A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life.

Background: Nursing workload is increasingly thought to contribute to both nurses' quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualising and measuring the effects of workload in healthcare. In contrast, we conceptualised a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes.

Effects of mental demands during dispensing on perceived medication safety and employee well-being: a study of workload in pediatric hospital pharmacies.

Background: Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes, such as job satisfaction.

Objectives: This study sought to measure the effect of workload on safety and employee outcomes in 2 pediatric hospitals and to do so using a novel approach to pharmacy workload measurement.

Methods: Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks.

Morphometric histology for infant gastroesophageal reflux disease: evaluation of reliability in 497 esophageal biopsies.

Objectives: We sought to determine the reliability of morphometric measurements on infant esophageal biopsies using a light microscope with eyepiece micrometer.

Methods: We measured epithelial thickness, basal layer thickness (B), papillary height (P) and epithelial lymphocyte and eosinophil numbers on approximately 500 existing esophageal suction biopsies from infants previously evaluated for reflux esophagitis. We tested these measurements for interobserver, test-retest and internal consistency reliability.

Sandifer syndrome posturing: relation to abdominal wall contractions, gastroesophageal reflux, and fundoplication.

Sandifer syndrome designates abnormal posturing in patients with gastroesophageal reflux. To explore its mechanisms via examining relationships among Sandifer syndrome posturing, abdominal wall contractions, and reflux episodes, we studied an affected child in detail. The study utilized esophageal pHmetry, surface electromyography, and split-screen videography.

Natural history of infant reflux esophagitis: symptoms and morphometric histology during one year without pharmacotherapy.

Objectives: To determine the natural history of infant gastroesophageal reflux disease (GERD) with esophagitis, we periodically analyzed symptoms and biopsies during 1 yr in 19 infants randomly assigned to placebo in a pharmacotherapy study.

Methods: One hundred infants who were referred during 1994-1999 for GERD, were unresponsive to 2-wk life-style measures, and manifested morphometric reflux esophagitis, were assigned at random to one of four treatment arms. This analysis examines the 19 (ages 2.

The Effects of Increasing Doses of Ranitidine on Gastric pH in Children.

Background: Ranitidine is widely used for gastroesophageal reflux disease (GERD) in children, but optimal dosing is unclear. We compared effects of weight-based doses of oral ranitidine on gastric pH in children with clinical GERD.

Methods: Children ages 4-11 years with clinical GERD were enrolled in a multi-center prospective randomized study comparing a fixed dose of ranitidine (Zantac 75) with placebo after an overnight fast; gastric pH was measured for 6 h after the fixed dose (Phase 1).

Eosinophilic esophagitis: strictures, impactions, dysphagia.

Eosinophilic esophagitis, long known to be a feature of acid reflux, has recently been described in patients with food allergies and macroscopically furrowed esophagus. The pathophysiology and optimal management of patients with eosinophilic esophagitis is unclear. We describe our clinical experience related to eosinophilic esophagitis and obstructive symptoms in children and propose etiopathogenesis and management guidelines.

Efficacy of telephone teaching of conservative therapy for infants with symptomatic gastroesophageal reflux referred by pediatricians to pediatric gastroenterologists.

Objectives: To evaluate the efficacy of a specific protocol of conservative therapy for infant gastroesophageal reflux.

Study Design: Retrospective evaluation of the response to telephone teaching of conservative therapy by a single instructor as part of the screening process for a pharmacotherapy study of infantile reflux. Feeding modifications included the use of a protein-hydrolysate formula thickened with one tablespoon of dry rice cereal per ounce, at restricted volumes.

Autosomal dominant infantile gastroesophageal reflux disease: exclusion of a 13q14 locus in five well characterized families.

Objectives: A genetic locus for pediatric reflux was proposed on chromosome 13q14, but is unconfirmed in independent kindreds. We sought to test this locus in families with multiple affected infants from our database of well characterized infants with reflux.

Methods: We screened the database for families with multiple affected infants.