Just water for cleaning baby? A cross-sectional survey of the newborn skin cleansing practices of parents in the UK

Globally, 5–30% of children have eczema which could be partly attributable to skin cleansing routines. Evidence-based international guidance on this topic is lacking and dated national UK guidelines may not reflect best practices. We conducted a mixed method, UK-wide (England, Scotland, Northern Ireland and Wales) cross-sectional survey to investigate parental cleansing of their newborn's skin; 973 responses were suitable for inclusion. Sixty percent (60%) of participants delayed the first cleansing after birth for 48 h and 79.4% of participants cleansed their newborn's nappy area with each change. Participants from Scotland were more likely to cleanse their newborn within the first 48 h (X₂² = 29.3, p < 0.001) and then cleanse more frequently (X₂⁴ = 14.51, p < 0.006) than those in England and Wales. 59.7% of participants used water alone for cleansing their newborn's body. Further research is needed into the appropriateness and effectiveness of parents' newborn skin cleansing practices and influences on their decision-making.     

To be vaccinated or not? A survey of Turkish emergency physicians regarding smallpox

We investigated Turkish emergency physicians' opinions about the threat of smallpox, smallpox vaccination, and the treatment of patients with suspected smallpox, and sought to identify factors that affect willingness to receive smallpox vaccination. Anonymous surveys were sent by mail to university-affiliated Emergency Departments in Turkey. Ten of the 21 university-based Emergency Medicine programs participated in the study, and 125 physicians (48% of all emergency physicians in Turkey) completed the survey. The probability of a bioterror attack using smallpox within Turkish borders was viewed as none or minimal by 43.2% of participants. Only 22.4% of the participants stated that they would agree to be vaccinated. The only factor that affected the rate of participants' willingness to receive smallpox vaccination was the occurrence of a smallpox case within Turkish borders. Decisions about the treatment of patients with suspected smallpox are strongly influenced by whether or not the physician has been vaccinated against smallpox. At the time of the survey, even during the weeks leading up to and during the war in Iraq, Turkish emergency physicians' perceived risk of a bioterror attack using the smallpox virus was low. A significant number of Turkish emergency physicians were unwilling to participate in a hypothetical vaccination program. This study shows that the occurrence of a smallpox case within Turkish borders would significantly increase the willingness of emergency physicians to receive the smallpox vaccine. Decisions about treatment of patients with suspected smallpox are strongly influenced by whether or not the physician has been vaccinated against smallpox.     

To plug or not to plug?

Coronary artery disease remains a common problem in industrialized countries. Percutaneous coronary interventions are usually performed utilizing the femoral approach. Arterial puncture-closing devices have been developed in hope to avoid manual compression and shortening the period of rest. In a recent meta-analysis in the Journal of the American Medical Association these devices have shown only marginal benefits over manual compression. Further, well designed studies are necessary to document the comparative effects of these devices versus manual compression.     

To pump or not to pump?

Coronary artery bypass grafting is performed on the beating heart and thus requires the use of cardiopulmonary bypass. To avoid the complications associated with cardiopulmonary bypass, off-pump bypass (OPB) is viewed as a desirable alternative. Technological advancements have made OPB a viable option in an expanding population of patients. As a result, the number of OPB surgeries performed annually in the United States has increased. Critical care nurses are increasingly likely to provide care for patients after off-pump surgery. The differences between on-pump and OPB surgeries affect the postoperative nursing care requirements. While there are many common aspects of postoperative cardiac care for these 2 groups of surgical patients, there is a need to focus on the unique aspects of care for OPB patients. Despite promising short-term results in OPB patients, questions surrounding this procedure remain. Studies are under way to determine long-term graft patency.