A Predefined Rule-Based Multi-Factor Risk Stratification Is Associated With Improved Outcomes at a Rural Primary Care Practice.

This study built a predefined rule-based risk stratification paradigm using 19 factors in a primary care setting that works with rural communities. The factors include medical and nonmedical variables. The nonmedical variables represent 3 demographic attributes and one other factor represents transportation availability.

Multi-criteria text mining model for COVID-19 testing reasons and symptoms and temporal predictive model for COVID-19 test results in rural communities.

This study is conducted to build a multi-criteria text mining model for COVID-19 testing reasons and symptoms. The model is integrated with a temporal predictive classification model for COVID-19 test results in rural underserved areas. A dataset of 6895 testing appointments and 14 features is used in this study.

[Patients Ability to Provide Information about Prescribed Drugs - a Cross-Sectional Study in Ten General Practice].

Background: For the correct intake and safe handling of their own medication it is important that patients know about their own medication and can give certain information. This study examines what information patients can provide about their prescribed medication and which factors influence the ability to provide information.

Methods: A cross-sectional study was conducted.

Ethamsylate for the prevention of morbidity and mortality in preterm or very low birth weight infants.

Background: Ethamsylate decreases blood loss in certain clinical situations such as menorrhagia and following some surgical procedures. This potential to reduce bleeding has led to the hypothesis that it may have a role to play in reducing intraventricular haemorrhage in preterm infants.

Objectives: To determine if ethamsylate, when compared to placebo or no treatment, reduces morbidity and/or mortality in preterm infants.

The PREM score: a graphical tool for predicting survival in very preterm births.

Objective: To develop a tool for predicting survival to term in babies born more than 8 weeks early using only information available at or before birth.

Design: 1456 non-malformed very preterm babies of 22-31 weeks' gestation born in 2000-3 in the north of England and 3382 births of 23-31 weeks born in 2000-4 in Trent.

Outcome: Survival to term, predicted from information available at birth, and at the onset of labour or delivery.

Sudden oronasal bleeding in a young child.

Unlabelled: Sudden severe upper-airway obstruction occurring in a hospital setting can sometimes precipitate an episode of acute haemorrhagic pulmonary oedema. A review of 197 published case reports shows that the presenting feature is almost always the sudden appearance of blood stained fluid coming up through the larynx or out through the mouth and nose of an adult or child in obvious respiratory distress. Such overt features are seen in 10-15% of cases of sudden severe, but sub-lethal, upper-airway obstruction.

Evaluation of the Ages and Stages Questionnaires in identifying children with neurosensory disability in the Magpie Trial follow-up study.

Aim: To evaluate performance of the Ages and Stages Questionnaires (full ASQ), and a shortened version (short ASQ), in detecting children with severe neurosensory disability in the Magpie Trial follow-up study.

Methods: All children, born to women in the Magpie Trial and selected for follow-up, with a completed full 30 items and/or short 9-items ASQ were included in this analysis. Sensitivity and specificity, corrected for verification bias, were computed to assess detection ability.

Uncertainty in classification of repeat sudden unexpected infant deaths in Care of the Next Infant programme.

It is misleading to classify every unexplained infant death as natural if no unnatural cause has been established, argue and

Coffee and pregnancy.

A moderate reduction in caffeine intake in the second half of pregnancy has no effect on birth weight or length of gestation

How effectively can clinical examination pick up congenital heart disease at birth?

Aims: To assess what proportion of all cardiac abnormality can be suspected at birth when all clinical examination before discharge is undertaken by a small stable team of clinicians.

Methods: A prospective audit of all the 14 572 births in a maternity unit only staffed by nurse practitioners between 1996 and 2003.

Results: 1.

Can all neonatal resuscitation be managed by nurse practitioners?

Aim: To assess the ability of nurse practitioners to manage the care of all babies requiring resuscitation at birth in a unit without on site medical assistance.

Method: A prospective review, and selective external audit, of the case records of all 14 572 babies born in a maternity unit in the north of England during the first eight years after nurse practitioners replaced resident paediatric staff in 1996.

Results: Every non-malformed baby with an audible heart beat at the start of delivery was successfully resuscitated.

Hyperglycaemia and the very preterm baby.

Neonatal hyperglycaemia, as usually defined (a whole blood glucose of >7 mmol/L), is common in the first week of life in babies born more than 12 weeks early. However, a review of a cohort of all such births in the north of England suggests that significant glycosuria is uncommon, and that there is no threat of an osmotic diuresis until the urine contains 2% glucose (by which time the blood glucose level almost always exceeds 15 mmol/L). The current statistical or epidemiological definition of hyperglycaemia (derived from data on term babies) needs to be replaced, for clinical purposes, by a more operationally relevant definition.

Vitamin K--what, why, and when.

Policies for giving babies vitamin K prophylactically at birth have been dictated, over the last 60 years, more by what manufacturers decided on commercial grounds to put on the market, than by any informed understanding of what babies actually need, or how it can most easily be given. By a pure fluke a 1 mg IM dose, designed to prevent early vitamin deficiency bleeding ("haemorrhagic disease of the newborn") has been found to protect against late deficiency bleeding-a condition unrecognised at the time this policy took hold. Alternative strategies for oral prophylaxis are now opening up (see pp 109 and 113), but these are also, at the moment, dictated more by what the manufacturers choose to provide than by what would make for ease of delivery either in poor countries, or in the developed world.