NICU nurse manager Jill Krause says part of her job is to empower unit nurses to be problem solvers when changes are needed to improve care. Listening to staff and patients' families while sharing the reasons why change is needed is an important leadership tool, Krause writes.
The number of women who started biologics to treat autoimmune diseases decreased between conception and delivery, 31% of pregnant women using the drugs stopped within the third trimester and 38% stopped during the second trimester, according to a study in Arthritis Care & Research. "The concern highlighted by our study is that this discontinuation pattern was occurring irrespective of changes in certain indicators of disease activity and use of concomitant treatments," researchers wrote.
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A study in JAMA Pediatrics found that newborns whose mothers were exposed to higher levels of residential particulate matter, such as car emissions, had shorter telomere length in their cord blood and in the placenta, compared with those whose mothers were exposed to less air pollution. The findings also showed that maternal particulate exposure during the second trimester had the greatest impact on telomere length.
Nearly 5.6 million youths worldwide died before age 5 in 2016, a new low, but neonatal mortality rates rose from 41% in 2000 to 46% in 2016, and about 60 million children could die before reaching age 5 between 2017 and 2030, 50% of whom would be newborns, should such rates continue, according to a United Nations report. The report also showed preterm birth and childbirth complications accounted for 30% of newborn deaths, and about 80% of newborn deaths occurred in southern Asia and sub-Saharan Africa, while pneumonia and diarrhea were the most prevalent causes of child mortality.
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Infants with trisomy 13 or 18 who underwent congenital heart surgery had a more than 50% lower risk of in-hospital mortality, compared with those who didn't receive surgery, with benefits persisting until 24 months of follow-up, researchers reported in Pediatrics. The findings also showed reduced in-hospital mortality risk among female infants, those with higher weights and those who were older at admission.
Children born preterm had lower scores in tests of IQ, motor skills, reading, spelling, mathematics and behavior at primary school age, compared with those born full term, and the poorer performance persisted until secondary school age, except for mathematics, UK researchers reported in BJOG: An International Journal of Obstetrics and Gynaecology. The findings also showed reduced working memory and processing speed until after school age as well as a twofold higher risk of attention-deficit/hyperactivity disorder diagnosis among those born preterm.
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