bluuebunny/crossref_metadata_2025 huggingface dataset:
Today’s Health Crisis: A Laughing Matter?
Authors: Buxman Karyn
Published: May 2012

ACCORDING TO A RECENT STUDY, one of every three U.S. nurses surveyed under age 30 planned to leave their jobs within the next year. One in five nurses plans to leave the profession within five years because of unsatisfactory working conditions. According to the Bureau of Labor Statistics, 450,000 additional registered nurses will be needed to fill the present demand through the year 2008. Experts worry about the year 2020, when the registered nurse shortage is projected to reach 500,000 positions, coinciding with the increasing needs of healthcare in an aging U.S. population.
Noise in the Intensive Care Nursery
Authors: Kellman Neil
Published: May 2012

THE PARABLE OF THE GARDEN

The problem of juxtaposing noise and premature babies brings to mind the paradoxical situation of my neighhbor’s garden. This garden is an oasis of visual calm, with evergreen bushes sculpted into flowing waves in the traditional Japanese landscape style which alternate serenely with the perfect miniature green seas of the lawn. However, the great paradox here is the noise made by the tools needed to create this tiny paradise. The gas lawn mower is a familiar evil, but the latest laborsaving invention—the leaf blower— makes life as a neighbor hardly worth living while it’s being used. It is the coexistence and contradiction of these opposites that provides the theme for this article on noise in the intensive care nursery.
Cerebral Palsy and the NICU Graduate
Authors: McMurray Jennifer , Wilson Jones Martha , Khan Jamil
Published: May 2012

PUT YOURSELF IN THIS SITUAtion. You have three drips to remix, your oscillator patient is starting to crash, and you have just been asked to work a double shift because the hospital is short staffed. The unit secretary informs you that the mother of one of your former primary patients is on the telephone and is hysterical. A physician at the neonatal follow-up clinic has just told her that her baby has cerebral palsy (CP). She wants reassurance, information, and input from you because you established a rapport with her when her infant was in the neonatal intensive care unit and she trusts you. You remember cerebral palsy from your pediatric rotation in nursing school, but you don’t see many actual diagnoses made in the NICU, and your recollection is foggy.
Infant Holding Policies and Practices in Neonatal Units
Authors: Franck Linda , Bernal Holly , Gale Gay
Published: May 2012

Purpose:To describe neonatal unit policies and practices regarding the holding of infants by parents.

Design:U.S. national cross-sectional descriptive survey.

Sample:Nurses representing 215 neonatal units providing regional-level (22 percent), community-level (45 percent), and intermediate-level (33 percent) care.

Main Outcome Variable:Proportion of respondents who reported neonatal intensive care unit criteria permitting parents and family members to hold their infant by conventional and skin-to-skin methods.

Results:All but one of the neonatal units offered parents the chance to hold their extubated infants conventionally; 73 percent offered parents to hold their extubated infants skin-to-skin. Sixty-four percent of neonatal units offered parents the option to hold their intubated infants conventionally. In contrast, only 45 percent of the units offered parents to hold their intubated infants skin-to-skin. Factors that influenced parental holding practices included potential benefits to infants and parents, concerns about infant safety, and level of support from neonatal staff members.
Transition to the Neonatal Nurse Practitioner Role: Making the Change from the Side to the Head of the Bed
Authors: Cusson Regina , Viggiano Nicole
Published: May 2012

Role transition is never easy, but is complicated by the experienced neonatal nurse’s frustration with reverting to a student role and becoming a novice practitioner, sometimes after years of developing a reputation as an expert nurse. This article discusses this transition, focusing on the skills needed to move successfully from nurse to nurse practitioner. Common to all advanced practice transitions are stages similar to those Benner identifies in her novice-toexpert theory of nursing practice. Feelings of frustration and inadequacy are common during the first year as an NNP. Studies focusing on role transition and role development suggest that a strong nursing identity is important for success in the NNP practice environment. Strategies to enhance the transition are discussed.
Research Methodologies in Neonatal Nursing
Authors: Meier Paula
Published: May 2012

THERE IS LITTLE DISAGREEMENT AMONG NURSES concerning the need for clinical research to clarify and expand the profession’s knowledge base. Yet if we stop for a moment and reflect on why we perform certain activities in the course of our daily practice, seldom is the reason grounded in research. Our rationales are more likely to be an outcome of our apprentice-style education; we do what we do in the way we do it because a nursing colleague, instructor, or a member of a related health care profession once told us this is the correct way. Although these patterns are difficult to change, we, as nurses, accepted the responsibility for research when we began to refer to ourselves as “professionals.” Members of a profession constantly use research findings to modify their knowledge base; and as a consequence, clients of that profession’s service expect to benefit from the application of new research knowledge to practice.
Early Intervention Best Practice: Collaboration Among an NICU, an Early Intervention Program, and an NICU Follow-up Program
Authors: Hussey-Gardner Brenda , McNinch Abigail , Anastasi Jean , Miller Melanie
Published: May 2012

Maryland’s PRemature Infant Developmental Enrichment (PRIDE) program is a collaborative endeavor between the University of Maryland Medical Systems (UMMS) and the Baltimore Infants and Toddlers Program (BITP). This article discusses the components of Maryland’s PRIDE, the program’s implications for nursing, and recommendations for replication.
Congenital Heart Disease in the Neonate
Authors: Fran Hazinski Mary
Published: May 2012

Part I: Epidemiology, Cardiac Development, and Fetal Circulation

CONGENITAL HEART DISEASE IS PRESENT IN ROUGHLY eight to ten out of every thousand newborn infants.1However, within the neonatal intensive care unit, the incidence of congenital heart disease is much higher than this, because low birth weight or small-for-date infants are more likely to have congenital heart disease than normal infants.2
The Best NICU in America 2002 Aurora Sinai Medical Center Milwaukee, Wisconsin
Authors: Furumo Virginia
Published: May 2012

I AM WRITING TO YOU TO EXPRESS MY HEARTFELT OPINION that we are the best NICU in America. Our unit opened in 1978 and became what it is today because of the commitment and caring of the nursing staff. I have worked side by side with these nurses for 24 years. They are all like family to me and the families they serve.
A Neonatal End-of-Life Palliative Protocol— An Evolving New Standard of Care?
Authors: Glicken Anita , Merenstein Gerald
Published: May 2012

IN 1979 THE CHILDREN’ S Hospital, Denver began to address the needs of the unfortunate group of infants who exhibit evidence of poor prognosis and for whom the question is raised whether any more should be done to prolong their lives.1This program for the NICU was based on concepts first introduced and popularized by the hospice movement.2,3It was recognized that generally NICU staff are concerned with neonatal survival—a rescue mode of care. Staff are often ill-equipped to provide adequate care to the family of the dying infant. This program proposed a new approach to the very difficult issues involved in the care of these very sick and dying infants. The Neonatal Hospice Program was a comprehensive plan focusing on four main areas: decisionmaking process and shift to palliative care, creation of a home-like, family room setting for the infant and family, involvement of family in the dying process and hospice training for NICU staff. Over the past 20 years, elements of this program have been implemented in many NICUs. However, the adaptation of a comprehensive program for palliative neonatal care has not been universally implemented. NICU staff and families of dying infants continue to seek change in hospital practice. Catlin and Carter have undertaken important research in exploring current trends in the care for the infant from whom life support is withdrawn or withheld.
Creation of a Neonatal End-of-Life Palliative Care Protocol
Authors: Catlin Anita , Carter Brian
Published: May 2012

Objective:To create a protocol delineating the needs of patients, families, and staff necessary to provide a pain-free, dignified, family-, and staff-supported death for newborns who cannot benefit from intensive, life-extending, technological support.

Study design:Using Internet e-mail, a Delphi study with sequential questionnaires soliciting participant response, investigator analysis, and follow-up responses from participants was conducted to build a consensus document. Institutional review was granted and respondents gave consent. Recruitment was conducted at medical, ethics, nursing, and multidisciplinary organization meetings. Synthesis of 16 palliative care/end-of-life protocols developed by regional, institutional, and parent organizations was included. Participants from 93 locations in the US and 4 abroad gave feedback to 13 questions derived from clinical experience and the literature. The data underwent four rounds of analysis with 95% retention of the 101 participants over an 18-month period.

Results/Conclusion:Specific consensus-based recommendations are presented with a description of palliative care; categories of candidates; planning and education needed to begin palliative care services; relationships between community and tertiary centers; components of optimally supported neonatal death; family care, including cultural, spiritual, and practical needs; ventilator withdrawal, including pain and symptom management; recommendations when death does not occur after cessation of lifeextending interventions; family follow-up care; and necessary ongoing staff support.
The Best NICU in America 2002 Children’s Hospital Columbus, Ohio
Authors: Caines Adeline
Published: May 2012

AFTER READING CHARLES RAIT’S EDITORIAL IN THE February issue of Neonatal Network,® I was prompted to write about my experience in the best NICU in America. I have been an NlCU nurse since 1975 and have worked as staff nurse, assistant manager, and clinical leader in various Level II and Level III NICUs in New York and Connecticut. In September 2000, my family and I relocated to Columbus, Ohio. In April 2001 I started working as the NICU Case Manager/Clinical Nurse Specialist in the regional Level III NICU at Columbus Children’s Hospital (CCH). The aura of excellence was apparent from the very first interview and throughout my orientation. Although I was an NICU nurse for 25 plus years, I had to attend a comprehensive NICU course. This course not only refreshed my knowledge, and skills, but oriented me to the Midwest and Children’s way of doing things. Columbus Children’s was eager for me to learn their ways and at the same time was anxious to learn about the way NICU care was managed on the East Coast.
Direct Hyperbilirubinemia: A Case Study of Parenteral Nutrition–inducedCholestatic Jaundice
Authors: Hengst Joan
Published: May 2012

THIS COLUMN USES THE CASE study approach to examine the clinical process of forming a differential diagnosis of late-onset jaundice, or direct hyperbilirubinemia, in a preterm infant. It also reviews the normal pathophysiology of bilirubin metabolism and the defining characteristics of indirect and direct hyperbilirubinemia.
Some Pain, Some Gain: Reflections on the Past Two Decades of Neonatal Pain Research and Treatment
Authors: Franck Linda
Published: May 2012

This review reflects back on the progress that has been made in infant pain research over the past 20 years and how the research has influenced (or has failed to influence) the attitudes and practices of health professionals about infant pain. Progress in understanding of infant pain neurobiology, treatment, and measurement are discussed, and new directions for future research are proposed.
Letters
Authors: Kate Zampino Sarah
Published: May 2012

Thank you very much for your offer to include my picture in Neonatal Network.® Obviously, I do not remember when I was on the cover but I have seen the picture. I am honored to be part of your 20th anniversary celebration. My mom is an NICU nurse and I see your magazines around our house, usually by her bathtub, all the time. I really think you should put my mom and her friends on the cover of Neonatal Network.® I don’t even think about being a premature baby nor do I have any side effects or anything. My mom and the other nurses, therapists, and doctors are the really great people in the world. My mom cannot talk about her work too much but sometimes it is really hard. Like, I can always tell when she takes care of a baby who died or a really sick baby that is not going to make it. Sometimes she even comes home and cries. I can also always tell when she takes care of a mom who is just 14 years old because then she lectures me about birth control for weeks. So, anyway, I think it is the neonatal nurses who need more recognition even though my mom says they (nurses) really like to hear about all their babies especially the ones that are grown up like me.
The History of the Neonatal Nurse Practitioner: Reflections from “Under the Looking Glass”
Authors: Johnson Patricia
Published: May 2012

The neonatal nurse practitioner (NNP) emerged in the 1970s. During the first two decades, nurses who functioned in this new advanced-practice role were forced to overcome interprofessional isolation, variable educational preparation, underutilization, and title ambiguity. However, after nearly 30 years of evolution influenced by the changing health care environment, technological advancements in newborn care, medical personnel shortages, and the advanced-practice nurse movement, the NNP is now a recognized member of the neonatal health care team nationwide. The NNP has achieved the level of provider status, but only after successfully overcoming many practice restrictions and restraints over the decades. This article chronicles the history of the NNP and recounts the external and internal elements that contributed to the development of this profession.
Chicagoland Remembers...
Authors: Lawlor-Klean Phyllis
Published: May 2012

A walk down memory lane is provided from the perspective of Chicagoland nurses who have each provided neonatal care for 20 years or greater. Sixteen nurses were interviewed, representing at least 11 different units in the area. Combined, over 390 years of neonatal care have been provided by these nurses. An oral history was obtained by asking each the same three questions: What has changed in the past 20 years in neonatal nursing? What are your fondest memories of neonatal nursing in the past 20 years? What drives your “passion for little people”? This special group of nurses will warm your heart with their responses. They are a reminder of how much neonatal nursing has changed, but also how the “passion for little people” remains the same. On this special anniversary, nurses in many units, not only in Chicago, will be able to reflect with similar stories.
Knowledge Translation and Evidence-Based Perinatal/Neonatal Health Care
Authors: Ohlsson Arne
Published: May 2012

Knowledge translation is the process of bridging the gap between the overwhelming amount of research data/ information/evidence and its critical appraisal, synthesis, dissemination, and application as knowledge by influential role models. Knowledge translation includes ongoing surveillance of the results of the implementation of new knowledge. By conducting research that is driven by relevant, well-defined questions and by using the most powerful study designs available, researchers generate valid new information that can later be translated into knowledge and applied in the clinical setting. Systematic reviews of the literature serve as good examples of knowledge management, when defined as “making proper use of the sum of what is known.” Such reviews may identify that an intervention is effective without any harmful side effects, that it is noneffective, or that further research is warranted. Consumers of perinatal/neonatal health care or their ombudsmen should be encouraged to take part in setting the agenda and defining important outcomes for such research.
The Literature of Neonatal Nursing: Stories from the Turning Points Column
Authors: Bingham Raymond
Published: May 2012

The stories of neonatal care are a rich source of information, going beyond the typical clinical article to convey the meaning of nursing in this special environment. During its run, the Turning Points column in Neonatal Network® gave nurses, doctors, and family members affected by the NICU an outlet to share their stories with others. The brief overview of the columns’ contents provided in this article displays the wide variety of patient cases, workplace issues, and family situations encountered by neonatal nurses.
Looking Forward, Looking Back
Authors: Fraser Askin Debbie
Published: May 2012

MAJOR MILESTONES SUCH AS birthdays and anniversaries provide us with an opportunity to look back and reflect on what has gone before us. They are also a perfect time to look to the future. This special anniversary issue of Neonatal Network® features many reflections of the past twenty years of neonatal care—although for many of us, our history of caring for babies goes back much farther. Do we start with the opening of the first NICU in 1965, or do our influences reach back much farther to the work of some of the early pioneers in neonatal care? Do we mark our beginnings with the development of the first infant incubator (Stéphane Tarnier, Paris France) in 1878, or with the work of another Parisian, Pierre-Constant Budin who in the late 19th century developed many of the principles that formed the basis of neonatal medicine?
Neonatal Herpes Simplex: Pulmonary and Intracranial Findings
Authors: Carey Barbara
Published: May 2012

AS THE RATE OF HERPES infection has risen in the general population and specifically in women of childbearing age, the rate of fetal and newborn acquisition has also increased. Neonatal herpes virus infection has been estimated to range from 1 in 3,000 to 1 in 20,000 live births.1 Approximately two-thirds of these cases are caused by herpes simplex virus (HSV) Type II, and the remaining third is caused by HSV Type I.2
Congenital Cutaneous Candidiasis: A Case Presentation
Authors: Knobel Robin
Published: May 2012

When an infant presents in the delivery room with macular and papular skin lesions covering the trunk, extremities, and/or skin folds, the neonatal nurse practitioner covering deliveries must be aware of possible skin lesion differential diagnoses. Among these is congenital cutaneous candidiasis, a rare, usually benign skin infection. If this condition is recognized early, unnecessary testing and treatment of newborns who present with these symptoms might be avoided.
Partnerships Between Mothers and Professionals in the NICU: Caregiving, Information Exchange, and Relationships
Authors: Bruns Deborah , McCollum Jeanette
Published: May 2012

Purpose:The purpose of this study was to examine the perspectives of mothers, nurses, and neonatologists on the importance and implementation of NICU practices related to caregiving, information exchange, and relationships within the context of family-centered care.

Design:This study design was descriptive. The PARTNERS Questionnaire was developed and implemented, including both quantitative and qualitative items in the three areas (caregiving, information exchange, relationships). For the parent participants, it was a retrospective study.

Sample:Two hundred fifteen questionnaires were distributed to professionals and 157 questionnaires were mailed to mothers of NICU graduates. A total of 196 questionnaires (53 percent) was returned (55 mothers, 18 neonatologists, and 123 nurses).

Results:Ratings of importance to the respondent and ratings of degree of implementation of items in the three areas were uniformly high. Mothers and nurses had significantly higher ratings than neonatologists in implementation of caregiving. In addition, mothers and nurses rated importance higher than implementation for the areas of information exchange and relationships.
Free Radicals
Authors: Pilcher Jobeth
Published: May 2012

Free radicals may be the cause of many neonatal complications, such as chronic lung disease and brain injury. Treatment options for these complications using antioxidants are being evaluated through research. This article begins with a review of the basic science of free radicals. It then discusses neonatal complications potentially caused by free radicals. A brief description of research into potential treatment options is also included.
Prenatal Cocaine Exposure and Neonatal/Infant Outcomes
Authors: Cambell Shelly
Published: May 2012

Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.
Magnetic Resonance Imaging and the Neonate
Authors: Purdy Isabell , Wiley Dorothy
Published: May 2012

Over the past decade, advances in neuroimaging have given birth to a new field of diagnostic pediatric neurologic assessment that includes magnetic resonance imaging (MRI). This invaluable tool helps medical professionals to resolve many clinical and research questions related to neonatal neurodevelopment that other imaging technology cannot explain. Nurses and others who accompany infants to MRI would benefit from a better understanding of early neurodevelopment and of the neuroimaging procedure. Knowing the advantages and disadvantages of MRI techniques can help nurses be better patient advocates, parent liaisons, and caregivers to infants having MRI scans.
Volume-Guaranteed Ventilation
Authors: Riley Cheryl , Pilcher Jobeth
Published: May 2012

Pressure-limited, time-cycled ventilation has been the primary mode of ventilation for neonates for several decades. But the realization that volume rather than pressure causes ventilator-induced lung injury has led to the development of new strategies for ventilation. Volume guarantee is a mode of ventilation that automatically adjusts the inspiratory pressure to achieve a set tidal volume according to changes in lung compliance or resistance or the patient’s respiratory drive. Volume-guaranteed ventilation delivers a specific, preset volume of gas, and inspiration ends when it has been delivered. This mode of ventilation requires careful attention to the infant and to ventilator settings.
Gastroesophageal Reflux and Histamine2 Antagonists
Authors: Givens Bell, Susan
Published: May 2012

GASTROESOPHAGEAL REFLUX (GER) IS THE RETROGRADE movement of the stomach contents into the esophagus, frequently caused by relaxation of the lower esophageal sphincter (LES). The pathophysiology of GER in neonates is not clear. However, many risk factors have been defined (Table 1).1Several developmental factors may influence the incidence of GER in neonates. Jadcherla suggests abdominal wall muscle tone, diaphragmatic activity, esophageal dysmotility, and LES tone as possible reasons for the prevelance of GER in the neonatal population.
The Neonatal Liver Part II: Assessment and Diagnosis of Liver Dysfunction
Authors: Diehl-Jones William , Fraser Askin Debbie
Published: May 2012

The liver, the largest organ in the body, performs many essential functions, including the storage and filtration of blood, production of bile, regulation of plasma proteins and glucose, and biotransformation of drugs and toxins. Many neonates display signs of hepatic dysfunction such as hyperbilirubinemia, hepatomegaly, or elevated liver enzymes. Primary liver disease in neonates is rare; much of the liver dysfunction seen in the neonatal period is secondary to systemic illness such as sepsis or hypoxic injury. It is important for the clinician to have the skills and knowledge necessary to distinguish intrinsic liver disease from liver dysfunction resulting from extrahepatic causes. Early intervention to address the cause of dysfunction is critical to successful management of liver disease. This article reviews the assessment of liver function in neonates and examines the techniques used to diagnose liver dysfunction.
Neonatal Abstinence Syndrome: Strategies for Care of the Drug-Exposed Infant
Authors: Greene Carol , Goodman Michael
Published: May 2012

Neonatal abstinence syndrome (NAS), a clinical condition that has been recognized for over 30 years, remains a significant clinical issue, although our knowledge of abstinence, its treatment, and outcome continues to grow. The condition is now complicated by polydrug use (which is becoming more prevalent) as well as concomitant use of tobacco, and psychoactive substances that are frequently prescribed to pregnant women. This article reviews the neonatal effects of a variety of substances, discusses the state of the art for clinical care of drug-exposed infants, including NAS patients, and updates the reader on areas of current research.
Milrinone
Authors: Givens Bell Susan
Published: May 2012

MANY NEONATES WHO UNDERGO SURGICAL REPAIR FOR congenital heart defects are at high risk for developing low cardiac output syndrome following surgery.1A variety of causes contributes to diminished cardiac output. Four major factors are (1) age less than one month, (2) weight less than 2.5 kg, (3) preoperative condition, and (4) complexity of the heart defect.2
An Evidence-Based Guideline for Introducing Oral Feeding to Healthy Preterm Infants
Authors: McCain Gail
Published: May 2012

The ability of a preterm infant to make the transition from gavage to oral nipple feeding depends on the infant’s neurodevelopment in relation to behavioral organization, to a rhythmic suck-swallow-breathe pattern, and to cardiorespiratory regulation. Research-based knowledge about infant neurodevelopment in these three areas has led to the creation of a semidemand feeding method to aid in this transition. The method combines the use of nonnutritive sucking to promote awake behavior for feeding, use of behavioral assessment to identify readiness for feeding, and systematic observation of and response to infant behavior cues to regulate frequency, length, and volume of oral feedings. Semidemand feeding may be individualized for healthy preterm infants. This article discusses both the relevant knowledge about neurodevelopment and the semidemand feeding method itself.
Correlates of Depressive Symptoms in Mothers of Preterm Infants
Authors: Morawski Mew Andea , Holditch-Davis Diane , Belyea Michael , Shandor Miles Margaret , Fishel Anne
Published: May 2012

Purpose: To identify factors related to depressive symptoms in mothers of preterm infants and to changes in depressive symptoms between hospitalization and when the infant was six months corrected age and to determine whether these factors differentiate mothers at high risk for depression from mothers at low risk for depression.

Design: Correlational.

Sample: During hospitalization, 39 mothers of preterm infants and, at six months corrected infant age, 34 mothers of preterm infants.

Main Outcome Variable: Depressive symptoms as measured on the Center for Epidemiological Studies Depression scale.

Results: At enrollment, 19 mothers (48.7 percent) had elevated depressive symptom scores. When the infants were six months corrected age, mean scores had decreased by 36 percent, and only 20 percent of the mothers had elevated scores. During hospitalization, the correlates of depressive symptoms were similar to the factors that differentiated between mothers at high risk and those at low risk for depression. However, the correlates of depressive symptoms during hospitalization were different from correlates of changes in depressive symptoms between hospitalization and six months corrected infant age. Identifying correlates of maternal depressive symptoms may lead to earlier identification and treatment of women at risk for depression, thereby decreasing the negative effects on infant development.
Legal Issues in Neonatal Nursing
Authors: Miller Lisa
Published: May 2012

Welcome to the debut of “Jurisprudence,” a column that will explore legal issues in neonatology and neonatal nursing. Jurisprudence is defined as the science or philosophy of law. The term originates from the Latin word jurisprudentia, or “knowledge of law,” and from the root words jus, meaning right, and prudentia, from providere, meaning to foresee. Through case reviews and analysis, statutory updates, and expert commentary, this column is intended to stimulate dialog and discussion regarding the impact of law on the practice of neonatology and, more specifically, on neonatal nursing.
Disaster Preparedness: Emergency Planning in the NICU
Authors: Phillips Pamela , Niedergesaess Yvonne , Powers Richard , Brandt Roberta
Published: May 2012

Hospital emergency management has evolved beyond satisfying regulatory requirements. Although tools and resources have been developed to support hospitals in emergency planning, there appears to be a scarcity of resources to guide hospital departments. To ensure that standards of care are maintained and to minimize the impact on the hospital and/or a nursing unit, Good Samaritan Hospital has developed a mobile emergency system and an Emergency Operations Plan (EOP) template to assist other nursing units in their planning efforts. This article focuses on the development of emergency bedside backpacks, mobile disaster boxes, disaster documentation and forms go-kits, and guidelines for creating such a plan. The ongoing equipment testing, inventory rotation, staff training, and exercising response protocols are all crucial to test the effectiveness of the program in place. All these activities require a multidisciplinary approach to ensure integration with hospital-wide emergency planning efforts.
Hemolytic Disease of the Newborn Caused by Anti-Wright (Anti-Wra): Case Report and Review of Literature
Authors: Squires Amanda , Nasef Nehad , Lin Yulia , Callum Jeannie , Khadawardi Emad M. , Drolet Christine , Core David , Simmons Brian
Published: May 2012

Antibodies to red cell antigens that are found at low frequency in the general population are rare causes of hemolytic disease of the newborn. To understand how to detect these cases, we provide a basic review of routine antenatal maternal antibody testing and report a case of a neonate with severe HDN caused by anti-Wright (anti-Wra), successfully managed with transfusion, phototherapy, and high-dose intravenous immunoglobulin.

When hemolysis in a newborn is suspected in the absence of major blood group incompatibility or commonly detected maternal red cell antibodies, a direct antiglobulin test should be performed. A positive DAT should alert the clinician to the presence of maternal antibodies against low-incidence antigens. Antibodies to the Wraantigen are one such rare cause of HDN.
Neonatal Care in a Japanese NICU: Notes Based on a Site Visit
Authors: Chirinian Nevart , Uji Atsuko , Isayama Tetsuya , Shah Vibhuti
Published: May 2012

This article presents an overview of a neonatal intensive care unit along with resuscitative care and management of the 22 to 23 weeks gestational age infant is as it was noted during a visit to the NICU of a large academic center in Japan.

Non-English speaking neonatology communities may be at a disadvantage of having their research and practices well known in the English speaking ones. Thus, visits such as this are beneficial in exchanging ideas and practices that may ultimately be mutually beneficial in reducing mortality and morbidity in a specific category of neonates.
Case Reports of Congenital Central Hypoventilation Syndrome
Authors: Marsh Kim , Ehrhardt Elizabeth
Published: May 2012

Congenital central hypoventilation syndrome (CCHS), which occurs in less than 1 in every 50,000 infants and children, is a rare syndrome first noted in literature by Mellins in 1970. Congenital central hypoventilation syndrome is a condition in which the patient loses the drive to breathe during deep sleep and can mimic many diseases. Until recently, CCHS has largely been a diagnosis of exclusion; fortunately, there is now a genetic test available to confirm the diagnosis.

The purpose of this article is to discuss the steps taken to confirm the diagnosis of CCHS. In addition to the history of the disease and clinical manifestations, genetics and prognosis of children with CCHS will be discussed. Two cases are presented for illustration of hospital course and preparation for discharge.
Cleaning optimisation of reverse osmosis membranes used for wastewater reclamation
Authors: Bernat X. , Prats G. , Gibert O. , Lefèvre B. , Tobella J.
Published: May 2012

Wastewater reclamation contributes to the preservation of conventional water resources and thus helps to ensure appropriate human development for future generations. Wastewater reclamation can be achieved through several technologies. One of the most common technologies is the tertiary treatment of urban municipal wastewater, which is often based on membrane technologies. Reverse osmosis is an effective separation technology for removing dissolved salts and low molecular weight organic compounds. However, membranes suffer from fouling, which directly reduces technical, environmental and economic feasibility of the process and hence of the reclamation plant. One of the strategies helpful to reduce fouling is the optimisation of the membranes’ cleaning and maintenance. The aim of this work is to test the impact of the membrane cleaning protocol design on the recovery of the original properties of a reverse osmosis membrane used for several years in a wastewater reclamation plant in Spain. Furthermore, the work is focused on the validation of the adequacy of the most-common indicators used for assessing membranes’ cleaning efficiency.
A New Method in User-Centered Design: Collaborative Prototype Design Process (CPDP)
Authors: Andrews Christopher , Burleson Debra , Dunks Kristi , Elmore Kimberly , Lambert Carie S. , Oppegaard Brett , Pohland Elizabeth E. , Saad Danielle , Scharer Jon S. , Wery Ronda L. , Wesley Monica , Zobel Gregory
Published: May 2012

To build upon user-centered design methods, we used a collaborative and multi-modal approach to involve users early in the design process for a website. This article presents our methods and results and addresses the benefits and limitations of the Collaborative Prototype Design Process (CPDP), including ways in which this new method can be implemented. The CPDP is an innovative approach to user-centered website design that emphasizes collaboration, iterative testing, and data-driven design. The CPDP balances the power and needs of users with those of designers and, thus, enables design teams to test more tasks and involve more users. We divided our initial team into three independent design teams to separately profile users, test usability of low-fidelity paper prototypes, and then create and test usability of resulting wireframes. After completing the user-centered design and usability testing, the three teams merged to analyze their diverse findings and create a final prototype.
Challenges and Rewards of Teaching Intercultural Communication in a Technical Writing Course: A Case Study
Authors: Cárdenas Diana L.
Published: May 2012

Community-based projects immerse technical writing students in intercultural communication, addressing local needs and shaping documents in human terms. Students at a South Texas university work to establish communication with clients in a city-county health department to create effective documents and disseminate family health legislation. To prepare students for interactions in multicultural settings, the teacher provides an instructional framework that highlights the concepts and values of intercultural communication and the principles for effective problem-solving. Students engaged in the Baby Moses ( el niño Moisés) project encounter misunderstandings, rhetorical challenges within the process of document creation, and cultural tensions that thwart their goal to disseminate information to the community. Students and the teacher learn that the classroom, like the city-county health department, is a fertile site for cultural disequilibrium, tensions, and potential cultural awareness. To insure a viable Technical and Professional Writing Program in a culturally diverse university and surrounding community, the teacher identifies opportunities that help students develop and enhance their identities as culturally-sensitive communicators and effective problem solvers.
Identity politics, music, and musical discourse in the age of globalization
Authors: Radoman Valentina
Published: May 2012

An immense number of scientific works have been written on the phenomenon of
identity. Insisting on the consideration of the aforementioned phenomenon has
become prominent in social and humanistic sciences - and especially in
cultural studies as a specific interdisciplinary field - since the 1960s.
Unlike previous studies and notions that see identity as a centered,
unchangeable and homogeneous entity that manifests itself as objective social
facts, much research has led to the conclusion that identity is a complex,
multifaceted, changeable, unstable construct which occurs and changes its
meaning in various historical, social and discursive contexts. After that,
the focus of research was shifted from the consideration of ways of
constructing identity to understanding the occurrence of new aspects of
identity, that is, multiplication, fragmentation and destruction of existing
identities, especially in the era of globalization. Along with the statement
that any art is political, as art per se is one of ideological instruments
which conceals the horrible, in terms of the Lacanian ?Real?, and which would
destroy society if it could be seen, visualized, heard or touched, there are
discussed some aspects of the work of Kevin Volans and Aleksandra Vrebalov,
composers whose works have been promoted and brought into the world of music
by the Kronos Quartet, a music institution whose work is based on the idea of
promoting multiculturalism - a phenomenon which accompanies globalization.
Modern open politicization of works of art and musical institutions, which
are themselves political instruments, has been interpreted, in the spirit of
the conclusions of left-orientated scientists, as a social decision, within
neo-liberal capitalism, which enables the acceleration of the process of
globalization, that is, the unimpeded flow of Capital.
Traditional music and the anatomy of the festival network between Yugoslavian cultural politics and vernacular values
Authors: Jakovljevic Rastko
Published: May 2012

As official policies in the post-war Yugoslavia were oriented towards
economy, mainly tied to towns, rural areas were focused on agriculture to a
large extent, as it had been before. However, the Party was determined to
revive villages, being of the opinion that life in those areas should be
purified from ?primitivism? so that it could be set to a higher level
concerning issues of education, political structure, local organization and
cultural life. Since people in villages felt determined to maintain their
local culture, customs and music, the State officials had to find ways to
articulate uncanny social behaviors. At the time, folklore and vernacular
creative impulse in Serbia was sustained as a ?hard cultural form? that by
accident or on purpose converted into ?soft cultural form? through a wide
range of festival activities in Yugoslavia. This significant turn permitted
?relatively easy separation of embodied performance from meaning and value,
and relatively successful transformation at each level? (Appadurai 1996: 90).
The discussion of this paper intends to form a dialogue on the transformation
of social structure and politics, which gradually led to severe changes in
the areas of traditional musical practice.
Trumpeting through the iron curtain: The breakthrough of jazz in socialist Yugoslavia
Authors: Vucetic Radina
Published: May 2012

During the Cold War, jazz became a powerful propaganda weapon in the battle
for ?hearts and minds?. As early as the 1950s, the American administration
began its Cold War ?jazz campaign?, by broadcasting the popular jazz radio
show Music USA over the Voice of America, and by sending its top jazz artists
on world tours. In this specific cultural Cold War, Yugoslavia was, as in its
overall politics, in a specific position between the East and the West. The
postwar period in Yugoslavia, following the establishment of the new
(socialist) government, was characterized by strong resistance towards jazz
as ?decadent? music, until 1948 when ?no? to Stalin became ?yes? to jazz.
From the 1950s, jazz entered Yugoslav institutions and media, and during the
following two decades, completely conquered the radio, TV, and record
industry, as well as the manifestations such as the Youth Day. On account of
the openness of the regime during the 1950s and 1960s, Yugoslavia was
frequently visited by the greatest jazz stars, such as Dizzy Gillespie, Louis
Armstrong and Ella Fitzgerald. In the context of the Cold War, the promotion
of jazz in Yugoslavia proved to be beneficial for both sides - by exporting
jazz, America also exported its freedom, culture and system of values, while
Yugoslavia showed the West to what extent its political system was open and
liberal, at least concerning this type of music.
Depth dose determination for a mixed radiation field using a thin plastic scintillator dosimetry system
Authors: Aydarous Abdulkadir , Waker Anthony
Published: May 2012

Plastic scintillators, due to their favorable characteristics compared with
other dosimetry techniques, were used as detectors to estimate dose
distributions in high gradient dose fields. In this study, a thin plastic
scintillator (type BC-408) was coupled to a photomultiplier tube and
multichannel analyzer as a technique for real-time dose measurements. The
well-defined beta, gamma, and beta-gamma emitters (137Cs, 133Ba, 22Na, 109Cd,
55Fe, and 241Am) have enabled parallel depth dose measurements with
Monte-Carlo calculations to be critically compared. The measurements of doses
were made for depths range of 0.1 mm to 5 mm. The MCNP dose results were
comparable with the plastic scintillator detector and can be used to
approximately estimate the dose rate values from mixed electron-photon
fields. The minimum dose rate that can be measured by the plastic
scintillator system was ~2 ?Gy/h and was for 109Cd source of activity 222 Bq.
Natural radionuclides and 137Cs in moss and lichen in eastern Serbia
Authors: Cuculovic Ana , Popovic Dragana , Cuculovic Rodoljub , Ajtic Jelena
Published: May 2012

The paper presents the results of radionuclides determination in moss
(Homolothecium sp., Hypnum Cupressiforme sp., and Brachythecium sp.) and
lichen (Cladonia sp.) sampled in the region of Eastern Serbia during
1996-2010. The activities in moss are in the range of 100-500 Bq/kg d. w. for
40K, and 5-50 Bq/kg d. w. for 226Ra and 232Th, while the ?soil-to-moss?
transfer factors are 0.45 for 40K, 3 for 226Ra, and 0.3 for 232Th. The
spatial distribution of the 137Cs activities is highly non-uniform; some
values reach 500 Bq/kg d. w., with less than 10% of the samples, mainly the
ones taken prior to 2000, with the activity above 1000 Bq/kg d. w. The
variations in the content of natural radionuclides among the moss species are
not significant. The frequency pattern of the activities of natural
radionuclides in lichen is similar to the one in moss, but the activities in
lichen are to some extent lower. The mean activity of 137Cs in lichen is
below 400 Bq/kg d. w. The mean activities of 7Be in moss and lichen sampled
in 2006 and 2008 are in the range of 41-122 Bq/kg d. w., with pronounced
variations between the sampling sites.
Gantry orientation effect on the neutron and capture gamma ray dose equivalent at the maze entrance door in radiation therapy
Authors: Ghiasi Hosein , Mesbahi Asghar
Published: May 2012

In the present study, the effect of gantry orientation on the photoneutron
and capture gamma dose calculations for maze entrance door was evaluated. A
typical radiation therapy room made of ordinary concrete was simulated using
MCNPX Monte Carlo code. Gantry rotation was simulated at eight different
angles around the isocenter. Both neutron and capture gamma dose vary
considerably with gantry angle. The ratios of the maximum to the minimum
values for neutron and capture gamma dose equivalents were 1.9 and 1.4,
respectively. On the other hand, comparison of the Monte Carlo calculated
mean value over all orientations with Monte Carlo calculated neutron and
gamma dose showed that the Wu-McGinley method differed by 5% and 2%,
respectively. However, for more conservative shielding calculations, factors
of 1.6 and 1.3 should be applied to the calculated neutron and capture gamma
doses at downward irradiation. Finally, it can be concluded that the gantry
angle influences neutron and capture gamma dose at the maze entrance door and
it should be taken into account in shielding considerations.
A proposal for a new U-D2O criticality benchmark: RB reactor core 39/1978
Authors: Pesic Milan
Published: May 2012

In 1958, the experimental RB reactor was designed as a heavy water critical
assembly with natural uranium metal rods. It was the first nuclear fission
critical facility at the Boris Kidric (now Vinca) Institute of Nuclear
Sciences in the former Yugoslavia. The first non-reflected, unshielded core
was assembled in an aluminium tank, at a distance of around 4 m from all
adjacent surfaces, so as to achieve as low as possible neutron back
reflection to the core. The 2% enriched uranium metal and 80% enriched
uranium dioxide (dispersed in aluminum) fuel elements (known as slugs) were
obtained from the USSR in 1960 and 1976, respectively. The so-called ?clean?
cores of the RB reactor were assembled from a single type of fuel elements.
The ?mixed? cores of the RB reactor, assembled from two or three types of
different fuel elements, were also positioned in heavy water. Both types of
cores can be composed as square lattices with different pitches, covering a
range of 7 cm to 24 cm. A radial heavy water reflector of various thicknesses
usually surrounds the cores. Up to 2006, four sets of clean cores (44 core
configurations) have been accepted as criticality benchmarks and included
into the OECD ICSBEP Handbook. The RB mixed core 39/1978 was made of 31
natural uranium metal rods positioned in heavy water, in a lattice with a
pitch of 8?2 cm and 78