Patterns of Pediatric Palliative and End-of-Life Care in Neonatal Intensive Care Patients in the Southern U.S.

Context: Despite high rates of mortality among infants in the Southern U.S., little is known about the timing of pediatric palliative care (PPC), the intensity of end-of-life care, and whether there are differences among sociodemographic characteristics.

Curating duplicates: operationalizing similiarity in the Smithsonian Institution with Haida rattles, 1880-1926.

In the late nineteenth century, the anthropology curators of the Smithsonian Institution consulted their cataloguing systems and storerooms, assessing specimens in order to determine which could be designated as duplicate specimens and exchanged with museums domestically and abroad. The status of 'duplicate' for specimens was contingent on conceptions of similiarity impacted by disciplinary classification praxis, with particular emphasis on object nomenclature and formal attributes. Using rattles from Haida Gwaii collected between 1881 and 1885 by James Swan for the Smithsonian Institution, this article explores how anthropology curators designated rattles as exchangeable duplicate specimens.

Collect Once, Use Many Times: Attaining Unified Metrics for Tuberculosis Preventive Treatment for People Living With HIV.

The World Health Organization (WHO) recommends providing tuberculosis preventive treatment (TPT) to all persons living with HIV and to all household contacts of persons with bacteriologically confirmed pulmonary tuberculosis disease. Regrettably, the absence of a harmonized data collection and management approach to TPT indicators has contributed to programmatic challenges at local, national, and global levels. However, in April 2020, the WHO launched the Consolidated HIV Strategic Information Guidelines, with an updated set of priority indicators.

Tuberculosis Preventive Treatment Scale-Up Among Antiretroviral Therapy Patients - 16 Countries Supported by the U.S. President's Emergency Plan for AIDS Relief, 2017-2019.

Tuberculosis (TB) is the leading cause of death among persons living with human immunodeficiency virus (HIV) infection. In 2018, an estimated 251,000 persons living with HIV infection died from TB, accounting for one third of all HIV-related deaths and one sixth of all TB deaths (1). TB preventive treatment (TPT) is recommended by the World Health Organization (WHO) for persons living with HIV infection without active TB disease (i.

Ambient air pollution and adverse birth outcomes: a natural experiment study.

Background: Radical regulations to improve air quality, including traffic control, were implemented prior to and during the 2008 Beijing Olympic Games. Consequently, ambient concentrations of nitrogen dioxide (NO2) and particular matter 10 micrometers or less (PM10), were reduced in a distinct and short window of time, which presented a natural experiment for testing the relationships between maternal exposure to PM10 and NO2 during pregnancy and adverse birth outcomes.

Methods: We estimated the effect of PM10 and NO2 exposure during each trimester of gestation on the risk of preterm birth among live births and the birth weight among term babies.

Elevated levels of protein in urine in adulthood after exposure to the Chinese famine of 1959-61 during gestation and the early postnatal period.

Background: Animal models have suggested that undernutrition during gestation and the early postnatal period may adversely affect kidney development and compromise renal function. As a natural experiment, famines provide an opportunity to test such potential effects in humans. We assessed whether exposure to the Chinese famine of 1959-1961 during gestation and early postnatal life was associated with the levels of proteinuria among female adults three decades after exposure to the famine.

Exploring early and future use of DNP prepared nurses within healthcare organizations.

A strategy to gather data on DNP utilization and impact was designed using Donabedian's conceptual model and was piloted by surveying chief nursing officers (CNOs) leading Michigan's public and teaching hospital systems. Few of the responding CNOs reported currently employing DNP-prepared nurses. The majority reported gaps in knowledge related to role expectations and projected outcomes from a DNP-prepared nurse.

Parameters for sample size estimation from a group-randomized HIV prevention trial in HIV clinics in sub-Saharan Africa.

Sample size calculations for a group-randomized trial (GRT) require an estimate of the expected intraclass correlation coefficient (ICC). However, few ICC estimates from GRTs in HIV/AIDS research have been published, leaving investigators with little data on which to base expectations. We used data from a multi-country study to estimate ICCs for variables related to physical and mental health and HIV risk behaviors.

Chart documentation of informed consent for operative vaginal delivery: is it adequate?

Objectives: To determine the documentation frequency of informed consent for women undergoing a trial of nonemergent instrumental delivery.

Study Design: A retrospective chart review of instrumented vaginal deliveries from 1992 to 2005 was performed. Cases were identified from a Labor and Delivery database and hospital records were reviewed for documentation of associated risks, general consent for the procedure, indication, and option of cesarean delivery (CD).

Anal sphincter defects and bowel symptoms in women with and without recognized anal sphincter trauma.

Objective: The purpose of this study was to determine the rate of new bowel symptoms and anal sphincter defects in primiparous women with and without recognized anal sphincter (AS) injury.

Study Design: One hundred seventeen primiparous women classified with increasing degrees of perineal trauma and 21 controls delivered by cesarean section were enrolled immediately postpartum and demographic and delivery data were collected. At 6 weeks' postpartum, subjects completed a bowel function questionnaire and endoanal ultrasonography was performed.

Anal incontinence in women with and those without pelvic floor disorders.

Objective: To compare the prevalence of anal incontinence and anal sphincter injury in women with pelvic floor disorders (cases) with those in a group of normal control subjects and to evaluate the relationship between sphincter injury and anal incontinence in each group.

Methods: We previously reported the results of a cross-sectional study of 100 women with pelvic floor disorders (> or = stage II pelvic organ prolapse and/or urinary incontinence). In this study, we compared those cases with 90 controls (stage 0 or I pelvic organ prolapse and no urinary incontinence) who completed the Rockwood-Thompson fecal incontinence severity index, in which scoring (0-61) is based on the frequency and type of anal incontinence.

Differences in outcomes after third- versus fourth-degree perineal laceration repair: a prospective study.

Objective: The purpose of this study was to compare outcomes after third- versus fourth-degree laceration repair.

Study Design: Fifty-six primiparous women who sustained a third- or fourth-degree tear were enrolled at delivery and demographic and obstetric data were collected. At 6 weeks' postpartum, subjects completed a bowel function questionnaire and endoanal ultrasonography was performed.

An evaluation of bariatric Web sites for patient education and guidance.

Bariatric surgery for the treatment of obesity has become a trend, with television and music celebrities touting it as a cure. There has been an extraordinary growth rate in the number of people each year undergoing bariatric surgery, and many of these patients are obtaining their information about the surgery from the Internet. As more and more people turn to the Internet for healthcare information, the need to monitor those Web sites for accuracy and quality expands.

Anal sphincter injury in women with pelvic floor disorders.

Objective: 1) To estimate the rate of anal incontinence and anal sphincter injury in a group of women with pelvic floor disorders; 2) to evaluate the relationship between anal incontinence and anal sphincter injury as demonstrated by endoanal ultrasonography; 3) to explore any associations between operative vaginal delivery and anal sphincter injury in this population.

Methods: A cohort of 100 women with stage II or greater pelvic organ prolapse and/or urinary incontinence completed the Rockwood-Thompson Fecal Incontinence Severity Index Questionnaire (FISI). Pelvic organ prolapse was recorded using the Pelvic Organ Prolapse Quantification system.

Thermal balloon endometrial ablation for management of acute uterine hemorrhage.

Background: Life-threatening abnormal uterine bleeding can be managed by a variety of techniques, which include intravenous estrogen, dilation and curettage, endometrial ablation, uterine artery embolization, or hysterectomy. Thermal balloon endometrial ablation has been used in the management of chronic dysfunctional uterine bleeding but has not been described in a case of acute uterine hemorrhage.

Case: A 44-year-old woman with end-stage liver disease presented with vaginal bleeding and fever.