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Pediatric quality

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https://www.readbyqxmd.com/read/28648809/improving-quality-in-measuring-time-to-initiation-of-cpr-during-in-hospital-resuscitation
#1
Ashley Siems, Elyse Tomaino, Anne Watson, Michael C Spaeder, Lillian Su
OBJECTIVE: Time from the onset of "low or no flow" indicators of cardiac failure to initiation of cardiopulmonary resuscitation is an important quality metric thought to improve the likelihood of survival and preservation of end organ function. We hypothesized that delays in initiation of chest compressions were under recognized during in-hospital resuscitation and aimed to develop a system which identifies the actual time of deterioration during cardiac events. METHODS: Retrospective review on prospectively identified resuscitation records and monitor data were compared...
June 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28648539/prothrombin-complex-concentrates-in-pediatric-cardiac-surgery-the-current-state-and-the-future
#2
REVIEW
Elena Ashikhmina, Sameh Said, Mark M Smith, Vilmarie Rodriguez, William C Oliver, Gregory A Nuttall, Joseph A Dearani, Hartzell V Schaff
BACKGROUND: After decades of practice of pediatric cardiac surgery, postoperative bleeding due to the immaturity of hemostasis, hemodilution, and hypothermia remains a concern. Recently, a new approach for adult coagulopathy after bypass has emerged. Prothrombin complex concentrates (PCCs), designed to treat bleeding in hemophilia patients, are safely and efficiently used off label for hemorrhage after bypass. However, optimal dosing, indications and contraindications, and laboratory tests to assess the efficacy of PCC use in children have not yet been established...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648327/incidence-of-acute-complications-following-surgery%C3%A2-for-syndactyly-and-polydactyly-an-analysis-of-the-national-surgical-quality-improvement-program-database-from-2012-to-2014
#3
Thomas J McQuillan, Jessica E Hawkins, Amy L Ladd
PURPOSE: Congenital hand differences are infrequent phenomena, and their treatment represents a relatively small fraction of cases performed by hand surgeons. Little is known about the incidence of wound complications and acute postoperative problems given the relative rarity of these procedures. This study sought to characterize the incidence of complications within 30 days of surgery for congenital hand differences. METHODS: The National Surgical Quality Improvement Program (NSQIP) contains prospective data regarding 30-day morbidity from 64 pediatric centers across the United States...
June 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28647947/continuous-glucose-monitoring-in-pediatrics-the-gap-between-potential-benefits-and-the-reality-of-utility
#4
Regina L Taddeo, Joanne T Moser, Pantea P Minnock
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647107/-justification-of-off-label-antibiotics-uses-in-hospitalized-children
#5
Christelle Berthod, Behrouz Kassaï, Remy Boussageon, Léopold Adelaide, Matthias Jacquet-Lagrèze, Audrey Lajoinie
Unlicensed and off-label (UL/OL) drugs are commonly used in pediatrics wards, especially the antibiotics. It remains unclear if this strategy is justified by randomized controlled trials of good quality? OBJECTIVE: The aim of this study was to compare the level of evidence of UL/OL antibiotics prescription in hospitalized children. The initial hypothesis was that the UL/OL antibiotics prescriptions had a lower level of evidence than licensed antibiotics. METHOD: This observational study assessed the antibiotics prescription in the children mother and women hospital of Lyon...
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#6
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
June 23, 2017: Pediatrics
https://www.readbyqxmd.com/read/28645463/etiologies-of-chronic-cough-in-pediatric-cohorts-chest-guideline-and-expert-panel-report
#7
Anne B Chang, John J Oppenheimer, Miles Weinberger, Cameron C Grant, Bruce K Rubin, Richard S Irwin
BACKGROUND: In children (aged ≤14-years) there is no published systematic review on the etiologies of chronic cough or, the relationship between obstructive sleep apnea (OSA) and chronic cough. We thus undertook systematic reviews based on key questions (KQs) using the PICO format. The KQs were: Among children with chronic (>4 weeks) cough: (1) are the common etiologies different from adults? (2) are the common etiologies age and/or setting dependent? and; (3) is obstructive sleep apnea (OSA) an etiology of chronic cough in children? METHODS: We used the CHEST expert cough panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28644945/complications-and-cost-of-syndactyly-reconstruction-in-the-united-states-analysis-of-the-pediatric-health-information-system
#8
Maria F Canizares, Lanna Feldman, Patricia E Miller, Peter M Waters, Donald S Bae
BACKGROUND: Syndactyly is one of the most common congenital differences of the upper extremity and offers an exceptional opportunity to evaluate value-based care in pediatric orthopedic surgery. We designed a study to characterize complications and cost associated to syndactyly surgery among US pediatric hospitals. METHODS: A total of 2047 patients were identified for syndactyly surgery at 38 pediatric hospitals from 2009 to 2012 using the Pediatric Health Information System (PHIS) database...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644422/immersive-virtual-reality-for-pediatric-pain
#9
REVIEW
Andrea Stevenson Won, Jakki Bailey, Jeremy Bailenson, Christine Tataru, Isabel A Yoon, Brenda Golianu
Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain...
June 23, 2017: Children
https://www.readbyqxmd.com/read/28644360/quality-improvement-in-pediatric-endoscopy-a-clinical-report-from-the-naspghan-endoscopy-committee
#10
Robert E Kramer, Catharine M Walsh, Diana G Lerner, Douglas S Fishman
The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28643117/children-s-family-experiences-development-of-the-promis-%C3%A2-pediatric-family-relationships-measures
#11
Katherine B Bevans, Anne W Riley, Jeanne M Landgraf, Adam C Carle, Rachel E Teneralli, Barbara H Fiese, Lisa J Meltzer, Anna K Ettinger, Brandon D Becker, Christopher B Forrest
PURPOSE: To describe the development of pediatric family relationships measures, with versions for child self-report (8-17 years) and parent-report for children 5-17 years old. Measures were created for integration into the Patient Reported Outcomes Measurement Information System (PROMIS(®)). METHODS: Semi-structured interviews with 10 experts, 24 children, and 8 parents were conducted to elicit and clarify essential elements of family relationships. A systematic literature review was conducted to identify item concepts representative of each element...
June 22, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28641740/the-power-of-language-nutrition-for-children-s-brain-development-health-and-future-academic-achievement
#12
Lauren Head Zauche, Ashley E Darcy Mahoney, Taylor A Thul, Michael S Zauche, Arianne B Weldon, Jennifer L Stapel-Wax
Language Nutrition, a term created to describe language exposure that is rich in quality and quantity and delivered in the context of social interactions, is crucial for a child's development and is strongly associated with his/her future literacy, academic achievement, and health. However, significant differences in children's early language environments contribute to disparities in their educational and health trajectories. Interventions, including book distribution programs, coaching parents to enrich their child's language environment, and public awareness campaigns, have all been shown to positively influence a child's access to language-rich interactions...
July 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28641549/relevance-of-cat-and-dog-sensitization-by-skin-prick-testing-in-childhood-eczema-and-asthma
#13
Kam Lun E Lun Hon, Kathy Yin Ching Tsang, Ting Fan Leung
BACKGROUND: Household animal dander has been implicated as aeroallergen in childhood atopic diseases. Many parents seek healthcare advice if household pet keeping may be detrimental in atopic eczema (AE) and atopies. AIM: We investigated if skin sensitization by cat/dog dander was associated with disease severity and quality of life in children with AE. METHODS: Demographics, skin prick test (SPT) results, disease severity (Nottingham eczema severity score NESS), Children Dermatology Life Quality Index (CDLQI), blood IgE and eosinophil counts of a cohort of AE patients were reviewed...
June 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28641244/computerized-lung-sound-screening-for-pediatric-auscultation-in-noisy-field-environments
#14
Dimitra Emmanouilidou, Eric D McCollum, Daniel E Park, Mounya Elhilali
GOAL: Chest auscultations offer a non-invasive and low-cost tool for monitoring lung disease. However, they present many shortcomings including inter-listener variability, subjectivity, and vulnerability to noise and distortions. The current work proposes a computer-aided approach to process lung signals acquired in the field under adverse noisy conditions, by improving the signal quality and offering automated iden- tification of abnormal auscultations indicative of respiratory pathologies...
June 19, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28641166/care-coordination-at-a-pediatric-accountable-care-organization-aco-a-qualitative-analysis
#15
Baria Hafeez, Sophia Miller, Anup D Patel, Zachary M Grinspan
OBJECTIVE: Care coordinators may help manage care for children with chronic illness. Their role in pediatric epilepsy care is understudied. We aimed to qualitatively describe the content of a care coordination intervention for children with epilepsy. METHODS: We conducted nine semi-structured interviews and one focus group with care coordinators at a pediatric accountable care organization (ACO) in Ohio. The care coordinators used a modified version of a published care coordination checklist for children with epilepsy (Patel AD, 2014)...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28640708/medulloblastoma-from-myth-to-molecular
#16
Vijay Ramaswamy, Michael D Taylor
Current therapies for medulloblastoma were introduced primarily in the 1980s and consist of predominantly cytotoxic, nontargeted approaches. Mortality from medulloblastoma remains significant. In addition, many survivors suffer from severe treatment-related effects of radiation and cytotoxic chemotherapy. Further intensification of nonspecific therapy is unlikely to offer additional benefits, because survival rates have reached a plateau. Recent publications in medulloblastoma have revolved largely around the recognition that medulloblastoma per se does not exist, but rather, that there are a group of histologically similar but clinically and molecularly distinct entities that have been grouped under that rubric...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28640698/pediatric-gliomas-current-concepts-on-diagnosis-biology-and-clinical-management
#17
Dominik Sturm, Stefan M Pfister, David T W Jones
Gliomas are the most common CNS tumors in children and adolescents, and they show an extremely broad range of clinical behavior. The majority of pediatric gliomas present as benign, slow-growing lesions classified as grade I or II by the WHO classification of CNS tumors. These pediatric low-grade gliomas (LGGs) are fundamentally different from IDH-mutant LGGs occurring in adults, because they rarely undergo malignant transformation and show excellent overall survival under current treatment strategies. However, a significant fraction of gliomas develop over a short period of time and progress rapidly and are therefore classified as WHO grade III or IV high-grade gliomas (HGGs)...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28639735/neonates-with-cancer-and-causes-of-death-lessons-from-615-cases-in-the-seer-databases
#18
Ahmad S Alfaar, Waleed M Hassan, Mohamed Sabry Bakry, Ibrahim Qaddoumi
Neonatal tumors are rare with no standard treatment approaches to these diseases, and the patients experience poor outcomes. Our aim was to determine the distribution of cancers affecting neonates and compare survival between these cancers and older children. We analyzed SEER data (1973-2007) from patients who were younger than 2 years at diagnosis of malignancy. Special permission was granted to access the detailed (i.e., age in months) data of those patients. The Chi-square Log-rank test was used to compare survival between neonates (aged <1 month) and older children (>1 month to <2 years)...
June 22, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28638969/introduction-childhood-and-disability
#19
EDITORIAL
Erica K Salter
From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care...
June 21, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28637654/implementation-of-instrument-based-vision-screening-for-preschool-age-children-in-primary-care
#20
Jonathan R Modest, Katherine M Majzoub, Bruce Moore, Vijeta Bhambhani, Sarah R McLaughlin, Louis Vernacchio
BACKGROUND: Vision screening is an essential element of well-child care for young children. Recently, several professional groups have recommended the use of instrument-based screening; however, studies demonstrating the effectiveness of this technique in pediatric primary care settings are lacking. METHODS: We designed a cluster randomized quality improvement project to test the implementation of instrument-based vision screening for 3- to 5-year-old children within a pediatric primary care network...
June 21, 2017: Pediatrics
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