Withholding Hydration and Nutrition in Newborns

In the twenty-first century, decisions to withhold or withdraw life-supporting measures commonly precede death in the neonatal intensive care unit without major ethical controversy. However, caregivers often feel much greater turmoil with regard to stopping medical hydration and nutrition than they do when considering discontinuation of mechanical ventilation or circulatory support. Nevertheless, forgoing medical fluids and food represents a morally acceptable option as part of a carefully developed palliative care plan considering the infant’s prognosis and the burdens of continued treatment. Decisions to stop any form of life support should focus on the clinical circumstances, not the means used to sustain life.     

知情权与新生儿重症监护病房(NICU)患儿父母的信息交流技巧

在新生儿重症监护病房(neonatal intensive care unit,NICU)中接受治疗的危重新生儿约90%结果良好,而这些患儿的父母100%都在此过程中遭受不同程度的心理创伤.患儿父母及其家人应被充分告知患儿的病情、治疗方案及可能的预后,这是他们拥有的知情权.在临床工作中,怎样运用良好的信息交流技巧让患儿父母充分理解病情、配合治疗又不过分紧张这对患儿的康复比对患儿实施具体的诊疗方案更重要.从患儿父母、医护人员、人文关怀的角度探讨NICU医护人员与患儿父母之间信息交流的技巧.     

Effects of neonatal treatment with cyproterone acetate on aggressive behavior induced by footshock in adult male rats

High levels of androgens are required to organize aggressive behavior in adult male rats. Footshock-induced aggression was tested in Wistar rats allocated to one of three experimental groups: control (oil-injected) males (M), males neonatally injected with the antiandrogen cyproterone acetate (CA), and males treated as in the CA group but gonadectomized just before puberty (CAG). An antiaggressive effect of CA in those adult male rats neonatally treated with this compound was found. Neonatal exposure to cyproterone acetate exerts an antiandrogenic effect over the expression of shock-induced aggressive behavior. The behavioral effects of CA were not countered by adult treatment with testosterone propionate.     

Positive evidence for neonatal imitation: A general response,adaptive engagement

The study employed four gestural models using frame‐by‐frame microanalytic methods, and followed how the behaviours unfolded over time. Forty‐two human newborns (0–3 days) were examined for their imitation of tongue protrusion, ‘head tilt with looking up’, three‐finger and two‐finger gestures. The results showed that all three gesture groups were imitated. Results of the temporal analyses revealed an early and a later, second stage of responses. Later responses were characterized by a suppression of similar, but non‐matching movements. Perinatal imitation is not a phenomenon served by a single underlying mechanism; it has at least two different stages. An early phase is followed by voluntary matching behaviour by the neonatal infant.     

Bereavement and Religion Online: Stillbirth,Neonatal Loss,and Parental Religiosity

Stillbirth and neonatal death often trigger immense and long‐lasting grief in parents. These life‐altering losses both call upon and call into question parents’ religious beliefs and practices. This qualitative research examines the impact of stillbirth and neonatal death on parental religiosity, broadly conceived to include personal spirituality and any religious affiliation, including atheism. It examines religion online, a nontraditional but important social context for grief, especially regarding statistically rare tragedies such as stillbirth and neonatal death. Content analysis of postings on a hub website for “babyloss” parents yields four major themes: religious disorientation, religious reorientation, changed relationships with others, and a quest for meaning.     

Differential Effects of Short- and Long-Term Early Maternal Separation on Subsequent Maternal Behavior in Rats

Female Sprague-Dawley pups were separated from mothers every other day for 8 hr (long-term separation/LTS), 4 hr (short-term separation/STS), or 0 hr (no separation/NS) from postnatal day 2–20. In adulthood, they were mated and tested for maternal behaviors during two lactations. It was expected that females separated from mothers as pups would show deficits in maternal behavior as adults. Contrary to expectations, LTS showed better nest building and grouped young faster during both lactations. LTS were first to display aggression and displayed more aggression during the second lactation. Notably, while some measures decreased from first to second lactation in NS and STS, LTS maintained levels of maternal care. These results suggest that extended periods of maternal separation may exaggerate some aspects of maternal behavior.     

基层医务人员院外实施心肺复苏的意愿及障碍因素的质性研究

为了解基层医务人员院外实施心肺复苏(cardiopulmonary resuscitation,CPR)的意愿及其障碍因素,探讨消除障碍因素的途径,以提高院外心肺复苏实施率。采用目的抽样法对14名基层医务人员进行深度访谈,运用内容分析法对资料进行整理、分析。归纳出两大主题,即基层医务人员院外实施CPR的意愿和实施CPR的障碍因素,其中障碍因素包括急救技能不佳、担心疾病传播、社会压力大、相关法律缺乏4个亚主题。基层医务人员在院外实施CPR存在不同程度的顾虑,需尽快制定相关课程的再培训计划和相关政策或法律以提高基层医务人员院外实施CPR的意愿。     

From imitation to conversation: the first dialogues with human neonates

The functional maturity of the newborn infant's brain, the resemblances between neonatal imitation and imitation in adults and the possibly lateralized neonatal imitation suggest that the mirror neuron system may contribute to neonatal imitation. Newborn infants not only imitate but also initiate previously imitated gestures, and are able to participate in overlapping imitation–initiation communicative cycles. Additionally, these social responses in neonates are faster than previously thought, and may enable them to have long‐lasting intimate interactions much before language develops. Infants are equipped with a powerful, innate, reciprocal communicative ability already at birth. The earliest communication originates from imitation and this communicative ability presumably later evolves to language. Copyright © 2006 John Wiley & Sons, Ltd.     

成功心肺复苏的合适急救团队人数的研究

探讨成功心肺复苏中合适的急救团队人数。采用回顾性分析方法,对64例实施心肺复苏成功的心搏骤停患者临床资料进行对比分析。医生3人～4人组完成高质量胸外按压（46．9％）、气管插管（42．2％）的比率高于1人～2人组（P〈0．05）,护士4人～5人组高质量完成相关操作优于2人～3人组（P〈0．05）。医师3人～4人、护士4...