Predictors of nurturant parenting in teen mothers living in three generational families

Direct and indirect effects of grandparents on maternal nurturance in teen mothers (TM) living in three-generational families were explored with path analytic techniques in a sample of 107 working-class families. Perceived support from the teen's mother, grandparents' nurturance toward the baby, and the presence of the grandfather as a father figure in the home were hypothesized as increasing TM nurturance. TM nurturance was found to be positively predicted by grandparent nurturance and negatively predicted by TM perceived support from her mother. The strongest predictor of TM nurturance was grandfather nurturance toward the baby.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43953/1/10578_2006_Article_BF02353198.pd

Use of dexmedetomidine to facilitate extubation in surgical intensive-care-unit patients who failed previous weaning attempts following prolonged mechanical ventilation: A pilot study

INTRODUCTION: Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist that exhibits sedative, analgesic, anxiolytic, and sympatholytic effects without respiratory-drive depression. We prospectively evaluated the use of dexmedetomidine to facilitate the withdrawal of mechanical ventilation and extubation in 5 trauma/surgical intensive-care-unit patients who had failed previous weaning attempts due to agitation and hyperdynamic cardiopulmonary response. METHODS: Intravenous infusion of dexmedetomidine commenced at 0.5 or 0.7 mu g/kg/h without a loading dose. Background sedation and analgesia with propofol, benzodiazepines, and opiates was discontinued or reduced as tolerated. Dexmedetomidine infusion was titrated between 0.2 and 0.7 mu g/kg/h to maintain a stable cardiopulmonary response and modified Ramsay Sedation Score between 2 and 4. RESULTS: Following dexmedetomidine administration, propofol infusion was weaned and discontinued in 4 patients. In the fifth patient, benzodiazepine and opiate infusions were reduced. Ventilatory support in all patients could be weaned to continuous positive airway pressure of 5 cm H2O without agitation, hemodynamic instability, or respiratory decompensation. All patients were extubated while receiving dexmedetomidine infusion (mean dose of 0.32 +/- 0.08 mu g/kg/h). One patient required reintubation for upper-airway obstruction. CONCLUSION: Dexmedetomidine appears to maintain adequate sedation without hemodynamic instability or respiratory-drive depression, and thus may facilitate extubation in agitated difficult-to-wean patients; it therefore deserves further investigation toward this novel use