PubMed Health⌕ Search

Biomedical subjects

M Cuttini

Publications and source records attributed to M Cuttini.

33 records · Page 2Linked to original sources
PubMed1997

[Ethical decisions making in neonatal intensive care. Survey among nursing staff in 2 French centers].

A European Concerted Action, Euronic, has been set up to study the attitudes and self-reported practices of the staff working in neonatal intensive care units about parent's information and ethical decisionmaking. This paper presents the results of a preliminary qualitative survey conducted in two French units and including 23 physicians and nurses. The answers indicate that withdrawal of treatments are part of their practices. Parents are never directly involved in the decision-making process. The decision to withdraw life sustaining treatments generate psychological distress among the caregivers. Nurses consider that they are more emotionally involved with the baby and the parents. They express concerns about painful treatments and life-prolonging therapies. Most respondents believe that an ethical committee would be of little help in the decision-making process and that the actual legislation should not be modified as it gives obligation for more in-depth consideration of each case.

Decision Making↗
PubMed1997

The EURONIC Project: a European concerted action on information to parents and ethical decision-making in neonatal intensive care.

The paper presents the background, objectives and methods of a European concerted action project aimed at exploring the transmission of information to parents and the ethical decision-making process in neonatal intensive care from the perspective of health personnel, and in relation to the legal, cultural, social and ethical backgrounds of the various European countries. Eight countries are taking part in the project (France, Germany, Italy, Luxembourg, Spain, Sweden, The Netherlands and the United Kingdom), which is about to be extended also to Central and Eastern Europe (Estonia, Lithuania and Hungary). In each of them, the medical and nursing personnel of a number of randomly selected units will be interviewed through an anonymous, self-administered questionnaire. Information on the organisation and policies of the Units and on the national legislation will also be collected. The key features of the study lie in the multidisciplinary and international approach, the random selection of the sample as a guarantee of representativeness and lack of selection bias, the focus on the staff practices as well as on their attitudes and opinions.

Adult↗
PubMed1995

Effectiveness of adjunctive treatment with steroids in reducing short-term mortality in a high-risk population of children with bacterial meningitis.

Bacterial meningitis is still an important cause of death and/or persistent nervous system damage in children living in developing countries. The aim of the study was to evaluate the effectiveness of steroids in reducing mortality and neurologic sequelae in children affected by bacterial meningitis within the context of a developing country (Mozambique), where the case-fatality rate of this disease is over 30 per cent. Seventy children with bacterial meningitis were randomized to receive either conventional antibiotic therapy or antibiotic therapy plus dexamethasone. On hospital admission there were no statistically significant differences between the two groups with regard to clinical and laboratoristic features. When dexamethasone was used early mortality, within 24 h, was significantly reduced (1/34 v. 8/36, P < 0.05). Total mortality among steroid treated patients, including those who were comatose on admission, was also reduced even if the difference did not reach statistical significance. A favourable trend in terms of fewer serious neurologic abnormalities was also observed among survivors in the steroid treated patients (5/26 v. 7/24). Fever and CSF abnormalities also disappeared more rapidly in patients receiving dexamethasone (P < 0.05). This study showed that the beneficial effect of adjunctive steroid therapy in children with bacterial meningitis can be even more important in areas where the case-fatality rate of this disease is still very high.

Anti-Bacterial Agents↗
PubMed1994

Mothers' health after the birth of the first child: the case of employed women in an Italian city.

While the number of mothers resuming employment soon after the birth of a child is growing, knowledge about the effect that having both a baby and a job has on mental and physical health is still scarce. In this paper, we studied the health of 141 Italian first-time mothers, who were all employed during pregnancy. When their child was 15 months old, 84% were back at work; 24-36% suffered from lack of sleep, extreme tiredness and backache; more than half had experienced some feelings of depression since the birth. Considering the whole sample, poorly educated and unmarried mothers reported more physical health problems. Being employed per se showed no influence, but poorly educated mothers and those with a less qualified job reported more problems. On the basis of our results, we suggest that future research on new mothers, work and health should systematically include "domestic" variables and the characteristics of the paid job; and should analyze more thoroughly the influence of marriage status and educational level on health.

Adult↗
PubMed1994

Teaching research: the experience of an introductory course for student nurses in Italy.

This paper describes the experience of an introductory course in research methodology which was developed at the Nursing School of the Istituto per l'Infanzia of Trieste, Italy. Third-year student nurses were led to understand the basic principles of research through the design and implementation of a real research project, aimed at exploring mothers' views about rooming-in, nursery organization, and the quality of care received during the first days after delivery. A problem-solving approach to research, where methodological choices were presented as 'problems' whose best solution had to be found on the basis of the study objective and of the available resources, small group working under the supervision of a tutor, and oral class presentation of the work performed, represented the major teaching strategies.

Adult↗
PubMed1993

Outcome of teenage pregnancy in Maputo, Mozambique.

OBJECTIVE: To evaluate the perinatal outcome of teenage pregnancies in comparison with a population of older, high-risk women. METHOD: Data about 15,207 high-risk women delivered during 1989 at the Central Hospital of Maputo, Mozambique, were collected retrospectively from the clinical records. Of these women 2185 were less than 19 years old. Frequencies were compared through the chi 2-test or, when required, Fisher's exact test. Odds ratios and 95% confidence intervals were computed. RESULT: Frequency of operative vaginal deliveries (forceps and/or vacuum extraction), cesarean section rate and low birth rate were significantly higher among women under 19 than in the older ones. Also, maternal mortality and stillbirth rates were greater among teenagers, although the differences were not statistically significant. CONCLUSION: Among the selected, high-risk hospital population of a developing country young maternal age, both by itself and in association with other risk factors, represents an important predictor of adverse perinatal outcome for mothers and babies. Implications for family planning and reproductive education programs are discussed.

Adolescent↗
PubMed1993

Staff views on parental visiting of very low birthweight infants in neonatal intensive care units--results of a staff enquiry across eleven countries of the European Community. EC-Study Group on Parental Involvement in Neonatal Intensive Care.

As part of a larger European study of parental visiting and involvement in the care of very low birth weight infants in neonatal intensive care units, the results of a self-completed anonymous enquiry of 1008 medical/nursing staff of 35 units in 11 European countries are presented. The study demonstrates a general agreement with parental visiting and involvement, with sometimes striking differences in views of staff of different countries, but with little or no differences between medical and nursing staff. Staff with more than seven years experience in neonatal care have a less positive attitude towards parent's presence in the unit. The same holds true for staff of units that have a restricted policy toward parents' visiting, i.e. units which do not have a 24-hours visiting policy for parents.

Attitude of Health Personnel↗
PubMed1991

Proportionality of small for gestational age babies as a predictor of neonatal mortality and morbidity.

Neonatal mortality and morbidity of 2609 babies who weighed less than the fifth centile for gestational age were studied in order to evaluate the relationship between the type of intrauterine growth retardation and the short-term prognosis after birth. Of these babies, 1175 had both a birthweight and head circumference below the fifth centile ('proportionately small'); the others, whose body weight was below but head circumference above the fifth centile, were defined as 'disproportionately small'. The former group showed a consistently higher risk of death during the neonatal period. Morbidity defined by birth asphyxia, respiratory distress and neonatal infections was higher in those proportionately small babies who were delivered at term. The picture reversed for hyperbilirubinaemia, which was more frequent among disproportionately small babies. Proportionality, defined on the basis of the correspondence between birthweight and head circumference centiles, appears to be a simple and non-invasive clinical method to identify babies who are at higher risk of adverse outcome.

Asphyxia Neonatorum↗
PubMed1989

Evaluation of the performance of two different infusion pump systems in a neonatal intensive care unit.

The aim of this study was to evaluate the performance of two different types of intravenous infusion pumps currently used in the Neonatal Intensive Care Unit of the Burlo Garofolo Children's Hospital, Trieste, Italy. During a 1-month-period two volumetric (Oximetrix Shaw) and four peristaltic (Ivac) pumps were studied. The total number of days of observation (pump-days) were 63 and 58 respectively. The accuracy, which is the difference between the volume of fluid to be infused according to the doctor's prescription and that actually delivered to the baby, expressed as a percentage on the daily programme, is satisfactory for both types of instruments, even if below the standard set by the manufacturers. Efficiency is evaluated through a separate set of criteria developed 'a priori' within each category of pumps, taking into account accuracy and the number of adjustments of infusion rate required per day. It appears that both volumetric and peristaltic pumps show in most days of observation a level of efficiency defined as good or medium: 81% and 72% respectively. For volumetric pumps this satisfactory performance is equally divided into the classes good and medium, whilst for peristaltic ones there is a predominance of medium days.

Equipment Design↗
PubMedDate not supplied

[Communication in the neonatal intensive therapy unit: the opinions of parents and of medical personnel compared].

Within the framework of an European international project, the issue of parents-staff communication in Neonatal Intensive Care Units was explored. 5 Italian unit participated in the project. 80 mothers and 62 fathers of singleton, not malformed, very low birthweight babies were interviewed during the fourth week of their baby's life, while the views of the health personnel (60 doctors and 106 nurses) were collected through an anonymous, self-administered questionnaire. Most of the staff feels that parents should be informed completely about their baby's conditions and prognosis, while the actual practices about transmission of information are reported differently according to professional status: more nurses than doctors feel that the information is not as complete as it should be. Uncertainty of prognosis is the most commonly quoted reason for restricting the information. Parents, on the other hand, are generally satisfied about the information received, although some of them complain about the style of communication, and especially the need to ask repeatedly in order to be informed. These results show some of the gaps existing in communication both within the staff and with parents, and suggest possible ways of improvement.

Adult↗
PubMedDate not supplied

[The success of maternal feeding with very low birth weight premature infants, singletons and twins: a 10-year experience].

UNLABELLED: There are very few reports about the feasibility of maternal milk feeding in very low birthweight preterm infants (VLBW), especially in twins. Therefore we conducted a cohort retrospective study to evaluate the feeding patterns of the 226 VLBW discharged from our neonatal intensive care unit from 1987 to 1996. Their gestational age was 30 +/- 2.6 weeks, birthweight 1166 +/- 224 g and they were hospitalized for 67 +/- 37 days (means +/- 1 SD). Of the 226 VLBW 49% were males, 39% had birthweight below 10 degrees centile for gestational age and 56% were born to non-residents in our area. There were 181 single births and 45 (20%) multiple births, of which 16 from pregnancies with 3 or more fetuses. Of the total cases 22% were discharged feeding maternal milk (MM) exclusively and 21% on mixed-feeding, maternal + formula milk (FM). Percentages were respectively 23% and 18% for single newborns, 11% and 29% for twins. Singletons and twins were discharged on FM with comparable percentages (59 and 60%). With passing years we have noticed a significant increase (chi square for linear trend < 0.01) for maternal milk feeding. In the last 2 years 49% of singletons and 38% of twins were discharged on MM, 14% and 24% on MM + FM, and only 37% and 38% on FM only. Between singletons and twins there were no statistically significant differences as far as feeding at discharge is concerned. CONCLUSIONS: most mothers, if correctly informed and encouraged, are able to breast-feed, exclusively or partially, their VLBW offspring, including twins, in the first months of life.

Breast Feeding↗