Asistencia al duelo neonatal: diez años de experiencia en una unidad de neonatología / Grief support group: ten years of experience in a neonatal unit

Objetivo: La Unidad de Neonatología, se propuso mejorar la calidad de la atención de la familia del recién nacido que fallece. Pacientes y Método: Tras constituirse un Comité de Manejo del Duelo Neonatal, se capacitó al personal al inicio y luego anualmente. Se elaboró un Manual de Procedimientos, aplicado desde marzo de 2000. Se presenta el análisis cuantitativo de los resultados de la aplicación del Manual y el análisis cualitativo del impacto del programa en el personal y en los padres. Resultados: Fallecieron 440 niños entre el 1 de marzo de 2000 hasta el 31 de diciembre de 2009. El aviso de muerte inminente se realizó en el 98,8 por ciento de los casos, la presencia de los padres en el momento de la muerte llegó a un 85,9 por ciento, lo que estuvo determinado significativamente por el lugar de residencia y la hora del fallecimiento. El 87,8 por ciento de los padres abrazaron a su hijo, mientras que el 5,8 por ciento sólo lo miraron. Se describe, además, el impacto del programa sobre el personal y las opiniones de los padres en una conversación post-mortem. Conclusión: El programa del Duelo Neonatal mejoró la calidad de la atención a los padres del recién nacido moribundo.

Objective: A Neonatal Unit decided to improve the family quality care of dying newborns. Patients and Method: After a Neonatal Grief Management Committee was established, care providers were immediately trained and followed by annually training programs. A Procedures Manual was elaborated and implemented since March 2000. A quantitative analysis of the Manual application results and a qualitative analysis regarding the program impact on care providers and parents are presented. Results: 440 children died between March 1, 2000 and December 31, 2009. The new of imminent death was delivered in 98.8 percent of cases; the presence of parents at the time of death reached 85.9 percent which was significantly determined by the place of residence and time of death. 87.8 percent of parents hugged their child, while 5.8 percent only looked at him. The program's impact on care providers and the views of parents in post-mortem conversations are described. Conclusion: The Neonatal Grief Program improved the quality care of the parents of dying newborns.

Physician 'defiance' towards hand hygiene compliance: Is there a theory-practice-ethics gap?

The theory-practice gap has always existed. This gap is often cited as a culmination of theory being idealistic and impractical, even if practical and beneficial, is often ignored. Most of the evidence relating to the non-integration of theory and practice assumes that environmental factors are responsible and will affect learning and practice outcomes, hence the gap. Therefore, the author believes that to 'bridge the gap' between theory and practice, an additional dimension is required: ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices as worthy and relevant to their role as healthcare providers [HCP]. Hence, this introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in healthcare practice [3]. The literature suggests that there is a crisis of ethics where theory and practice integrate, and healthcare providers are failing to fulfill our duty as patient advocates. Physician hand hygiene practices and compliance at King Abdulaziz Cardiac Centre [KACC] are consistent with those of other physicians in the global healthcare arena. That is one of noncompliance to King Abdulaziz Medical City [KAMC] organizational expectations and the World Health Organization [WHO] requirements? An observational study was conducted on the compliance of cardiac surgeons, cardiologists and nurses in the authors' cardiac center from January 2010 to December 2011. The hand hygiene [HH] compliance elements that were evaluated pertained to the WHO's five moments of HH recommendations. The data was obtained through direct observation by KAMC infection prevention and control practitioners. Physician hand hygiene compliance at KACC was consistently less than 60%, with nurses regularly encouraging physicians to be diligent with hand hygiene practices in the clinical area. Hand hygiene compliance will not improve unless evidence-based recommendations are adopted and endorsed by all healthcare professionals and providers

Mesoderm enhancing effect of human seminal plasma inhibin and its synthetic C-terminal nonapeptide fragment in the chick embryo.

Isomers of fibroblast growth factor and members of the transforming growth factor beta family have been identified as potent mesoderm inducing factors, particularly in amphibians. Activins belonging to the latter group are capable of inducing all types of mesoderm. Inhibins, also belonging to the same family of proteins have an exactly opposite biological action than activins in the adult organism. We have examined the effects of human seminal plasma inhibin on the early development of the chick embryo, where also activins appear to be important in mesoderm induction. Contrary to expectations, inhibin brought about stimulation of development of somites and heart, structures of mesodermal origin, and increase in the body length in more than 50% of the treated chick blastoderms. A synthetic fragment of human seminal plasma inhibin, a nonapeptide fragment of C-terminal end, also exhibited similar effects. In some cases the treatments resulted in completely abnormal development while in some increase in the number of somites was associated with abnormality in the anterior region. Our results demonstrate that human seminal plasma inhibin does not act as an inhibitor of mesoderm induction in the chick embryo but in amniotes inhibin-related molecules may have a role as mesoderm enhancers.