Warming Infant Feeds: What is the Evidence and What are the Questions?

Warming of infant feedings is a common practice in every neonatal intensive care unit (NICU). This has become a focus of practice based on the need to warm frozen or refrigerated milk. The temperature to which feeds should be warmed is debated. Literature regarding warming of feeds is available but sparse. This article will present and discuss the status of research to support warming of feeds and to what temperature. The effect of milk warming on the infant and on the milk as currently known will also be discussed with recommendations for further research and practice recommendations in the interim.     

What is quality, who wants it, and why?

The health services literature is replete with examples of the failure of total quality management to produce significant change in organizational performance. Some authors suggest that incremental quality improvement be abandoned in favor of structural reengineering. However, these naysayers ignore the critical impact of environmental change, managed care, and customer service as primary organizational drivers that demand an enhanced focus on continuous quality improvement. Coupled with these factors is the movement towards the creation of learning organizations. At the core of any learning organization is a commitment to quality and the empowerment of employees to identify and improve quality.     

What is empathy, and can empathy be taught?

Empathy is a commonly used, but poorly understood, concept. It is often confused with related concepts such as sympathy, pity, identification, and self-transposal. The purposes of this article are to clearly distinguish empathy from related terms and to suggest that the act of empathizing cannot be taught. According to Edith Stein, a German phenomenologist, empathy can be facilitated. It also can be interrupted and blocked, but it cannot be forced to occur. What makes empathy unique, according to Stein, is that it happens to us; it is indirectly given to us, "nonprimordially." When empathy occurs, we find ourselves experiencing it, rather than directly causing it to happen. This is the characteristic that makes the act of empathy unteachable. Instead, promoting attitudes and behaviors such as self-awareness, nonjudgmental positive regard for others, good listening skills, and self-confidence are suggested as important in the development of clinicians who will demonstrate an empathic willingness.     

What is ventilator-associated pneumonia and why is it important?

Hospital-associated pneumonia (HAP) is one of the most common infections acquired among hospitalized patients. HAP is associated with excess mortality and increased medical care costs. The rise in HAP due to antibiotic-resistant bacteria has resulted in more common administration of inappropriate antimicrobial treatment, with an associated increased risk of hospital mortality. Ventilator-associated pneumonia (VAP) refers to HAP occurring in patients requiring mechanical ventilation. VAP is the most common nosocomial infection among patients with acute respiratory failure. Physicians treating patients with HAP and VAP should be aware of the predominant local pathogens associated with these infections and their antimicrobial susceptibility patterns. This will allow more appropriate initial antibiotic selection in order to optimize treatment regimens and clinical outcomes. Additionally, clinical strategies aimed at the prevention of HAP and VAP should be employed in all hospital settings caring for patients at risk for these infections.     

What is and who created chiropractic massage?

Even though many massage techniques are called chiromassage, this term must be used to describe a technique created by its inventor, Dr. Ferrándiz, who based on knowledge from German, Swiss and Oriental techniques, developed his own technique and in order to differentiate it from other techniques, gave it the name chiro-meaning hand-massage; which is to say massage using hands, without the use of any apparatus. Once this clarification has been made, the author analyzes the parts which compose a good chiromassage: 1) preparatory exercises: exploration, initial contact, magnetic sedative passes, etc. 2) kneading: in order to distort and elongate muscle fibers, 3) specific exercises: distinct one for each individual case, and 4) finalizing exercises: vibrations, drumming with one's fingers, venal drainage and magnetic sedative passes.     

What is Fatigue? Pathological and Nonpathological Fatigue

Aid in understanding issues surrounding the construct validity of fatigue including the distinction between pathological versus nonpathological fatigue. Fatigue is a universal symptom reported by individuals in the general population as well as by those suffering from different medical and psychological illnesses, including cancer, multiple sclerosis, chronic fatigue syndrome, depression, and anxiety. Chronic fatigue is a significant problem in many primary care settings, and the debilitating and prolonged nature of fatigue can pose significant economic consequences for society. Researchers have struggled to better assess and understand the etiology and classification of fatigue within different illness groups.     

What is qi?

At a conference of practitioners and scholars of Chinese Medicineheld in Australia recently, it was reported that China has,in recent decades, spent an inordinate amount of resources onexperiments to determine the existence and nature of Qi. Thenub of the report was that China is easing up on this research.The veracity of the claim that these experiments are slowingdown for lack of concrete breakthroughs is not confirmed inthis article. The quest to define Qi continues, with there beingno breakthroughs that we know of.