bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Parents of Premature Infants Gather Information and Obtain Support
Authors: Brazy Jane , H. Anderson Barbara , Becker Patricia , Becker Marion 
Published: May 2012

Purpose:To identify the process by which parents of premature infants seek information, the kinds of information they seek, and the resources they use to meet their educational and support needs.Design/Sample:Descriptive study using 19 parent interviews and 64 questionnaires.Main Outcome Variable:The process parents use to obtain information and support.Results:Parents of premature infants make a transition from being passive recipients of information to actively seeking it. They spend 10–20 hours a week gathering information during the first month of the baby’s hospitalization. They desire more information than is provided, particularly in the areas of infant health, infant care, and coping. Family is the primary source of support prior to birth and after discharge, but during the infant’s convalescence, nurses are the main source of support and help for parents in understanding and adapting to their baby. Many parents would use a computer-based resource for information if it were available to them.
Neonatal Thermal Care, Part I: Survey of Temperature Probe Practices
Authors: Blackburn Susan , DePaul Debra , Loan Lori , Marbut Kristie , Taquino Lauren , Thomas Karen , Wilson Suzanne 
Published: May 2012

Purpose: To determine nurses’ practices regarding skin temperature probes.Design: Data were collected using an anonymous questionnaire, which was returned by mail. Questionnaires were distributed by volunteer neonatal nurses. Items included frequency of probe change, position of probe, use of probes in skin and air servocontrolled incubators and radiant warmers, as well as demographic data.Sample: Eighty-three neonatal nurses.Results: Nurses reported that skin servocontrolled incubators are used widely, but generally only for infants less than 28 weeks gestational age; a high proportion of respondents reported using continuous monitoring of skin temperature in air servocontrol incubators. Although most nurses reported positioning infants to prevent their lying on the probe, 21 percent reported using the same probe site regardless of infant position. Routine changing of the probe cover was reported by a number of nurses. Practices were influenced by individual knowledge, beliefs, and experience as well as by unit protocols, which varied widely.
From Gavage to Oral Feedings: Just a Matter of Time
Authors: Lemons Pamela 
Published: May 2012

The ability to safely and efficiently feed by mouth is based on oral-motor competence, neurobehavioral organization, and gastrointestinal maturity. Although most infants successfully make the transition to oral feedings as they approach term gestation, infants who were very immature at birth have historically had the most difficulty achieving this milestone. Postnatal complications (chronic lung disease, intraventricular hemorrhage, seizures, and so on) are also associated with delays in the onset of the first feeding, as well as with delays in achieving full enteral intake.Weaning the infant to breast is a slow and gradual process that may necessitate supplemental gavage or bottle feedings. A variety of measures—such as positioning, containment, reduced milk flow, and imposed rest breaks—may help to facilitate better oral intake, but infants probably benefit most from the passage of time. Frequently, the older the infant is at first feeding, the shorter the time required to make the transition to full oral feedings. Rather than attempting to accelerate the inherent maturational processes that form the basis for oral feeding, efforts might better be spent in providing adequate nutritional support while avoiding unnecessary stress and fatigue.
Congenital Toxoplasmosis
Authors: Martin Sara 
Published: May 2012

Toxoplasma gondii, a parasite, has three modes of transmission: oral intake of raw or undercooked meat or contaminated fruits and vegetables, ingestion of materials contaminated with cat feces, and transplacental infection. The focus of this article is congenital toxoplasmosis, which is transmitted to the fetus across the placenta.When primary infection of the mother occurs during pregnancy, there is a 40 percent chance of fetal infection; rate of transmission and severity of infection are related to gestational age at the time of infection. The brain and retina are often affected, and there can be a wide range of clinical disease. Amniocentesis or cordocentesis provides the most accurate diagnosis.At birth, 80–90 percent of infants with congenital toxoplasmosis are asymptomatic. But further testing may reveal retinal and central nervous system abnormalities, and there is a risk of long-term sequelae. Chorioretinitis, hydrocephalus, intracranial calcifications, and convulsions are the typical presentation of classic congenital toxoplasmosis. Serology is the most common method of diagnosing neonatal infection, but more complex tests are also utilized. The prognosis for the untreated infant is poor; however, when antibiotic therapy is started early, the rate of sequelae is reduced significantly.
When It Is More than Transient Neonatal Hypoglycemia: Hyperinsulinemia— A Case Study Challenge
Authors: Shirland Lee 
Published: May 2012

Persistent uncontrolled neonatal hypoglycemia may cause irreversible brain damage. Hyperinsulinemia is a rare cause of persistent hypoglycemia, diagnosed by excluding other etiologies. Inappropriately high fasting serum insulin levels with concurrent hypoglycemia confirm the diagnosis.Initial interventions for hyperinsulinemia are conservative. The first line of therapy is administration of adequate intravenous (IV) glucose to maintain serum or whole blood glucose levels at or greater than 40 mg/dl. When enteral feedings are tolerated, schedules and caloric concentration are adjusted. Pharmacologic therapy is added to facilitate weaning from IV glucose. The drug of first choice is diazoxide. Octreotide is added if diazoxide therapy fails. Partial or complete pancreatectomy is the final treatment option.Nursing care for infants with hyperinsulinemia must also focus on the support and education of families. Family education must be individualized and should cover feeding regimes, administration of medication, proper use of equipment, and care during illness.
Behaviors of Very Preterm Neonates as Documented Using NIDCAP Observations
Authors: Pressler Jana , Helm James , Hepworth Joseph , Wells Nancy 
Published: May 2012

Purpose:The purpose of this study was to describe the range and frequency of behaviors in neonates 24–30 weeks postconceptional age (PCA) using the Newborn Individualized Developmental Care Assessment Program (NIDCAP).Design:A prospective design with convenience sampling was used.Sample:Starting 24–72 hours postnatally and continuing through 30 weeks PCA, 8,144 two-minute observations of 85 NIDCAP behaviors were collected and analyzed from 42 neonates born at 24–29 weeks gestation.Main Outcome Variable:The main outcome variables were the frequencies of the 85 neonatal behaviors measured by the NIDCAP. Frequencies were organized first by subsystem (autonomic, motor, or state) and were categorized further based on week of PCA. Comparisons of behavioral frequencies by number of weeks PCA were completed using correlation and regression analyses.Results:The most frequently observed behaviors were irregular respirations, pink color, postured flexion of the extremities, immature light sleep, and drowsiness. Least frequently observed behaviors consisted of burps, bowel movement, grunting, smooth motor movements, cooing, and speech movement. Regression analysis illustrated that the pattern of behavior was significantly similar week to week.
Noise in the Intensive Care Nursery
Authors: Kellman Neil 
Published: May 2012

THE PARABLE OF THE GARDENThe 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.
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.
Congenital Heart Disease in the Neonate
Authors: Fran Hazinski Mary 
Published: May 2012

Part I: Epidemiology, Cardiac Development, and Fetal CirculationCONGENITAL 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
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.
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.
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.
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.
Can the Retinal Screening Interval Be Safely Increased to 2 Years for Type 2 Diabetic Patients Without Retinopathy?
Authors: Chalk Daniel , Pitt Martin , Vaidya Bijay , Stein Ken 
Published: May 2012

OBJECTIVE
In the U.K., people with diabetes are typically screened for retinopathy annually. However, diabetic retinopathy sometimes has a slow progression rate. We developed a simulation model to predict the likely impact of screening patients with type 2 diabetes, who have not been diagnosed with diabetic retinopathy, every 2 years rather than annually. We aimed to assess whether or not such a policy would increase the proportion of patients who developed retinopathy-mediated vision loss compared with the current policy, along with the potential cost savings that could be achieved.

RESEARCH DESIGN AND METHODS
We developed a model that simulates the progression of retinopathy in type 2 diabetic patients, and the screening of these patients, to predict rates of retinopathy-mediated vision loss. We populated the model with data obtained from a National Health Service Foundation Trust. We generated comparative 15-year forecasts to assess the differences between the current and proposed screening policies.

RESULTS
The simulation model predicts that implementing a 2-year screening interval for type 2 diabetic patients without evidence of diabetic retinopathy does not increase their risk of vision loss. Furthermore, we predict that this policy could reduce screening costs by ∼25%.

CONCLUSIONS
Screening people with type 2 diabetes, who have not yet developed retinopathy, every 2 years, rather than annually, is a safe and cost-effective strategy. Our findings support those of other studies, and we therefore recommend a review of the current National Institute for Health and Clinical Excellence (NICE) guidelines for diabetic retinopathy screening implemented in the U.K.
Modalité épistémique, évidentialité et dépendance contextuelle
Authors: de Saussure Louis 
Published: May 2012

Cet article défend un point de vue pragmatique sur les effets épistémiques et évidentiels de marqueurs qui font traditionnellement débat à ce sujet, à savoir les verbes modaux et le futur épistémique. Notre approche, qui admet une spécification inférentielle de la signification vériconditionnelle, cherche à échapper à l’idée d’une polysémie de ces marques en leur supposant un contenu minimal en l’espèce et en attribuant leurs effets à l’inférence en contexte plutôt qu’à une prédétermination sémantique. Pour nous, les effets de sens épistémiques et évidentiels constatables empiriquement ne sont donc pas dus à un encodage complexe de valeurs polysémiques ou d’ajustements du fait de colocations et coercitions sémantiques : ces morphèmes donnent lieu à des enrichissements selon des principes pragmatiques généraux destinés à obtenir des sens pertinents en contexte.
FLE, FLS, FLM : continuum ou interrelations ?
Authors: Goï Cécile , Huver Emmanuelle 
Published: May 2012

Les catégories de FLS, FLE, FLM sont souvent définies à priori – i.e. hors des contextes dans lesquels elles sont investies – et comme spécifiques les unes par rapport aux autres. Elles auraient alors leurs frontières, leur « dedans » et leur « dehors » ainsi que leurs zones de pertinence, voire de réalité. Le processus sociohistorique de leurs constructions respectives demeure ainsi souvent occulté, ce qui revient à les appréhender sous un angle essentiellement méthodologique, c’est-à-dire au regard des contenus, des méthodes et des fonctions d’enseignement qui les rapprochent et/ou les éloignent les unes des autres. Or ce point de vue fonctionnel, voire techniciste, n’interroge pas la manière dont les acteurs s’approprient ces catégories, les font leur et s’en emparent ou non, ou de manière diversifiée. En effet, le sens que revêtent ces critérisations dépend non seulement d’éléments définitionnels, mais aussi, et surtout, d’enjeux politiques ainsi que des parcours personnels, académiques et professionnels ou, plus largement, de l’identité professionnelle de ces acteurs. C’est donc sous cet angle, qui touche les histoires (plus ou moins locales ou individuelles, plus ou moins globales ou collectives), les représentations, et probablement aussi les imaginaires, que nous abordons la question des convergences et des divergences entre FLE, FLS et FLM. En nous appuyant sur nos propres expériences d’enseignement et de formation dans des contextes diversifiés, mais aussi – et surtout – sur le projet de recherche PARAADIV (Parcours d’apprenants, altérité, diversité), nous voyons en quoi les catégories FLS, FLE et FLM ne peuvent pas être considérées comme exclusivement objectives, mais doivent être aussi vues comme subjectivement construites, autour d’enjeux de construction et de positionnement identitaires et professionnels, traversés de part en part par le rapport des enseignants à la diversité et à l’altérité à l’autre et à eux-mêmes.