Detecting and responding to deterioration of a baby during labour: surveys of maternity professionals to inform co-design and implementation of a new standardised approach.

Objectives: Detecting and responding to deterioration of a baby during labour is likely to benefit from a standardised approach supported by principles of track-and-trigger systems. To inform co-design of a standardised approach and associated implementation strategies, we sought the views of UK-based maternity professionals.

Design: Two successive cross-sectional surveys were hosted on an online collaboration platform (Thiscovery) between July 2021 and April 2022.

Adverse childhood experiences predict anxiety during postpartum and early childhood parenting.

Perinatal anxiety disorders (PAD) affect one in five pregnant/postpartum people and are associated with adverse maternal and child health outcomes. Effective treatment and prevention rely on early identification and management of risk factors. Our study fills a gap in literature about how maternal adverse childhood experiences (ACEs) relate to PAD during and beyond the postpartum period.

Assessment of Outcomes in Patients with Heart Failure and End-Stage Kidney Disease after Fluid Resuscitation for Sepsis and Septic Shock.

Background: Sepsis fluid resuscitation is controversial, especially for patients with volume overload risk. The Surviving Sepsis Campaign recommends a 30-mL/kg crystalloid fluid bolus for patients with sepsis-induced hypoperfusion. Criticism of this approach includes excessive fluid resuscitation in certain patients.

How to co-design a prototype of a clinical practice tool: a framework with practical guidance and a case study.

Clinical tools for use in practice-such as medicine reconciliation charts, diagnosis support tools and track-and-trigger charts-are endemic in healthcare, but relatively little attention is given to how to optimise their design. User-centred design approaches and co-design principles offer potential for improving usability and acceptability of clinical tools, but limited practical guidance is currently available. We propose a framework (FRamework for co-dESign of Clinical practice tOols or 'FRESCO') offering practical guidance based on user-centred methods and co-design principles, organised in five steps: (1) establish a multidisciplinary advisory group; (2) develop initial drafts of the prototype; (3) conduct think-aloud usability evaluations; (4) test in clinical simulations; (5) generate a final prototype informed by workshops.

The COVID-19 Pandemic and Parental Attitudes Toward Routine Childhood Vaccines.

Background And Objectives: The coronavirus disease 2019 (COVID-19) pandemic may have impacted parental attitudes toward childhood vaccines. However, few data sources followed attitudes before and after onset of the pandemic. We used data from a parental survey to describe the effect of the pandemic on parental attitudes toward childhood vaccines.

Dual Antiplatelet Therapy After an Acute Nonminor Stroke.

Background: In select patients with minor ischemic stroke, dual antiplatelet therapy (DAPT) with aspirin plus clopidogrel is recommended if initiated early and continued for 21 to 90 days. Dual antiplatelet therapy use, in a broader population, has shown to increase the risk of bleeding without an increased antithrombotic benefit. An ongoing area of uncertainty is whether DAPT would benefit the nonminor stroke population when continued for 21 to 90 days.

Impact of Pharmacists to Improve Patient Care in the Critically Ill: A Large Multicenter Analysis Using Meaningful Metrics With the Medication Regimen Complexity-ICU (MRC-ICU) Score.

Objectives: Despite the established role of the critical care pharmacist on the ICU multiprofessional team, critical care pharmacist workloads are likely not optimized in the ICU. Medication regimen complexity (as measured by the Medication Regimen Complexity-ICU [MRC-ICU] scoring tool) has been proposed as a potential metric to optimize critical care pharmacist workload but has lacked robust external validation. The purpose of this study was to test the hypothesis that MRC-ICU is related to both patient outcomes and pharmacist interventions in a diverse ICU population.

Prevalence and Predictors of Pediatric COVID-19 Vaccine Acceptance.

Objective: As pediatric COVID-19 vaccine eligibility expands, understanding predictors of vaccine intent is critical to effectively address parental concerns. Objectives included: (1) Evaluate maternal COVID-19 vaccine intent for child(ren) and associated predictors of stated intent; (2) Describe attitudes related to hypothetical vaccination policies; (3) Summarize themes associated with intention to vaccinate child(ren) for COVID-19.

Study Design: Mothers enrolled in Heath eMoms, a longitudinal survey project, were recruited for this electronic COVID-19 survey.

Efficacy and Safety of Nonvitamin K Oral Anticoagulants following Cardiac Valve Replacement.

Objective: To compare the efficacy and safety of nonvitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) following bioprosthetic cardiac valve replacement.

Methods: This was a retrospective analysis conducted at a community teaching hospital in the southeastern United States between August 2015 and August 2018. Patients 18 years of age and older who underwent cardiac valve replacement and were prescribed oral anticoagulation were screened for inclusion.

Acute Hepatocellular Injury Associated With Azithromycin.

Purpose: A report of acute azithromycin-induced hepatocellular injury is described.

Summary: An 83-year-old male was admitted with possible community-acquired pneumonia and received azithromycin and ceftriaxone. After 2 doses of azithromycin, the patient's aspartate aminotransferase and alanine aminotransferase were greater than 3 times the upper limit of normal and continued to rise with subsequent doses.

Frames of Reference and Antecedentless Anaphora in Spanish Conversation.

This study examines native Spanish speakers' use of anaphoric pronouns and null subjects in conversational discourse in the absence of coreferential antecedents. It also considers the adequacy of Gundel et al.'s proposal  (Language 69(2):274-307, 1993) that the cognitive status "in focus" corresponds with speakers' use of minimal referring expressions (i.

A Review of Pregnancy-Related Maternal Mortality in Wisconsin, 2006-2010.

Introduction: Maternal mortality is a key indicator of maternal health and the general state of health care. This report summarizes maternal deaths in Wisconsin from January 2006 through December 2010.

Methods: Maternal deaths were identified using death certificates and supporting links with infant birth and fetal death certificates.