Addressing caregiver mental health in the neonatal ICU.

Purpose Of Review: The neonatal ICU (NICU) setting is a unique opportunity to not only detect major changes in caregiver mental health through universal perinatal mood and anxiety disorder (PMAD) screening but also intervene with specialized support. We review evidence for addressing caregiver mental health in the NICU, explore current guidelines and models for integrated behavioural health programmes, and describe challenges specific to NICUs, particularly in standalone paediatric hospitals.

Recent Findings: Parents of infants admitted to the NICU are at an increased risk for developing PMADs at rates well above the general postpartum community.

Patterns and Predictors of Mortality After Waitlist Dropout of Patients With Hepatocellular Carcinoma Awaiting Liver Transplantation.

Background: There is a lack of information about survival after dropout from the liver transplant waiting list. Therefore, we aimed to assess the overall survival, and risk factors for death, after waiting list dropout due to hepatocellular carcinoma (HCC) progression.

Methods: We assessed patients who dropped out of the liver transplant waiting list between 2000 and 2016 in a single, large academic North American center.

Liver Transplantation for NASH-Related Hepatocellular Carcinoma Versus Non-NASH Etiologies of Hepatocellular Carcinoma.

Background: Liver transplant (LT) for nonalcoholic steatohepatitis (NASH) related hepatocellular carcinoma (HCC) is not well characterized in the literature. The aim of the study was to examine characteristics and outcomes of patients who had LT for NASH-HCC (NASH) versus HCC from other liver diseases (non-NASH).

Methods: Using a 2-center retrospective design, all patients from 2004 to 2014 that received LT for HCC were analyzed.

Palliative care and active disease management are synergistic in modern surgical oncology.

Palliative care has long been described in medical literature but only recently is being discussed in the surgical domain. Mounting evidence suggests that early integration of palliative care improves patient outcomes and this is especially true of oncology patients. Thus, the pendulum is swinging toward recognizing that palliative care and active disease management are not mutually exclusive but rather synergistic in modern surgical oncology.

Factors affecting family satisfaction with inpatient end-of-life care.

Background: Little data exists addressing satisfaction with end-of-life care among hospitalized patients, as they and their family members are systematically excluded from routine satisfaction surveys. It is imperative that we closely examine patient and institution factors associated with quality end-of-life care and determine high-priority target areas for quality improvement.

Methods: Between September 1, 2010 and January 1, 2012 the Canadian Health care Evaluation Project (CANHELP) Bereavement Questionnaire was mailed to the next-of-kin of recently deceased inpatients to seek factors associated with satisfaction with end-of-life care.

Interpreting principal components in biomechanics: representative extremes and single component reconstruction.

Principal component analysis is a powerful tool in biomechanics for reducing complex multivariate datasets to a subset of important parameters. However, interpreting the biomechanical meaning of these parameters can be a subjective process. Biomechanical interpretations that are based on visual inspection of extreme 5th and 95th percentile waveforms may be confounded when extreme waveforms express more than one biomechanical feature.

Interjoint coordination and the personal lift-assist device.

It has been suggested that interjoint coordination may serve to reduce joint stress and muscular demand and to maintain balance during dynamic lifting tasks, thus having implications for safe lifting practices. Before recommending the use of an on-body ergonomic aid, the Personal Lift-Assist Device (PLAD), it is important to determine any effects this device may have on interjoint coordination. Principal component analyses were applied to relative phase angle waveforms, defining the hip-knee and lumbar spine-hip coordination of 15 males and 15 females during a repetitive lifting task.

Local dynamic stability of trunk movements during the repetitive lifting of loads.

The local dynamic stability of trunk movements was assessed during repetitive lifting using nonlinear Lyapunov analyses. The goal was to assess how varying the load-in-hands affects the neuromuscular control of lumbar spinal stability. Thirty healthy participants (15M, 15F) performed repetitive lifting at 10 cycles per minute for three minutes under two load conditions: zero load and 10% of each participant's maximum back strength.

Local dynamic stability of the lifting kinematic chain.

While a stable trunk and centre of mass (CoM) trajectory are required during lifting, it is unclear how stability is controlled. Thirty healthy participants (15M, 15F) performed repetitive, symmetric lifting at 10 cycles per minute for 3 min with a load-in-hands equivalent to 10% of their maximum back strength. Short- and long-term maximum finite-time Lyapunov exponents (λ(max-s) and λ(max-l)), describing responses to small (local) perturbations, estimated the local dynamic stability of the foot, shank, thigh, pelvis, lower back, and upper back segments.

The personal lift-assist device and lifting technique: a principal component analysis.

The personal lift-assist device (PLAD) is a non-motorised, on-body device that acts as an external force generator using the concept of stored elastic energy. In this study, the effect of the PLAD on the lifting kinematics of male and female lifters was investigated using principal component analysis. Joint kinematic data of 15 males and 15 females were collected using an opto-electronic system during a freestyle, symmetrical-lifting protocol with and without wearing the PLAD.

Does the personal lift-assist device affect the local dynamic stability of the spine during lifting?

The personal lift-assist device (PLAD) is an on-body ergonomic aid that reduces low back physical demands through the restorative moment of an external spring element, which possesses a mechanical advantage over the erector spinae. Although the PLAD has proven effective at reducing low back muscular demand, spinal moments, and localized muscular fatigue during laboratory and industrial tasks, the effects of the device on the neuromuscular control of spinal stability during lifting have yet to be assessed. Thirty healthy subjects (15M, 15F) performed repetitive lifting for three minutes, at a rate of 10 lifts per minute, with and without the PLAD.