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Children with medical complexity

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https://www.readbyqxmd.com/read/29351045/gender-views-and-relationships-in-families-of-children-with-craniofacial-differences
#1
Danielle N Shapiro, Jennifer Waljee, Steven Buchman, Kavitha Ranganathan, Seth Warshcausky
OBJECTIVE: Gender values and beliefs are known to influence family functioning. The aim of the current study was to describe the association between views about gender and family functioning within families with a child with a craniofacial difference (CFD). DESIGN: Participants included 74 dyads composed of children (8-18 years old) with CFD (n = 36 female), including cleft lip/palate, and a parent (n = 56 female). Children and caregivers both completed the activities subscale of the Occupations, Activities, and Traits-Attitudes Measure (C/OAT-AM)...
February 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29346235/posttraumatic-stress-in-children-after-injury-the-role-of-acute-pain-and-opioid-medication-use
#2
Aimee K Hildenbrand, Nancy Kassam-Adams, Lamia P Barakat, Kristen L Kohser, Jeffrey A Ciesla, Douglas L Delahanty, Joel A Fein, Lindsay B Ragsdale, Meghan L Marsac
OBJECTIVES: After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346231/the-complex-association-of-race-ethnicity-with-pain-treatment-quality-in-an-urban-medical-center-with-2-pediatric-emergency-departments
#3
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29344711/adult-picc-device-may-be-used-as-a-tunnelled-central-venous-catheter-in-children
#4
Brooke T Lawson, Ian A Zealley
PURPOSE: Central venous access in children, in particular small children and infants, is challenging. We have developed a technique employing adult peripherally inserted central venous catheters (PICCs) as tunnelled central venous catheters (TCVCs) in children. The principal advantage of this novel technique is that the removal technique is less complex than that of conventional cuffed TCVCs. The catheter can be removed simply by being pulled out and does not require general anaesthesia...
January 17, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29338077/blenderized-enteral-nutrition-diet-study-feasibility-clinical-and-microbiome-outcomes-of-providing-blenderized-feeds-through-a-gastric-tube-in-a-medically-complex-pediatric-population
#5
Kelsey Gallagher, Annika Flint, Marialena Mouzaki, Andrea Carpenter, Beth Haliburton, Louise Bannister, Holly Norgrove, Lisa Hoffman, David Mack, Alain Stintzi, Margaret Marcon
BACKGROUND: Chronically ill children often require feeding via gastrostomy tubes (G-tubes). Commercial formula is most commonly used for enteral feeding; however, caregivers have been requesting blenderized tube feeds (BTFs) as an alternative. The objective of this study was to evaluate the feasibility of using BTFs in a medically complex pediatric population and assess their impact on clinical outcomes, as well as the microbiota. METHODS: Twenty pediatric participants were included...
January 16, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29330225/genetics-in-endocrinology-genetic-counseling-for-congenital-hypogonadotropic-hypogonadism-and-kallmann-syndrome-new-challenges-in-the-era-of-oligogenism-and-next-generation-sequencing
#6
Luigi Maione, Andrew A Dwyer, Bruno Francou, Anne Guiochon-Mantel, Nadine Binart, Jerome Bouligand, Jacques Young
Congenital hypogonadotropic hypogonadism (CHH) and Kallmann syndrome (KS) are rare, related diseases that prevent normal pubertal development and cause infertility in affected men and women. However, the infertility carries a good prognosis as increasing numbers of patients with CHH/KS are now able to have children through medically assisted procreation. These are genetic diseases that can be transmitted to patients' offspring. Importantly patients and their families should be informed of this risk and given genetic counseling...
January 12, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29329165/repeat-rapid-response-events-in-children-characteristics-and-outcomes
#7
Kristen M Meulmester, Nancy Jaimon, Aarti C Bavare
OBJECTIVE: We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN: A 3-year retrospective study. SETTING: High-volume tertiary academic pediatric hospital. PATIENTS: All rapid response events were reviewed to identify repeat rapid response events...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29318107/the-3600child-profile-a-reliable-and-valid-tool-to-visualize-integral-child-information
#8
Miriam Weijers, Frans J M Feron, Caroline H G Bastiaenen
A 3600Child-profile, with theoretically ordered, integral child-information visualized in one image, is designed by the Dutch preventive Child and Youth Health Care (CYHC). The introduction of this new data/information carrier gives an important incentive to enhance a transformation towards personalized health care for children and adolescents by supporting the complex medical thought process of CYHCmedical doctors (MD's). This information tool aims to effectively estimate child's functioning, detect emerging health problems and inform parents and caregivers...
March 2018: Preventive Medicine Reports
https://www.readbyqxmd.com/read/29317608/epigenetics-and-cerebral-organoids-promising-directions-in-autism-spectrum-disorders
#9
REVIEW
Sheena Louise Forsberg, Mirolyuba Ilieva, Tanja Maria Michel
Autism spectrum disorders (ASD) affect 1 in 68 children in the US according to the Centers for Disease Control and Prevention (CDC). It is characterized by impairments in social interactions and communication, restrictive and repetitive patterns of behaviors, and interests. Owing to disease complexity, only a limited number of treatment options are available mainly for children that alleviate but do not cure the debilitating symptoms. Studies confirm a genetic link, but environmental factors, such as medications, toxins, and maternal infection during pregnancy, as well as birth complications also play a role...
January 10, 2018: Translational Psychiatry
https://www.readbyqxmd.com/read/29317386/the-perceived-ease-of-use-and-usefulness-of-loop-evaluation-and-content-analysis-of-a-web-based-clinical-collaboration-system
#10
Allison M Kurahashi, Jennifer N Stinson, Margaret van Wyk, Stephanie Luca, Trevor Jamieson, Peter Weinstein, Joseph A Cafazzo, Bhadra Lokuge, Eyal Cohen, Adam Rapoport, Amna Husain
BACKGROUND: Patients with complex health care needs require the expertise of many health care providers. Communication, collaboration, and patient-centered care positively impact care quality and patient outcomes. Few technologies exist that facilitate collaboration between providers across settings of care and also engage the patient. We developed a Web-based clinical collaboration system, Loop, to address this gap. The likelihood of a technological system's uptake is associated with its perceived ease of use and perceived usefulness...
January 9, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29317153/should-patients-with-complex-febrile-seizure-be-admitted-for-further-management
#11
Heather Olson, Tiffany Rudloe, Tobias Loddenkemper, Marvin B Harper, Amir A Kimia
BACKGROUND AND AIMS: Children with first complex febrile seizure (CFS) are often admitted for observation. The goals of this study were 1) to assess the risk of seizure recurrence during admission, 2) to determine whether early EEG affects acute management. DESIGN/METHODS: We retrospectively reviewed a cohort of children 6-60months of age admitted from a Pediatric Emergency Department for first CFS over a 15year period. We excluded children admitted for supportive care of their febrile illness...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29311178/using-state-administrative-data-to-identify-social-complexity-risk-factors-for-children
#12
Kimberly C Arthur, Barbara A Lucenko, Irina V Sharkova, Jingping Xing, Rita Mangione-Smith
PURPOSE: Screening for social determinants of health is challenging but critically important for optimizing child health outcomes. We aimed to test the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examined their relationship to emergency department (ED) use. METHODS: We conducted a retrospective cohort study among children younger than 18 years with Washington State Medicaid insurance coverage (N = 505,367)...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29309846/barriers-to-physical-activity-in-urban-school-children-with-asthma-parental-perspective
#13
Amy Kornblit, Agnieszka Cain, Laurie J Bauman, Nicole Brown, Marina Reznik
OBJECTIVE: Physical activity (PA) levels are low in today's youth and may even be lower in those with asthma. Barriers to PA have not been well studied in inner-city, minority children with asthma. We conducted a qualitative study to characterize parental perceptions of barriers to PA and ways to improve PA levels in children with asthma. METHODS: We used the socio-ecological model (SEM) to inform development of our interview guide. Questions fell into two SEM domains: 1) interpersonal (parent, family) barriers and 2) community (neighborhood, school) barriers...
January 5, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29307670/validity-and-comprehensibility-of-outcome-measures-in-children-with-shoulder-and-elbow-disorders-creation-of-a-new-pediatric-and-adolescent-shoulder-and-elbow-survey-pedi-ases
#14
Benton Heyworth, Lara Cohen, Johan von Heideken, Mininder S Kocher, Maura Daly Iversen
BACKGROUND: Valid patient-reported outcomes (PROs) for the shoulder and elbow do not exist for children. We assessed children's comprehension of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form, identified response errors, and modified items to create a new pediatric shoulder and elbow PRO. METHODS: We recruited 50 children (aged 10-18 years) with shoulder or elbow disorders from a children's hospital-based orthopedic clinic for this qualitative study...
January 5, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29304798/-we-were-being-treated-like-the-queen-understanding-trial-factors-influencing-high-paediatric-malaria-treatment-adherence-in-western-kenya
#15
Caroline Jones, Ambrose O Talisuna, Robert W Snow, Dejan Zurovac
BACKGROUND: Adherence to anti-malarial medication is highly variable but frequently suboptimal. Numerous interventions with a variety of methodological approaches have been implemented to address the problem. A recently conducted, randomized, controlled trial in western Kenya evaluated the effects of short message service (SMS) reminders on paediatric adherence to artemether-lumefantrine (AL) and found over 97% adherence rates in both intervention and control arms. The current study was undertaken to explore participants' experiences in the trial and identify the factors contributing to the high adherence rates...
January 5, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29296062/determinants-of-successful-medical-education-of-caregivers-of-children-with-congenital-heart-diseases
#16
Ahmad S Azhar, Zaher F Zaher, Noran M Abu-Ouf, Jameel Al-Ata, Sara Taisir A Alsheblie
Objective: To assess the implementation and efficiency of medical education among the caregivers of children with congenital heart disease (CHD) and to investigate its success factors. Material and method: A cross-sectional study was conducted from February 2014 to March 2014 in a tertiary healthcare center. Study included 120 caregivers of children with CHD visiting the Paediatric Cardiology Clinic that included 93% mothers, aged 31.72 ± 6.67 years, 38.3% Saudi citizens and 45...
January 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29284043/complex-patterns-of-concomitant-medication-use-a-study-among-norwegian-women-using-paracetamol-during-pregnancy
#17
Stefania Salvatore, Diana Domanska, Mollie Wood, Hedvig Nordeng, Geir Kjetil Sandve
BACKGROUND: Studies on medication safety in pregnancy often rely on an oversimplification of medication use into exposed or non-exposed, without considering intensity and timing of use in pregnancy, or concomitant medication use. This study uses paracetamol in pregnancy as the motivating example to introduce a method of clustering medication exposures longitudinally throughout pregnancy. The aim of this study was to use hierarchical cluster analysis (HCA) to better identify clusters of medication exposure throughout pregnancy...
2017: PloS One
https://www.readbyqxmd.com/read/29283024/assessment-of-executive-functions-in-children-and-adolescents-with-acquired-brain-injury-abi-using-a-novel-complex-multi-tasking-computerised-task-the-jansari-assessment-of-executive-functions-for-children-jef-c%C3%A2
#18
Yafit Gilboa, Ashok Jansari, Bernadette Kerrouche, Emel Uçak, Anne Tiberghien, Ouarda Benkhaled, Delphine Aligon, Aude Mariller, Valentine Verdier, Amaia Mintegui, Geneviève Abada, Céline Canizares, Andrew Goldstein, Mathilde Chevignard
OBJECTIVES: The Jansari assessment of Executive Functions for Children (JEF-C©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C© in children and adolescents with acquired brain injury (ABI). METHODS: Twenty-nine patients with ABI aged 10-18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire...
December 28, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/29280785/the-epidemiology-of-health-care-associated-infections-in-pediatric-cardiac-intensive-care-units
#19
Jeffrey A Alten, Akm Fazlur Rahman, Hayden J Zaccagni, Andrew Shin, David S Cooper, Joshua J Blinder, Lauren Retzloff, Inmaculada B Aban, Eric M Graham, Jeffrey Zampi, Yuliya Domnina, Michael G Gaies
BACKGROUND: Health-care associated infections (HAI) represent serious complications for patients within pediatric cardiac intensive care units (CICU). HAI are associated with increased morbidity, mortality, and resource utilization. There are few studies describing the epidemiology of HAI across the entire spectrum of patients (surgical and non-surgical) receiving care in dedicated pediatric CICUs. METHODS: Retrospective analyses of 22,839 CICU encounters from 10/2013-9/2016 across 22 North American CICUs contributing data to the Pediatric Cardiac Critical Care Consortium clinical registry...
December 26, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29276597/urinary-perforation-in-spina-bifida-neurosurgical-and-infectious-consequences
#20
Deborah Callanan, Timothy Phillips, Micam Tullous
As the number of medically complex children increases, pediatricians and emergency physicians face challenges in evaluating complications from devices placed to treat their underlying conditions. We present a child with spina bifida who developed a perforation of his vesicostomy leading to peritonitis, septic shock, and urgent externalization of his ventriculoperitoneal shunt. Multiple consultants may need to be promptly involved in the management of children with underlying medical problems. Because procedural complications are often reported only in the surgical specialty literature, pediatricians and emergency physicians should seek information from their patients' specialists about potential problems...
2017: SAGE Open Medical Case Reports
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