Aerosol delivery to ventilated newborn infants: historical challenges and new directions

There are several aerosolized drugs which have been used in the treatment of neonatal respiratory illnesses, such as bronchodilators, diuretics, and surfactants. Preclinical in vitro and in vivo studies identified a number of variables that affect aerosol efficiency, including particle size, aerosol flows, nebulizer choice, and placement. Nevertheless, an optimized aerosol drug delivery system for mechanically ventilated infants still does not exist. Increasing interest in this form of drug delivery requires more controlled and focused research of drug/device combinations appropriate for the neonatal population. In the present article, we review the research that has been conducted thus far and discuss the next steps in developing the optimal aerosol delivery system for use in mechanically ventilated neonates

Maintaining nutrition in aged care residents with a train-the-trainer intervention and nutrition coordinator

Objective: To investigate the impact of a train-the-trainer program on the nutritional status of older people in residential care. ----- Design: Prospective, randomized controlled study. Setting: Eight nursing homes in Southeast Queensland, Australia. ----- Participants: A total of 352 residents participated - 245 were female (69.6%). The mean age was 84.2 years and the majority (79.4%) were classified as high dependency. ----- Intervention: Residents from four nursing homes were randomly selected for a nutrition education program coordinated by Nutrition Coordinators. Residents from the other four nursing homes (control) received usual care. ----- Measurements: The Subjective Global Assessment was used to determine prevalence of malnutrition at baseline and six months post intervention. The Resident Classification Scale measured functional dependency. Prescribed diet, fluids, oral hygiene status and allied health referrals were obtained by chart audit. ----- Results: Approximately half the residents were well nourished with 49.4% moderately or severely malnourished. Residents in the intervention group were more likely to maintain or improve their nutritional status compared with the control group who were more likely to experience a deterioration (P=0.027). The odds of the control group being malnourished post test was 1.6 times more likely compared with the intervention group but this did not reach statistical significance (P=0.1). ----- Conclusion: The results of the study encourage the implementation of a Nutrition Coordinator program to maintain nutritional status of aged care residents. Nevertheless, malnutrition rates continue to be unacceptably high. In a rapidly aging society, the aged care sector needs to confront malnutrition and provide better resources for staff to take measures against this problem

San Andreas and the Spiralling of the Analogico–Digital Animated Image

© 2017, © The Author(s) 2017. This article considers the contemporary state of mainstream Hollywood cinema as a profoundly animation-driven form of spectacular entertainment characteristic of global digital media in the era of what Bernard Stiegler calls hypercapitalism. With reference to the work of Esther Leslie, Dick Tomasovic and Stiegler, the author develops a critical account of what Leslie calls the ‘petrified unrest’ evident in the deployment of animation techniques and technologies in contemporary mainstream film and media through analysis of the recent Hollywood blockbuster, San Andreas (dir. Brad Peyton, 2015). This film’s big budget, spectacle-driven narrative and extensive deployment of the latest digital ‘motion design’ tools qualifies it as an exemplary instance of the paradoxical form of contemporary mainstream digital cinema, one which is both innovative and utterly conventional at the same time in Leslie’s account. The author elaborates what Stiegler describes as the spiralling instability of the current, hypercapitalist dynamic in which this paradoxical but ultimately unsustainable ‘petrified unrest’ manifests as a disorienting experience of technological and cultural transformation. For it is only in coming to terms with the profound connections between technological and cultural becoming that the potential can be found to move on from this disorienting condition of digital transformation under the prevailing hypercapitalist mode animating what Leslie terms our ‘dreamt reality’