An investigation into specialty trainee engagement with e-learning.

Aim:: The objectives of this study were to determine paediatric specialty trainees' engagement with e-learning in Health Education England North West and the characteristics of sites accessed by specialty trainees, and to assess the quality of web interfaces being used and whether this aligns with the best evidence for e-learning provision.

Methods:: A two-phase mixed methods design was used: a scoping exercise to elicit specialty trainees' preferred e-learning tools and a quality assessment of the named sites, and specialty trainee telephone interviews.

Results:: A total of 135 respondents identified 86 sites.

Living and managing with the long-term implications of neonatal chronic lung disease: The experiences and perspectives of children and their parents.

Objective: The purpose of the study was to investigate children's perspectives of living with chronic lung disease (CLD) and their parents' long-term experiences of caring for them.

Background: CLD caused by prematurity of birth is associated with continuing respiratory, neuro-developmental and psychosocial issues.

Methods: 10 children (6-15 years old) with CLD and 12 parents were involved in semi-structured qualitative interviews.

Two-year outcomes for infants with low cord pH at birth.

Objective: To determine the long-term outcome of infants born with cord pH ≤ 7.0 and no clinical evidence of asphyxia at birth.

Setting: Tertiary Referral Centre.

The first five years: a mixed methods study investigating reflections on working as a hospital consultant.

Objectives: This paper revisits the same cohort of hospital consultants approximately five years after they were first appointed to investigate their reflections on establishing themselves in their role.

Design: Mixed methods using a short survey and in-depth semistructured interviews.

Setting: The study was conducted within one Deanery in the North of England.

Respiratory morbidity, healthcare utilisation and cost of care at school age related to home oxygen status.

Unlabelled: The aim of the study was to determine whether respiratory morbidity, lung function, healthcare utilisation and cost of care at school age in prematurely born children who had bronchopulmonary dysplasia (BPD) were influenced by use of supplementary oxygen at home after neonatal intensive care unit discharge. Healthcare utilisation and cost of care in years 5 to 7 and respiratory morbidity (parent-completed respiratory questionnaire) and lung function measurements at least at age 8 years were assessed in 160 children. Their median gestational age was 27 (range 22-31) weeks and 65 of them had received supplementary oxygen when discharged home (home oxygen group).

First year specialist trainees' engagement with reflective practice in the e-portfolio.

Doctors in specialist training posts in the Mersey Deanery are expected to reflect on their clinical practice and to document their learning experiences in an e-portfolio. This study aims specifically to explore how they have engaged in reflection on their practice and how they utilise their learning portfolio to document evidence of this. A modified Delphi technique was used to develop a grading system to identify the level of reflection recorded by participants in the e-portfolio.

A reference interval for sweat chloride in infants aged between five and six weeks of age.

Background: This study was designed to establish a reference interval for sweat chloride for infants without evidence of cystic fibrosis (CF), aged between 5 wk and 6 wk, a time when sweat testing is an integral part of newborn screening for CF. In addition, we compared the gold standard method of sweat testing (quantitative pilocarpine iontophoresis [QPIT, coulometry]) with an emerging methodology (Macroduct [ISE]).

Methods: This was a prospective study on healthy infants at 5-6 wk of age.

Electrical potential difference across the nasal epithelium is reduced in premature infants with chronic lung disease but is not associated with lower airway inflammation.

Airway liquid content and insufficient absorptive airway ion transport at birth are potentially important factors in the development and severity of neonatal respiratory disease. The role of deficient absorptive airway ion transport in the development of chronic lung disease of prematurity is unknown. Additionally, lung inflammatory mediators modulate airway ion transport.

Twelve-month prospective study of oxygen saturation measurements among term and preterm infants.

Background: Optimising home oxygen delivery in infants has important logistical and safety implications. This can be aided by having a suitable reference range of normal values for arterial oxygen saturation using pulse oximetry (SpO(2)).

Objectives: To describe oxygenation profiles in healthy preterm and term infants in relation to gestational and postnatal age, to extend reference values to guide home oxygen therapy.

High versus restricted use of home oxygen therapy, health care utilisation and the cost of care in chronic lung disease infants.

Unlabelled: Use of home oxygen therapy for prematurely born infants with chronic lung disease (CLD) can facilitate early discharge, but affected infants might require more readmissions. Our aim was to determine if health care utilisation and associated costs in the first 2 years were greater in centres with a high compared to centres with restricted use of home oxygen therapy. A retrospective review of the hospital and general practitioner (GP) medical records of 235 infants with CLD (median gestational age 27 weeks; range 22-33 weeks) was performed to note their readmissions, outpatient attendances, community service referrals and cost of care in the first 2 years after birth.

Airway ion transport on the first postnatal day in infants delivered vaginally or by elective cesarean section.

To determine airway ion transport in term infants on the first day of postnatal life, and to test the hypothesis that infants born without labor have reduced sodium absorption, we measured nasal potential difference using a modified perfusion protocol suitable for newborn infants. We examined maximal stable baseline potential difference, the change after perfusion with 10(-4) M amiloride (Deltaamil), and the change after perfusion with a zero-chloride solution (Deltazero Cl-) in infants born after elective cesarean section (n = 21) or normal labor (n = 20). Maximal stable baseline potential difference was not different in the two cohorts (-24.

Bronchoalveolar lavage surfactant protein a, B, and d concentrations in preterm infants ventilated for respiratory distress syndrome receiving natural and synthetic surfactants.

Surfactant proteins (SPs) play an important role in surfactant metabolism and function. Understanding their relative contribution to clinical outcome remains incomplete. Exogenous surfactants differ in their SP content and physiologic effects.

Detectable IL-8 and IL-10 in bronchoalveolar lavage fluid from preterm infants ventilated for respiratory distress syndrome.

Pro-inflammatory cytokines such as IL-8 play an important role in the inflammatory response to neonatal airway injury. Difficulty in detecting counter-regulatory cytokines such as IL-10 in lavage fluid from preterm infants led to the suggestion that its deficit may be a factor in the etiology of chronic lung disease of prematurity (CLD). The aim of the study was to determine IL-8 and IL-10 concentrations in lavage fluid from preterm infants ventilated for respiratory distress syndrome.