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Critical ill child

Isabelle Bragard, Marie-Christine Seghaye, Nesrine Farhat, Marie Solowianiuk, Mariane Saliba, Anne-Marie Etienne, Katharina Schumacher
OBJECTIVES: Residents beginning their specialization in pediatrics and emergency medicine (EM) are rapidly involved in oncall duties. Early acquisition of crisis resource management by novice residents is essential for patient safety, but traditional training may be insufficient. Our aim was to investigate the impact of a 2-day simulation-based course on residents to manage pediatric and neonatal patients. METHODS: First year residents participated in the course...
October 6, 2016: Pediatric Emergency Care
Melanie Gleason, Lisa Cicutto, Christy Haas-Howard, Bridget M Raleigh, Stanley J Szefler
Asthma is one of the most common illnesses of school-aged children and can lead to both health and educational disparities. Children from low socioeconomic backgrounds and racial/ethnic minorities suffer the greatest impact. They often lack the asthma self-management skills to successfully monitor, navigate, and negotiate appropriate asthma care. School settings are a strategic point of contact for this additional support. School nurses can monitor for signs of asthma worsening, manage symptoms, provide care coordination, and reinforce self-management skills...
October 2016: Current Allergy and Asthma Reports
Fernando Maria de Benedictis, Andrew Bush
Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy...
October 4, 2016: Archives of Disease in Childhood
Kenneth A Michelson, Richard G Bachur, Jason A Levy
OBJECTIVES: The presence of critically ill patients may impact care for other ED patients. We sought to evaluate whether the presence of a critically ill child was associated with the time to (1) receipt of the first medication among other patients, and (2) administration of diagnosis-specific medications. METHODS: We performed a retrospective cohort study of all paediatric ED visits over 3 years. Patients were exposed if they arrived during the first hour of a critically ill patient's care...
September 28, 2016: Emergency Medicine Journal: EMJ
Robert F Tamburro, Tammara L Jenkins, Patrick M Kochanek
OBJECTIVE: To summarize the scientific priorities and potential future research directions for pediatric critical care research discussed by a panel of experts at the inaugural Strategic Planning Conference of the Pediatric Trauma and Critical Illness Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. DATA SOURCES: Expert opinion expressed during the Strategic Planning Conference. STUDY SELECTION: Not applicable...
September 27, 2016: Pediatric Critical Care Medicine
Nienke J Vet, Saskia N de Wildt, Carin W M Verlaat, Miriam G Mooij, Dick Tibboel, Matthijs de Hoog, Corinne M P Buysse
OBJECTIVE: Our earlier pediatric daily sedation interruption trial showed that daily sedation interruption in addition to protocolized sedation in critically ill children does not reduce duration of mechanical ventilation, length of stay, or amounts of sedative drugs administered when compared with protocolized sedation only, but undersedation was more frequent in the daily sedation interruption + protocolized sedation group. We now report the preplanned analysis comparing short-term health-related quality of life and posttraumatic stress symptoms between the two groups...
September 22, 2016: Pediatric Critical Care Medicine
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry J Zimmerman, Christopher J L Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster, Robert F Tamburro
BACKGROUND AND AIMS: The pediatric Critical Illness Stress-induced Immune Suppression (CRISIS) trial compared the effectiveness of 2 nutraceutical supplementation strategies and found no difference in the development of nosocomial infection and sepsis in the overall population. We performed an exploratory post hoc analysis of interaction between nutraceutical treatments and host immune status related to the development of nosocomial infection/sepsis. METHODS: Children from the CRISIS trial were analyzed according to 3 admission immune status categories marked by decreasing immune competence: immune competent without lymphopenia, immune competent with lymphopenia, and previously immunocompromised...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Sophie Geoghegan, Kate Oulton, Catherine Bull, Joe Brierley, Mark Peters, Jo Wray
OBJECTIVE: Meeting the needs of parents of critically ill children is increasingly being recognized as an important factor in the child's clinical outcome as well as the implications it has for future parenting. Little is specifically known about the experience of parents who have a child in the ICU for a prolonged period. Our objective was to understand the experiences of this group to assist in the identification of mechanisms for providing support. DESIGN: Qualitative study based on semistructured interviews...
September 19, 2016: Pediatric Critical Care Medicine
Angelica M Roncancio, Kristy K Ward, Chakema C Carmack, Becky T Muñoz, Miguel A Cano, Felicity Cribbs
HPV vaccine series completion rates among adolescent Hispanic females and males (~39 and 21 %, respectively) are far below the Healthy People 80 % coverage goal. Completion of the 3-dose vaccine series is critical to reducing the incidence of HPV-associated cancers. This formative study applies social marketing theory to assess the needs and preferences of Hispanic mothers in order to guide the development of interventions to increase HPV vaccine completion. We conducted 51 in-depth interviews with Hispanic mothers of adolescents to identify the key concepts of social marketing theory (i...
September 13, 2016: Journal of Community Health
Nienke J Vet, Niina Kleiber, Erwin Ista, Matthijs de Hoog, Saskia N de Wildt
This article discusses the rationale of sedation in respiratory failure, sedation goals, how to assess the need for sedation as well as effectiveness of interventions in critically ill children, with validated observational sedation scales. The drugs and non-pharmacological approaches used for optimal sedation in ventilated children are reviewed, and specifically the rationale for drug selection, including short- and long-term efficacy and safety aspects of the selected drugs. The specific pharmacokinetic and pharmacodynamic aspects of sedative drugs in the critically ill child and consequences for dosing are presented...
2016: Frontiers in Pediatrics
Cynthia M LaFond, Catherine Van Hulle Vincent, Kimberly Oosterhouse, Diana J Wilkie
: The purpose of this study was to provide a current and comprehensive evaluation of nurses' beliefs regarding pain in critically ill children. DESIGN AND METHODS: A convergent parallel mixed-methods design was used. Nurse beliefs were captured via questionnaire and interview and then compared. RESULTS: Forty nurses participated. Most beliefs reported via questionnaire were consistent with effective pain management practices. Common inaccurate beliefs included the need to verify pain reports with physical indicators and the pharmacokinetics of intravenous opioids...
September 3, 2016: Journal of Pediatric Nursing
(no author information available yet)
School readiness includes not only the early academic skills of children but also their physical health, language skills, social and emotional development, motivation to learn, creativity, and general knowledge. Families and communities play a critical role in ensuring children's growth in all of these areas and thus their readiness for school. Schools must be prepared to teach all children when they reach the age of school entry, regardless of their degree of readiness. Research on early brain development emphasizes the effects of early experiences, relationships, and emotions on creating and reinforcing the neural connections that are the basis for learning...
September 2016: Pediatrics
Eric Sy, Juan J Ronco, Rowan Searle, Constantine J Karvellas
PURPOSE: We evaluated the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score to predict survival in a Canadian critically ill cohort with acute-on-chronic liver failure. METHODS: We retrospectively examined 274 acute-on-chronic liver failure patients admitted to a quaternary level intensive care unit (ICU) between April 1, 2000, and April 30, 2011. We evaluated severity of illness scores, including the Acute Physiology and Chronic Health Evaluation (APACHE) II, model for end-stage liver disease (MELD), Child-Turcotte-Pugh (CTP), SOFA, and CLIF-SOFA...
August 10, 2016: Journal of Critical Care
Edgar Arnold Lungu, Regien Biesma, Maureen Chirwa, Catherine Darker
BACKGROUND: Access to child health services is an important determinant of child health. Whereas, child health indicators are generally better in urban than rural areas, some population groups in urban areas, such as children residing in urban slums do not enjoy this urban health advantage. In the context of increasing urbanisation and urban poverty manifesting with proliferation of urban slums, the health of under-five children in slum areas remains a public health imperative in Malawi...
2016: BMC Health Services Research
Paul Hodgkins, Andrew Lloyd, M Haim Erder, Juliana Setyawan, Margaret D Weiss, Rahul Sasané, Beenish Nafees
OBJECTIVE: Defining minimal important difference (MID) is critical to interpreting patient-reported outcomes data and treatment efficacy in clinical trials. This study estimates the MID for the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) and the Child Health and Illness Profile-Parent Report (CHIP-CE-PRF76) among parents of young people with attention-deficit/hyperactivity disorder (ADHD) in the UK. METHODS: Parents of children (6-12 years; n=100) and adolescents (13-17 years; n=117) with ADHD completed a socio-demographic form, the CHIP-CE-PRF76, the WFIRS-P, and the Pediatric Quality of Life scale at baseline and 4 weeks later...
August 18, 2016: CNS Spectrums
Galen E Switzer, Jessica Bruce, Deidre M Kiefer, Hati Kobusingye, Rebecca Drexler, RaeAnne M Besser, Dennis L Confer, Mary M Horowitz, Roberta J King, Bronwen E Shaw, Suzanna M van Walraven, Lori Wiener, Wendy Packman, James W Varni, Michael A Pulsipher
OBJECTIVES: To examine health-related quality of life (HRQoL) among sibling pediatric hematopoietic stem cell donors from predonation through 1 year postdonation, to compare donor-reported HRQoL scores with proxy-reports by parents/guardians and those of healthy norms, and to identify predonation factors (including donor age) potentially associated with postdonation HRQoL, to better understand the physical and psychosocial effects of pediatric hematopoietic stem cell donation. STUDY DESIGN: A random sample of 105 pediatric donors from US centers and a parent/guardian were interviewed by telephone predonation and 4 weeks and 1 year postdonation...
August 10, 2016: Journal of Pediatrics
Sainath Raman, Samiran Ray, Mark J Peters
Purpose. Administration of supplemental oxygen is common in paediatric intensive care. We explored the current practice of oxygen administration using a case vignette in paediatric intensive care units (PICU) in the united kingdom. Methods. We conducted an online survey of Paediatric Intensive Care Society members in the UK. The survey outlined a clinical scenario followed by questions on oxygenation targets for 5 common diagnoses seen in critically ill children. Results. Fifty-three paediatric intensive care unit members from 10 institutions completed the survey...
2016: Critical Care Research and Practice
C Kühner
The peripartum period represents a critical phase for the onset and course of mental disorders. During this phase, mental disorders occur as first onset or, more often, as recurrent or ongoing chronic conditions with onset and further course of illness in- or outside the peripartal period. No clear risk increase exists for the more prevalent mental disorders such as depressive and anxiety disorders during this period, whereas there is an increased risk for bipolar disorder. Peripartal mental disorders may impact fetal and child development through different mechanisms...
September 2016: Der Nervenarzt
Veronika Waldboth, Christine Patch, Romy Mahrer-Imhof, Alison Metcalfe
INTRODUCTION: The transition into adulthood is a developmental stage within the life cycle. A chronic childhood condition can disrupt this transition and create major challenges for both the young person and his or her family. Little is known about families' experiences when living with a rare genetic disease. Therefore, the purpose of this literature review was to understand experiences of families living with a chronic childhood disease during transition into adulthood by integrating evidence...
October 2016: International Journal of Nursing Studies
Diana Jefferies, Debbie Horsfall, Virginia Schmied
PROBLEM: Often, there is a sense of shock and disbelief when a mother murders her child. BACKGROUND: Yet, literary texts (plays, poems and novels) contain depictions of women experiencing mental illness or feelings of desperation after childbirth who murder their children. AIM: To further understand why a woman may harm her child we examine seven literary texts ranging in time and place from fifth century BCE Greece to twenty-first century Australia...
July 18, 2016: Women and Birth: Journal of the Australian College of Midwives
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