Parent-infant co-sleeping and the implications for sudden infant death syndrome.

In 2015 the National Institute for Health and Care Excellence (NICE) updated its 2006 guideline to clarify the association between parent infant co-sleeping and sudden infant death syndrome (SIDS). The practice of co-sleeping is a topic of continuing controversy and debate. Rather than highlighting the risks, the emphasis of the NICE guideline is to provide parents with balanced information so that they can make informed decisions about where their babies sleep. This contradicts previous public health messages on co-sleeping that discourages parents from the practice. Consequently, the updated national guideline has been criticised for failing to provide parents with safer sleep information, which has led to widespread confusion for parents and professionals. Health professionals can deliver safer sleep advice to support parents in their decision-making. However, as a result of inconsistent guidelines and evidence about parent-infant co-sleeping, health professionals may feel apprehensive and ill-equipped to provide advice and support. This article draws on a non-exhaustive literature review to discuss the risks and benefits of parent-infant co-sleeping, and the implications of this practice for SIDS. It also aims to provide transparency and improve understanding for health professionals so that they can support parents to adopt safer sleep strategies for their baby.

Survivors Perceptions of Recovery following Air Medical Transport Accidents.

Abstract Objective: Air medical transport (AMT) teams play an essential role in the care of the critically ill and injured. Their work, however, is not without risk. Since the inception of the industry numerous AMT accidents have been reported. The objective of this research is to gain a better understanding of the post-accident sequelae for professionals who have survived AMT accidents. The hope is that this understanding will empower the industry to better support survivors and plan for the contingencies of post-accident recovery. Methods: Qualitative methods were used to explore the experience of flight crew members who have survived an AMT accident. "Accident" was defined using criteria established by the National Transportation Safety Board. Traditional focus group methodology explored the survivors' experiences following the accident. Results: Seven survivors participated in the focus group. Content analysis revealed themes in four major domains that described the experience of survivors: Physical, Psychological, Relational and Financial. Across the themes survivors reported that industry and company response varied greatly, ranging from generous support, understanding and action to make safety improvements, to little response or action and lack of attention to survivor needs. Conclusion: Planning for AMT post-accident response was identified to be lacking in scope and quality. More focused efforts are needed to assist and support the survivors as they regain both their personal and professional lives following the accident. This planning should include all stakeholders in safe transport; the individual crewmember, air medical transport companies, and the industry at large.

Length of hospital stay after percutaneous coronary interventions.

INTRODUCTION AND AIM: Post-percutaneous coronary intervention (PCI) length of hospital stay (LOHS) is one of the key modifiers of hospital cost and quality assessment. Commencing 2000, the cardiovascular services at our institution engaged in a continuous quality improvement program to reduce post-PCI LOHS. METHODS: All PCI patients were screened for potential early discharge. An expedited discharge protocol was applied to all suitable patients. Length of hospital stay and other outcomes were monitored daily. Data were compiled and reported monthly and quarterly by an independent chart review and data analysis team. RESULTS: Over the study period, PCI volume increased 4-fold. Annually, 61.8% to 78.4% of the patients were rendered suitable for abbreviated LOHS. Timely discharge of suitable candidates gradually improved from 77.6% (n = 116) discharged within 48 hours in 2000 to 95% (n = 480) discharged within 30 hours in 2006. CONCLUSION: With the appropriate continuous quality improvement program, 30-hour post-PCI discharge is feasible in more than 95% of suitable cases.

Efficacy of fexofenadine in the prophylactic control of cat allergen-induced allergic rhinitis.

BACKGROUND: To date, it is unknown whether fexofenadine mitigates the worsening of symptoms induced by the cat allergen Felis domesticus allergen 1. OBJECTIVE: To determine the effects of a single dose of fexofenadine hydrochloride, 180 mg, in preventing and controlling cat allergen-induced allergic rhinitis symptoms using the cat room challenge model. METHODS: This single-center, randomized, double-blind, placebo-controlled, 2-way crossover study consisted of a screening visit, 1 or 2 qualifying visits, and 2 treatment periods separated by a mean +/- SD washout period of 14 +/- 3 days. Patients were randomized to treatment sequence 1 (placebo followed by fexofenadine) or sequence 2 (fexofenadine followed by placebo). Baseline end points were obtained before study drug administration, and allergen challenges were initiated 1 1/2 hours after dosing. The primary end point was the change from predose baseline in the total symptom score (sum of rhinorrhea, itchy nose/palate/ throat, sneezing, and itchy/watery/red eyes) after 30 minutes of allergen exposure compared with placebo. RESULTS: Of 211 patients screened, 66 were randomized and 63 completed the study. Mean change in the total symptom score from predose baseline was significantly less with fexofenadine compared with placebo 30 minutes after initiation of the cat allergen challenge (2 hours after dosing) (P = .03). The overall incidence of treatment-emergent adverse events was low and comparable for both groups. CONCLUSION: Prophylactic treatment with a single dose of fexofenadine hydrochloride, 180 mg, significantly mitigated the worsening of allergic rhinitis symptoms induced by exposure to cat allergen compared with placebo use.

Building safer urban communities in the south pacific

In November 2001, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and the Suth Pacific Geoscience Commission (SOPAC) organised a 2 day regional workshops on 'Building Safer Urban Communities in the South Pacific' in Suva, Fiji. A working group of the chief fire officers and other officials from Pacific Islad Countries (PLCs) assessed the current capacity of their countries to conduct Urban Search and Rescue (USAR) operations. They noted that this capacity is extremely limited, primarily becacuse of a lack of awareness of the function and generally weak coordination in emergency response. The working group concluded that PICs do need their own USAR capacity because of the high level of risk to their urban areas, and they outlined the next steps needed to develop such a capacity. (AU)