Challenges facing vaccinators in the 21 century: results from a focus group qualitative study.

 Barriers to vaccination and the important role of healthcare professionals (HCPs) in influencing immunization decisions made by parents/patients have been well documented. Little information describes challenges that HCPs face in carrying out their role as vaccinators. We conducted a focus group study asking HCPs to describe their expectations as frontline vaccinators versus the day-to-day reality they faced.

Time to positivity (TTP) of neonatal blood cultures: a trend analysis over a decade from Ireland.

Blood culture (BC) remains gold standard for the evaluation and diagnosis of neonatal sepsis. Time when BC becomes positive and the type of microorganism isolated are crucial in deciding the antimicrobial management. Likely pathogenicity of organisms growing in BC could potentially be predicted based on the "time to positivity" (TTP).

Randomized Trial of Platelet-Transfusion Thresholds in Neonates.

Background: Platelet transfusions are commonly used to prevent bleeding in preterm infants with thrombocytopenia. Data are lacking to provide guidance regarding thresholds for prophylactic platelet transfusions in preterm neonates with severe thrombocytopenia.

Methods: In this multicenter trial, we randomly assigned infants born at less than 34 weeks of gestation in whom severe thrombocytopenia developed to receive a platelet transfusion at platelet-count thresholds of 50,000 per cubic millimeter (high-threshold group) or 25,000 per cubic millimeter (low-threshold group).

Caffeine Treatment for Apnea of Prematurity and the Influence on Dose-Dependent Postnatal Weight Gain Observed Over 15 Years.

To analyze the influence on weight gain of infants exposed to two dosage regimens of oral caffeine citrate (CC) for apnea of prematurity. Retrospective descriptive observational study of an eligible very low birth weight cohort over a 15-year period in an Irish University hospital. Data were analyzed between two distinct postnatal ages: 14-28 and 29-56 days.

Spiritual care in neonatology: analysis of emergency baptisms in an Irish neonatal unit over 15 years.

Background: Emergency baptism remains an important emotional and spiritual element for many parents of critically ill infants in the neonatal unit. There is no published data available as to which neonates are baptised and their outcomes.

Objectives: To evaluate trends, outcomes and characteristics of newborn infants baptised over a 15-year period in an Irish maternity hospital.

Does an elective induction policy negatively impact on vaginal delivery rates? A 30-month review of an elective induction policy.

Background: The rate of induction of labour varies across Health Service Executive hospital regions in Ireland averaging at 23.3 per 100 deliveries in 2005-2009. The increasing rate of elective induction of labour in Ireland calls for more studies looking into associated maternal and/or neonatal outcomes.

A population survey of prevalence rates of antenatal depression in the Irish obstetric services using the Edinburgh Postnatal Depression Scale (EPDS).

Ireland has the second-highest birth rate in Europe and poorly developed perinatal psychiatry services. There are no screening services for antenatal depression and no data available on prevalence rates of depression among women attending the Irish obstetric services. The aim of this study was to assess the prevalence rates of depression during pregnancy in a population sample in Ireland using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool.

Maternal Vaccination as an Essential Component of Life-Course Immunization and Its Contribution to Preventive Neonatology.

Maternal immunisation schedules are increasingly coming under the spotlight as part of the development of lifetime immunisation programmes for the role that they play in improving maternal, foetal, and neonatal health. Maternally-acquired antibodies are critical in protecting infants during the first months of their lives. Maternal immunisation was previously overlooked owing to concerns regarding vaccinations in this untested and high-risk population but is now acknowledged for its potential impact on the outcomes in many domains of foetal and neonatal health, aside from its maternal benefits.

Utilization of conventional radiography in a regional neonatal intensive care unit in Ireland.

Objective: To audit the demand and radiation exposure of conventional radiography in a regional neonatal intensive care unit (NICU) in Ireland.

Methods: A retrospective study of radiographs performed on all admissions to the NICU in University Maternity Hospital Limerick (UMHL) over 2 years.

Results: A total of 1405 radiographs were performed on 506 infants.

Youngest survivor of perinatal infection by : case analysis and literature review highlighting the merits of placental swab culture.

has been noted as a causative organism in both neonatal and perinatal sepsis. Positivity of blood cultures at birth among preterm infants may be influenced by the maternal use of peripartum antimicrobials and a normal C-reactive protein result within the first 24 hours need not always reflect the absence of fetal invasion by the highly pathogenic organisms. For these reasons, supportive and adjunctive approaches such as appropriately collected placental swabs for culture would be of value in optimizing the antimicrobial choice for sick preterm infants during the early neonatal period.

Induction of Lactation in the Biological Mother After Gestational Surrogacy of Twins: A Novel Approach and Review of Literature.

One of the important challenges in surrogate pregnancies is the early bonding of genetic mother with her infant and the establishment of breastfeeding. A combination of pharmacological and nonpharmacological methods is often used for the induction of lactation. Reports of induced lactation in surrogacy are limited and scattered.

Margins of viability.

A poem reflecting the compassion, conflicts, dilemmas and outcome in the management of an extremely premature 22-week gestation baby girl. Challenges faced by neonatologists in offering optimal care to extremely low birth weight (ELBW) newborn infants and their families is summarised in this poem as an emotional transaction between the clinician and the periviable baby.

The first occurrence of a CTX-M ESBL-producing Escherichia coli outbreak mediated by mother to neonate transmission in an Irish neonatal intensive care unit.

Background: Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease.

Periventricular Calcification, Abnormal Pterins and Dry Thickened Skin: Expanding the Clinical Spectrum of RMND1?

Background: We report a consanguineous Sudanese family whose two affected sons presented with a lethal disorder characterised by severe neonatal lactic acidosis, hypertonia, microcephaly and intractable seizures. One child had additional unique features of periventricular calcification, abnormal pterins and dry thickened skin.

Methods: Exome enrichment was performed on pooled genomic libraries from the two affected children and sequenced on an Illumina HiSeq2000.

A review of carbon dioxide monitoring in preterm newborns in the delivery room.

Introduction: The physiologic adaptation to extra uterine life during the immediate neonatal period is unique. Many newborns require assistance in this adaptive process. Recent evidence now supports titrating oxygen to guide resuscitation but no guidance is provided on utilizing exhaled CO2 measurements.