Introduction: Acute respiratory tract infections (ARTIs) are a major cause of morbidity and mortality in paediatric patients. Therefore, early detection of the viral aetiologies of ARTIs is essential for patient management and infection control. In this study, we evaluated the performance of a new multiplex polymerase chain reaction (PCR) assay (xTAG Respiratory Viral Panel [RVP] Fast v2) in the detection of respiratory viruses by comparing it with that of viral culture and direct immunofluorescence (IF) staining. Methods: Nasopharyngeal swab and aspirate samples were collected prospectively from 199 patients who presented with ARTIs at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia during a 10-month period. The PCR assay was conducted in parallel with conventional culture and direct IF staining methods. Results: The positive rate of the xTAG RVP Fast v2 assay (78.4%) in detecting respiratory viruses was higher than that of the viral isolation (7.5%) and direct IF (23.1%) methods. Using the xTAG RVP Fast v2 assay, human enterovirus/human rhinovirus (HEV/HRV) was the most frequently detected (46.2%). The xTAG RVP Fast v2 assay revealed mixed infection caused by two or three respiratory viruses in 40 specimens, and these were undetected by the viral isolation and direct IF methods. Conclusion: The xTAG RVP Fast v2 assay was superior to conventional methods in the identification of common respiratory viruses, with higher sensitivity and shorter turnaround times for laboratory results.

PURPOSE: The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. METHODS: A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. RESULTS: Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "postsigning relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". CONCLUSION: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.
Adolescent ; Adult ; Child ; Child, Preschool ; *Decision Making ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Middle Aged ; Palliative Care/*psychology ; Parents/*psychology ; *Professional-Family Relations ; Qualitative Research ; Resuscitation Orders/*psychology ; Taiwan ; Young Adult

OBJECTIVETo investigate the influence of the consistency of resin composite and insertion techniques on the homogeneity of the Class I restorations.

METHODSStandardized Class I cavities were prepared in polymethyl methyacrylate (PMMA) blocks and restored with three resin composites (Prodigy, Tetric EvoCeram and Tetric Ceram HB) using either a packing or an injection technique by six operators. Then the restorations were sectioned longitudinally and inspected for the presence of porosities and voids with microscope. The consistence of the three resins was tested using an area method.

RESULTSThere is little porosity in original resin. After insertion, large numbers of porosities were observed in restorations, with Tetric EvoCeram presented much more porosities (1137.1 +/- 365.0 for packing and 566.1 +/- 206.4 for injection) than Prodigy (241.0 +/- 116.1, 195.8 +/- 28.7) and Tetric Ceram HB (193.1 +/- 35.8, 156.3 +/- 33.0). Tetric Ceram HB showed the highest consistency, followed by Tetric EvoCeram and Prodigy. No linear correlation was found between the consistency of the composite and the porosity of their restorations. For Tetric EvoCeram, the restorations inserted with packing showed significant more porosity than that with injection. Contrastively, the restorations of Prodigy or Tetric Ceram HB presented no apparent difference for the two filling techniques.

CONCLUSIONSThe porosity in restoration was primarily created during the insertion. There was no linear correlation between the consistency of the composite and the porosity of their restorations. The porosity of composite resin is material-brand dependent. The influence of filling techniques on the porosity of restoration is depending on the composite used.

Composite Resins ; Dental Cavity Preparation ; methods ; Dental Restoration, Permanent ; methods ; Porosity