Conclusions: Increasing fluid intake was the action most parents reported “always” taking when caring for a child with an ARI. Parents take their child to see a provider when they “just know” their child will not get better or when the child has discolored phlegm or discharge. Most reported reasons for not taking child to a provider were because the child got better on their own and they knew how to treat their child on their own. When seeing a provider for an ARI, parents considered it very important that the provider listen to the child's symptoms, examine their child for the cause of their symptoms, and provide symptom management advice. Parents expect providers to treat the ARI in one visit and allow for follow‐up by phone or e‐mail. Implications for practice: Nurse practit...

In this study, we have evaluated these features of the Finnish national susceptibility surveillance data for two respiratory tract pathogens, Streptococcus pneumoniae and Haemophilus influenzae. For this purpose internal quality control results for two isolates (S. pneumoniae ATCC 49619 and H. influenzae ATCC 49247) were analyzed from 21 clinical microbiology laboratories over a 3‐year period. The results show that standardization of the susceptibility testing methods has proceeded well. The number of protocols used for susceptibility testing has declined (from seventeen methods to two with S. pneumoniae and from eleven to three with H. influenzae) and the reproducibility is good. Nevertheless, we noticed that a few laboratories test and report susceptibility results without defined brea...

Purpose of review: Emerging data are raising concerns that patients with known or suspected obstructive sleep apnea (OSA) are at increased risk for a myriad of perioperative complications. Strategies to identify patients preoperatively with OSA, or at risk for OSA, are being advocated. In addition, approaches to identify patients most at risk for OSA-related postoperative complications have been described. While lacking solid evidence, a number of perioperative management strategies have been proposed for the care of these patients. Recent findings: Recent studies utilizing different methodologies have provided additional evidence regarding the impact that OSA can have on postoperative outcomes, including increased risk of difficult intubations, adverse pulmonary outcomes, and delirium. Tools, such as the STOP-Bang questionnaire and limited channel monitoring, have been investigated with regards to their utility to identify not only patients at risk for OSA but also those at risk for more severe OSA. Consensus-based guidelines for the perioperative care of OSA patients have recently been published. Summary: OSA is quite common in patients presenting for elective surgery and has been linked to increased perioperative complications. Attempts to identify these patients preoperatively appear prudent. Protocols on how best to manage these patients are available, although validation of their effectiveness is needed.

Purpose of review: To understand clinical characteristics and risk factors for cognitive impairment in patients with obstructive sleep apnea (OSA) syndromes. Recent findings: Primary snoring increases the risk of neurocognitive impairment and lower intelligence quotients in infants and children. Middle-aged adults with severe OSA are at greater risk for cognitive impairment than young adults with apnea of equal severity. Older women with OSA are at increased risk for minimal cognitive impairment or dementia, 5 years later. Summary: Certain age groups (younger and older) are particularly susceptible to the negative effects of OSA on cognition. Other influences that increase the risk for cognitive dysfunction in OSA include premature birth, apolipoprotein e4 allele status and other genetic polymorphisms, lower socioeconomic status, fewer years of education, and ethnicity.