bluuebunny/crossref_metadata_2025 huggingface dataset:
Boundary troubles: working the academic–policy interface
Authors: Newman Janet
Published: November 2011

The boundary between academic research and policy making is characterised by at least two different sets of ‘troubles’. This article draws on the author's experience as scientific adviser to a UK government department to highlight the often-problematic relationship between researchers and policy actors, and to tease out conflicting understandings of the value and robustness of different kinds of ‘evidence’. The article assesses the contributions of both governance theory and theories of governmentality to understanding the case material, and challenges the idea that there might be a new settlement between social science and policy that represents a ‘post-ideological’ turn in policy making.
Systematic Review and Meta-Analysis of Efficacy, Safety, and Tolerability Data from Randomized Controlled Trials of Drugs Used to Treat Postherpetic Neuralgia
Authors: Edelsberg John S , Lord Claudia , Oster Gerry
Published: November 2011

Objective:

To conduct a systematic review of available data from reports of randomized controlled trials on the efficacy, safety, and tolerability of drugs used to treat postherpetic neuralgia (PHN), a common type of neuropathic pain.

Data Sources:

The MEDLINE (1950-June 30. 2009) and EMBASE (1974-June 30, 2009) databases were used to identify source studies, in conjunction with a review of reference citations from identified published reports.

Study Selection and Data Extraction:

We selected all English-language reports of randomized placebo-controlled trials of the efficacy, tolerability, and safety of drugs (oral or transdermal) used for treatment in patients with PHN. Studies with treatment duration less than 4 weeks were excluded. From each identified trial, we extracted information on (1) placebo-corrected percentage reductions in pain intensity from randomization to end of active treatment; (2) relative risks of withdrawal due to lack of efficacy; (3) relative risks of various adverse events; and (4) relative risks of withdrawal due to adverse events.

Data Synthesis:

Twelve reports of randomized controlled trials in patients with PHN were identified, involving 8 different agents (amitriptyline, capsaicin, divalproex sodium, gabapentin, morphine, nortriptyline, pregabalin, tramadol). Most studies were small, involving fewer than 200 patients. Pain intensity was reported to have been reduced significantly with all drugs (range: 13.8% [tramadol] to 42,4% [amitriptyline]); data were pooled using techniques of meta-analysis when information was available from more than 1 trial. No clinical trial reported a significant reduction in risk of withdrawal as a result of lack of efficacy. Analysis of adverse events was greatly limited by erratic and inconsistent reporting and wide variation in sample sizes.

Conclusions:

While available literature establishes the efficacy of 6 drugs in treatment of PHN, it does not provide adequate guidance as to which agents are best to treat this condition, in part because of inadequate reporting of data on tolerability and safety.
Sum-Product Estimates Applied to Waring's Problem over Finite Fields
Authors: Cochrane Todd , Cipra James
Published: November 2011

Let
Plagiarizing your own autobiography, and other strange tales
Authors: Prouty Ken
Published: November 2011

Miles Davis was known for his troubled relationships with writers, often expressing disdain for those who would comment upon his life and music. As a result, critical understanding of Davis has often been obscured, resulting from a self-generated silence from Davis himself, as a means to direct his own critical discourse. The allegations of plagiarism surrounding the publication of Miles: The Autobiography illustrate Davis’s imposition of a discursive silence on his critics and admirers alike. By refusing to speak openly and honestly about himself, Davis forced critics and scholars to fill in gaps in his narrative, with speculation and, in the case of the autobiography, other written work. By being ‘difficult’ or ‘uncooperative,’ Davis engaged in a process that was similar to his interactions with musicians, leaving spaces for others to fill. Thus, an aesthetic of silence underscores both his approach to music, and his engagement with the broader discourse.
Reliability of a Visual Recognition System for Detection of Johnsongrass(Sorghum halepense) in Corn
Authors: Andújar Dionisio , Ribeiro Ángela , Fernández-Quintanilla Cesar , Dorado José
Published: November 2011

The feasibility of visual detection of weeds for map-based patch spraying systems needs to be assessed for use in large-scale cropping systems. The main objective of this research was to evaluate the reliability and profitability of using maps of Johnsongrass patches constructed at harvest to predict spatial distribution of weeds during the next cropping season. Johnsongrass patches visually were assessed from the cabin of a combine harvester in three corn fields and were compared with maps obtained in the subsequent year prior to postemergence herbicide application. There was a good correlation (71% on average) between the position of Johnsongrass patches on the two maps (fall vs. spring). The highest correlation (82%) was obtained with relatively large infestations, whereas the lowest (58%) was obtained when the infested area was smaller. Although the relative positions of the patches remained almost unchanged from 1 yr to the next, the infested area increased in all fields during the 4-yr experimental period. According to our estimates, using a strategy based on spraying full rates of herbicides to patches recorded in the map generated in the previous fall resulted in higher net returns than spraying the whole field, either at full or half rate. This site-specific strategy resulted in an average 65% reduction in the volume of herbicide applied to control this weed.
Tolerance of Six Zoysiagrass Cultivars to Aminocyclopyrachlor
Authors: Flessner Michael L. , McCurdy James D. , McElroy J. Scott
Published: November 2011

Aminocyclopyrachlor (AMCP) is labeled for use on zoysiagrass, but some injury has been observed. Differential zoysiagrass cultivar response to herbicide treatment has been previously reported. This greenhouse study evaluated the response of ‘BK-7’, ‘Cavalier’, ‘Emerald’, ‘Empire’, ‘Meyer’, and ‘Zorro’ zoysiagrass to 0, 0.005, 0.02, 0.11, 0.52, and 2.4, 11 kg ai ha−1, AMCP. Visual estimation of percent necrosis and normalized difference vegetative index (NDVI) analysis were conducted. Based on rating dates and data types three tolerance groups were established: Cavalier, Meyer, and Zorro are the most tolerant; Emerald and Empire are intermediate; and BK-7 is the least tolerant to AMCP. All zoysiagrass cultivars had sufficient tolerance at the labeled rate. Visual and NDVI analyses were highly correlated; however, NDVI data were subject to greater standard error and pseudoR2values.
Toy or Tool of the Trade? Part II
Authors: Thomas Patricia
Published: November 2011

PART I OF THIS SERIES INTRODUCED the basics of personal digital assistant (PDA) technology, including built-in features, choosing a model that meets your needs, and ideas on how to begin using your PDA. Part II of this series examines software and hardware that can enhance your PDA’s usefulness. Thousands of software programs are currently available for PDAs. In this column, we’ll look at some, such as medical references and database management tools, that increase the functionality of your PDA. Included is information on installing new software and deleting programs you no longer need. We’ll also examine hardware additions—such as memory cards, digital cameras, MP3 players, bar-code scanners, infrared printers, and global positioning system (GPS) technology—that are available for your PDA. Vendors from whom you can obtain these goodies are also identified.
Findings from the National Institute of Nursing Research Related to Neonatal Care
Authors: Bingham Raymond J.
Published: November 2011

THE BIRTH OF A CHILD IS A TIME OF GREAT HOPE AND joy in most families. However, pregnancy and childbirth can present major challenges and risks. A pregnancy complicated by risk factors endangers the health and well-being of both the mother and the fetus. A preterm birth or otherwise abnormal delivery places great stresses on family structures to cope, on nurses to provide optimal care, and on the fragile infant to grow and develop.
Highly Active Antiretroviral Therapy in Neonates and Young Infants
Authors: Bell Susan Givens
Published: November 2011

SINCE THE U.S. PUBLIC HEALTH Service published its guidelines for the reduction of vertical transmission of human immunodeficiency virus (HIV) in 1994, Pediatric AIDS Clinical Trials Group (PACTG) 076 zidovudine (ZDV) regimen (Table 1) has been the standard of care in developed countries.1 The initial study of ZVD administration in mother-infant pairs demonstrated a significant reduction in vertical transmission of HIV-1: 7.6 percent in the treatment group versus 22.6 percent in the placebo group.2 Clearly, early and adequate prenatal care for the management of the HIVinfected pregnant woman is the key to providing the best possible outcome for the mother and her infant. However, women seek prenatal care at various stages of their pregnancies, and some present to labor and delivery suites having had no prenatal care. Thus, the Perinatal HIV Guidelines Working Group developed recommendations for prophylaxis against mother-to-child transmission of HIV that cover a variety of clinical scenarios.3 Discussion of these recommendations is beyond the scope of this article, but readers can find the recommendations at http://AIDSinfo.nih.gov.
Harlequin Ichthyosis: A Case Study
Authors: Murphy-Brown Laura , Vella Judith , Lawlor-Klean Phyllis
Published: November 2011

The most severe manifestation of congenital ichthyosis presents itself in the form known as harlequin ichthyosis. Harlequin ichthyosis is characterized by a profound thickening of the fetal skin. Affected infants are born with a thick “horny shell” of dense, waxy, platelike scales with deep, irregular fissures covering the body. Contraction of the extremities is seen, along with deformities of the ears, eyes, mouth, and digits. This “armor” limits movement and compromises the skin’s barrier defense, leaving the newborn at risk for metabolic abnormalities and infection. A case study of our unit’s experience is provided.
Kangaroo Care: Is It for Everyone?
Authors: Neu Madalynn
Published: November 2011

Purpose: In spite of the benefits reported for kangaroo holding, many mothers of preterm infants requiring intensive care do not choose to hold kangaroo style. The purpose of this study is to describe factors that influence mothers of healthy preterm infants to choose kangaroo holding compared to the standard care method of blanket holding.

Sample: Twenty-four primiparous mothers of healthy infants born at 30–34 weeks gestational age.

Design: In this naturalistic inquiry, mothers were interviewed twice: once while the infant was hospitalized and again after the infant was discharged home.

Results: Mothers’ holding practices divided them into three groups: (1) kangaroo holding in hospital and home, (2) blanket holding in hospital and home, and (3) holding practice switched from hospital to home. Three themes emerged from the interview data: (1) emotional state, (2) holding environment, and (3) benefits of close contact with the infant.
Gaps and Disparities in Neonatal Nursing Care
Authors: McCain Gail
Published: November 2011

AS I WAS PREPARING THE “UPDATE ON RESEARCH Evidence for Neonatal Care” column for this issue, I was surprised to read that nursery nurses were not placing healthy newborns in the supine position for sleep as prevention for sudden infant death syndrome (SIDS).1 But what equally got my attention was that Latina and Pacific Islander mothers were less likely than white mothers to be instructed by their nurses about the use of the supine position for infant sleep.
Car Seat Safety: Literature Review
Authors: Lincoln Michelle
Published: November 2011

After staggering numbers of infants were killed in automotive crashes in the 1970s, the American Academy of Pediatrics (AAP) recommended in 1974 universal use of car seats for all infants. However, positional problems were reported when car seats are used with premature infants less than 37 weeks gestational age as a result of head slouching and its sequelae. In 1990, the AAP responded with another policy statement introducing car seat testing. It recommended that any infant at or under 37 weeks gestational age be observed in a car seat prior to discharge from the hospital. The AAP did not give specific guidelines on type of car seat, length of testing, equipment, or personnel proficiency, however. Few nurseries have standard policies to evaluate car seats, to teach parents about car seats, or to position newborns in them, and not all hospitals actually conduct car seat challenges or have common standards for testing that is performed.
Intraventricular Hemorrhage in the Premature Neonate
Authors: Owens Rebecca
Published: November 2011

THE MOST COMMON VARIETY of neonatal intracranial hemorrhage is an intraventricular hemorrhage (IVH).1Although much research has been conducted concerning the etiology and prevention of IVH in the preterm infant, the problem continues to plague very low birth weight (VLBW) infants (<1,500 grams) in particular. The risk of IVH correlates inversely with gestational age. The incidence of hemorrhage in the infant <28 weeks gestation is three times that of infants 28–31 weeks gestational age. The incidence of severe hemorrhage in infants <28 weeks gestational age istwicethat of infants 28–31 weeks gestational age.2
Identifying, Understanding, and Working with Grieving Parents in the NICU, Part II: Strategies
Authors: Dyer Kirsti
Published: November 2011

Supporting parents in coping with stress and loss improves the health and development of their child. This article looks at the need for monitoring the health and well-being of parents of infants in the NICU, including practical matters for health care professionals providing follow-up care. It is important to increase public and professional awareness of the grief response. Practical suggestions for coping with the NICU experience, many of them from professionals who are also parents of NICU patients, are offered for grieving parents and family members.
Hyperoxemia and Hypocapnia are Associated with Poor Outcomes in Infants with Asphyxia, Pain Assessment Tool, and Hyperbilirubinemia is Not Associated with Autism Spectrum Disorders
Authors: McCain Gail
Published: November 2011

This column highlights selected research abstracts from published studies and systematic reviews about neonatal care. The original abstracts, from peer-reviewed journals, are followed with a commentary by the column editor. The goal of this column is to inform the readers of Neonatal Network:® The Journal of Neonatal Nursing about the most up-to-date research evidence for use in neonatal nursing practice. If you would like to see a particular research publication, research review, or research-based guideline in this column, please advise the column editor (e-mail: gmccain.com).
The Anatomy of A National Meeting or Where is My Crystal Ball?
Authors: Askin Debbie Fraser
Published: November 2011

MANY OF YOU ATTENDING THIS MEETING, SOME FOR the first time, will be reading this editorial at the National Neonatal Nurses Meeting in Chicago. You might wonder, as I used to, how this meeting gets put together. Why Chicago and not your hometown? Why some of the same old speakers, or, why not more of the big names?
Palliative Care for Infants, Children, and Adolescents: A Practical Handbook
Authors: Carter Brian , Leveton Marcia
Published: November 2011

Palliative Care for Infants, Children, and Adolescents: A Practical Handbook is a comprehensively well written book encompassing the pediatric population, with a practical, didactic, and academic approach to palliative care. This book’s treatment of end-of-life issues would benefit all pediatric caregivers affiliated with life-limiting or life- threatening conditions, regardless of setting. One of the more poignant aspects of this book is its attempt to promote and advance palliative care for children in the face of prevailing barriers. We are reminded that, although we strive to cure and promote life, we must not fail to give to the pediatric patient state-of-the-art care in the face of life-limiting and certain-death circumstances.
Intravenous Immunoglobulin in the Management of Hemolytic Disease of the Newborn
Authors: Mundy Cynthia
Published: November 2011

Jaundice caused by hemolysis continues to challenge practitioners caring for infants in the NICU. Bilirubin levels can rise quickly in the first days of life, and interventions must be prompt to prevent side effects related to hyperbilirubinemia. Conventional treatments such as hydration and phototherapy are common, but new studies suggest that use of intravenous immunoglobulin (IVIG) as an additional treatment may prevent the need for exchange transfusion in some babies. This article presents a case study of an infant with blood-type incompatibility treated successfully with multiple doses of IVIG, discusses the pathophysiology and clinical presentation of hemolytic jaundice, and reviews current management strategies for this disease.
Creating a Winning Team: Lessons from Football
Authors: Simons Sherri Lee
Published: November 2011

LEADING EMPLOYEES IS AN unpredictable and complicated task for most nurses promoted into management roles. The people who work in a neonatal intensive care unit are individuals, each with unique talents, knowledge, abilities, and energy. Patient care is provided through the efforts of an interdisciplinary team, which includes the patient and the patient’s family. High- functioning health care teams create the interdependence and energy necessary for well-coordinated, high-quality patient care delivery and outcomes.1
Findings from the National Institute of Nursing Research Related to Neonatal Care: 2005 Update
Authors: Bingham Raymond J.
Published: November 2011

This annotated bibliography from the National Institute of Nursing Research (NINR) presents recent findings on a variety of studies related to prenatal conditions and the benefits of prenatal care, advances in our understanding about infant care and family issues in the newborn intensive care unit (NICU), and the importance of clinicians in supporting and communicating with the family. By sharing this bibliography, we hope to increase the awareness of these valuable research findings within the nursing community and support the continued development of evidence-based practice in antenatal, postpartum, and neonatal care.
Cloacal Exstrophy
Authors: Hyun Susanne Jane
Published: November 2011

Cloacal exstrophy is an extremely rare and devastating complex of congenital abnormalities resulting in multiple debilitating morbidities. Infants with this disorder require numerous surgical interventions to repair gastrointestinal, genitourinary, spinal, and orthopedic malformations. Treatment involves the combined efforts of many medical and nursing specialists. This article discusses the embryology, clinical presentation, and management (both early and long term) of cloacal exstrophy, with emphasis on gender reassignment issues and quality of life.
Floating into Management: How to Keep Your Boat Afloat and Survive the Flood
Authors: Simons Sherri Lee
Published: November 2011

ALTHOUGH INEXPERIENCED NEW nurses entering an NICU receive a thorough orientation, new nurse managers may be given office keys and a limited formal education that generally focuses on task-oriented functions, such as interviewing, appraising, and disciplinary processes. Borrowing from themes used by Michael Levine in describing how to survive challenges in one’s personal life, this article presents eight basic principles of leadership that can help the novice manager keep afloat when flooded with challenges and demands.1
Immunomodulation, Part III : Intravenous Immunoglobulin
Authors: Bell Susan Givens
Published: November 2011

SEPSIS CONTINUES TO BE A MAJOR cause of morbidity and mortality in the NICU. In a 2002 study of late-onset sepsis in very low birth weight (VLBW) infants, the National Institute of Child Health and Human Development Neonatal Research Network found that, of 6,215 infants who survived beyond three days, 1,313 (21 percent) experienced at least one episode of blood culture–proven sepsis. Not only does sepsis increase the lengthandcost of stay in the NICU, but VLBW neonates with sepsis are significantly more likely to die than are uninfected infants (18 percent versus 7 percent).1The most recently published statistics on sepsis-related neonatal mortality reveal that early neonatal mortality from sepsis declined from an average of 24.9/100,000 live births between 1985 and 1991 to an average of 15.6/100,000 live births between 1995 and 1998. The rate of late neonatal mortality from sepsis increased from 14.8/100,000 live births between 1985 and 1991 to 16.2/100,000 live births between 1995 and 1998.2
What’s Happening in the Bigger World of Publishing: A “Heads-Up”
Authors: Askin Debbie Fraser
Published: November 2011

THE BUSINESS OF PUTTING TOGETHER A JOURNAL THAT is relevant, interesting, and scholarly has become increasingly more challenging and complex. Pressure from funding agencies to make government-sponsored research results freely accessible, the increasing movement towards online access to articles, and a general need to attend to the bottom line in a shrinking market for print journals, has resulted in two troubling events that I would like to share with you. The details of the first, the severing of ties between the American Journal of Nursing (AJN) and the American Nurses Association (ANA), are outlined in the accompanying letter that was sent to ANA by members of the International Association of Nurse Editors. In the second case, the editor-in-chief and the senior deputy editor of the Canadian Medical Association Journal (CMAJ), the journal of the Canadian Medical Association (CMA) were fired in February of this year. The reason for the firing—editorial freedom. The editors of the CMAJ commissioned a story on women’s experiences in obtaining the morning-after pill from pharmacies in Canada. When the Canadian Pharmacists Association heard about the story, they complained to the publisher of CMAJ who asked the editors to withhold the story.1 The editors chose to publish a negotiated revision but were fired for irreconcilable differences.2
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

The Academy of Neonatal Nursing is proud to announce the winners of our first Excellence in Neonatal Nursing Practice Award. Many nurses from around the country were nominated for demonstrating a strong commitment to their patients and for showing creativity, intelligence, perseverance, and unbending will to do their best. This year’s co-recipients are Luzviminda C. Jusayan, RN, of Virginia Beach, Virginia, and Amy Nagorski Johnson, DNSc, RNC, of Newark, Delaware.
Cobedding in the NICU: A New Adventure
Authors: Taylor Cheryl , LaMar Kimberly
Published: November 2011

With advances in neonatal and obstetric care over the past few years, the number of premature, multiple-birth neonates entering NICUs has increased. As we have started to recognize the special bond that twins and higher multiples share, cobedding has emerged as an NICU practice. As with any change, the introduction of cobedding presents challenges in the NICU. Both the theoretical benefits and the potential concerns are many. Although nursing staff and parents may be excited about the prospect of placing these infants in the same crib, careful investigation and planning are necessary for any new procedure. This article discusses the cobedding of multiples as implemented at the University of Michigan. As a new practice, cobedding warrants further research, especially regarding its proposed benefits and implementation in the NICU.
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

There is still limited space available for the 4th National Advanced Practice Neonatal Nurses Conference at the Sheraton Waikiki in Honolulu, Hawaii. Internationally recognized guest speakers will share their latest findings on a wide range of current neonatal topics, while the afternoons will be free for participants to enjoy the splendors of beautiful Hawaii. Academy members will receive a discount on conference tuition. Save more by recruiting a member!
Neonatal Back Transport: Perspectives from Parents of Medicaid-Insured Infants and Providers
Authors: Hanrahan Krystal , Attar Mohammad-Ali , Frohna Alice , Gates Molly , Lang Sylvia , Clark Sarah
Published: November 2011

Purpose:To examine parents’ and health care providers’ perceptions of back transport from a tertiary care neonatal intensive care unit to a community hospital.

Design:Qualitative, hypothesis-generating, cross-sectional study utilizing focus group methodology.

Sample:Participants included 12 parents of back-transported infants insured by Medicaid, 6 regional NICU health care providers, and 17 community hospital special care nursery health care providers.

Main Outcome Measures:Participant perceptions of factors that support or impede successful back transport.

Results:Data from the focus groups were analyzed to identify five main themes: early communication about back transport, preparing parents for back transport, communication between hospitals at the time of back transport, follow-up and information exchange after back transport, and improving the back-transport experience for parents.
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

This year’s conference lineup is definitely one of our best yet! Just a sampling of evidence-based topics and discussions includes “Proteomics: The Future of Neonatal- Perinatal Medicine,” “Boggy Baby Syndrome,” “Mortality and Morbidity Related to Multiple Births,” and “Cytokines: What Are They and What Do They Do?” Earn an additional 2.5 continuing education credits by signing up for the lunch and breakfast symposiums. The Friday lunch symposium, “How to Interpret a Cochrane Review,” presented by Sharyn Gibbins, PhD, will address a systematic and meaningful approach to interpretation of evidence. Dr. Gibbins is the head of interdisciplinary research and evidence-based practice at the Sunnybrook Health Science Centre in Ontario, Canada. Saturday’s breakfast symposium, “Workforce Issues for Neonatal Nurse Practitioners,” presented by Margaret Steinbach, RN, MSN, ARNP, vice president of advanced practitioners of the Pediatrix Group in Sunrise, Florida, will tackle workforce issues including benefits, salary, and staffing requirements in the face of a nursing shortage. Purchasing tickets for both together saves you $5.
Keeping a Watchful Eye on Retinopathy of Prematurity
Authors: Scott Carol , Wittmann-Price Ruth , Thear Gayle
Published: November 2011

RETINOPATHY OF PREMATURITY (ROP) is a time-sensitive issue for preterm infants.1To ensure patient safety and promote good outcomes, the clinician must be diligent in screening and treating these infants.2,3
A Preterm Infant with Intestinal Lymphangiectasia: A Diagnostic Dilemma
Authors: McDonald Karen , Bears Christina
Published: November 2011

Intestinal lymphangiectasia (IL) is a potentially fatal disorder of the lymphatic system if it is not recognized and proper treatment initiated. The disease is characterized by lymphocytopenia, peripheral edema, and hypoalbuminemia. Because IL is a rare disease, the symptoms, diagnostic workup, and treatment are unfamiliar to many clinicians. Current literature documents only a few reported cases of IL in a preterm infant. This case report of a preterm infant reviews history, symptomatology, and the diagnostic workup performed. The steps in making the diagnosis, the treatment, and the prognosis of this condition are also presented.
The Wheel of Time
Authors: Askin Debbie Fraser , Rait Suzanne , Berman Ute , Parker Tabitha
Published: November 2011

2009 WHEN WE FIRST STARTED OUR nursing careers in local NICUs, we didn’t even think about what neonatal care would be like in 2009! (Would there even be premies any more?) We took care of 30-week premature infants that we were happy “made it.” Developmental care was birthing itself; fabulous research was being done. It was an incredible job—taking care of premature infants. As the years went by, premies became smaller; technology became “bigger”; fertility drugs seemed to help create more multiple pregnancies: smaller, earlier births; and it seemed that more cesarean sections were needed.
Coarctation of the Aorta: A Case Presentation
Authors: Raeside Lavinia
Published: November 2011

Coarctation is a constriction or narrowing of the aorta and presents most commonly within the first two weeks of life. This article reviews a case study of an infant diagnosed with coarctation of the aorta on day 8 of life. It includes an overview of the etiology, clinical presentation, and management plus an account of the infant’s transport to a regional pediatric intensive care unit (PICU).
Changing Times: Dotting our T’s and Crossing our I’s
Authors: Fraser Askin Debbie
Published: November 2011

IN THIS DAY AND AGE EVERYONE HAS CHOICES. BECAUSE YOU are reading this editorial, I’m going to assume that you have made the choice to spend at least some of your scarce leisure or work time maintaining your competence by reading your professional journal. Putting together a peer-reviewed journal is a responsibility that we take seriously. It is our mission at Neonatal Network® and The Academy of Neonatal Nursing to provide nursing education that is up-to-date, evidence-informed, at a reasonable cost.
Inadvertent Catheterization of the Ascending Lumbar Vein
Authors: Trotter Carol
Published: November 2011

A NUMBER OF SERIOUS COMPLICATIONS can arise from malpositioned central venous catheters (CVCs), including cardiac tamponade and perforation, pleural effusions, and infusion into the vertebral venous system anywhere along the spinal column. Figure 1 is an x-ray of a premature infant taken after insertion of a 2.0 Silastic peripherally inserted central catheter (PICC), demonstrating the catheter entering the left ascending lumbar vein (ALV). Routine contrast injection of 0.3 mL of iothalamate meglumine 60 percent (Conray, Covidien Imaging Solutions, Hazelwood, Missouri) at the time of the PICC-placement film demonstrated that the contrast material extended into the vertebral venous plexus. The catheter was immediately withdrawn before intravenous fluid was administered, and the infant experienced no complications.
Case Study: Trisomy 13, A Palliative Care Case
Authors: Wirth Jennifer
Published: November 2011

PALIATIVE CARE IS AN IMPORTANT piece of the health care puzzle, one that is being utilized more frequently to provide excellent patient care throughout the life span. Although the need for palliative care services among the NICU patient population is often overlooked, this fragile patient population would at times greatly benefit from these services. It is vital that health care providers be aware of, knowledgeable about, and active in recognizing the need for palliative care referrals. This case study, from a nurse’s perspective, focuses on a patient diagnosed with trisomy 13 shortly after birth. It discusses the patient’s demographics and history, his disease/ diagnosis, and the nursing process surrounding the case, as well as the nurse-patient-family relationship and an evaluation of what was accomplished.
Gently Encouraging Breastfeeding in the NICU
Authors: Discenza Deb
Published: November 2011

HAVING AN INFANT IN THE NICU is far from the picturesque mother-child scene most people imagine. When a baby is born early, the parents must face a totally new world filled with life support machines, feeding tubes, medications, an incubator, as well as a team of doctors and nurses. As the new parents digest what has happened and what may soon happen to their baby, they feel far from “normal.” Maybe they can change a diaper and take the baby’s temperature, but they need a stronger sense that they are important to their baby’s health and well-being in this strange new land of the NICU.
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

Neonatal nurses hold the future of the health of our world in their hands every day in the NICU. On September 15, take some time to acknowledge that special neonatal nurse… you! Thank you for all your wonderful nursing care and for being a part of ANN.
Taking Care of the NICU Mom
Authors: Discenza Deb
Published: November 2011

NICU NURSES HAVE CHALLENGING jobs working with both extremely fragile newborns and their families. The mother in this family unit is one of the most important people to take care of, in addition to the newborn. So much has happened and continues to happen to her child(ren) that she is in a tailspin of physical and emotional pain. There are many ways to help the new mother through this trying time, and the NICU nurse is often the one who can be the most effective in getting mom on a solid path forward. Here are some suggestions for NICU nurses working with these shell-shocked mothers.
Little Boy Blue
Authors: Gunn Jennie
Published: November 2011

THEY WERE TWINS, ALREADY NAMED, sleeping within, growing and moving. After several pregnancies that failed, there were babies now that could survive. The precious babies weighed nearly four pounds each at seven months. It was a possibility that, after years of trying, my child could become a parent and I, a grandmother.
January February 2010 Letter to the Editor
Authors: Kalyn Angela
Published: November 2011

Regarding the report of Gardner and Shirland1, I would like to clarify a few points. Firstly, our article (Kalyn, et al.2 [Ref 35]) was incorrectly categorized as a case controlled or cohort trial in Table 1 (Level IV evidence). It was actually a well designed, randomized controlled cross over trial (Level 2 evidence). An a priori sample size of 50 was calculated for a power of 0.8 and an alpha of 0.05 for a small effect size and an average correlation of 0.8 for 4 physiological variables. We utilized a cross over design with random allocation of infants to a suction procedure. After the initial suction and recovery each infant had a 90 minute washout followed by the alternate suction method. This minimized the change in respiratory status of the infant and more clearly delineated the response to the specific suction method. The final sample consisted of 200 infants who were stratified into three weight groups to account for varying endotracheal tube sizes and disease processes.
Retinopathy of Prematurity: An Example of a Successful Screening Program
Authors: VanStone Wendy
Published: November 2011

Retinopathy of prematurity (ROP) is a persistent and often devastating morbidity associated with premature and low birth weight infants. It continues to be a frequent diagnosis in the neonatal intensive care unit, despite technologic advances and increased knowledge. The American Academy of Pediatrics (AAP) has issued practice guideline recommendations for ROP screening and treatment that aid in creating a consistent and reliable ROP protocol. Challenges exist in screening for and treating ROP, including delayed or omitted exams, lack of qualified examiners, lack of parental compliance with follow-up care, and fear of litigation. This article provides a detailed example of a successful ROP program based on the AAP recommendations and utilizing a multidisciplinary approach to ensure optimal ROP care for the preterm infant. It also discusses the role of the ROP coordinator assigned to the NICU.
Dads of Premature Infants Are Important Too
Authors: Discenza Deb
Published: November 2011

WE ARE ALL FAMILIAR WITH THE media image of the fumbling father handed his newborn—born at term and without complications—for the very first time. But what about the father of a baby born prematurely and immediately moved to the NICU? At least the fumbling father gets the chance to hold his baby. Fathers of preterm infants are often shuffled aside and made to feel completely useless. Many go back to work and visit their baby only every so often. That needs to change.
The Power of Nursing
Authors: Fraser Debbie
Published: November 2011

IN CELEBRATION OF NATIONAL NURSES WEEK THE ANA AND professional nursing organizations across the United States have come together to address an issue critical to our future—building an even more powerful nursing profession that can take the lead on addressing the complexities of patient care, reshaping the work environment, and influencing health policies to benefit patients and their families. This critical message is being carried to all nurses through each organization’s professional publications.
Techniques of Early Respiratory Management of Very Low and Extremely Low Birth Weight Infants
Authors: Miller Nichole
Published: November 2011

The generalized anatomic and physiologic immaturity of preterm infants of very low birth weight (VLBW) (≤1,500 g) and extremely low birth weight (ELBW) (≤1,000 g) places them at high risk for death or associated negative sequelae, including chronic lung disease of infancy (CLDI). The standard treatment for pulmonary immaturity, mechanical ventilation (MV) at birth, can lead to barotrauma, volutrauma, pulmonary edema, infection, and inflammation. To minimize these negative outcomes, multiple treatment strategies have been proposed and evaluated as to their subsequent clinical course. This article compares, contrasts, and integrates the use of MV, nasal continuous positive airway pressure (NCPAP), and surfactant administration to encourage and support consideration of their use in the VLBW and ELBW population. Supporting a reduction of the use of MV in favor of NCPAP is safe and recommended because this practice is likely to decrease the probable sequelae of CLDI while permitting an individualized approach.
I Danced at His Wedding
Authors: Scherf Rosalyn
Published: November 2011

ON OCTOBER 1, 2007, RN magazine published my article “David’s Story” about a patient of mine who was born prematurely 30 years ago. When David was just a day or two old, he was almost pronounced dead, but a bold and dedicated respiratory therapist asked if she could try to help him. And help him she did! David was kept alive at an outlying hospital until he could be admitted to our tertiary NICU, which at the time of David’s birth was full. Three days later, our unit at Jackson Memorial Hospital in Miami, Florida, had room to take David. At the end of that RN article, I wrote, “Maybe I’ll even get to dance at his wedding.”
A Fatal Case of Neonatal Adenovirus Infection
Authors: Kelley Cynthia
Published: November 2011

Adenovirus can produce severe disease and even death in the immunocompromised neonate. Symptoms of adenovirus infection are similar to those seen with bacterial infections in neonates, making early recognition and diagnosis difficult. Consideration of adenovirus as a causative agent is important to early diagnosis. Currently available culture techniques, particularly the shell vial culture technique, make more rapid identification of adenovirus infection possible. Early identification and treatment are necessary to improve patient outcomes and prevent the spread of infection to other neonates. Available agents for the treatment of adenovirus have had mixed results, yet their use is preferable to nontreatment of critical patients. This article presents the case of a preterm infant who became fatally ill from disseminated adenoviral infection.
November December 2010 News of the Academy
Authors: Brott Shirley
Published: November 2011

Our conferences are growing! Fourteen hundred nurses attended the 10th National Neonatal Nurses Conference and the 13th National Mother Baby Nurses Conference. Attendees began each morning with a tranquil ferry ride across the Savannah River in anticipation of learning, networking, and seeing friends…and family! Eight family members of Rodney Koehler, RN, flew in and surprised him to be present for his Excellence in Neonatal Nursing Practice Award presentation. Rod and his family danced the night away on one of the two “filled to capacity” river boatcruises. Imagine…500 neonatal nurses grooving to the music along the Savannah River! The Lady and Son’s restaurant was a hit as well, with 300 nurses taking part in Paula Deen’s dining experience. Check out some of the raffle prizes at the 10th anniversary celebration: Acer Netbook, Kindle, Flip Video camera, Nikon camera, Academy membership, and $50 Visa gift card. All monies collected from the sale of raffle tickets went to the Florence Nightingale International Foundation (FNIF), Girl Child Education Fund and the Greenbriar Children’s Center (GCC) in Savannah. FNIF was chosen in acknowledgement of 2010 being designated “The Year of the Nurse.” Monies were donated to this same fund from the sale of raffle tickets at the 7th National Advanced Practice Neonatal Nurses Conference in San Francisco at the beginning of this year. GCC provides services that promote the healthy development of children and the strengthening of families. Photos from the conferences can be seen on page 384 and on the Academy of Neonatal Nursing’s website, www.academyonline.org.
Congenital Central Hypoventilation Syndrome and the PHOX2B Gene Mutation
Authors: Marion Tara L. , Bradshaw Wanda T.
Published: November 2011

Congenital central hypoventilation syndrome (CCHS) is a rare syndrome of dysfunction of the autonomic nervous system characterized by a decreased response to hypercarbia. It is a disorder in which affected individuals fail to breathe during sleep despite progressive hypercapnia and hypoxia. Infants simply fall asleep and quit breathing. They are found by their parents or caregivers blue and lifeless. CCHS is an autosomal dominant disease. It has been linked with tumors of neural crest origin, segmental aganglionosis of the colon, and diffuse autonomic dysregulation but can occur alone. Discovery of the genetic link between the paired-like homeobox 2B (PHOX2B) genetic mutations and CCHS represents a breakthrough in the diagnosis of CCHS, association of mutated alleles with disease severity, and clues to the pathophysiology responsible for the disorder. Early genetic screening and intervention can provide the families of these infants with hope for achieving a normal life.
CBT-IA: The First Treatment Model for Internet Addiction
Authors: Young Kimberly S.
Published: November 2011

Research has identified Internet addiction as a new clinical disorder that causes relational, occupational, and social problems. Cognitive behavioral therapy (CBT) has been suggested as the treatment of choice for Internet addiction, and addiction recovery in general has used CBT as part of treatment planning. This article outlines cognitive behavioral therapy–Internet addiction (CBT-IA), a uniquely designed model for treating Internet addiction applying CBT with harm reduction therapy (HRT). CBT-IA uses a three-phase approach. In the first phase, behavior modification is used to gradually decrease the amount of time the addict spends online. In the second phase, cognitive therapy is used to address denial that is often present among Internet addicts and to combat the rationalizations that justify excessive online use. The third phase applies HRT to identify and treat coexisting issues involved in the development of compulsive Internet use. As the first model of its kind, it can be used both on an outpatient and inpatient basis to deal with this emergent client population.
The ABCs of In-Situ Combustion Simulations: From Laboratory Experiments to the Field Scale
Authors: Gutiérrez D. , Moore R. G. , Ursenbach M. G. , Mehta S. A.
Published: November 2011

Air-injection-based recovery processes are receiving increased interest due to their high recovery potentials and applicability to a wide range of reservoirs. However, most operators require a certain level of confidence in the potential recovery from these (or any) processes prior to committing resources, which can be achieved with the use of numerical reservoir simulation.

In a previous paper (JCPT, April 2009, pp. 23–34) it was proposed that, after successful laboratory testing, analytical calculations and semi-quantitative simulation models would be used for pilot design and further optimization of the actual operation. However, the specific steps for building the field-scale simulation models were not explicitly addressed. This paper discusses a detailed workflow which could be followed to engineer an air injection project using thermal reservoir simulation.

The first step of the simulation study involves the selection of a kinetic model which could be either developed specifically for the reservoir in question or taken from public literature. Second, the oil would be characterized in terms of the same pseudo-components employed by the kinetic model and relevant PVT data would be matched to develop a fluid model for the thermal simulator. This new fluid model is used in the field-scale simulation model to history match the production history (i.e. prior to air injection) of the field. Third, relevant combustion tube tests would be history matched to validate the kinetic model and refine the thermal data that would go into the field-scale model. Finally, the results and knowledge gained from the combustion tube match(es) are applied to the field-scale model with the proper upscaling of some parameters. This simulation model would aid in selecting optimum well locations and operating strategies of the pilot. It would then be refined as the actual operation progresses to enhance its predictability and allow further optimization of the project.

Technical considerations, advantages, and limitations of each step of the workflow are discussed in detail. This paper also presents workflow variations and recommendations applicable to new and already mature air injection projects for which simulation models are being developed.