By rescreening all infants before hospital discharge, the false-positive rate of UNHS performed using automated ABR can be reduced to <1%. However, for the false-positive results that do occur, any long-lasting and detrimental emotional impact between mother and infant seems to be small and could be reduced even more with improved understanding about UNHS.

ABSTRACT. Background and Objectives. The falsepositive rates of previously reported universal newborn hearing screening (UNHS) programs range between 2.5% and 8%. Critics of UNHS programs have claimed that this rate is too high and might lead to a number of the negative effects produced by false-positive screening tests, namely emotional trauma, disease labeling, iatrogenesis from unnecessary testing, and increased expense in terms of time and money.We previously reported, based on some preliminary data, that as many as 80% of newborns who failed the initial hearing screen subsequently passed when they were retested the following day, before being discharged from the hospital. We now present the results of this intervention for our entire UNHS program during a 7-month period.Methods. We analyzed data from 3142 non-neonatal intensive care unit infants screened with an automated auditory brainstem response at the Women's Hospital of Greensboro from November 1, 1999 to May 31, 2000. A protocol was developed wherein all infants who failed the initial UNHS were rescreened with another automated auditory brainstem response before hospital discharge. Data collected included pass/fail rates during the inpatient stay as well as follow-up data and risk factors for congenital hearing loss.Results. Confirmed hearing loss occurred in 8 nonneonatal intensive care unit infants, a rate of 2.5/1000. Eighty percent of newborns who failed the initial hearing screen passed on rescreening before hospital discharge. This produced a false-positive rate of 0.8% and a corresponding positive predictive value of 24%. If inhospital rescreening had not occurred, our false-positive rate and positive predictive value would have been 3.9% and 6.1%, respectively.Conclusions. Our simple intervention of rescreening all infants who failed their initial UNHS before hospital discharge reduced the false-positive rate of UNHS to 0.8%. We suggest that this simple, inexpensive intervention should be instituted for all similar UNHS programs. Pediatrics 2001;107(3). URL: http://www.pediatrics.org/ cgi/content/full/107/3/e29; universal newborn hearing screening, screening, false-positive, hearing, audiology, automated auditory brainstem response.

A pilot study of telenursing for terminally ill patients at home was launched as a collaborative effort between KUMC and the Kendallwood Hospice. The service used the public telephone network. Interactive video equipment was installed in the homes of three nurses who received after-hours calls and in the homes of six hospice patients living in either Kansas or Missouri. Data concerning the utilization patterns were gathered for two separate three-month periods. Patients and caregivers reported general satisfaction with the telehospice system. Both the nurses and social worker providers became comfortable about video-calls. Nurses conducted video-assessments to determine whether an 'in person' visit was necessary. This was particularly helpful for rural patients who were living a long way from the base station. In addition, Kendallwood serves an urban population and, in certain areas, night-time nursing visits raise safety concerns.

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Many parents who expect outpatient treatment prefer to take their child to a primary care pediatrician during evening hours, but present to the ED because of lack of primary care access.

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This study investigated the rates of severe substance misuse, severe emotional disturbance, and dual diagnosis in a meal-line population of mixed ethnicity, 75% of whom were homeless and the remainder near-homeless. Alcohol and/or drug use was reported by 93% and severe substance misuse was found in 39% of the population. Severe mental illness was found in 54% of the population. Both conditions, dual diagnosis, was found in 29% of the cases. A cluster analysis of the total population found three types: those with dual diagnosis (24.27%), those with serious substance misuse and personality disorder (39.3%), and those with neither severe disorder (37.3%). The ethnicity of the homeless individual was very weakly, if at all, associated with the disorders.