Breaking bad news and the importance of compassionate palliative care of the infant

Bad news to parents regarding their infant is information that negatively impacts the parent’s feelings and view of the present and/or future. It is implemented in situations with feelings of no hope or those that induce a threat to a parent’s mental and physical well-being. The term is difficult to define as it is based on parent’s subjective feelings. However, it is important to be aware of the impact of bad news as it can cause severe anguish and stress on the parent’s emotional stability. The style of delivering bad news has a significant impact on the physician/parent relationship and the satisfaction of the family upon the healthcare team and palliative care system. In the case of an inevitable death of an infant, the implementation of palliative care follows the delivery of bad news. The strategy of palliative care and the philosophy of communication between the healthcare provider and family unit leave a lasting impression on the parents regarding the care of their infant. Clinicians should strive to educate themselves regarding the art of breaking bad news as well as the approach to palliative care to minimize the suffering and grief of the family in their time of sorrow

Term Neonate With Liver Laceration, Obstructive Uropathy, and Ascites—Secondary to Extravasation of Total Parenteral Nutrition

We report a rare, but serious, complication of a malpositioned umbilical venous catheter in a term male infant who developed laceration, hematoma, and necrosis of liver, ascites, and left-sided obstructive uropathy secondary to extravasation of total parenteral nutrition. Abdominal paracentesis confirmed the presence of parenteral nutrition in the peritoneal cavity. Although, the umbilical venous catheterization is a common intravenous access used in neonatal intensive care units, judicious continued monitoring of its use should be practiced to avoid serious complications

Restorative yoga therapy for third-year medical students in pediatrics rotation: Working to improve medical student well-being

BACKGROUND: Stress experienced by medical students is a well-documented and widespread phenomenon that may have physical and psychological effects on their well-being. One solution is to provide students with the tools to recognize and cope with stress. The aim of this study was to incorporate restorative yoga training—a well-recognized tool for stress reduction—in the third-year medical student pediatrics clerkship and assess the intervention's impact on students' well-being. MATERIALS AND METHOD: Restorative yoga, as a prospective intervention, was offered to third-year medical students at Texas Tech University Health Sciences Center during their pediatrics rotation. The study was between March and August 2020. Each yoga session lasted 45-minutes, once a week for six weeks. Participants completed anonymous questionnaires before and after the intervention via the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). RESULT: Over the six-month study period, 25 (71%) of 35 medical students, having been given the option, chose to participate. The WEMWBS contains 14 statements on well-being, and all but one from the list showed a positive increase in average rating from pre intervention to post intervention. The statements “I've been feeling more relaxed” and “I've been thinking clearly” showed the greatest average increase. Following Chi-squared testing, two statements were found to be significantly different (P < 0.05) before intervention and after intervention: “I've been feeling more relaxed” and “I've been feeling good about myself.” CONCLUSION: Students' well-being is paramount to medical schools. Restorative yoga offers hopeful outcomes for effective mitigation of the stresses of medical education and may be recommended for wider use

Why Are We Cutting? A Survey of Cultural Views on Circumcision in the Texas Panhandle

To determine the factors that may contribute to parents’ decision to circumcise their son in the Texas Panhandle region, voluntary surveys were distributed to all mothers with term male newborns during the mandatory discharge planning class. The father being circumcised ( P < .0001), Caucasian ( P < .05), and some graduate school of the caregiver ( P < .011) were factors most correlated with newborns being circumcised. Newborns of Hispanic origin, those having Medicaid insurance, and a Catholic affiliation were less likely to be circumcised. No significant correlations were found between circumcision and other ethnic affiliations, caregiver’s age, father’s involvement, and medical counseling. Of note, one third of caregivers were not counseled by a medical professional about circumcision. While the American Academy of Pediatrics Circumcision Policy Statement is clear that a neutral position must be maintained, this does not preclude having a discussion of the benefits versus the risks of circumcision