Investigating the Crime Scene-Molecular Signatures in Inflammatory Bowel Disease.

Inflammatory bowel diseases (IBD) are without cure and troublesome to manage because of the considerable diversity between patients and the lack of reliable biomarkers. Several studies have demonstrated that diet, gut microbiota, genetics and other patient factors are essential for disease occurrence and progression. Understanding the link between these factors is crucial for identifying molecular signatures that identify biomarkers to advance the management of IBD. Recent technological breakthroughs and data integration have fuelled the intensity of this research. This research demonstrates that the effect of diet depends on patient factors and gut microbial activity. It also identifies a range of potential biomarkers for IBD management, including mucosa-derived cytokines, gasdermins and neutrophil extracellular traps, all of which need further evaluation before clinical translation. This review provides an update on cutting-edge research in IBD that aims to improve disease management and patient quality of life.

Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the NICU. Part B: Recommendations and Justification. A Joint Position Statement From the CANN, CAPWHN, NANN, and COINN.

The use of age-appropriate care as an organized framework for care delivery in the NICU is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the "universe of developmental care" conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the NICU. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for healthcare professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of these core measures require a strong framework for institutional operationalization presented in these guidelines. Part B will present the recommendations and justification of each steps behind the present guidelines to facilitate their implementation.

Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the Neonatal Intensive Care Unit. Part A: Background and Rationale. A Joint Position Statement From the CANN, CAPWHN, NANN, and COINN.

The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the "universe of developmental care" conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.

Establishment of the Relationship Between Fathers and Premature Infants in Neonatal Units.

BACKGROUND: Parents and their preterm infants (born between 32-37 weeks of gestation) are often overlooked by the healthcare system. And very little attention is given to the relationship parents develop with their infants in the neonatal unit (NNU). Specifically, very few studies focused on fathers and how they establish a relationship with their infants. However, we know that the father-infant relationship is extremely important for their future social development and more. PURPOSE: This article presents the results of a qualitative study of the establishment of the father-premature infant relationship in an NNU. METHODS/SEARCH STRATEGY: The study's theoretical framework was Bell's model of the parent-infant relationship, which encompasses discovery, physical proximity, communication, involvement, and emotional attachment. Ten fathers of premature infants (gestational age: 32-37 weeks) participated in 2 semistructured interviews (1 individual and 1 "in situ," ie, at the infant's bedside) during the first week following the premature birth. FINDINGS/RESULTS: The results confirm the emergence of different components of the relationship between fathers and their children from the first days of hospitalization in the NNU. The commitment component is the basis for the development of other components in the relationship with their children. Furthermore, involvement influences the deployment of emotional attachment, discovery, physical proximity, and communication toward premature infants. Similarly, the 5 themes of the model can be seen as forming a dynamic nexus in which each theme influences the others. IMPLICATIONS FOR PRACTICE: For neonatal nurses, this model of the early father-child relationship helps the understanding of the deployment of that relationship according to 5 components. Similarly, it provides awareness of the experiences of fathers so that nurses can be better equipped to support and individualize interventions tailored to their specific needs, thus helping them develop and sustain the relationship with their children. IMPLICATIONS FOR RESEARCH: This study allows us to better understand fathers' experience regarding the establishment of the relationship to their premature infants born between 32 and 37 weeks of gestation. However, there is little understanding about the early paternal experience and more research on this dyad is necessary in neonatology.

Decreasing noise level in our NICU: The impact of a noise awareness educational program.

BACKGROUND: The literature demonstrates that most NICUs exceed the standard recommendations for noise levels and that high noise levels have a negative impact on patients and staff. OBJECTIVE: The objective of this research was to measure baseline noise level in an NICU, compare it to recommendations of international bodies, and evaluate the impact of a noise awareness educational program (NAEP) as a strategy to decrease it. DESIGN/METHODS: Means of hourly average noise levels in decibels (dB) were compared with the recommendations and pre- and postintervention (P = .05). RESULTS: Mean noise-level preintervention was significantly higher than recommended (58.15 vs 45 dB; P < 0.001). The participation rate in NAEP was excellent and most participants thought that the content was relevant and would change their practice. Overall, at first glance, the impact of the NAEP was not as expected: the noise levels increased nonsignificantly postintervention (58.15 vs 58.46 dB; P < .181). However, a significant increase in activity level (number of nurses and patient) was thought to be responsible for the lack of significance postintervention. After controlling for these variables, it was demonstrated that the noise level did significantly decrease postintervention (6.33 vs 5.42 dB per RN & 4.68 vs 4.08 dB per patient, P < .000). CONCLUSION: Although the efficacy of the program was significantly limited by an increase in general activity, it raised staff awareness and had important effects reflected by the significant decrease in mean noise level after standardization and the participant's comments.

Evaluation of a developmental care training programme for neonatal nurses.

Although the impact of developmental care on premature infants has been investigated at length, often the issue of professional development and training related to this type of care has not been examined. The aim of the present study was to evaluate the impact of a developmental care training programme on nurses' behaviours and cognitive attributes with regard to the prevention of overstimulation of premature infants. The Theory of Reasoned Action (TRA) was the framework underlying the study. This programme evaluation used a quasi-experimental one group pre-test/post-test design. Participants were nurses working in a neonatal intensive care unit. Data were collected by self-administered questionnaires. Significantly higher post-test scores were observed for knowledge and for a variety of theoretical constructs. The results of this study showed the potential of such training programmes to help nurses implement developmental care.

I'm trying to heal...noise levels in a pediatric intensive care unit.

The literature demonstrates clearly that most intensive care units exceed the standard recommendations for noise levels in hospitals, and that high noise levels have negative impacts on patients and staff. The purpose of this study was to evaluate the level of noise in a PICU and compare it to the recommendations of international bodies. We outline recommendations to promote the awareness of this problem and suggest strategies to decrease the level of noise in a PICU. The orientations of these strategies are threefold: 1) architectural-acoustic design, 2) equipment design and, most importantly, 3) staff education.