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Pediatric quality

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https://www.readbyqxmd.com/read/29235739/assistance-of-medical-clowns-improves-the-physical-examinations-of-children-aged-2-6-years
#1
Noam Meiri, Amichi Ankri, Faten Ziadan, Itay Nahmias, Muriel Konopnicki, Zeev Schnapp, Omer Itzhak Sagi, Mohamad Hamad Saied, Giora Pillar
BACKGROUND: A good physical exam is necessary to help pediatricians make the correct diagnosis and can save unnecessary imaging or invasive procedures. Distraction by medical clowns may create the optimal conditions for a proper physical examination. METHODS: Children aged 2-6 years who required physical examination in the pediatric emergency department were recruited and randomly assigned to one of two groups: physical exam by a pediatrician in the presence of caregivers vs...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29233726/understanding-the-factors-that-control-the-quality-of-mini-tablet-compression-flow-particle-size-and-tooling-dimension
#2
Junshu Zhao, David Yin, Jasmine Rowe, Sherif Badawy, Faranak Nikfar, Preetanshu Pandey
Despite the increasing importance of mini-tablet for its advantages as pediatric formulations and in modified release applications, its popularity is limited due to the lack of formulation and processing knowledge in developing such dosage forms. In this study, common grades of microcrystalline cellulose and roller compacted granules with a range of powder properties were used to evaluate the critical material properties required for the successful manufacturing of 1.7 mm mini-tablets. It was found that blends with small particle size had poor flow properties that did not support consistent die filling and also tended to cause tooling jam and damage...
December 9, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29233168/a-protocol-for-a-systematic-review-of-economic-evaluation-studies-conducted-on-neonatal-systemic-infections-in-south-asia
#3
Shruti Murthy, Denny John, Isadora Perpetual Godinho, Myron Anthony Godinho, Vasudeva Guddattu, N Sreekumaran Nair
BACKGROUND: Neonatal systemic infections and their consequent impairments give rise to long-lasting health, economic and social effects on the neonate, the family and the nation. Considering the dearth of consolidated economic evidence in this important area, this systematic review aims to critically appraise and consolidate the evidence on economic evaluations of management of neonatal systemic infections in South Asia. METHODS: Full and partial economic evaluations, published in English, associated with the management of neonatal systemic infections in South Asia will be included...
December 12, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29230802/measurement-properties-of-instruments-that-assess-participation-in-young-people-with-autism-spectrum-disorder-a-systematic-review
#4
REVIEW
Francesca Lami, Kristine Egberts, Alexandra Ure, Rowena Conroy, Katrina Williams
AIM: To systematically review the measurement properties of instruments assessing participation in young people with autism spectrum disorder (ASD). METHOD: A search was performed in MEDLINE, PsycINFO, and PubMed combining three constructs ('ASD', 'test of participation', 'measurement properties'). Results were restricted to articles including people aged 6 to 29 years. The 2539 identified articles were independently screened by two reviewers. For the included articles, data were extracted using standard forms and their risk of bias was assessed...
December 12, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29230635/quality-of-life-and-growth-after-childhood-craniopharyngioma-results-of-the-multinational-trial%C3%A2-kraniopharyngeom-2007
#5
Kerstin Heinks, Svenja Boekhoff, Anika Hoffmann, Monika Warmuth-Metz, Maria Eveslage, Junxiang Peng, Gabriele Calaminus, Hermann L Müller
CONTEXT: Quality of life (QoL) after childhood-onset craniopharyngioma (CP) is frequently impaired due to tumor and/or treatment-related factors such as endocrine deficits and hypothalamic involvement/lesions. PATIENTS AND METHODS: In a multinational trial, we prospectively analyzed parental and self-assessment of CP patient QoL at 3 months, 1 and 3 years after CP diagnosis related to growth hormone (GH) substitution. 47 of 194 CP recruited between 2007 and 2015 in KRANIOPHARYNGEOM 2007 were analyzed for QoL 1 and 3 years after CP diagnosis...
December 11, 2017: Endocrine
https://www.readbyqxmd.com/read/29229566/agreement-between-parent-proxy-and-child-self-report-of-pain-intensity-and-health-related-quality-of-life-after-surgery
#6
Brooke E Lifland, Rita Mangione-Smith, Tonya M Palermo, Jennifer A Rabbitts
OBJECTIVES: Monitoring patient-centered health outcomes after hospital discharge is important for identifying patients experiencing poor recovery after surgery. Utilizing parent reports may improve the feasibility of monitoring recovery when children are not available to provide self-report. We therefore aimed to examine agreement between parent and child reports of child pain and health-related quality of life (HRQOL) in children after hospital discharge from inpatient surgery. METHODS: 295 children aged 8-18 years and their parents reported on child pain intensity using an 11-point Numerical Rating Scale and on HRQOL using the 0-to-100 point Pediatric Quality of Life Inventory Version 4...
December 8, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29229171/special-considerations-in-pediatric-kidney-transplantation
#7
REVIEW
Sean A Hebert, Rita D Swinford, David R Hall, Jason K Au, John S Bynon
Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney failure, many with urological issues. Early urological evaluation for post-transplant bladder dysfunction and emphasis on immunization adherence are the mainstays of pediatric pretransplant and post-transplant evaluations...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29229144/postoperative-neonatal-mortality-prediction-using-superlearning
#8
Jennifer N Cooper, Peter C Minneci, Katherine J Deans
BACKGROUND: The variable risks associated with neonatal surgery present a challenge to accurate mortality prediction. We aimed to apply superlearning, an ensemble machine learning method, to the prediction of 30-day neonatal postoperative mortality. MATERIALS AND METHODS: We included neonates in the 2012-2014 National Surgical Quality Improvement Program Pediatric. Patients treated in 2012-13 were used in model development (n = 6499), and patients treated in 2014 formed the validation sample (n = 3552)...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29228940/communicating-wisely-teaching-residents-to-communicate-effectively-with-patients-and-caregivers-about-unnecessary-tests
#9
Geetha Mukerji, Adina Weinerman, Sarah Schwartz, Adelle Atkinson, Lynfa Stroud, Brian M Wong
BACKGROUND: With rising healthcare costs and a focus on quality, there is a growing need to promote resource stewardship in medical education. Physicians need to be able to communicate effectively with patients/caregivers seeking tests and treatments that are unnecessary. This study aimed to evaluate the impact of an interactive workshop on residents' knowledge of resource stewardship and communication skills when counseling patients/caregivers about requests for unnecessary testing. METHODS: Participants were 83 Internal Medicine and Pediatrics residents at the University of Toronto in 2014-15...
December 11, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29227371/a-quality-improvement-initiative-reduces-cast-complications-in-a-pediatric-hospital
#10
Julie Balch Samora, Walter P Samora, Kevin Dolan, Kevin E Klingele
BACKGROUND: Casts, while frequently used as routine treatment in pediatric orthopaedic practice, are not without complications. At our large tertiary care pediatric hospital, the baseline rate of all casting complications was 5.6 complications per 1000 casts applied (0.56%). We tested the hypothesis that we could use quality improvement (QI) methodology to decrease the overall cast complication rate and improve patient care. METHODS: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act cycles, to decrease our cast complication rate...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29226228/seminar-program-for-postgraduate-specialty-training-in-general-practice-proposal-for-a-5-year-thematic-catalogue
#11
Susanne Sommer, Erika Baum, Julia Magez, Jean-Francois Chenot, Gesine Weckmann, Jost Steinhäuser, Susanne Heim, Dagmar Schneider, Stephan Fuchs
Introduction: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide. We have investigated, if the development of a common 5-year program of learning topics is conceivable between the different university departments of General practice in Germany. Method: The seminar program working group of the DEGAM (German College of General Practitioners and Family Physicians) has conducted an online survey based on information gathered via preliminary telephone conference (n=7; physicians with postgraduate teaching experience) among all German university departments of General Practice and two non-university teaching institutions, identified via the internet...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29226185/parental-and-pediatricians-perception-of-need-for-subspecialty-training-in-pediatric-emergency-medicine-for-delivering-emergency-care-to-pediatric-patients
#12
Ernest G Leva, Diane Bunn Vanarsdale, Niel F Miele, Anna Petrova
The quality of pediatric emergency care may depend on the competence of the emergency department physicians. It is important to know whether parents and general pediatricians associate the quality of pediatric emergency care with the pediatric emergency medicine (PEM) training of the emergency department physicians. We designed the study to determine parental and pediatricians' opinion and expectation in regard to this question. Most of the surveyed parents' and pediatricians' recognize the importance of PEM training and believed that physicians trained in PEM can provide better emergency care for children...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29223545/the-bowel-function-and-quality-of-life-of-hirschsprung-disease-patients-who-have-reached-18-years-of-age-or-older-the-long-term-outcomes-after-undergoing-the-transabdominal-soave-procedure
#13
Shun Onishi, Kazuhiko Nakame, Tatsuru Kaji, Masato Kawano, Tomoe Moriguchi, Koshiro Sugita, Keisuke Yano, Mioko Nomura, Koji Yamada, Waka Yamada, Ryuta Masuya, Takafumi Kawano, Seiro Machigashira, Motoi Mukai, Satoshi Ieiri
BACKGROUND/PURPOSE: Hirschsprung disease (HD) is considered curable, but the postoperative bowel function is not always satisfactory. In this study, we evaluated the general condition, bowel function, and social performance in adults who were older than 17years of age who had undergone definitive operations in childhood. METHOD: From 1984 to 2016, 110 patients with HD underwent definitive surgery at our institute. Sixty-three patients who had undergone the transabdominal Soave procedure reached 18years of age...
December 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#14
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29222704/healthcare-system-barriers-to-long-term-follow-up-for-adult-survivors-of-childhood-cancer-in-british-columbia-canada-a-qualitative-study
#15
A Fuchsia Howard, Arminee Kazanjian, Sheila Pritchard, Rob Olson, Haroon Hasan, Kelly Newton, Karen Goddard
PURPOSE: Risk-stratified life-long follow-up care is recommended for adult childhood cancer survivors (CCS) to ensure appropriate prevention, screening, and management of late effects. The identification of barriers to long-term follow-up (LTFU), particularly in varying healthcare service contexts, is essential to develop and refine services that are responsive to survivor needs. We aimed to explore CCS and healthcare professionals (HCP) perspectives of healthcare system factors that function as barriers to LTFU in British Columbia, Canada...
December 8, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29222303/responsiveness-of-patient-reported-outcome-measurement-information-system-promis-pain-domains-and-disease-specific-patient-reported-outcome-measures-in-children-and-adults-with-sickle-cell-disease
#16
REVIEW
Susanna Curtis, Amanda M Brandow
Case 1: A 33-year-old man with hemoglobin SS (homozygous hemoglobin S) disease presents for his regular clinic visit. He had 6 hospital admissions for pain over the past year. He also has avascular necrosis of the right hip. He takes daily hydroxyurea with hematologic changes indicative of compliance. He also takes morphine sustained release twice daily and morphine immediate release every 6 hours as needed for pain. He feels that more optimal pain control at home would help him reduce his number of hospital admissions in the upcoming year and improve his daily functioning at home...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29219080/health-practitioners-emotional-reactions-to-caring-for-hospitalized-children-in-lom%C3%A3-togo-a-qualitative-study
#17
Bassantéa Lodegaèna Kpassagou, Kokou Messanh Agbémélé Soedje
BACKGROUND: Health practitioners frequently encounter dying, death and suffering. While providing health care can be stressful, the literature on how different health practitioners cope with the emotional challenges associated with their work is sparse. Further, much of this literature is based on studies conducted in high-income countries. In this study, we explored emotional distress and associated coping strategies among health practitioners working in a pediatric oncology department in a large teaching hospital in Lomé, Togo...
December 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29218922/methods-for-examining-data-quality-in-healthcare-integrated-data-repositories
#18
Vojtech Huser, Michael G Kahn, Jeffrey S Brown, Ramkiran Gouripeddi
This paper summarizes content of the workshop focused on data quality. The first speaker (VH) described data quality infrastructure and data quality evaluation methods currently in place within the Observational Data Science and Informatics (OHDSI) consortium. The speaker described in detail a data quality tool called Achilles Heel and latest development for extending this tool. Interim results of an ongoing Data Quality study within the OHDSI consortium were also presented. The second speaker (MK) described lessons learned and new data quality checks developed by the PEDsNet pediatric research network...
2018: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/29218814/knowledge-compliance-with-good-clinical-practices-and-barriers-to-effective-control-of-postoperative-pain-among-nurses-from-hospitals-with-and-without-a-hospital-without-pain-certificate
#19
Lucyna Tomaszek, Grażyna Dębska
AIMS AND OBJECTIVES: (1) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate. (2) To identify the determinants of nurses' knowledge. (3) To define barriers to effective control of postoperative pain. BACKGROUND: Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses...
December 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#20
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
December 8, 2017: Pediatric Blood & Cancer
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