The objectives of the study were to evaluate the psychometric properties and appropriateness of instruments for the study of resilience in adolescents. A search was completed using the terms resilience and instruments or scales using the EBSCO database (CINAHL, PreCINAHL, and Academic Search Premier), MEDLINE, PsychINFO and PsychARTICLES, and the Internet. After instruments were identified, a second search was performed for studies reporting the psychometric development of these instruments. Using inclusion and exclusion criteria, six psychometric development of instrument studies were selected for a full review. A data extraction table was used to compare the six instruments. Two of the six instruments (Baruth Protective Factors Inventory [BPFI] and Brief-Resilient Coping Scale) lacked evidence that they were appropriate for administration with the adolescent population due to lack of research applications. Three instruments (Adolescent Resilience Scale [ARS], Connor-Davidson Resilience Scale, and Resilience Scale for Adults) had acceptable credibility but needed further study in adolescents. One instrument (Resilience Scale [RS]) was determined to be the best instrument to study resilience in the adolescent population due to psychometric properties of the instrument and applications in a variety of age groups, including adolescence. Findings of this review indicate that the RS is the most appropriate instrument to study resilience in the adolescent population. While other instruments have potential (e.g., ARS, BPFI) as they were tested in the adolescent and young adult populations, they lack evidence for their use at this time. An evaluation of the review and recommendations are discussed.

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Background Endotracheal tube cuff pressure must be maintained within a narrow therapeutic range to prevent complications. Cuff pressure is measured and adjusted intermittently. Objectives To assess the accuracy and feasibility of continuous monitoring of cuff pressure, describe changes in cuff pressure over time, and identify clinical factors that influence cuff pressure. Methods In a pilot study, data were collected for a mean of 9.3 hours on 10 patients who were orally intubated and receiving mechanical ventilation. Sixty percent of the patients were white, mean age was 55 years, and mean intubation time was 2.8 days. The initial cuff pressure was adjusted to a minimum of 20 cm H 2 O. The pilot balloon of the endotracheal tube was connected to a transducer and a pressure monitor. Cuff pressure was recorded every 0.008 seconds during a typical 12-hour shift and was reduced to 1-minute means. Patient care activities and interventions were recorded on a personal digital assistant. Results Values obtained with the cufflator-manometer and the transducer were congruent. Only 54% of cuff pressure measurements were within the recommended range of 20 to 30 cm H 2 O. The cuff pressure was high in 16% of measurements and low in 30%. No statistically significant changes over time were noted. Endotracheal suctioning, coughing, and positioning affected cuff pressure. Conclusions Continuous monitoring of cuff pressure is feasible, accurate, and safe. Cuff pressures vary widely among patients.

Developmental care, a philosophy of care that requires rethinking the relationships between infants, families, and healthcare providers, is in place in the majority of neonatal intensive care units in the United States. Developmental care includes a variety of activities designed to manage the environment and individualize the care of the premature infant based on behavioral observations. The goal is to promote a stable, well-organized infant who can conserve energy for growth and development. Research about the effects of developmental care has shown a trend toward improved short-term physiologic, development, and resource utilization outcomes for infants up to 24 months of age, but benefits beyond this age are unclear. Most of the research has focused on developmental care as a whole, but there is also strong scientific evidence for specific components of developmental care. The NICU care provider should use developmental care interventions that are clearly supported by evidence, and use others based on judgment and the infant's responses.