Bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) are common and significant morbidities of prematurely born infants. These diseases have in common altered and pathologic vascular formation in the face of incomplete organ development. Therefore, it is reasonable to question whether factors affecting angiogenesis could have a joint pathogenic role for both diseases. Inhibition or induced expression of a single angiogenic factor is unlikely to be 100% causative or protective of either of BPD or ROP. It is more likely that interactions of multiple factors leading to disordered angiogenesis are present, increasing the likelihood of common pathways in both diseases. This review explores this possibility by assessing the evidence showing involvement of specific angiogenic factors in the vascular development and maldevelopment in each disease. Theoretical interactions of specific factors mutually contributing to BPD and ROP are proposed and, where possible, a timeline of the proposed relationships between BPD and ROP is developed. It is hoped that future research will be inspired by the theories put forth in this review to enhance the understanding of the pathogenesis in both diseases.
Background: Cytomegalovirus (CMV) is the most common viral infection seen in newborns. Although postnatally acquired CMV (pCMV) infection rarely results in serious manifestations in term infants, preterm infants can develop severe clinical illness. However, the long-term implications of pCMV infection of preterm infants are unknown. Few robust studies on longterm outcomes of pCMV infection have been performed, and those reported often present conflicting results. Our objective was to assess the long-term outcomes for low birthweight (LBW) preterm infants after pCMV infection. Methods: A systematic review of English and non-English articles using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science was conducted. Search strategies included a mix of keywords and database-specific subject headings for CMV and LBW infants. Editorials, comments, reviews and animal-only studies were excluded. Case reports, observational, experimental and randomized controlled trials that examined pCMV in preterm or VLBW infants and longterm (>1 month) impact of pCMV were included. Results: pCMV infection in preterm infants is associated with increased risk for pulmonary and neurologic complications and increases length of stay. There is less evidence to suggest that pCMV is associated with necrotizing enterocolitis, ophthalmologic, audiologic and anthropomorphic complications in preterm infants. Conclusions: Preterm infants with pCMV, especially those with symptomatic infection, may have long-term pulmonary and neurodevelopmental morbidity compared with their pCMV negative counterparts. Our results highlight the importance of pCMV detection and prevention in preterm infants in the neonatal intensive care unit. Large prospective studies are needed to fully define outcomes and determine if treatment improves outcomes.
This paper reports on research which was conducted to explore how university students and those who had graduated and been subsequently employed, made career decisions. Specifically, through interviews and focus group discussions with 22 university students and 28 graduates from Australian undergraduate and postgraduate courses in a variety of disciplines, four questions were explored: Do university students know their own desired postcourse employment, or in other words, what they want to be after graduation; if so, at what point in their student experience do they come to this decision; what elements come into play in university student career decision-making; and to what extent do students and graduates feel that their career decision-making is supported by their universities? Research was grounded in, and results aligned with, the 'chaos theory of careers.' The main findings were that at the enrolment-stage of university and during their studies, most students were pessimistic about their career outcomes and felt largely unsupported in identifying suitable career goals. However, the outcomes after graduation were unexpectedly positive in that, by this point most had identified career goals and were in careers they had desired. Most of the research participants who had been in their careers for an extended length of time were casual academics who were dissatisfied with their career progression and status. Although they had identified academic career goals and secured employment in their chosen industry, they were disappointed by continuous short-term contracts and what they perceived as poor career supports extended by their university employers. A 'university student and graduate careerknowledge framework' was derived. The key takeaway from this research was a set of recommendations for universities regarding how to better support students to make career choices.
We describe what to include and why, and outline when and how to teach the essential components of brief motivational interviewing knowledge and skills in a medical curriculum.
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