scholarly journals What is the significance of hearing a heart murmur during the newborn physical examination?

2021 ◽  
Vol 29 (3) ◽  
pp. 158-170
Author(s):  
Helen Louise Seignior
Keyword(s):  
Literature Review ◽  
Physical Examination ◽  
Newborn Screening ◽  
Pulse Oximetry ◽  
Research Question ◽  
Signs And Symptoms ◽  
Optimal Timing ◽  
Heart Murmur ◽  
The Uk ◽  
Critical Literature

Background Newborn screening for congenital heart disease (CHD) forms part of the newborn physical examination (NPE) in the UK. However, research has shown that up to 50% of cases of CHD can be missed by this examination. The purpose of this literature review is to investigate the significance of hearing an asymptomatic heart murmur at the NPE in relation to the presence of CHD. Methodology A critical literature review was conducted to answer the research question. The findings were discussed using a narrative synthesis approach. Findings There was considerable heterogeneity of results. The prevalence of murmur in newborns ranged between 0.6%–10.7%. Between 13%–67% of those newborns had some form of CHD, although many had clinically insignificant lesions. Between 2%–9% of newborns with murmurs had a form of critical CHD (CCHD). The ability to discern whether a heart murmur relates to pathology or not improves with experience. No single optimal timing for the NPE was identified. Pulse oximetry was shown to increase sensitivity of screening for CCHD. Conclusion There is a significant increase in the prevalence of CHD when a newborn has a heart murmur, hence referral for diagnostic echocardiography is required when a heart murmur is identified. Pulse oximetry is an important adjunct to newborn screening for CCHD. Some newborns affected by CCHD will not present with murmur at the NPE. Therefore, those caring for newborns during the early days must know the signs and symptoms of CHD so that appropriate medical assistance can be sought.

Synchronization in Strategic Planning: A Roadmapping Framework

2019 ◽  
Vol 16 (06) ◽  
pp. 1950044 ◽  
Author(s):  
Sukrit Vinayavekhin ◽  
Robert Phaal
Keyword(s):  
Strategic Planning ◽  
Literature Review ◽  
Case Studies ◽  
Multinational Firms ◽  
Research Question ◽  
Process Approach ◽  
The Uk

The research question is “How can firms approach synchronization in strategic planning?”, aiming to investigate opportunities for improved synchronization within strategic planning. The focus is on roadmapping, as a relatively simple, flexible and widely used method that includes time as an explicit dimension. The adopted methodology is a process approach, consisting of literature review, exploratory interviews, practitioner interviews, and case studies with large multinational firms based in the UK that are familiar with roadmapping. As a result, four types of synchronization have been identified and discussed, including generic forms of each type, illustrated with industrial examples from the case studies.

scholarly journals First-Year Outcomes of Critical Congenital Heart Disease Screening in Maryland

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986822
Author(s):  
Deborah Badawi ◽  
Johnna Watson ◽  
Steven Maschke ◽  
Lawrence Reid
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Newborn Screening ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Year ◽  
Critical Congenital Heart Disease ◽  
Pulse Oximetry Screening

Objectives. Newborn screening for critical congenital heart disease (CCHD) was added to the Recommended Uniform Screening Panel in 2011, and states have been gradually adding pulse oximetry as point-of-care screening to panels. Few data are available on the effectiveness of pulse oximetry as a mandated screening. This study describes outcomes of the first year of screening in Maryland. Methods. A web-based data collection tool for screening results and outcomes, eScreener Plus, was utilized. Data collected from the start of screening from September 1, 2012, to December 31, 2013, were analyzed. Well-baby nursery data were evaluated separately from neonatal intensive care unit (NICU) data to determine whether setting influenced effectiveness. Results. In the first 15 months of newborn screening for CCHD in Maryland, 4 asymptomatic infants were diagnosed with a critical cardiac condition by newborn screening. Eleven infants passed but were later identified with a primary or secondary target condition. Seventy-one percent of infants with CCHD were identified prenatally or by clinical signs and symptoms. Pulse oximetry screening for CCHD had a specificity of more than 99% in both the well-baby nursery and the NICU. Sensitivity in the well-baby nursery was 10% and 60% in the NICU. Conclusion. Further investigation and interpretation of specific protocols that were used and outcomes of screening is needed for continued refinement of the well-baby algorithm and NICU protocol development. Pulse oximetry screening in newborns provides valuable clinical information, but many infants with CCHD are still not identified with current protocols.

scholarly journals The Legal Critical Literature Review

2015 ◽  
Author(s):  
Muhammad Nuruddeen
Keyword(s):  
Literature Review ◽  
Literature Search ◽  
Research Question ◽  
Central Research ◽  
Research Gaps ◽  
Literature Reviews ◽  
Key Terms ◽  
Critical Literature ◽  
The Ideal

This paper explains the legal critical literature review in the critical context of the logic of scholarship. The paper asks what makes a critical literature review effective in research. It suggests that critical literature reviews are effective in research when they more easily allow the identification of research gaps, in the specified context. The methodology employs cumulative synthesis from the relevant materials, following Bentham’s ideas on synthesis, that analysis opposes both generalization and synthesis. The paper begins its argument by outlining the nature of a critical literature review. Then, it proceeds with a review of key terms required by the writer. Following this essential background, the paper discusses literature gaps and literature search methodologies. Then it moves on to the ideal format of a critical literature review. Finally, argument deals with the purpose of a critical literature review and techniques for writing the critical literature review. A legal critical literature review will be maximally effective when it sets a correct context for research, identifies fallacies in the scholarship in order to discover research gaps, and then forms this outcome into a central research question. Keywords: legal critical literature review, research gaps, fallacies, research question.

scholarly journals Sudden irreversible hearing loss post COVID-19

2020 ◽  
Vol 13 (11) ◽  
pp. e238419 ◽  
Author(s):  
Foteini Stefania Koumpa ◽  
Cillian T Forde ◽  
Joseph G Manjaly
Keyword(s):  
Hearing Loss ◽  
Intensive Care ◽  
Literature Review ◽  
Physical Examination ◽  
Care Setting ◽  
Causative Factor ◽  
Sudden Onset ◽  
Intensive Care Setting ◽  
Early Course ◽  
The Uk

Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.

scholarly journals Microfinance institutions' failure to address poverty: A narrative critical literature review

2017 ◽  
Vol 14 (1) ◽  
pp. 79
Author(s):  
Sigurður Guðjónsson
Keyword(s):  
Corporate Governance ◽  
Literature Review ◽  
Poverty Reduction ◽  
Social Performance ◽  
Research Question ◽  
Microfinance Institutions ◽  
Line Searches ◽  
And Performance ◽  
Dual Performance ◽  
Critical Literature

This critical literature review begins by giving a short introduction to the microfinance industry. Microfinance institutions (MFIs) are explained and an account is given of their dual performance goals of financial performance (‘financial sustainability’) and social performance (‘outreach’). While MFIs’ social performance is directly aimed at poverty reduction, it is noteworthy that often they fail to address poverty (i.e., they fail to deliver outreach). The aim of the paper is to answer the following research question: Why have microfinance institutions (MFIs) failed to address poverty? In order to establish the reason, the first step is to look at how the MFIs are managed and controlled, i.e. to examine MFIs’ corporate governance literature. This critical literature review was conducted using systematic on-line searches in the databases Scopus and Web of Knowledge; the main key words used were microfinance, gender, corporate governance and performance. The unconvincing nature of the findings of a review of the corporate governance literature suggests that another factor should be taken into consideration: that of gender; after all, MFIs are mainly used by women. The findings from reviewing the microfinance literature suggests that microfinance gender literature may explain why MFIs have not adequately addressed poverty, but this literature consists of a few studies only and further studies are needed. The literature on gender in general is more substantial, however. Some account of it will be given in this literature review. The findings of this literature review should benefit policymakers on the one hand, who are in a position to advance gender equality, while on the other hand it should be of use to academics, who can research MFIs in relation to gender; further studies of gender in MFIs are encouraged.

Risk Transferin Public Private Partnership/Private Finance Initiative Procurement Documents:The Differencebetween The United Kingdom and Malaysia

2016 ◽  
Vol 4 (4) ◽  
pp. 30
Author(s):  
Nooriha Abdullah ◽  
Darinka Asenova ◽  
Stephen J. Bailey
Keyword(s):  
United Kingdom ◽  
Public Procurement ◽  
Research Question ◽  
Public Private Partnership ◽  
Private Finance Initiative ◽  
Private Partnership ◽  
Risk Transfer ◽  
Private Finance ◽  
The United Kingdom ◽  
The Uk

The aim of this paper is to analyse the risk transfer issue in Public Private Partnership/Private Finance Initiative (PPP/PFI) procurement documents in the United Kingdom (UK) and Malaysia. It utilises qualitative research methods using documentation and interviews for data collection. The UK documents (guidelines and contracts) identify the risks related to this form of public procurement of services and makeexplicittheappropriateallocation of those risks between the public and the private sector PPP/PFI partners and so the types of risks each party should bear. However, in Malaysia, such allocation of risks was not mentioned in PPP/PFI guidelines. Hence, a question arises regarding whether risk transfer exists in Malaysian PPP/PFI projects, whether in contracts or by other means. This research question is the rationale for the comparative analysis ofdocumentsand practicesrelatingtorisk transfer in the PPP/PFI procurements in both countries. The results clarify risk-related issues that arise in implementing PPP/PFI procurement in Malaysia, in particular how risk is conceptualised, recognised and allocated (whether explicitly or implicitly), whether or not that allocation is intended to achieve optimum risk transfer, and so the implications forachievement ofvalue for moneyor other such objectivesinPPP/PFI.

Odontoid cervical gout causing atlantoaxial instability: case report

2019 ◽  
Vol 30 (4) ◽  
pp. 541-544
Author(s):  
Justin Slavin ◽  
Marcello DiStasio ◽  
Paul F. Dellaripa ◽  
Michael Groff
Keyword(s):  
Rheumatoid Arthritis ◽  
Spinal Cord ◽  
Case Report ◽  
Physical Examination ◽  
Odontoid Process ◽  
Signs And Symptoms ◽  
Cord Compression ◽  
Atlantoaxial Instability ◽  
Posterior Stabilization ◽  
Rotatory Subluxation

The authors present a case report of a patient discovered to have a rotatory subluxation of the C1–2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process eventually proving to be caused by gout. This patient represented a diagnostic conundrum as she had known prior diagnoses of not only gout but also sarcoidosis and possible rheumatoid arthritis, and was in the demographic range where concern for an oncological process cannot fully be ruled out. Because she presented with signs and symptoms of atlantoaxial instability, she required posterior stabilization to reduce the rotatory subluxation and to stabilize the C1–2 instability. However, despite the presence of a large retroodontoid pannus, she had no evidence of spinal cord compression on physical examination or imaging and did not require an anterior procedure to decompress the pannus. To confirm the diagnosis but avoid additional procedures and morbidity, the authors proceeded with the fusion as well as a posterior biopsy to the retroodontoid pannus and confirmed a diagnosis of gout.

Critical Review of K-12 Filipina/o American Curriculum

2009 ◽  
Vol 7 (1) ◽  
pp. 1-24 ◽  
Author(s):  
Patricia Halagao ◽  
Allyson Tintiangco-Cubales ◽  
Joan Cordova
Keyword(s):  
Literature Review ◽  
Critical Pedagogy ◽  
Historical Development ◽  
Research Study ◽  
Application Development ◽  
Theoretical Frameworks ◽  
Curricular Content ◽  
K 12 ◽  
Pedagogical Approaches ◽  
Critical Literature

This research study provides the first comprehensive and critical literature review of K–12 Filipina/o American curricula found in formal and informal educational settings. Thirty-three Filipina/o American curricula representing a diverse array of authors, audiences, content, and pedagogical approaches were reviewed. The authors of this study developed a “Critical Framework of Review” rooted in critical pedagogy in order to analyze the historical development of Filipina/o American curricula along with an analysis of major topics, concepts, guiding theoretical frameworks, pedagogical approaches, and outcomes. The review concludes with a discussion and summary of the overarching themes of Filipina/o curricular content, instruction, and impact gained from this study and recommendations for the application, development, distribution, and research of more Filipina/o American K–12 curriculum resources.

scholarly journals Keeping Dairy Cows for Longer: A Critical Literature Review on Dairy Cow Longevity in High Milk-Producing Countries

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 808
Author(s):  
Gabriel M. Dallago ◽  
Kevin M. Wade ◽  
Roger I. Cue ◽  
J T. McClure ◽  
René Lacroix ◽  
...  
Keyword(s):  
Literature Review ◽  
Dairy Cow ◽  
Animal Health ◽  
Current Status ◽  
Dairy Farmers ◽  
Age At First Calving ◽  
Productive Life ◽  
Use Of Resources ◽  
Animal Remains ◽  
Critical Literature

The ability of dairy farmers to keep their cows for longer could positively enhance the economic performance of the farms, reduce the environmental footprint of the milk industry, and overall help in justifying a sustainable use of animals for food production. However, there is little published on the current status of cow longevity and we hypothesized that a reason may be a lack of standardization and an over narrow focus of the longevity measure itself. The objectives of this critical literature review were: (1) to review metrics used to measure dairy cow longevity; (2) to describe the status of longevity in high milk-producing countries. Current metrics are limited to either the length of time the animal remains in the herd or if it is alive at a given time. To overcome such a limitation, dairy cow longevity should be defined as an animal having an early age at first calving and a long productive life spent in profitable milk production. Combining age at first calving, length of productive life, and margin over all costs would provide a more comprehensive evaluation of longevity by covering both early life conditions and the length of time the animal remains in the herd once it starts to contribute to the farm revenues, as well as the overall animal health and quality of life. This review confirms that dairy cow longevity has decreased in most high milk-producing countries over time and its relationship with milk yield is not straight forward. Increasing cow longevity by reducing involuntary culling would cut health costs, increase cow lifetime profitability, improve animal welfare, and could contribute towards a more sustainable dairy industry while optimizing dairy farmers’ efficiency in the overall use of resources available.

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