Neonatal sleep patterns: implications for nursing.

The article describes newborn sleep patterns and includes a discussion of factors influencing neonatal sleep. An important nursing role is to teach parents about infant sleep and to reinforce American Academy of Pediatrics' recommendations on sleep position. Central nurseries, feeding schedules, and constant lighting affect newborn sleep behavior. Nurses can change policies and create an environment in the hospital that enhances parent-infant synchrony. Nurses also have a role both prenatally and in follow-up settings to educate parents about newborn sleep.

An STS-based map of the human genome.

A physical map has been constructed of the human genome containing 15,086 sequence-tagged sites (STSs), with an average spacing of 199 kilobases. The project involved assembly of a radiation hybrid map of the human genome containing 6193 loci and incorporated a genetic linkage map of the human genome containing 5264 loci. This information was combined with the results of STS-content screening of 10,850 loci against a yeast artificial chromosome library to produce an integrated map, anchored by the radiation hybrid and genetic maps. The map provides radiation hybrid coverage of 99 percent and physical coverage of 94 percent of the human genome. The map also represents an early step in an international project to generate a transcript map of the human genome, with more than 3235 expressed sequences localized. The STSs in the map provide a scaffold for initiating large-scale sequencing of the human genome.

Infant botulism.

Constipation in children is rarely thought of as a serious health condition. It is, however, one of the leading symptoms of the pathologic sequence in infantile botulism. The pathogenesis, common clinical manifestations, and common grounds in treatment and prognosis in infant botulism are summarized. The nursing role is presented, focusing on airway management, nutritional needs, environmental support, and parental role in an intensive care unit. An exemplar case study is presented.

On the horizon: surfactant replacement therapy.

During the past decade, significant advances in the treatment of neonatal respiratory distress syndrome (RDS) have been directly attributable to the emergence of surfactant replacement therapy. Using a variety of surfactant preparations, clinical trials have been accomplished in a number of centers on large numbers of infants. These clinical trials showed that there were applications of surfactant replacement both in the prevention mode, early in life, and in the rescue mode, once RDS is diagnosed. There were no evident adverse effects on the infants, and there was significant reduction in mortality and severity of disease in the treated infants. Currently, a large number of neonatal intensive care units are enrolling infants in treatment investigational drug (IND) protocols as defined by the Food and Drug Administration (FDA) while the new drug applications are pending. Surfactant replacement therapy has numerous implications for neonatal nurses and will be part of all neonatal nursing skills in the near future.

Effects of discontinuing cover gowns on a postpartal ward upon cord colonization of the newborn.

To determine if the incidence of bacterial cord colonization in neonates increased when cover gowns were discontinued on a postpartal ward, a study was conducted. All infants who were admitted to and discharged from the well infant nursery at an Army medical center in Denver, Colorado, were cultured at the umbilicus at the time of admission and at discharge. The control group (N = 74) continued to gown as usual; the experimental group (N = 50) did not wear gowns. Visitors in both groups received the same instructions regarding handwashing. For all organisms, the control group demonstrated 80% colonization of infants who were negative on admission, and the experimental group demonstrated a colonization rate of 62%. When the chi square is applied, these data are statistically significant for P = 0.02 and P = 0.05. The experimental group had less colonization than the control group.