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https://www.readbyqxmd.com/read/29452747/accuracy-of-clinician-practice-compared-with-three-head-injury-decision-rules-in-children-a-prospective-cohort-study
#1
Franz E Babl, Ed Oakley, Stuart R Dalziel, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Susan Donath, Stephen Hearps, Charlotte Molesworth, Louise Crowe, Silvia Bressan, Mark D Lyttle
STUDY OBJECTIVE: Three clinical decision rules for head injuries in children (Pediatric Emergency Care Applied Research Network [PECARN], Canadian Assessment of Tomography for Childhood Head Injury [CATCH], and Children's Head Injury Algorithm for the Prediction of Important Clinical Events [CHALICE]) have been shown to have high performance accuracy. The utility of any of these in a particular setting depends on preexisting clinician accuracy. We therefore assess the accuracy of clinician practice in detecting clinically important traumatic brain injury...
February 13, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29450701/burden-characteristics-and-process-of-care-among-the-pediatric-and-adult-trauma-patients-in-botswana-s-main-hospitals
#2
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Botswana is notable among countries with high rates of Road Traffic Collisions (RTC); like many other lower-middle-income countries (LMICs), it lacks trauma systems. The World Health Organization recommends 'Essential Trauma Care' in countries with no formal trauma systems. The proportion of injuries in Emergency Departments and the care process were investigated to gain an overview for enabling the design of a relevant LMICs trauma system. METHOD: Blunt and penetrating trauma patients were included from three major hospitals, examining the proportion of injuries, patient characteristics, the care process and comparing these between pediatrics and adults...
February 15, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29442287/recent-developments-in-adolescent-and-young-adult-aya-acute-lymphoblastic-leukemia
#3
REVIEW
Victor M Orellana-Noia, Michael G Douvas
PURPOSE OF REVIEW: Adolescent and Young Adult (AYA) Oncology is a relatively new field encompassing research in the unique pathophysiology, clinical care, and psychosocial issues facing patients between the ages of 15 and 40 with cancer. About 100,000 of the approximately 1.5 million people diagnosed annually with cancer in the USA are in this age range. This chapter will review notable new developments in the care of adolescents and young adults with acute lymphoblastic leukemia (ALL) within the last 3 years...
February 14, 2018: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/29439733/measuring-empathy-in-pediatrics-validation-of-the-visual-care-measure
#4
Michele Arigliani, Luigi Castriotta, Anna Pusiol, Annachiara Titolo, Enrico Petoello, Alberto Brun Peressut, Elisabetta Miorin, Iana Elkina, Federico Marzona, Davide Cucchiaro, Elisa Spanghero, Matteo Pavan, Raffaele Arigliani, Stewart W Mercer, Paola Cogo
BACKGROUND: Empathy is a key element of "Patient and Family Centered Care", a clinical approach recommended by the American Academy of Pediatrics. However, there is a lack of validated tools to evaluate paediatrician empathy. This study aimed to validate the Visual CARE Measure, a patient rated questionnaire measuring physician empathy, in the setting of a Pediatric Emergency Department (ED). METHODS: The empathy of physicians working in the Pediatric ED of the University Hospital of Udine, Italy, was assessed using an Italian translation of the Visual Care Measure...
February 13, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29438126/sonographic-evaluation-and-monitoring-of-pneumoperitoneum-after-air-enema-reduction-for-intussusception
#5
Amy Z Zhou, Amy Toporowski, James W Tsung
Abdominal radiography and computed tomography scans are standard tests to diagnose pneumoperitoneum. With the growing availability of point-of-care ultrasound, pneumoperitoneum may be diagnosed in settings without easy access to radiography or computed tomography, such as in overcrowded emergency departments or resource-poor environments. The use of point-of-care ultrasound to diagnose or monitor pneumoperitoneum has been described in adult but not pediatric patients. We present a case of point-of-care ultrasound detection of pneumoperitoneum and monitoring for tension pneumoperitoneum, after failed air enema reduction for intussusception in an infant...
February 12, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29437489/controller-adherence-following-hospital-discharge-in-high-risk-children-a-pilot-randomized-trial-of-text-message-reminders
#6
Chén C Kenyon, Siobhan M Gruschow, William O Quarshie, Heather Griffis, Michelle C Leach, Joseph J Zorc, Tyra C Bryant-Stephens, Victoria A Miller, Chris Feudtner
OBJECTIVE: To assess the feasibility of a mobile health, inhaled corticosteroid (ICS) adherence reminder intervention and to characterize adherence trajectories immediately following severe asthma exacerbation in high-risk urban children with persistent asthma. METHODS: Children aged 2-13 with persistent asthma were enrolled in this pilot randomized controlled trial during an asthma emergency department (ED) visit or hospitalization. Intervention arm participants received daily text message reminders for 30 days, and both arms received electronic sensors to measure ICS use...
February 13, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29437047/public-health-approach-to-addressing-the-needs-of-children-affected-by-congenital-zika-syndrome
#7
Cheryl S Broussard, Carrie K Shapiro-Mendoza, Georgina Peacock, Sonja A Rasmussen, Cara T Mai, Emily E Petersen, Romeo R Galang, Kimberly Newsome, Megan R Reynolds, Suzanne M Gilboa, Coleen A Boyle, Cynthia A Moore
We have learned much about the short-term sequelae of congenital Zika virus (ZIKV) infection since the Centers for Disease Control and Prevention activated its ZIKV emergency response in January 2016. Nevertheless, gaps remain in our understanding of the full spectrum of adverse health outcomes related to congenital ZIKV infection and how to optimize health in those who are affected. To address the remaining knowledge gaps, support affected children so they can reach their full potential, and make the best use of available resources, a carefully planned public health approach in partnership with pediatric health care providers is needed...
February 2018: Pediatrics
https://www.readbyqxmd.com/read/29437046/zika-and-public-health-understanding-the-epidemiology-and-information-environment
#8
Pia D M MacDonald, E Wayne Holden
Because Zika is a newly emerging infectious disease with little previous information known about it, there are many epidemiologic and clinical questions. The complexity of providing care to those who are at risk for infection or are already infected with Zika in this evidence-scarce environment cannot be understated. In this article, we provide an overview of the Zika virus (ZIKV) in the context of public health and pediatric health care. A broad public health focus is used to provide relevant information for addressing important questions about the epidemic and to facilitate communication with patients, parents, and caregivers within the current information environment...
February 2018: Pediatrics
https://www.readbyqxmd.com/read/29433912/factors-influencing-emergency-department-care-of-young-children-at-risk-for-clinically-important-traumatic-brain-injury
#9
Tara Rhine, Shari L Wade, Nanhua Zhang, Huaiyu Zang, Stephanie Kennebeck, Lynn Babcock
OBJECTIVES: Care decisions for young children presenting to the emergency department (ED) with head injury are often challenging (e.g. whether to obtain neuroimaging). We sought to identify factors associated with acute management of children at-risk for clinically important traumatic brain injury (ciTBI) and describe symptom management. METHODS: Observational evaluation of children, ages 0-4years, presenting to a pediatric ED following minor head injury. Children with ≥1 risk element per the Pediatric Emergency Care Academic Research Network's decision rule were deemed "at-risk" for ciTBI...
January 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29432907/educational-text-messages-decreased-emergency-department-utilization-among-infant-caregivers-a-randomized-trial
#10
Amy Ladley, Amanda Waltos Hieger, Joshua Arthur, Matthew Broom
OBJECTIVE: This study sought to determine the feasibility and effectiveness of text messages as an educational tool to reduce the prevalence of nonurgent emergency department (ED) visits among a population with high levels of low health literacy. METHODS: Prospective, randomized experiment conducted in a large, urban, academic pediatric primary care practice enrolled 231 caregivers of infants into 2 groups: 1) enhanced standard of care (ESoC) materials at well-child visits through 6 months (n=99 completing); 2) ESoC and 4 text messages/week through 6 months (n=108 completing)...
February 9, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29432338/patient-reported-experience-in-the-pediatric-emergency-department-what-matters-most
#11
Mher Barbarian, Andrea Bishop, Patricia Alfaro, Alain Biron, Daniel Adam Brody, Gabrielle Cunningham-Allard, Alexander Sasha Dubrovsky
INTRODUCTION: Although the Child Hospital Consumer Assessment of Healthcare Providers and Systems is a validated tool for the inpatient experience, it may not address features unique to the pediatric emergency department (PED). There is currently no publicly available validated patient-reported experience survey for the PED, and what matters most in this setting remains unknown. METHODS: Twelve semistructured interviews were conducted with a convenience sample of parents of children younger than 14 years at a Canadian PED...
February 9, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29432247/transition-from-pediatric-to-adult-neurologic-care
#12
Ann H Tilton, Claudio Melo de Gusmao
PURPOSE OF REVIEW: With advances in medical care, the number of youths surviving with medically complex conditions has been steadily increasing. Inadequate transition planning and execution can lead to gaps in care, unexpected emergency department visits, and an increase in health care costs and patient/caregiver anxiety. Many barriers that prevent adequate transition have been identified, including insufficient time or staff to provide transition services, inadequate reimbursement, resistance from patients and caregivers, and a dearth of accepting adult providers...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29431096/introduction-of-pediatric-physiological-and-anatomical-triage-score-in-mass-casualty-incident
#13
Chiaki Toida, Takashi Muguruma, Takeru Abe, Mafumi Shinohara, Masayasu Gakumazawa, Naoki Yogo, Aya Shirasawa, Naoto Morimura
BACKGROUND: Triage has an important role in providing suitable care to the largest number of casualties in a disaster setting, but there are no secondary triage methods suitable for children. This study developed a new secondary triage method named the Pediatric Physiological and Anatomical Triage Score (PPATS) and compared its accuracy with current triage methods. METHODS: A retrospective chart review of pediatric patients under 16 years old transferred to an emergency center from 2014 to 2016 was performed...
February 12, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29429783/pediatric-stroke-and-its-mimics-limitations-of-a-pediatric-stroke-clinical-pathway
#14
Amy M DeLaroche, Lalitha Sivaswamy, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND: Acute stroke protocols improve delivery of care but it is unclear whether these resource intensive protocols are able to differentiate stroke from mimics in children. The aim of this study is to describe our institution's experience with stroke mimics identified through our pediatric stroke clinical pathway (PSCP). METHODS: The PSCP was implemented in our level 1 pediatric emergency department in June 2014 for children aged one month to 18 years. For patients managed using the PSCP from June 2014 to December 2016, demographic and clinical data were compared for patients diagnosed with stroke or a stroke mimic...
October 31, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29429528/changes-in-lipid-metabolism-in-pediatric-patients-with-severe-sepsis-and-septic-shock
#15
Ana Carolina G Bermudes, Werther B de Carvalho, Patricia Zamberlan, Giovana Muramoto, Raul C Maranhão, Artur F Delgado
OBJECTIVES: Limited knowledge exists regarding the lipid profiles of critically ill pediatric patients with systemic inflammatory response syndrome. The aim of this study was to evaluate the relationship between the intensity of the inflammatory response and changes in the lipid profiles of critically ill pediatric patients admitted to a pediatric intensive care unit (PICU) with severe sepsis/septic shock. METHODS: This was a prospective and observational study at a 15-bed PICU at a public university hospital...
March 2018: Nutrition
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#16
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29425881/pediatric-oncology-provider-perceptions-of-a-pediatric-palliative-care-service-the-influence-of-emotional-esteem-and-emotional-labor
#17
Julia E Szymczak, Theodore Schall, Douglas L Hill, Jennifer K Walter, Shefali Parikh, Concetta DiDomenico, Chris Feudtner
CONTEXT: Pediatric palliative care consults for children with cancer often occur late in the course of disease and close to death, when earlier involvement would reduce suffering. The perceptions that pediatric oncology providers hold about the pediatric palliative care service (PPCS) may shape referral patterns. OBJECTIVE: To explore how pediatric oncology providers at one institution perceived the hospital's PPCS and the way these perceptions may influence the timing of consultation...
February 6, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29422435/the-catch-to-confidentiality-the-use-of-electronic-health-records-in-adolescent-health-care
#18
Timothy Stablein, Keith J Loud, Christopher DiCapua, Denise L Anthony
PURPOSE: This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors. METHODS: Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR...
February 6, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29422230/commercial-sexual-exploitation-of-children-health-care-use-and-case-characteristics
#19
Gail Hornor, Jennifer Sherfield
OBJECTIVE: The purpose of this study was to describe pediatric health care utilization, familial psychosocial factors, child sexual abuse case characteristics, and patient demographic characteristics of adolescents prior to or at the time of their most recent identification as a victim of commercialized sexual exploitation of children (CSEC). METHODS: A retrospective chart review was conducted for the above detailed information of all adolescents presenting to the Emergency Department (ED) or Child Advocacy Center (CAC) of a pediatric hospital with concerns of suspected CSEC...
February 6, 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29416346/prediction-of-emergence-agitation-using-withdrawal-reaction-following-rocuronium-injection-in-preschool-aged-patients-undergoing-inguinal-herniorrhaphy-a-preliminary-exploratory-observational-trial
#20
Dae Hee Kim, Go Un Roh, Young Bok Lee, Chang Ik Choi, Jae Moon Lee, Yun Jeong Chae
Purpose: The development of emergence agitation (EA) is associated with several factors including age, preoperative anxiety, postoperative pain, anesthesia method, and surgery type. No studies have investigated whether the withdrawal reaction following rocuronium injection can predict the occurrence of EA. Therefore, we investigated this relationship in preschool-aged children undergoing inguinal herniorrhaphy, and which grade of withdrawal reaction is appropriate for identifying patients at risk of experiencing EA...
2018: Therapeutics and Clinical Risk Management
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