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https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#1
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28530457/-patient-turnover-in-a-multidisciplinary-emergency-department
#2
Csaba Varga, Zsuzsanna Lelovics, Viktor Soós, Tibor Oláh
INTRODUCTION: More than twenty emergency departments were opened across Hungary in the past years. Data deficiency on patient flow, trends and lack of knowledge of indicators could raise numerous logistical and organisational problems. AIM: Collection, analysis and provision of data to facilitate successful operations of emergency medical care services. METHOD: During a three-year period investigated, at the multidisciplinary Emergency Department of "Moritz Kaposi" Teaching Hospital, data on patient flow (n = 106,203), epidemiology, triage and international classification of diseases were analysed...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28530045/mental-health-challenges-among-adolescents-living-with-hiv
#3
Rachel C Vreeman, Brittany M McCoy, Sonia Lee
INTRODUCTION: Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28530038/hiv-treatment-and-care-services-for-adolescents-a-situational-analysis-of-218-facilities-in-23-sub-saharan-african-countries
#4
Daniella Mark, Alice Armstrong, Catarina Andrade, Martina Penazzato, Luann Hatane, Lina Taing, Toby Runciman, Jane Ferguson
INTRODUCTION: In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28522351/effect-of-early-supplemental-parenteral-nutrition-in-the-paediatric-icu-a-preplanned-observational-study-of-post-randomisation-treatments-in-the-pepanic-trial
#5
Ilse Vanhorebeek, Sascha Verbruggen, Michaël P Casaer, Jan Gunst, Pieter J Wouters, Jan Hanot, Gonzalo Garcia Guerra, Dirk Vlasselaers, Koen Joosten, Greet Van den Berghe
BACKGROUND: Large randomised controlled trials have shown that early supplemental parenteral nutrition in patients admitted to adult and paediatric intensive care units (PICUs) is harmful. Overdosing of energy with too little protein was suggested as a potential reason for this. This study analysed which macronutrient was associated with harm caused by early supplemental parenteral nutrition in the Paediatric Early versus Late Parenteral Nutrition In Critical Illness (PEPaNIC) randomised trial...
May 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28516470/survived-so-what-identifying-priorities-for-research-with-children-and-families-post-paediatric-intensive-care-unit
#6
Joseph C Manning, Pippa Hemingway, Sarah A Redsell
The involvement of patients and the public in the development, implementation and evaluation of health care services and research is recognized to have tangible benefits in relation to effectiveness and credibility. However, despite >96% of children and young people surviving critical illness or injury, there is a paucity of published reports demonstrating their contribution to informing the priorities for aftercare services and outcomes research. We aimed to identify the service and research priorities for Paediatric Intensive Care Unit survivors with children and young people, their families and other stakeholders...
May 17, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28488302/the-big-d-eal-professional-identity-through-discursive-constructions-of-patient
#7
Brett Schrewe, Joanna Bates, Dan Pratt, Claudia W Ruitenberg, William H McKellin
CONTEXT: Professional identity formation has become a key focus for medical education. Who one becomes as a physician is contingent upon learning to conceptualise who the other is as a patient, yet, at a time when influential ideologies such as patient-centred care have become espoused values, there has been little empirical investigation into assumptions of 'patient' that trainees take up as they progress through their training. METHODS: Our team employed a critical discourse analysis approach to transcripts originally produced from a micro-ethnography of medical student learning on an acute care in-patient paediatric ward...
June 2017: Medical Education
https://www.readbyqxmd.com/read/28486889/coming-full-circle-thirty-years-of-paediatric-fluid-resuscitation
#8
N J Glassford, B Gelbart, R Bellomo
Fluid bolus therapy (FBT) is a cornerstone of the management of the septic child, but clinical research in this field is challenging to perform, and hard to interpret. The evidence base for independent benefit from liberal FBT in the developed world is limited, and the Fluid Expansion as Supportive Therapy (FEAST) trial has led to conservative changes in the World Health Organization-recommended approach to FBT in resource-poor settings. Trials in the intensive care unit (ICU) and emergency department settings post-FEAST have continued to explore liberal FBT strategies as the norm, despite a strong signal associating fluid accumulation with pulmonary pathology in the paediatric population...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28454012/spatial-clustering-of-childhood-leukaemia-with-the-integration-of-the-paediatric-environmental-history
#9
Alberto Cárceles-Álvarez, Juan A Ortega-García, Fernando A López-Hernández, Mayra Orozco-Llamas, Blanca Espinosa-López, Esther Tobarra-Sánchez, Lizbeth Alvarez
BACKGROUND: Leukaemia remains the most common type of paediatric cancer and its aetiology remains unknown, but considered to be multifactorial. It is suggested that the initiation in utero by relevant exposures and/or inherited genetic variants and, other promotional postnatal exposures are probably required to develop leukaemia. This study aimed to map the incidence and analyse possible clusters in the geographical distribution of childhood acute leukaemia during the critical periods and to evaluate the factors that may be involved in the aetiology by conducting community and individual risk assessments...
April 25, 2017: Environmental Research
https://www.readbyqxmd.com/read/28443439/-i-can-t-think-of-a-better-career
#10
(no author information available yet)
After qualifying in the 1980s, Sheila McQueen held a variety of roles in paediatric critical care, including advanced practitioner. She moved to academia in 2002 working as a senior lecturer, and became head of department for public health and wellbeing at Northumbria University in 2013. She has been in her current role as professor of nursing and continuing professional education at the University of Sunderland since July 2016.
April 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28442215/-neopterin-levels-and-systemic-inflammatory-response-syndrome-in-pediatric-critically-ill-patients
#11
Raquel Gil-Gómez, Javier Blasco-Alonso, Pilar Sánchez-Yáñez, Vanessa Rosa-Camacho, Guillermo Milano Manso
INTRODUCTION: Neopterin and biopterin are sub-products of redox reactions, which act as cofactors of enzymes responsible for nitric oxide production. The hypothesis is presented that plasma neopterin and biopterin evolve differently during the first days in a critically ill child. METHODS: A single-centre prospective observational study was conducted on patients 7 days to 14 years admitted to our Paediatric Intensive Care Unit (PICU) and that met Systemic inflammatory response syndrome (SIRS) criteria...
April 22, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#12
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28390609/peri-operative-management-of-high-risk-paediatric-adenotonsillectomy-patients-a-survey-of-35-uk-tertiary-referral-centres
#13
Ryan Chin Taw Cheong, Philippe Bowles, Andrew Moore, Simon Watts
INTRODUCTION: Peri-operative management of high-risk paediatric patients undergoing adenotonsillectomy for treatment of obstructive sleep apnoea varies between tertiary referral hospitals. 'Day of surgery cancellation' (DoSC) rates of up to 11% have been reported due to pre-booked critical care being unavailable on the day of surgery as a result of competing needs from other hospital departments. We report the results of a survey of peri-operative management in UK tertiary care centres of high-risk paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea (OSA)...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28384894/ear-nose-and-throat-foreign-bodies-removed-under-general-anaesthesia-a-retrospective-study
#14
Neizekhotuo Brian Shunyu, Hanifa Akhtar, Habib Md Rezaul Karim, Nari M Lyngdoh, Md Yunus, Md Jamil
INTRODUCTION: For Otorhinolaryngologist, removal of Foreign Bodies (FB) from the ear, nose and throat is one of the common emergency procedures done. Most of the cases especially of the ear and nose can be managed without General Anaesthesia (GA). But in some cases GA may be needed. There are very few studies that address the scenario of ear, nose and throat foreign body that required GA for its removal and the complications associated with it. AIM: This study was conducted with the aim to study the patient's profile, types and distribution of FB removed under GA, and the associated complications...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28380408/haemodynamic-changes-with-paracetamol-in-critically-ill-children
#15
Samiran Ray, Thomas Brick, Sainath Raman, Paul J Birrell, Nigel J Klein, Mark J Peters
PURPOSE: Paracetamol has been associated with a reduction in blood pressure, especially in febrile, critically-ill adults. We hypothesised that blood pressure would fall following administration of paracetamol in critically-ill children and this effect would be greater during fever and among children with a high body surface area to weight ratio. METHODS: A 12-month prospective observational study of children (0-16years) admitted to paediatric intensive care, who underwent pulse contour analysis and received paracetamol concurrently...
March 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28367745/the-intersection-of-abandonment-hiv-positive-status-and-residential-care-for-a-group-of-perinatally-infected-adolescents
#16
REVIEW
Jeanette Schmid, Jenita Chiba
Although anti-retroviral treatments have significantly reduced the incidence of mother-to-child transmission of HIV and AIDS, there remains, for the foreseeable future, a group of adolescents who have been perinatally infected. Noting the paucity of information regarding the impact of paediatric AIDS and its intersection with residential care, this paper investigates the lived realities of 20 South African adolescents who were vertically infected with HIV and AIDS, were abandoned, and have been raised in residential care...
March 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28359769/regular-in-situ-simulation-training-of-paediatric-medical-emergency-team-leads-to-sustained-improvements-in-hospital-response-to-deteriorating-patients-improved-outcomes-in-intensive-care-and-financial-savings
#17
Ulf Theilen, Laura Fraser, Patricia Jones, Paul Leonard, Dave Simpson
AIM OF THE STUDY: The introduction of a paediatric Medical Emergency Team (pMET) was accompanied by weekly in-situ simulation team training. Key ward staff participated in team training, focusing on recognition of the deteriorating child, teamwork and early involvement of senior staff. Following an earlier study [1], this investigation aimed to evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications...
March 28, 2017: Resuscitation
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#18
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28298202/evaluation-of-sublingual-microcirculation-in-a-paediatric-intensive-care-unit-prospective-observational-study-about-its-feasibility-and-utility
#19
Rafael González, Jorge López, Javier Urbano, María José Solana, Sarah Nicole Fernández, María José Santiago, Jesús López-Herce
BACKGROUND: Evaluation of the microcirculation in critically ill patients is usually done by means of indirect parameters. The aim of our study was to evaluate the functional state of the microcirculation by direct visualization of sublingual microcirculation using Sidestream Dark Field Imaging, to determine the correlation between these findings and other parameters that are commonly used in the clinical practice and to assess the applicability of the systematic use of this technique in critically ill children...
March 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28292743/-the-score-matters-wide-variations-in-predictive-performance-of-18-paediatric-track-and-trigger-systems
#20
Susan M Chapman, Jo Wray, Kate Oulton, Christina Pagel, Samiran Ray, Mark J Peters
OBJECTIVE: To compare the predictive performance of 18 paediatric early warning systems (PEWS) in predicting critical deterioration. DESIGN: Retrospective case-controlled study. PEWS values were calculated from existing clinical data, and the area under the receiver operator characteristic curve (AUROC) compared. SETTING: UK tertiary referral children's hospital. PATIENTS: Patients without a 'do not attempt resuscitation' order admitted between 1 January 2011 and 31 December 2012...
March 14, 2017: Archives of Disease in Childhood
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