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https://www.readbyqxmd.com/read/29245167/-are-we-really-as-happy-as-we-think-we-are-a-critical-examination-of-work-satisfaction-in-a-university-pediatric-hospital
#1
Andreas Hiemisch, Yve Stöbel-Richter, Gesine Grande, Elmar Brähler, Wieland Kiess
Goals Despite numerous reported deficits and an increasingly tense working environment in German hospitals, employees themselves often assess their job satisfaction as being high to very high. Hence, the board of directors does not have important arguments for sustainable improvement of working conditions. This discrepancy between working conditions and subjective satisfaction was the motivation for this work. Methods Data were acquired via an attitude survey at the University Hospital for Children and Adolescents Leipzig, with employees sub-divided into medical, nursing and administrative/technical staff...
December 15, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29245068/overexpression-of-microrna-375-impedes-platelet-derived-growth-factor-induced-proliferation-and-migration-of-human-fetal-airway-smooth-muscle-cells-by-targeting-janus-kinase-2
#2
Yamei Ji, Xin Yang, Huixia Su
The abnormal proliferation and migration of airway smooth muscle (ASM) cells play a critical role in airway remodeling during the development of asthma. MicroRNAs (miRNAs) have emerged as critical regulators of ASM cell proliferation and migration in airway remodeling. In this study, we aimed to investigate the potential role of miR-375 in the regulation of platelet-derived growth factor (PDGF)-induced fetal ASM cell proliferation and migration. Our results showed that miR-375 expression was significantly decreased in fetal ASM cells that were treated with PDGF...
December 12, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29244842/intensive-care-treatments-associated-with-favorable-discharge-outcomes-in-argentine-children-with-severe-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#3
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Michael J Bell, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Carly K Farr, Gustavo J Petroni
OBJECTIVE: Little is known about the critical care management of children with traumatic brain injury (TBI) in low middle income countries. We aimed to identify indicators of intensive care unit (ICU) treatments associated with favorable outcomes in Argentine children with severe TBI. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with severe TBI who were admitted to an ICU in one of the seven study centers...
2017: PloS One
https://www.readbyqxmd.com/read/29244792/tight-glycemic-control-in-critically-ill-pediatric-patients-a-meta-analysis-and-systematic-review-of-randomized-controlled-trials
#4
Yiyang Zhao, Yang Wu, Bo Xiang
BACKGROUND: There still are controversies in the impact of tight glycemic control (TGC) in critically ill children. The aim of this study was to assess the benefits and risks of TGC compared with conventional glycemic control (CGC) in critically ill pediatric patients admitted to the pediatric intensive care unit (PICU) by using data retrieved from randomized controlled trials (RCTs). METHOD: EMBASE, CNKI, PubMed and the Cochrane Database were searched for RCTs comparing TGC with CGC in critically ill children in PICU...
December 15, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29243544/communication-is-key-the-utility-of-a-revised-neuropsychological-report-format
#5
Katherine T Baum, Christian von Thomsen, Megan Elam, Christel Murphy, Melissa Gerstle, Cynthia A Austin, Dean W Beebe
OBJECTIVE: The neuropsychological report is a critical tool for communicating evaluation results to multiple audiences who have varying knowledge about neuropsychology and often have limited ability to review long, complex reports. Considerable time is spent writing these reports and challenges persist related to readability, length/complexity, and billable clinical time (which may be capped by third-party payors or families' ability to pay). METHODS: This quality improvement effort systematically evaluated the redesign of pediatric neuropsychological reports in an outpatient clinic serving primarily medical populations...
December 15, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/29243536/variation-in-pediatric-organ-donor-management-practices-among-us-organ-procurement-organizations
#6
Robert S Ream, Eric S Armbrecht
INTRODUCTION: Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. RESEARCH QUESTION: To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29243190/faltering-growth-in-the-critically-ill-child-prevalence-risk-factors-and-impaired-outcome
#7
Frédéric V Valla, Julien Berthiller, Bénédicte Gaillard-Le-Roux, Carole Ford-Chessel, Tiphanie Ginhoux, Shancy Rooze, Fleur Cour-Andlauer, Rosan Meyer, Etienne Javouhey
Low body mass index (BMI) z score is commonly used to define undernutrition, but faltering growth allows for a complementary dynamic assessment of nutritional status. We studied the prevalence of undernutrition and faltering growth at admission in the pediatric intensive care (PICU) setting and their impacts on outcome. All (685) consecutive children (aged 0 to 18 years old) admitted in a single-center PICU over a 1-year period were prospectively enrolled. Nutritional status assessment was based on anthropometric measurements performed at admission and collected from medical files...
December 14, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29241376/non-endoscopic-biopsy-techniques-a-review
#8
David O Otuya, Yogesh Verma, Hamid Farrokhi, Lisa Higgins, Mireille Rosenberg, Christopher Damman, Guillermo J Tearney
Diseases of the stomach and small intestine account for approximately 20% of all gastrointestinal (GI)-related mortality. Biopsy of the stomach and small intestine remains a key diagnostic tool for most of the major diseases that affect the GI tract. While endoscopic means for obtaining biopsy is generally the standard of care, it has several limitations that make it less ideal for pediatric patients and in low resource areas of the world. Therefore, non-endoscopic means for obtaining biopsy samples is of interest in these settings...
December 15, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29240568/the-epidemiology-of-pediatric-head-injury-treated-outside-of-hospital-emergency-departments
#9
Cheryl K Zogg, R Sterling Haring, Likang Xu, Joseph K Canner, Hatim A AlSulaim, Zain G Hashmi, Ali Salim, Lilly D Engineer, Adil H Haider, Jeneita M Bell, Eric B Schneider
BACKGROUND: Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17y) patients presenting in outpatient settings with those of patients seeking non-hospitalized emergency department care. METHODS: We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department...
December 13, 2017: Epidemiology
https://www.readbyqxmd.com/read/29239979/monitoring-haloperidol-plasma-concentration-and-associated-adverse-events-in-critically-ill-children-with-delirium-first-results-of-a-clinical-protocol-aimed-to-monitor-efficacy-and-safety
#10
Valerie D Slooff, Desley K van den Dungen, Babette S van Beusekom, Naomi Jessurun, Erwin Ista, Dick Tibboel, Saskia N de Wildt
OBJECTIVES: As delirium in critically ill children is increasingly recognized, more children are treated with the antipsychotic drug haloperidol, while current dosing guidelines are lacking solid evidence and appear to be associated with a high risk of adverse events. We aim to report on the safety and efficacy of a recently implemented clinical dose-titration protocol with active monitoring of adverse events. DESIGN: From July 2014 until June 2015, when a potential delirium was identified by regular delirium scores and confirmed by a child psychiatrist, haloperidol was prescribed according to the Dutch Pediatric Formulary...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239978/picu-length-of-stay-factors-associated-with-bed-utilization-and-development-of-a-benchmarking-model
#11
Murray M Pollack, Richard Holubkov, Ron Reeder, J Michael Dean, Kathleen L Meert, Robert A Berg, Christopher J L Newth, John T Berger, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, Tammara L Jenkins, Robert Tamburro
OBJECTIVES: ICU length of stay is an important measure of resource use and economic performance. Our primary aims were to characterize the utilization of PICU beds and to develop a new model for PICU length of stay. DESIGN: Prospective cohort. The main outcomes were factors associated with PICU length of stay and the performance of a regression model for length of stay. SETTING: Eight PICUs. PATIENTS: Randomly selected patients (newborn to 18 yr) from eight PICUs were enrolled from December 4, 2011, to April 7, 2013...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239951/the-clinical-utility-of-noninvasive-pulse-co-oximetry-hemoglobin-measurements-in-dark-skinned-critically-ill-patients
#12
Susan M Murphy, Shahed Omar
BACKGROUND: The primary objective of this study was to assess the clinical usefulness of a point-of-care device which measures hemoglobin noninvasively (SpHb) in a group of critically ill participants with dark skin pigmentation. METHODS: One hundred forty-six adult and pediatric participants from a multidisciplinary intensive care unit had intermittent readings of noninvasive hemoglobin measurements performed at a minimum of 4 hourly intervals. A total of 371 readings were analyzed...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29235663/digital-screen-time-limits-and-young-children-s-psychological-well-being-evidence-from-a-population-based-study
#13
Andrew K Przybylski, Netta Weinstein
There is little empirical understanding of how young children's screen engagement links to their well-being. Data from 19,957 telephone interviews with parents of 2- to 5-year-olds assessed their children's digital screen use and psychological well-being in terms of caregiver attachment, resilience, curiosity, and positive affect in the past month. Evidence did not support implementing limits (< 1 or < 2 hr/day) as recommended by the American Academy of Pediatrics, once variability in child ethnicity, age, gender, household income, and caregiver educational attainment were considered...
December 13, 2017: Child Development
https://www.readbyqxmd.com/read/29234572/resection-of-a-pediatric-thalamic-juvenile-pilocytic-astrocytoma-with-whole-brain-tractography
#14
Howard L Weiner, Dimitris G Placantonakis
The resection of deep-seated brain tumors has been associated with morbidity due to injury to critical neural structures during the approach. Recent technological advancements in navigation and stereotaxy, surgical planning, brain tractography and minimal-access brain ports present the opportunity to overcome such limitations. Here, we present the case of a pediatric patient with a left thalamic/midbrain juvenile pilocytic astrocytoma (JPA). The tumor displaced the corticospinal fibers posteriorly and resulted in hemiparesis...
October 11, 2017: Curēus
https://www.readbyqxmd.com/read/29234503/study-protocol-for-a-phase-ii-dose-evaluation-randomized-controlled-trial-of-cholecalciferol-in-critically-ill-children-with-vitamin-d-deficiency-vitdal-picu-study
#15
Dayre McNally, Karin Amrein, Katharine O'Hearn, Dean Fergusson, Pavel Geier, Matt Henderson, Ali Khamessan, Margaret L Lawson, Lauralyn McIntyre, Stephanie Redpath, Hope A Weiler, Kusum Menon
Background: Clinical research has recently demonstrated that vitamin D deficiency (VDD) is highly prevalent in the pediatric intensive care unit (PICU) and associated with worse clinical course. Multiple adult ICU trials have suggested that optimization of vitamin D status through high-dose supplementation may reduce mortality and improve other clinically relevant outcomes; however, there have been no trials of rapid normalization in the PICU setting. The objective of this study is to evaluate the safety and efficacy of an enteral weight-based cholecalciferol loading dose regimen in critically ill children with VDD...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29233726/understanding-the-factors-that-control-the-quality-of-mini-tablet-compression-flow-particle-size-and-tooling-dimension
#16
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
#17
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/29232903/pediatric-thermal-burns-and-treatment-a-review-of-progress-and-future-prospects
#18
REVIEW
Elton Mathias, Madhu Srinivas Murthy
Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population...
December 11, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29232353/improving-pediatric-preparedness-in-critical-access-hospital-emergency-departments-impact-of-a-longitudinal-in-situ-simulation-program
#19
Jessica H Katznelson, Jiangxia Wang, Martha W Stevens, William A Mills
OBJECTIVES: Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios. METHODS: Five CAHs conducted 6 high-fidelity pediatric simulations over a 12-month period. Team performance was evaluated using a validated 35-item checklist representing commonly expected resuscitation team interventions...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29232173/tele-pediatric-intensive-care-for-critically-ill-children-in-syria
#20
Muhammad Bakr Ghbeis, Katherine M Steffen, Elizabeth A Braunlin, Gregory J Beilman, Jay Dahman, Waseem Ostwani, Marie E Steiner
BACKGROUND: Armed conflicts can result in humanitarian crises and have major impacts on civilians, of whom children represent a significant proportion. Usual pediatric medical care is often disrupted and trauma resulting from war-related injuries is often devastating. High pediatric mortality rates are thus experienced in these ravaged medical environments. INTRODUCTION: Using simple communication technology to provide real-time management recommendations from highly trained pediatric personnel can provide substantive clinical support and have a significant impact on pediatric morbidity and mortality...
December 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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