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BACKGROUND: To determine the association of placental pathologic lesions with postoperative outcomes, survival, and white matter injury (WMI) in preterm infants with NEC. METHODS: A retrospective chart review of 107 neonates with NEC (Bell stage > IIa) from Jan 2013- June 2020 was completed. Demographic, clinical, and outcome data were compared between infants with or without placental pathologic lesions. RESULTS: In this cohort, 59/107 (55%) infants had medical NEC, and 48 (45%) had surgical NEC. The infants had a mean gestational age of 28.1±3.7 weeks and a birth weight of 1103±647 g. Maternal vascular malperfusion (82/107, 76.6%) and acute histological chorioamnionitis (42, 39.3%) were the most common pathological placental lesions. Acute histologic chorioamnionitis with fetal inflammatory response was more common in infants with surgical NEC vs. medical NEC (35.4% vs. 15.3%; p = 0.02). The NEC Infants with WMI on brain MRI scans had a significantly higher incidence of acute histological chorioamnionitis (52% vs. 27.8%; P = 0.04). No significant differences in mortality, length of stay and postoperative outcomes in neonates with and without acute histologic chorioamnionitis with fetal inflammatory response were noted. On unadjusted logistic regression, acute histologic chorioamnionitis without fetal inflammatory response was also associated with higher odds of WMI (OR 2.81; 95% CI 1.05–7.54; p = 0.039). CONCLUSION: Acute histological chorioamnionitis without fetal inflammatory response was associated with higher odds of WMI in infants with NEC, with no significant impact on mortality and other postoperative outcomes. [ABSTRACT FROM AUTHOR]

Several studies have demonstrated the potential of robots as assistive tools for play activities. Through the use of robots, children with motor impairments may be able to manipulate objects and engage in play activities as their typically developing peers, thus having the same opportunities to learn cognitive, social, motor and linguistic skills. Robot use can also provide a proxy measure of disabled children's cognitive abilities by comparing their performance with that of typically developing children. This paper reports a study with eighteen typically developing children aged three, four and five years to assess at which ages the cognitive concepts of causality, negation, binary logic, and sequencing are demonstrated during Lego robot use. [ABSTRACT FROM AUTHOR]

Robots have been widely used in rehabilitation. Among the various applications, robots have been developed to assist children with motor disabilities in play and academic activities. Several studies have shown the efficacy of these robotic tools, not only for allowing children to actively participate in the activities, with direct impact on the development of their cognitive, social, and linguistic skills, but also as a means to assess children's understanding of cognitive concepts, when standard tests cannot be used due to physical or language limitations. In this paper the use of robots for assistive play is reviewed from the perspectives of rehabilitation engineering and robot design, aiming at defining a set of desirable characteristics for such robots. Commercially available robots are then surveyed in comparison to the defined characteristics to evaluate to what extent they can be used as assistive robots for play, learning and cognitive development. [ABSTRACT FROM AUTHOR]

User experience (UX) theories, models, and frameworks (TMFs) help scope user-centered design activities, aid in the selection of constructs and measures, and contextualize findings within a larger knowledge base. However, the fragmentation of literature across disciplines and the inconsistent use of TMFs makes integrating concepts and selecting UX tools challenging. Therefore, we conducted a focused review of the healthcare literature to identify a succinct list of UX-specific TMFs for academic UX researchers and industry practitioners alike.

Theoretical models of technology acceptance are critical to scope projects, select interventions, and measure adoption. We describe use of the Effective Technology Use (ETU) model in the design and deployment of software supporting electronic consult management. We applied the model to four project phases: (1) needs assessment; (2) software design; (3) deployment; and (4) uptake assessment. In this paper, we describe how we used the ETU to plan stakeholder meetings, conduct usability simulations, and organize findings from a qualitative analysis to identify implementation facilitators and barriers.

Medication history errors are common at admission, but can be mitigated through the implementation of medication reconciliation (MR). We designed multi-media software to assist clinicians with collection of an admission history. This manuscript describes a naturalistic usability study conducted on the hospital wards. Our goals were to 1) estimate the impact of our workflow upon departmental productivity and 2) determine the ability of our software to detect discrepancies. We furnished clinical pharmacists with our application on a tablet PC and asked them to collect a bedside history. We used 1) time-motion analysis to estimate cycle-time and 2) chart reviews to estimate error detection rates. Our intervention detected an average of 7.7 discrepancies per admission (11.7 per pharmacy-shift). A panel rated 67% of these discrepancies as 'high' or 'very high' risk. The cycle-time per admission was slightly longer than usual care processes (20.5 min vs. 17.9 min), but included a bedside interview. In general, pharmacists agreed that the technology improved the completeness and accuracy of a medication history. However, workflow leveling strategies are important to implementing a durable process. In conclusion, a pharmacist-mediated, patient-centered technology holds promise for improving the quality of MR and overall clinical performance.

Internationally, major efforts are underway to improve medication safety and reduce medication errors during transitions of care. One strategy that has emerged to improve data accuracy and close information gaps is the introduction of software applications and workflow models that allow patients to review, enter, and modify their own patient data (e.g. information about medications they are taking). Evaluating the quality and effectiveness of such patient-facing healthcare applications is critical, especially when this approach is applied to high-stakes clinical tasks such as medication reconciliation. In this paper we describe an approach that has been used to assess the usability of a patient-facing medication reconciliation and allergy review (MRAR) kiosk. The phases involved are described along with implications and challenges of carrying out this work.

Much clinical information is computerised and doctors' use of mobile devices such as iPad tablets to access this information is expanding rapidly. This study investigated the use of iPads during ward rounds and their usefulness in providing access to information during ward rounds. Ten teams of doctors at a large teaching hospital were given iPads for ten weeks and were observed on ward rounds for 77.3 hours as they interacted with 525 patients. Use of iPads and other information technology devices to access clinical information was recorded. The majority of clinical information was accessed using iPads (56.2%), followed by computers-on-wheels (35.8%), stationary PCs (7.9%) and smartphones (0.1%). Despite having read-only access on iPads, doctors were generally happy using iPads on ward rounds. These findings provide evidence of the value of iPads as a tool to access information at the point of care.