Variation in Visiting and Isolation Policies in Neonatal Units: A U.K. Nationwide Survey.

Global pandemics, such as H1N1, are a major risk for neonatal patients. We surveyed U.K. tertiary and district neonatal units about visiting and infection control policies relating to viral respiratory infections. There was marked variation with visiting policies, tertiary units being more restrictive. Isolation, screening, and outbreak management of infected babies was highly variable posing a risk in future pandemics.

Outcomes of Nosocomial Viral Respiratory Infections in High-Risk Neonates.

BACKGROUND AND OBJECTIVE: Neonatal respiratory disease, particularly bronchopulmonary dysplasia, remains one of the leading causes of morbidity and mortality in newborn infants. Recent evidence suggests nosocomially acquired viral respiratory tract infections (VRTIs) are not uncommon in the NICU. The goal of this study was to assess the association between nosocomial VRTIs, neonatal respiratory disease, and the health care related costs. METHODS: A matched case-control study was conducted in 2 tertiary NICUs during a 6-year period in Nottingham, United Kingdom. Case subjects were symptomatic neonatal patients with a confirmed real-time polymerase chain reaction diagnosis of a VRTI. Matched controls had never tested positive for a VRTI. Multivariable logistic regression was used to test for associations with key respiratory outcomes. RESULTS: There were 7995 admissions during the study period, with 92 case subjects matched to 183 control subjects. Baseline characteristics were similar, with a median gestation of 29 weeks. Rhinovirus was found in 74% of VRTIs. During VRTIs, 51% of infants needed escalation of respiratory support, and case subjects required significantly more respiratory pressure support overall (25 vs 7 days; P < .001). Case subjects spent longer in the hospital (76 vs 41 days; P < .001), twice as many required home oxygen (37%; odds ratio: 3.94 [95% confidence interval: 1.92-8.06]; P < .001), and in-hospital care costs were significantly higher (£49 664 [$71 861] vs £22 155 [$32 057]; P < .001). CONCLUSIONS: Nosocomial VRTIs in neonatal patients are associated with significant greater respiratory morbidity and health care costs. Prevention efforts must be explored.

Distraction of Mental Arithmetic by Background Speech.

When solving mental arithmetic problems, one can easily be distracted by someone speaking in the background and this distraction is greater if the speech comprises numbers. We explored the basis of this disruption by asking participants to solve mental addition problems (e.g., "45 + 17 = ?") in three different conditions: background speech comprising numbers in ascending order (e.g., "61, 62, 63, 64, 65"), background speech comprising numbers in descending order (e.g., "65, 64, 63, 62, 61"), and quiet. Performance was best in quiet, worse in the descending numbers condition, and poorest in the ascending numbers condition. In view of these findings, we suggest that disruption arises as a by-product of preventing the primed, but inaccurate, candidate responses from assuming the control of action. Alternative explanations are also discussed.