Cohort study of the pathogenesis and molecular epidemiology of catheter-related bloodstream infection in neonates with peripherally inserted central venous catheters.

Objective: To better define the pathogenesis of catheter-related bloodstream infection (BSI) in neonates with peripherally inserted central venous catheters (PICCs) to guide the development of more effective strategies for prevention.

Design: Prospective nested cohort study.

Setting: Level III neonatal intensive care unit in a community hospital.

HIV, disease plague, demoralization and "burnout": resident experience of the medical profession in Nairobi, Kenya.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression.