National audit of neonatal care reveals more positive experiences, but variations remain in key health outcomes for newborns, UK

Main Category: Pediatrics / Children's Health
Article Date: 19 Aug 2013 - 2:00 PDT Current ratings for:
National audit of neonatal care reveals more positive experiences, but variations remain in key health outcomes for newborns, UK

More than three quarters (79%) of the parents of babies in neonatal units are seen by senior healthcare professionals within 24 hours of admission and the majority of parents report positive experiences, but there is room for improvement in areas such as breastfeeding rates and levels of hypothermia in newborns, according to the 6th Annual National Neonatal Audit Programme 2012 (NNAP). The report is published today by the Royal College of Paediatrics and Child Health (RCPCH).

Commissioned by the Health Quality Improvement Partnership (HQIP), the audit measures neonatal units against a series of standards in order to assess if babies receive the right level and consistency of care across England and Wales.

The audit, which assessed 97% of English and Welsh units during 2012, found that:

79% of the parents of babies in neonatal units were seen by senior healthcare professionals within 24 hours of admission.57% of preterm babies born more than 7 weeks early were still receiving some of their mother's breast milk when discharged home. However just 33% of the babies were exclusively breast fed.90% of premature babies born 12 or more weeks early had their temperature recorded within an hour of birth - but 40% had a temperature less than 36.5oC.

Dr Mike Watkinson, RCPCH Project Lead for the National Neonatal Audit Programme, said:

"There is much to be positive about in this audit, with standards of care improving in many areas over the last five years. Data recording is also becoming more accurate and complete.

"But there is variation between units and neonatal networks in areas such as breastfeeding rates - something which we need to explore further to see how the moderately performing can be helped to match the best. It's also concerning that some trusts fail to record key data on every patient: this not only makes it a challenge to get a true national picture, but can under-estimate their own performance."

The audit also included a pilot of a confidential parent questionnaire, which showed that parents were satisfied with the level of involvement in their baby's care:

85% said they were 'always or nearly always' told about changes to their baby's condition or care79% said staff arranged their baby's care (such as weighing, bathing etc) to fit in with usual visiting times73% said doctors and nurses 'always or nearly always' involved them in discussions about their baby's care85% said they were 'definitely' involved as much as they wanted in the day-to-day care of their baby i.e. nappy changing

Dr Watkinson added:

"It's encouraging that the majority of parents in this pilot survey are happy with the standard of care their babies receive, but there are always improvements to make - and as we've identified with breastfeeding rates, more can be done to ensure health outcomes for these babies are even better."

In addition to the printed version of the audit, there will be an online resource highlighting examples of best practice which all units and the public can access.

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Near-death experiences are 'electrical brain surges'

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Academic Journal
Main Category: Neurology / Neuroscience
Also Included In: Cardiovascular / Cardiology
Article Date: 14 Aug 2013 - 0:00 PDT Current ratings for:
Near-death experiences are 'electrical brain surges'

Many people worldwide have reported 'near-death experiences' - particularly following a heart attack. But what causes the visions and perceptions that these survivors report after their brush with death? Scientists from the University of Michigan believe they have found the answer.

A near-death experience (NDE) is defined as a psychological event that occurs when a person is close to death.

Reported circumstances of a NDE, from the educational nonprofit the International Association for Near-Death Studies, include vivid perceptions of movement, light, darkness, encounters with deceased loved ones, encounters with spiritual presences or entities, and some people talk of an "out-of-body experience."

According to the researchers in the Michigan study, around 20% of cardiac arrest survivors have reported a NDE. However, they add that although these experiences have been described as "realer than real," it has been unclear as to whether the brain is able to produce these senses during clinical death.

Jimo Borjigin, who holds associate professorships in molecular and integrative psychology, and in neurology at the University of Michigan Medical School, says:

"We reasoned that if near-death experience stems from brain activity, neural correlates of consciousness should be identifiable in humans or animals even after the cessation of cerebral blood flow."

The researchers analyzed the recordings of brain activity, electroencephalograms (EEGs), of nine anesthetized rats as they were in the midst of induced cardiac arrest.

Researchers found that during near-death experiences, there is an electrical surge of brain activity

The study, published in the journal Proceedings of the National Academy of Sciences, revealed that following clinical death - when the heart stops beating and blood stops flowing to the brain, the rats showed brain activity patterns similar to "conscious perception."

Within the first 30 seconds of a cardiac arrest, all rats showed a widespread electrical surge of transient brain activity, which had characteristics similar to a fully active brain.

Additionally, when the rats were undergoing asphyxiation - death from lack of oxygen, they showed almost identical brain patterns.

George Mashour, assistant professor of anesthesiology and neurosurgery at the University of Michigan, explains:

"We were surprised by the high levels of activity. In fact, at near-death, many known electrical signatures of consciousness exceeded levels found in the waking state, suggesting that the brain is capable of well-organized electrical activity during the early stage of clinical death."

Borjigin adds: "This study tells us that reduction of oxygen, or both oxygen and glucose, during cardiac arrest can stimulate brain activity that is characteristic of conscious processing."

The study authors say that previously, it was assumed the brain was inactive during cardiac arrest, but this is the first time the neurophysiological state of the brain has been systemically investigated.

The researchers say their findings provide the first scientific framework for the near-death experiences reported by many cardiac arrest survivors.

"This study, performed in animals, is the first dealing with what happens to the neurophysiological state of the dying brain," Borjigin says.

"It will form the foundation for future human studies investigating mental experiences occurring in the dying brain, including seeing light during cardiac arrest."

There have been previous reports from neurologists looking into near death experiences. Researchers from the University of Kentucky wrote in 2006 that when a person is experiencing clinical death, the same parts of the brain are activated as when a person is having a dream.

Written by Honor Whiteman

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posted by Janet Webber on 14 Aug 2013 at 2:44 pm

I have had a near death experience when I "broke down" into a state of being outside of my body. My mind was aware that it was an eternal, empty, black, void of complete and utter nothingness and it felt like a horrific scream. It lasted only seconds but I could fathom exactly what forever felt like. To this day I am scared of Hell, that place where my soul went, that is infinitely horrifying and real.

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'Near-death experiences are 'electrical brain surges''

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