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  • 1
    Online Resource
    Online Resource
    Wiley ; 2014
    In:  Journal of Paediatrics and Child Health Vol. 50, No. 7 ( 2014-07), p. 536-539
    In: Journal of Paediatrics and Child Health, Wiley, Vol. 50, No. 7 ( 2014-07), p. 536-539
    Abstract: Neonates are at risk for potentially life‐threatening vitamin K deficiency bleeding. This can be readily prevented with prophylactic vitamin K following delivery. In this context, most vitamin K ‐deficiency bleeding occurs in those whose parents decline newborn vitamin K . One factor influencing parental decision‐making is information received from health professionals. This study examined attitudes and perceptions towards newborn vitamin K in relevant health‐care professionals. Methods A literature review and one‐on‐one semi‐structured interviews were conducted to inform questionnaire design. Midwives and selected medical staff employed in the S outh I sland of N ew Z ealand were then invited to complete an anonymous survey exploring attitudes and perceptions towards vitamin K prophylaxis in newborns. Results The survey achieved an overall response rate of 57%. Almost all responding medical staff and 76% of midwives agreed with the current N ew Z ealand M inistry of H ealth vitamin K guideline. All medical staff but only 55% of midwives feel that all babies should receive vitamin K . Differences were also seen between professionals with respect to vitamin K education and risks. Conclusion This is the first study to examine attitudes and perceptions of midwives and doctors to vitamin K prophylaxis in neonates. Considerable discrepancies in attitude are evident, and in some midwives, a lack of confidence in this intervention is apparent. How this affects education to families is unknown. Increased understanding of this phenomenon, along with improved education and communication to professionals and families, is required.
    Type of Medium: Online Resource
    ISSN: 1034-4810 , 1440-1754
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2007577-7
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  • 2
    In: Journal of Paediatrics and Child Health, Wiley, Vol. 52, No. 1 ( 2016-01), p. 60-66
    Abstract: The aim of this study was to measure urinary C ‐peptide concentrations, and then calculate C ‐peptide clearance ( C l), and excretion rate ( UER ) in neonates. In addition, the effect of gestational age ( GA ) and blood glucose levels ( BGL ) on C ‐peptide UER were investigated. Methods Insulin concentrations in plasma and C ‐peptide concentrations were measured in plasma and urine, in 20 neonates. Chemiluminescent immunoassays were used for insulin and C ‐peptide measurements, with urine diluted to 40% with bovine serum albumin 1% in phosphate buffered saline. Urine volume and time of collection were recorded and used to calculate UER and C l. Results The mean C l of C ‐peptide was 0.309 ± 0.329 mL/min/kg, and UER was 0.0329 ± 0.0342 pmol/min/kg. Correlations between C l or UER and GA were not significant ( P   〉  0.05). No significant correlation was shown between C l or UER and BGL ( P   〉  0.05). Conclusions Both C l and UER were highly variable in neonates, but were not correlated with GA . Additionally, BGL did not appear to affect C ‐peptide UER and C l. As GA and BGL did not appear to affect C l and UER , urinary C ‐peptide may provide a non‐invasive method of measuring insulin production in neonates.
    Type of Medium: Online Resource
    ISSN: 1034-4810 , 1440-1754
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2007577-7
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  • 3
    Online Resource
    Online Resource
    Wiley ; 2015
    In:  Journal of Paediatrics and Child Health Vol. 51, No. 5 ( 2015-05), p. 478-481
    In: Journal of Paediatrics and Child Health, Wiley, Vol. 51, No. 5 ( 2015-05), p. 478-481
    Type of Medium: Online Resource
    ISSN: 1034-4810 , 1440-1754
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2007577-7
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  • 4
    Online Resource
    Online Resource
    BMJ ; 2017
    In:  Archives of Disease in Childhood - Fetal and Neonatal Edition Vol. 102, No. 2 ( 2017-03), p. F162-F166
    In: Archives of Disease in Childhood - Fetal and Neonatal Edition, BMJ, Vol. 102, No. 2 ( 2017-03), p. F162-F166
    Type of Medium: Online Resource
    ISSN: 1359-2998 , 1468-2052
    Language: English
    Publisher: BMJ
    Publication Date: 2017
    detail.hit.zdb_id: 2188490-0
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  • 5
    Online Resource
    Online Resource
    BMJ ; 2016
    In:  Archives of Disease in Childhood Vol. 101, No. 1 ( 2016-01), p. e1.55-e1
    In: Archives of Disease in Childhood, BMJ, Vol. 101, No. 1 ( 2016-01), p. e1.55-e1
    Abstract: Preterm birth disrupts normal timing of physiological adaptation of insulin secretion putting premature neonates at risk of abnormal glucose homeostasis. The insulin/C-peptide (I/CP) ratio gives an indication of insulin clearance but has not been reported in neonates. Premature neonates have significantly higher fasting levels of GLP-1 than adults that increase even further with feeding. Aims To determine I/CP and insulin/blood glucose level (I/BGL) ratios in neonates and the effect of postmenstrual age (PMA) on these measures. To determine GLP-1 concentrations in never-fed versus fed neonates. Methods Plasma samples were obtained from 102 neonates admitted to Dunedin Hospital NICU. Plasma was analysed for insulin and C-peptide using chemiluminescent kits (Invitron, UK), GLP-1 and glucagon using ELISA (BioCore Pty Ltd, Australia). Statistical analyses were performed using Stata/IC (v11.2). Results The PMA range was 24–51.3 weeks. The median I/CP ratio was 0.44, 95% CI (0.44, 0.61). The median I/BGL ratio was 9.3, 95% CI (8.2, 10.6). Linear regressions of ln-transformed data were performed. I/CP and I/BGL ratios were significantly affected by PMA (p 〈 0.01). Negative correlations were found (r=−0.21 and −0.35 for I/CP and I/BGL respectively, p 〈 0.01) and I/CP changed around 34 weeks. Insulin concentrations were negatively correlated (r=−0.38, p 〈 0.01) with increasing PMA. ANOVA showed higher GLP-1 concentrations (p=0.011) in fed versus never-fed neonates. Conclusions These findings indicate insulin resistance in premature neonates prior to 34 weeks gestation. The significantly higher GLP-1 concentrations in fed neonates confirm that GLP-1 increases with the establishment of feeding.
    Type of Medium: Online Resource
    ISSN: 0003-9888 , 1468-2044
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 1481191-1
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  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2013
    In:  Journal of Pharmacy and Pharmacology Vol. 65, No. 3 ( 2013-01-29), p. 370-378
    In: Journal of Pharmacy and Pharmacology, Oxford University Press (OUP), Vol. 65, No. 3 ( 2013-01-29), p. 370-378
    Abstract: To investigate infusion variables that delay delivery of gentamicin through neonatal infusion lines. Methods Infusions were set up to simulate administration of gentamicin to neonates. The primary infusion was 10% dextrose (Baxter Colleague pump). A syringe driver was used to deliver a coloured marker via the T-connection over 35 min followed by a 1 ml normal saline flush over 35 min. Effects of dextrose concentration, primary infusion rate, dose volume and angle of the primary line were investigated. Gentamicin adsorption to in-line filters (Poisdyne Neo) and administration protocols from different neonatal intensive care units were also investigated. Key findings Low dose volumes ( & lt;0.4 ml) infused into slow-flowing glucose (dextrose) lines (3.8–4 ml/h) did not mix well at the T-connection. Coloured solutions formed an upper layer that moved in a retrograde direction towards the primary infusion bag. Gentamicin did not adsorb onto Posidyne Neo filters. Comparison of infusion protocols for gentamicin administration showed that slow infusion (30 min) into slow-flowing lines (4 ml/h) containing 10% glucose gave low recovery of drug during the infusion ( & lt;30% of intended dose). Conclusions Poor mixing at the T-connection appears to be the cause of delayed and/or incomplete gentamicin delivery for low dose volumes and slow infusion rates.
    Type of Medium: Online Resource
    ISSN: 2042-7158 , 0022-3573
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2013
    detail.hit.zdb_id: 2041988-0
    detail.hit.zdb_id: 2050532-2
    SSG: 15,3
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  • 7
    In: Journal of Paediatrics and Child Health, Wiley, Vol. 51, No. 9 ( 2015-09), p. 889-894
    Abstract: Low rates of childhood immunisation are linked to outbreaks of infectious disease. Identifying and addressing barriers to immunisation may lead to improved immunisation rates. Immunisation and newborn vitamin K prophylaxis have many similarities. We aimed to investigate whether parents who decline newborn vitamin K are also more likely to decline subsequent childhood immunisations. Methods We undertook a retrospective cohort study, examining the relationship between vitamin K administration and immunisation uptake by parents of babies born over a 2‐year period ( J anuary 2010– D ecember 2011) in D unedin, N ew Z ealand ( NZ ). Both written and electronic data from a single birthing unit and the NZ National Immunisation Register ( NIR ) were analysed to ascertain the relationship between declining newborn vitamin K prophylaxis and subsequent immunisation uptake. Results Records for 3575 babies were examined. Ninety‐two per cent of infants received intramuscular, and 5% received oral vitamin K . An increased risk ratio for non‐immunisation of 14.1 (95% confidence interval 7.8–25.9) for babies whose parents declined vitamin K was identified. Receiving oral vitamin K was also associated with subsequent non‐immunisation, with a risk ratio of 3.5 (95% confidence interval 1.7–7.3). Conclusions Parents who decline newborn vitamin K are more likely to decline immunisation for their child. These parents, as well as those that elect for oral vitamin K , are a small but easily identifiable group to whom additional education about the benefits of immunisation could be offered. This is especially pertinent at a time when there is a resurgence of immunisation preventable diseases.
    Type of Medium: Online Resource
    ISSN: 1034-4810 , 1440-1754
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2007577-7
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  • 8
    Online Resource
    Online Resource
    BMJ ; 2017
    In:  BMJ Paediatrics Open Vol. 1, No. 1 ( 2017-09), p. e000160-
    In: BMJ Paediatrics Open, BMJ, Vol. 1, No. 1 ( 2017-09), p. e000160-
    Type of Medium: Online Resource
    ISSN: 2399-9772
    Language: English
    Publisher: BMJ
    Publication Date: 2017
    detail.hit.zdb_id: 2895377-0
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  • 9
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2010
    In:  Journal of Pharmacy and Pharmacology Vol. 61, No. 4 ( 2010-01-08), p. 465-471
    In: Journal of Pharmacy and Pharmacology, Oxford University Press (OUP), Vol. 61, No. 4 ( 2010-01-08), p. 465-471
    Abstract: This study aimed to investigate intravenous infusions as used in the neonatal intensive care setting, to determine the effect of gentamicin dose (mg), gentamicin concentrations (mg/ml), flow rate (ml/h) and flush volume (ml) upon the length of infusion time. Methods Intravenous infusions were set up to simulate administration of gentamicin to neonates. Dextrose (10%, w/v) was administered as the primary intravenous fluid at 3.8 or 18.7 ml/h. Gentamicin doses (0.5 mg/0.2 ml, 2 mg/0.2 ml, 2.5 mg/1.0 ml, or 10 mg/1.0 ml) were delivered into the intravenous line at a T-connection using a Graseby pump over 35 min. This was followed by a saline flush of 1 or 2 ml over a further 35 min. At the end of each experiment a 2 ml 0.9% saline bolus was given. Analysis of gentamicin collected at 5-min intervals was by an HPLC method. Key findings The experiment demonstrated that under the infusion conditions neonates weighing 2.5 kg would receive only 80% of the drug at 60 min, increasing to 90–95% by 75 min. In extremely low birth weight neonates (0.5 kg), even lower percentage of gentamicin recovery occurred. At 60 min only 60% of the intended gentamicin dose had been delivered and this increased to only 70% by 75 min. Conclusions The delivery of gentamicin administered by intravenous infusion is substantially extended in extremely low birth weight neonates. This appeared to be primarily due to the small volumes and low infusion rates used in these patients.
    Type of Medium: Online Resource
    ISSN: 0022-3573 , 2042-7158
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2010
    detail.hit.zdb_id: 2041988-0
    detail.hit.zdb_id: 2050532-2
    SSG: 15,3
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  • 10
    Online Resource
    Online Resource
    Wiley ; 1999
    In:  The Australian Journal of Hospital Pharmacy Vol. 29, No. 6 ( 1999-12), p. 321-327
    In: The Australian Journal of Hospital Pharmacy, Wiley, Vol. 29, No. 6 ( 1999-12), p. 321-327
    Type of Medium: Online Resource
    ISSN: 0310-6810
    Language: English
    Publisher: Wiley
    Publication Date: 1999
    detail.hit.zdb_id: 2576048-8
    SSG: 15,3
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