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https://www.readbyqxmd.com/read/29161375/health-system-factors-affecting-implementation-of-integrated-management-of-childhood-illness-imci-qualitative-insights-from-a-south-african-province
#1
Himani Pandya, Wiedaad Slemming, Haroon Saloojee
The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework...
November 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29155486/toxic-stress-and-child-refugees
#2
John S Murray
The purpose of this article was to describe the phenomenon of toxic stress and its impact on the physical and mental health of child refugees. Almost two decades ago, researchers found that recurring adverse childhood events (ACEs; e.g., physical, psychological, and sexual abuse, neglect, and household dysfunction such as substance abuse, mental illness, and criminal behavior) were associated with a significant increase in serious illnesses during adulthood. Illnesses include heart, lung, and liver disease, cancer, and bone fractures...
November 20, 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/29153961/welcoming-expertise-bereaved-parents-perceptions-of-the-parent-healthcare-provider-relationship-when-a-critically-ill-child-is-admitted-to-the-paediatric-intensive-care-unit
#3
Ashleigh E Butler, Beverley Copnell, Helen Hall
BACKGROUND: Entering the paediatric intensive care unit with a critically ill child is a stressful experience for parents. In addition to fearing for their child's well-being, parents must navigate both a challenging environment and numerous new relationships with healthcare staff. How parents form relationships with staff and how they perceive both their own and the healthcare providers' roles in this early stage of their paediatric intensive care journey is currently unknown. PURPOSE: This paper explores bereaved parents' perceptions of their role and their relationships with healthcare providers when their child is admitted to the intensive care unit, as part of a larger study exploring their experiences when their child dies in intensive care...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153934/family-centered-care-from-the-perspective-of-parents-of-children-cared-for-in-a-pediatric-intensive-care-unit-an-integrative-review
#4
REVIEW
Carrie Hill, Kathleen A Knafl, Sheila Judge Santacroce
PROBLEM: The Institute for Patient- and Family-Centered Care's (IPFCC) definition of family-centered care (FCC) includes the following four core concepts: respect and dignity, information sharing, participation, and collaboration. To date, research has focused on the provider experience of FCC in the PICU; little is known about how parents of children hospitalized in the pediatric intensive care unit (PICU) experience FCC. ELIGIBILITY CRITERIA: Articles were included if they were published between 2006 and 2016, included qualitative, quantitative, or mixed methods results, related to care received in a PICU, and included results that were from a parent perspective...
November 16, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29118206/social-origins-of-developmental-risk-for-mental-and-physical-illness
#5
Judy L Cameron, Kathie L Eagleson, Nathan A Fox, Takao K Hensch, Pat Levitt
Adversity in early childhood exerts an enduring impact on mental and physical health, academic achievement, lifetime productivity, and the probability of interfacing with the criminal justice system. More science is needed to understand how the brain is affected by early life stress (ELS), which produces excessive activation of stress response systems broadly throughout the child's body (toxic stress). Our research examines the importance of sex, timing and type of stress exposure, and critical periods for intervention in various brain systems across species...
November 8, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29117060/cognitive-development-1-year-after-infantile-critical-pertussis
#6
John T Berger, Michele E Villalobos, Amy E Clark, Richard Holubkov, Murray M Pollack, Robert A Berg, Joseph A Carcillo, Heidi Dalton, Rick Harrison, Kathleen L Meert, Christopher J L Newth, Thomas P Shanley, David L Wessel, Kanwaljeet J S Anand, Jerry J Zimmerman, Ronald C Sanders, Teresa Liu, Jeri S Burr, Douglas F Willson, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Pertussis can cause life-threatening illness in infants. Data regarding neurodevelopment after pertussis remain scant. The aim of this study was to assess cognitive development of infants with critical pertussis 1 year after PICU discharge. DESIGN: Prospective cohort study. SETTING: Eight hospitals comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 18 additional sites across the United States...
November 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29096537/neurodevelopmental-disorders-in-the-picu-population
#7
Sarah A Sobotka, Sarah Peters, Neethi P Pinto
Attention deficit hyperactivity disorder (ADHD), affecting 11% of children and adolescents, increases risk for injury and may predispose children to illness. However, the prevalence of ADHD and other developmental disorders in the pediatric intensive care unit (PICU) has not been previously studied. We performed a single-center, prospective cohort study of children aged 6 to 12 years who were hospitalized in the PICU from May through August 2016. Parents described their child's educational and neurodevelopmental history, and completed ADHD and emotional/behavioral disorder screening on enrollment and 1 month after discharge...
November 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29037575/using-best-worst-scaling-to-rank-factors-affecting-vaccination-demand-in-northern-nigeria
#8
Sachiko Ozawa, Chizoba Wonodi, Olufemi Babalola, Tukur Ismail, John Bridges
BACKGROUND: Understanding and ranking the reasons for low vaccination uptake among parents in northern Nigeria is critical to implement effective policies to save lives and prevent illnesses. This study applies best-worst scaling (BWS) to rank various factors affecting parents' demand for routine childhood immunization. METHODS: We conducted a household survey in Nahuche, Zamfara State in northern Nigeria. Nearly two hundred parents with children under age five were asked about their views on 16 factors using a BWS technique...
November 7, 2017: Vaccine
https://www.readbyqxmd.com/read/29025070/interdisciplinary-family-conferences-to-improve-patient-experience-in-the-neonatal-intensive-care-unit
#9
Jennifer A Trujillo, Yesenia Fernandez, Lyla Ghafoori, Kristina Lok, Arwin Valencia
Parents play a significant role in the development of their neonate. They can affect the length of stay in a neonatal intensive care unit (NICU) and are seen as an integral part of the team. Parents are often put in positions where difficult decision making is required of them in the care of their critically ill child. Studies suggest that one way to improve the family's experience and to encourage their involvement is by establishing a formal and focused family conference. Therefore, the NICU social workers and the interdisciplinary team collaborated to formulate strategies to improve communication that would enhance current practice...
September 15, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28987753/prospective-evaluation-of-physical-contact-with-critically-ill-child-on-caregiver-spiritual-wellbeing
#10
Brian D Leland, Mara E Nitu, Maureen Hancock, Karen Moody, Richard Gunderman, Elizabeth Moser, Courtney M Rowan
OBJECTIVES: To evaluate whether a pediatric intensive care unit initiative promoting physical contact between caregiver and patient improves caregiver spiritual wellbeing. The secondary objectives were to evaluate caregiver perceptions of care before and after the initiative and to follow unplanned extubation rate as a marker of safety of the initiative. We hypothesized that caregiver spiritual wellbeing and caregiver perceptions of care would improve with implementation of our physical contact initiative known as Project ROSE (Reach Out, Soothe, and Embrace)...
October 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28975800/fathers-experiences-of-their-child-s-life-limiting-condition-an-attachment-narrative-perspective
#11
Oliver Bailey-Pearce, Jacqui Stedmon, Rudi Dallos, George Davis
When a child has a life-limiting illness, parental involvement is amplified, having to respond to the increased needs of the child. Both parents are affected by the illness, yet research has largely under-represented fathers' experiences of their child's illness. Seven fathers were interviewed about their experiences with their child's life-limiting illness. In addition, fathers' attachment strategies were assessed using the Adult Attachment Interview. Narrative analysis was implemented to explore the interviews, and indicators of attachment markers employed in the Adult Attachment Interview were also identified...
September 1, 2017: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#12
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28949771/delirium-in-the-critically-ill-child-assessment-and-sequelae
#13
Rebecca S Paterson, Justin A Kenardy, Alexandra C De Young, Belinda L Dow, Debbie A Long
Delirium is a common and serious neuropsychiatric complication in critically ill patients of all ages. In the context of critical illness, delirium may emerge as a result of a cascade of underlying pathophysiologic mechanisms and signals organ failure of the brain. Awareness of the clinical importance of delirium in adults is growing as emerging research demonstrates that delirium represents a serious medical problem with significant sequelae. However, our understanding of delirium in children lags significantly behind the adult literature...
2017: Developmental Neuropsychology
https://www.readbyqxmd.com/read/28946873/myanmar-mortality-registration-an-assessment-for-system-improvement
#14
Myitzu Tin Oung, Kerry Richter, Pramote Prasartkul, Viroj Tangcharoensathien
BACKGROUND: The vital registration system in Myanmar has a long history and geographical coverage is currently high. However, a recent assessment of vital registration systems of 148 countries showed poor performance of the death registration system in Myanmar, suggesting the need for improvement. This study assessed the quality of mortality data generated from the vital registration system with regard to mortality levels and patterns, quality of cause of death data, and completeness of death registration in order to identify areas for improvement...
September 25, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28943826/the-use-of-daptomycin-to-treat-methicillin-resistant-staphylococcus-epidermidis-bacteremia-in-a-critically-ill-child-with-renal-failure
#15
Stephen Morris, Kate Gould, Lee P Ferguson
Daptomycin is excreted primarily unchanged by the kidney. Dosage regimens in children with renal failure remain to be determined. We report the case of an 8-year-old child with multiorgan failure undergoing continuous peritoneal dialysis, successfully treated with intravenous daptomycin for methicillin-resistant Staphylococcus epidermidis bacteremia. A dosage of 8 mg/kg every 48 hour was used. Plasma peak and trough concentrations of daptomycin were 68 mg/L and 14.6 mg/L, respectively, on day 6 of treatment...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28941539/delirium-in-pediatric-critical-care
#16
REVIEW
Anita K Patel, Michael J Bell, Chani Traube
Delirium occurs frequently in the critically ill child. It is a syndrome characterized by an acute onset and fluctuating course, with behaviors that reflect a disturbance in awareness and cognition. Delirium represents global cerebral dysfunction due to the direct physiologic effects of an underlying medical illness or its treatment. Pediatric delirium is strongly associated with poor outcomes, including increased mortality, prolonged intensive care unit length of stay, longer time on mechanical ventilation, and increased cost of care...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28941538/sedation-analgesia-and-neuromuscular-blockade-in-pediatric-critical-care-overview-and-current-landscape
#17
REVIEW
Athena F Zuppa, Martha A Q Curley
Sedation is a mainstay of therapy for critically ill children. Although necessary in the care of the critically ill child, sedative drugs are associated with adverse effects, such as disruption of circadian rhythm, altered sleep, delirium, potential neurotoxicity, and immunosuppression. Optimal approaches to the sedation of the critically ill child should include identification of sedation targets and sedation interruptions, allowing for a more individualized approach to sedation. Further research is needed to better understand the relationship between critical illness and sedation pharmacokinetics and pharmacodynamics, the impact of sedation on immune function, and the genetic implications on drug disposition and response...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28939701/rapid-targeted-genomics-in-critically-ill-newborns
#18
Cleo C van Diemen, Wilhelmina S Kerstjens-Frederikse, Klasien A Bergman, Tom J de Koning, Birgit Sikkema-Raddatz, Joeri K van der Velde, Kristin M Abbott, Johanna C Herkert, Katharina Löhner, Patrick Rump, Martine T Meems-Veldhuis, Pieter B T Neerincx, Jan D H Jongbloed, Conny M van Ravenswaaij-Arts, Morris A Swertz, Richard J Sinke, Irene M van Langen, Cisca Wijmenga
BACKGROUND: Rapid diagnostic whole-genome sequencing has been explored in critically ill newborns, hoping to improve their clinical care and replace time-consuming and/or invasive diagnostic testing. A previous retrospective study in a research setting showed promising results with diagnoses in 57%, but patients were highly selected for known and likely Mendelian disorders. The aim of our prospective study was to assess the speed and yield of rapid targeted genomic diagnostics for clinical application...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28938289/discussing-benefits-and-risks-of-tracheostomy-what-physicians-actually-say
#19
Lauren M Hebert, Anne C Watson, Vanessa Madrigal, Tessie W October
OBJECTIVES: When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. DESIGN: We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#20
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
September 15, 2017: Pediatric Critical Care Medicine
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