BACKGROUND: Since 1983, no study has evaluated the costs and complications involved in the inpatient evaluation of antibiotic therapy for febrile infants aged 29 to 60 days. METHODS: A prospective quality indicator/quality assurance study of low-risk febrile young infants (FYIs) was conducted during a 16-month period after a retrospective pilot ...

This study explored effects of exposure to maternal voice on short-term outcomes in very low birth weight preterm infants cared for within an neonatal intensive care unit (NICU) without an ongoing program of developmental care. Using a comparative design, 53 infants born during their 27th to 28th postmenstrual week were ...

Harlequin ichthyosis is the most severe congenital keratinizing disorder. It is caused by mutations in the ABCA12 gene leading to defective lipid transport. The infants are born with ectropion, eclabium and fissured plate-like skin. Today these infants can survive with neonatal intensive care and retinoid therapy and need long-term interdisciplinary ...

OBJECTIVE: The purpose of this work was to analyse drugs prescribed in the first month of life among a group of newborns admitted to the Neonatal Intensive Care Unit and Neonatal Pathology of Cagliari University Hospital. METHOD: This pilot study was prospectively conducted during a 1-month period and involved all ...

OBJECTIVE: Parental involvement in the care of preterm infants in NICUs is becoming increasingly common, but little is known about its effect on infants' length of hospital stay and infant morbidity. Our goal was to evaluate the effect of a new model of family care (FC) in a level 2 ...

Moderately preterm infants (30-34(6/7) weeks' gestational age) represent the largest population of NICU residents. Whether their clinical outcomes are associated with differences in NICU nurse-staffing arrangements has not been assessed. The objective of this study was to test the influence of patient-to-nurse ratios (PNRs) on outcomes of care provided to ...

AIMS: The purpose of this study was to explore the relationships between specific nurse care-giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant 'stress'. BACKGROUND: Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates ...

Anogenital warts are an infectious disorder of the anogenital lesion caused by one or more human papilloma viruses. Verruca is commonly treated with freezing with liquid nitrogen, laser therapy or application of imiquimod. Such ablative treatment may cause pain and scars on the anogenital lesion. We herein report an infant ...

As the health, social, and developmental needs of infants in foster care become more complex, foster families are challenged to develop specialized knowledge to effectively address these needs. The goal of this qualitative research study was to identify the process of becoming a foster family and providing family foster caregiving ...

BACKGROUND: Childhood immunisation is recognised worldwide as an essential component of health systems and an indispensable indicator of quality of care for vaccine-preventable diseases. While performance of immunisation programmes is more commonly measured by coverage, ensuring that every child is immunised at the earliest/appropriate age is an important public health ...

Nosocomial neonatal candidiasis is a major problem in infants, which require intensive therapy. The subjects of the present study were three preterm infants admitted to the neonatal intensive care unit of the General Hospital "Dr. Manuel Gea Gonzalez". The infants developed Candida parapsilosis infection on the mean age of 13.6 ...

Extremely premature infants--i.e. infants born at less than 27 weeks gestation--often face a grim prognosis. Hence, the question arises whether they should always be given intensive care and who should be the one deciding about that. This article explores these issues and starts from empirical data on the outcome of ...

BACKGROUND: Excessive noise in nurseries has been found to cause adverse effects in infants, especially preterm infants in neonatal intensive care units (NICUs). The NICU design may influence the background sound level. We compared the sound level in two differently designed spaces in one NICU. We hypothesized that the sound ...

BACKGROUND: The incubator environment is essential for optimal physiological functioning and development of the premature infant but the infant is ultimately required to make a successful transfer from incubator to open cot in order to be discharged from hospital. Criteria for transfer lack a systematic approach because no clear, specific ...

AIM: To assess which infants' characteristics and specialized procedures are risk indicators for unilateral or bilateral hearing loss (HL) and to evaluate whether these risk indicators are associated with variation in prevalence of HL between Neonatal Intensive Care Units (NICUs). METHODS: For 2002-2005, data from the NICU hearing screening database ...

Physicians and parents face significant uncertainties when making care decisions for extremely low birth weight (ELBW) infants. Many published estimates of death and developmental outcome are from well-funded university programs and may not reflect outcomes of infants from a variety of settings. The best estimates of the probabilities of death ...

BACKGROUND: Increased maternal age is associated with pregnancy complications and there are few data available on neonatal outcome and utilization of neonatal resources. Our first aim was to use national New Zealand data to determine if the outcomes following admission to NICU are different for infants born to women aged ...

AIM: To test the hypothesis that implementing guidelines for the standardized care of the extremely premature infant (<27 weeks) in the first week of life would improve patient outcomes in an all referral NICU. METHODS: Data were collected on all infants <27 weeks gestational age and <7 days of age ...

Therapeutic hypothermia instituted within 6 h of birth has been shown to improve neurodevelopmental outcomes in term newborns with moderate-to-severe hypoxic-ischemic encephalopathy (HIE). The majority of infants who would benefit from cooling are born at centers that do not offer the therapy, and adding the time for transport will result ...

The diagnosis of severe type 1 spinal muscular atrophy (SMA) should be confirmed by an expert in paediatric neuromuscular disease. Invasive investigations are not usually necessary as the diagnosis is confirmed with a DNA blood test. Care thereafter should be delivered close to home by a multidisciplinary team with a ...

OBJECTIVE: Our objective was to determine the impact of Newborn Individualized Developmental Care and Assessment Program (NIDCAP)-based care on length of stay of very low birth weight (VLBW) infants. Secondary outcome measures were days of ventilation, incidence of chronic lung disease, and 18-month neurodevelopmental outcomes. METHODS: This cluster-randomized, controlled trial ...

OBJECTIVE: The goal was to investigate the effects of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on days of respiratory support and intensive care, growth, and neuromotor development at term age for infants born at <32 weeks. METHODS: Infants were assigned randomly, within 48 hours after birth, to ...

Validate risk-adjusted readmission rates as a measure of inpatient quality of care after accounting for outpatient facilities, using premature infants as a test case. Surviving infants born between January 1, 1998 and December 12, 2001 at five Northern California Kaiser Permanente neonatal intensive care units (NICU) with 1-year follow-up at ...

AIM: To assess medical and neurodevelopmental effects of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for a large sample of very early-born infants. METHODS: One hundred and seven singleton inborn preterm infants, <29 weeks gestational age (GA), <1250 g birth weight, enrolled in three consecutive phases, were randomized within ...

The endotracheal tube (ETT) is the most common artificial airway used in NICUs. Suctioning of the ETT is imperative to maintain patency and prevent complications. An extensive review of the literature revealed a lack of standardized criteria or guidelines for suctioning the ETT of neonates and infants in the NICU. ...

Following reduction in mortality rates of term and preterm babies hospitalized in NICUs, neonataology refocused its concerns on the survivors' elevated risks of long-term health and developmental problems, thus turning the "intact survival" of hospitalized newborns into an equivalently desired moral and professional goal as their "survival." Based on ethnographic ...

AIM: To determine current practice and opinion in relation to incubator humidity use in the management of preterm infants in neonatal intensive care units (NICU's) within the Australian and New Zealand Neonatal Network (ANZNN). METHODS: A survey was conducted in 26 NICU's in the ANZNN. A senior clinical nurse in ...

BACKGROUND: Benchmarking is that process through which best practice is identified and continuous quality improvement pursued through comparison and sharing. The Vermont Oxford Neonatal Network (VON) is the largest international external reference centre for very low birth weight (VLBW) infants. This report from 2004-7 compares survival and morbidity throughout Ireland ...

A critical incident is described as any sudden unexpected event that has the power to overwhelm the usual effective coping skills of an individual or a group and can cause significant psychological distress in usually healthy persons. A Just Culture model to deal with critical incidents is an approach that ...

The increase in prevalence of asthma is strongly dependent on environmental factors, including foods. Significant decreases in the intake of dietary zinc may be an important contributing factor to the increasing incidence of asthma. As zinc can not passively diffuse across cell membranes, specific zinc transporters are required for zinc ...

OBJECTIVES: To determine the relative role that academic hospitals (AHs) play in providing neonatal care for low-birth-weight infants within a single state and to determine if there are variations in inpatient costs for neonatal services among AHs. DESIGN: Retrospective analysis of hospital costs for low-birth-weight infants. SETTING: Cases were identified ...