This study was conducted to examine associations among breastfeeding duration, child care arrangement, and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The authors analyzed the nationally representative sample of infants born in 2001 who were enrolled in the Early Childhood Longitudinal Study-Birth Cohort (9 ...

To characterize tracheal intubation process of care and safety outcomes in a large tertiary pediatric intensive care unit using a pediatric adaptation of the National Emergency Airway Registry. Variances in process of care and safety outcome of intubation in the pediatric intensive care unit have not been described. We hypothesize ...

Foster care is a system created to protect children from an unsafe home environment yet multiple foster home placements, conflictual or nonexistent relationships between foster parents and birth parents, long, drawn out court battles, and living in an on-going state of not knowing when or if they will be going ...

The purpose of this study was to develop targeted materials to encourage Hispanic parents to seek eye care for their children. Hispanic children present with high rates of eye problems such as astigmatism, strabismus, and amblyopia. Related vision impairment can be prevented with timely detection and treatment. After failing a ...

: We sought to assess the attitudes of pediatric intensive care unit medical directors in California regarding the need for, the validity of, and the potential impact of benchmarking, public reporting, and pay-for-performance on pediatric critical care. : Cross-sectional survey. : Pediatric intensive care units in California. : Medical directors ...

: Inclusion of parents on interprofessional patient rounds is increasingly recognized as a parental right and as a marker of quality care in pediatric intensive care units. Creating policies and practices that welcome parents and their contributions into patient rounds has proven challenging in many settings. : To develop a ...

All primary care providers will care for children with cerebral palsy in their practice. In addition to well-child and acute illness care, the role of the medical home in the management of these children includes diagnosis, planning for interventions, authorizing treatments, and follow-up. Optimizing health and well-being for children with ...

There are constant challenges in developing a workforce fit to deliver care to children and young people requiring emergency or urgent care. These challenges are often compounded when the care setting for children and young people is within a general Emergency Department. This paper will review contemporary issues around who ...

Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months ...

Tracheal intubation in the pediatric intensive care unit is often performed in emergency situations with high risks. Simulation has been recognized as an effective methodology to train both technical and teamwork skills. Our objectives were to develop a feasible tool to evaluate team performance during tracheal intubation in the pediatric ...

Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building.

Rationale, aims and objectives  To bridge the gap between theory and practice, methods are needed that promote a positive attitude to change among health care professionals and facilitate the incorporation of new research findings. In this context, communication plays a significant role. The aim of this study was to analyse ...

The gap in median income between primary care physicians and specialists is well-publicized. Health care policy discourse that focused on this gap currently pits primary care physicians against all specialists. However, a number of specialists are also nonprocedural in that they derive the bulk of their income from evaluation and ...

To investigate the possibility of pediatric intensive care unit shortfalls, using pandemic models for a range of attack rates and durations. The emergence of the swine origin pH1N1 virus has led to concerns about shortfalls in our ability to provide pediatric ventilation and critical care support. Modeling of pediatric intensive ...

To describe a framework to assist pediatric intensive care unit physicians in conducting follow-up meetings with parents after their child's death. Many childhood deaths occur in pediatric intensive care units. Parents of children who die in pediatric intensive care units often desire a follow-up meeting with the physician(s) who cared ...

: We hypothesized that elevated blood urea nitrogen can be associated with all-cause mortality independent of creatinine in a heterogeneous critically ill population. : Multicenter observational study of patients treated in medical and surgical intensive care units. : Twenty intensive care units in two teaching hospitals in Boston, MA. : ...

To assess the association of abnormalities of ionized calcium levels with mortality in a heterogeneous cohort of critically ill patients. Retrospective, combined clinical and biochemical study. Four combined medical/surgical intensive care units. Cohort of 7,024 adult critically ill patients. None. We studied 177,578 ionized calcium measurements, from 7024 patients, with ...

Until recently, the sonographic visualization of pulmonary and pleural diseases was considered a poorly accessible method, due to the inability of sound to penetrate air-filled lung. Despite its limitations, lung ultrasonography is becoming an important diagnostic tool in a growing number of pathological situations such as pneumonia, atelectasis, interstitial-alveolar syndrome, ...

The passage of the Affordable Care Act (ACA) in March 2010 promised to put an end to the "doughnut hole," the gap in prescription-drug coverage that is the most controversial component of the Medicare Part D benefit.(1) Several months ago, seniors who had reached the spending threshold that marked the ...

The Aboriginal and Torres Strait Islander life expectancy gap is associated with lower primary care usage by Indigenous Australians. Many Indigenous Australians regard private general practitioners as their usual source of healthcare. However, a range of barriers results in relatively low access to primary care, with subsequent inadequate prevention and ...

To determine the prevalence and risk factors of symptoms of anxiety, depression, and posttraumatic stress disorder-related symptoms in patients with chronic obstructive pulmonary disease and their relatives after an intensive care unit stay. Prospective multicenter study. Nineteen French intensive care units. One hundred twenty-six patients with chronic obstructive pulmonary disease ...

To determine the relationship between the number of delirium days experienced by intensive care patients and mortality, ventilation time, and intensive care unit stay. Prospective cohort analysis. Patients from 68 intensive care units in five countries. Three hundred fifty-four medical and surgical intensive care patients enrolled in the SEDCOM (Safety ...

Central line-associated bloodstream infections (CLABSI) contribute to increased morbidity, mortality, length of stay, and excessive cost of care. This study was an observational cohort study using historical controls in the setting of a 9-bed surgical intensive care unit in a Level I trauma center; all patients admitted or transferred into ...

To explore the relationship between volume of paediatric intensive care unit (PICU) head injury (HI) admissions, specialist paediatric neurosurgical PICU practice, and mortality in England and Wales. Analysis of HI cases (age  <16 years) from the Paediatric Intensive Care Audit Network national cohort of sequential PICU admissions in 27 units ...

Background Acute myeloid leukemia is a life-threatening disease associated with high mortality rates. A substantial number of patients require intensive care. This investigation analyzes risk factors predicting admission to the intensive care unit in patients with acute myeloid leukemia eligible for induction chemotherapy, the outcome of these patients, and prognostic ...

Every shift change in the intensive care unit presents an opportunity for uncertainty among family members regarding rules and information exchange. High levels of uncertainty maintain a presence in the intensive care unit environment, and feelings of trepidation can increase with uncertainty. Critical care nurses in the intensive care unit ...

Sound levels in intensive care units can be high. Unfortunately, high levels of sound tend to result in poor sleep quality, which leads to slower healing, poorer immune response, and decreased cognitive function. To measure sound levels to which patients in intensive care units are typically exposed. Peak sound pressure ...

To ascertain knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP) in the primary care setting to prepare a scoping survey for identifying knowledge gaps in LBP management among Alberta's primary care practitioners, and to identify potential barriers to implementing a multidisciplinary LBP guideline. ...

OBJECTIVE: Vibrio vulnificus infection is uncommon but potentially life-threatening. The aim of this study was to evaluate clinical outcomes and prognostic factors for patients with V. vulnificus infections admitted to an intensive care unit. DESIGN: Retrospective study. SETTING: Multidisciplinary intensive care unit in a 2300-bed teaching hospital. PATIENTS: Eighty-five adult ...

OBJECTIVE: Coagulopathy occurs frequently in critically ill patients, but its epidemiology, current treatment, and relation to patient outcome are poorly understood. We described the prevalence, risk factors, and treatment of prolongation of the prothrombin time in critically ill patients using the international normalized ratio to standardize data and explored its ...

OBJECTIVES: To characterize the factors associated with delayed defecation in long-term ventilated patients and to examine the relationship between delayed defecation and logistic organ dysfunction scores, acquired bacterial infections, and mortality in the intensive care unit. DESIGN: Prospective observational cohort study. SETTING: A 21-bed polyvalent intensive care unit in a ...

OBJECTIVE: To describe the impact of novel pH1N1 virus in Atlanta, GA, for inpatient and intensive care services, including lung lavage data and determinants of disease outcome, from the earliest group of infected US population after initial cases. DESIGN: An observational review of all patients with laboratory-confirmed pH1N1 disease hospitalized ...

Indication, timing and technique of tracheostomy have undergone considerable changes during the past years. Percutaneous tracheostomy has become a standard procedure in modern intensive care. It can be performed by the intensive medicine specialists themselves with low complication rates. Advantages are less stomal infections, better cosmetic results and cost savings ...

Admission to an intensive care unit is a highly stressful event for both patients and their relatives. Feelings of anxiety, pain, fear and a sense of isolation are often reported by survivors of a critical illness, whilst the majority of relatives report symptoms of anxiety or depression while their relative ...

We report the findings from a prospective study determining the magnitude of errors in the visual estimation of weight and height of critically ill patients. Forty-two consecutive patients were weighed by a physician with a calibrated stretcher scale and length measured with a steel measuring tape. The predicted body weight ...

Surgical and trauma intensive care units provide the facilities, resources, and personnel needed to care for patients who have been severely injured, present with acute surgical emergencies, require prolonged and complex elective surgical procedures, or have severe underlying medical conditions. Correcting the immediately evident physiologic derangement is only the first ...

To describe the characteristics of children admitted to intensive care in 1982, 1995, and 2005-2006, and their long-term outcome. Pediatric intensive care unit in a university-affiliated children's hospital. Information for 2005-2006 admissions was obtained from pediatric intensive care unit database, and long-term outcome was ascertained through telephone interviews. Results were ...

Acute liver failure is an uncommon condition associated with multi organ involvement, high morbidity and mortality. Etiology of acute liver failure varies with age and geographical location. Most cases of acute liver failure in India are due to infectious causes predominantly viral hepatitis. A significant group with indeterminate causation remains, ...

We review the context of the environment of care in the intensive care unit setting in relation to patient safety and quality, specifically addressing healthcare-associated infection issues and solutions involving interdisciplinary teams. Issues addressed include current and future architectural design and layout trends, construction trends affecting intensive care units, and ...

Retinopathy of prematurity (ROP) is a common disease of premature infants. It is characterized by an abnormal proliferation of blood vessels in the developing retina and is the leading cause of childhood blindness in developed countries. This article describes a systematic approach to prospectively reduce the incidence of ROP in ...

Despite recent advances in antifungal treatments, the morbidity and mortality of fungal infections, especially invasive candidiasis, in patients in the intensive care unit setting remain high. Because of this, there has been a great interest in improving the evaluation, risk assessment, and prevention of fungal infections in the intensive care ...

The purpose of this study was to identify patient, intensive care and ward-based risk factors for early, unplanned readmission to the intensive care unit. A five-year retrospective case-control study at a tertiary referral teaching hospital of 205 cases readmitted within 72 hours of intensive care unit discharge and 205 controls ...

To describe the clinical course and treatment of a large mediastinal mass with unusual presentation and critical lower airway compression in an adolescent. Case report. Pediatric intensive care unit in a tertiary care, academic children's hospital. A previously well 15-yr-old boy presented to an outside physician with a 2-mo history ...

Intensive care psychosis, intensive care unit syndrome, acute confusional state and acute brain dysfunction are all delirium, a manifestation of acute brain failure associated with serious adverse outcomes. Most intensive care delirium is hypoactive and undetected. Screening for and managing delirium could significantly improve outcomes.

THE AIM of the study was to type Serratia marcescens responsible for nosocomial outbreaks in an intensive care unit in Sfax -Tunisia. METHODS: The relatedness between S. marcescens isolates was studied by Pulsed field gel electrophoresis (PFGE). We included 56 strains of Serratia marcescens isolated from patients hospitalized in the ...

OBJECTIVE: To test the hypothesis that duration of delirium in the intensive care unit is an independent predictor of long-term cognitive impairment after critical illness requiring mechanical ventilation. DESIGN: Prospective cohort study. SETTING: Medical intensive care unit in a large community hospital in the United States. PATIENTS: Mechanically ventilated medical ...

Sensitive detection of Staphylococcus aureus colonization is important for epidemiologic studies, infection control, and decolonization measures. We examined the sensitivity of nasal and pharyngeal sampling for S. aureus colonization in 331 children admitted to intensive care units. Pharyngeal screening was more sensitive than nasal screening (92.6% versus 63.1%, P < ...

The Liverpool Care Pathway (LCP) provides an evidence-based framework of care for the dying patient and provides guidance on comfort measures, discontinuation of inappropriate interventions, anticipatory prescribing, holistic care and care of the family after death. End-of-life care is becoming an important issue in critical care, and the LCP has ...

INTRODUCTION: Dexmedetomidine is a highly selective alpha(2)-adrenoreceptor agonist that produces dose-dependent sedation, anxiolysis, and analgesia without respiratory depression. Dexmedetomidine has been used in critically ill medical, surgical, and pediatric patients, as an adjunct to sedation and/or for treating drug or alcohol withdrawal. Information regarding the dosing and utilization of dexmedetomidine ...

Rectus sheath hematoma (RSH) is a rare but potentially serious complication that can occur after abdominal paracentesis. Although RSH is often self-limited, it can lead to life-threatening conditions when diagnosis and/or treatment are delayed. In the neuro-intensive care unit, the diagnosis is often difficult to make or delayed because most ...