ObjectiveIn the UK, 1 in 10 babies require specialist neonatal care. This care can last from hours to months depending on the need of the baby. The increasing survival of very preterm babies has increased neonatal care resource use. Evidence from multiple studies is crucial to identify factors which may be important for predicting length of stay (LOS). The ability to predict LOS is vital for resource planning, decision-making and parent counselling. The objective of this review was to identify which factors are important to consider when predicting LOS in the neonatal unit.DesignA systematic review was undertaken which searched MEDLINE, EMBASE and Scopus for papers from 1994 to 2016 (May) for research investigating prediction of neonatal LOS. Strict inclusion and exclusion criteria were applied. Quality of each study was discussed, but not used as a reason for exclusion from the review.Main outcome measurePrediction of LOS in the neonatal unit.Results9 studies were identified which investigated the prediction of neonatal LOS indicating a lack of evidence in the area. Inherent factors, particularly birth weight, sex and gestational age allow for a simple and objective prediction of LOS, which can be calculated on the first day of life. However, other early occurring factors may well also be important and estimates may need revising throughout the baby's stay in hospital.ConclusionsPredicting LOS is vital to aid the commissioning of services and to help clinicians in their counselling of parents. The lack of evidence in this area indicates a need for larger studies to investigate methods of accurately predicting LOS.
Objective To predict length of stay in neonatal care for all admissions of very preterm singleton babies. setting All neonatal units in England. Patients Singleton babies born at 24-31 weeks gestational age from 2011 to 2014. Data were extracted from the National Neonatal Research Database. Methods Competing risks methods were used to investigate the competing outcomes of death in neonatal care or discharge from the neonatal unit. The occurrence of one event prevents the other from occurring. This approach can be used to estimate the percentage of babies alive, or who have been discharged, over time. results A total of 20 571 very preterm babies were included. In the competing risks model, gestational age was adjusted for as a time-varying covariate, allowing the difference between weeks of gestational age to vary over time. The predicted percentage of death or discharge from the neonatal unit were estimated and presented graphically by week of gestational age. From these percentages, estimates of length of stay are provided as the number of days following birth and corrected gestational age at discharge. Conclusions These results can be used in the counselling of parents about length of stay and the risk of mortality. bACkgrOund
This selective review article examines treatment and intervention strategies for executive function (EF) deficits within the school environment. We begin by providing a broad definition of EF. We then examine the scope of EF deficits within the school setting and identify profiles of special populations of students who present with such deficits. A focus is placed on the developmental trajectory that both EF and the frontal lobes follow and how this drives the selection and effectiveness of treatments and interventions at particular "critical periods" throughout a child's academic career. Direct and indirect school-based diagnostic assessment methods to identify EF deficits in students will be briefly reviewed. Against that background, various treatment methods and intervention strategies to remediate both cognitive and affective EF deficits within the confines of the school setting will be presented. Individual and group intervention strategies will be presented as will their current acceptance within the scientific community and applicability to the educational arena. The importance of incorporating school-based neuropsychological assessment methods that aid in the differential diagnosis of academic and behavioral difficulties directly related to EF will also be discussed, as the accurate identification of these impairments is necessary to facilitate data-based decision making when selecting the most appropriate interventions following a developmental model in educational settings. Topics addressing EF treatment modalities and research-based interventions for clinical and school-based practitioners to consider within educational settings will also be presented as suggestions for future research with pediatric populations.
We have established the first prospective, collaborative study of spinal muscular atrophy, the second most common neuromuscular disease of childhood. One hundred and forty-one patients have been evaluated on at least four occasions over a 3-year period. The patients have been grouped by age of onset, as well as by function at the time of initial evaluation. The muscle strength of 96 patients aged 5 years or older was evaluated at 6-month intervals using a fixed myometry system. The new observations made are: (1) The present classification schema is not valid; for example, 49 patients with onset of weakness before 6 months of age (type I or Werdnig-Hoffmann disease), whose life span is said to be only 2 to 4 years, participated in the study and are 4 months to 31 years of age. (2) Thirty-seven patients were evaluated over an 18-month period. None lost strength during this time but four lost function. Although the period of observation was short, the results suggest that the loss of function in patients with spinal muscular atrophy might be explained by a process other than cell death that allows patient strength to be maintained and simultaneously prevents the motor unit from achieving its normal adult potential. ( J Child Neurol 1992;7:347-353).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.