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Pediatric residency

Kathleen Falster, Emily Banks, Sanja Lujic, Michael Falster, John Lynch, Karen Zwi, Sandra Eades, Alastair H Leyland, Louisa Jorm
BACKGROUND: Australian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children. METHODS: This statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children...
October 21, 2016: BMC Pediatrics
Isabelle Bragard, Nesrine Farhat, Marie-Christine Seghaye, Oliver Karam, Arthur Neuschwander, Yasaman Shayan, Katharina Schumacher
OBJECTIVES: Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias. METHODS: Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval...
October 18, 2016: Pediatric Emergency Care
Colleen Braun, David O Kessler, Marc Auerbach, Renuka Mehta, Anthony J Scalzo, James M Gerard
OBJECTIVES: The aims of this study were to provide validity evidence for infant lumbar puncture (ILP) checklist and global rating scale (GRS) instruments when used by residents to assess simulated ILP performances and to compare these metrics to previously obtained attending rater data. METHODS: In 2009, the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) developed checklist and GRS scoring instruments, which were previously validated among attending raters when used to assess simulated ILP performances...
October 18, 2016: Pediatric Emergency Care
Manasi Hulyalkar, Stephen J Gleich, Rahul Kashyap, Amelia Barwise, Harsheen Kaur, Yue Dong, Lei Fan, Srinivas Murthy, Grace M Arteaga, Sandeep Tripathi
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. Prospective pre- and post-interventional data included: team performance baseline assessment, patient safety discussion, guideline adherence, rounding time, and a survey of Residents' and Nurses' perception using a Likert scale...
October 18, 2016: Journal of Clinical Monitoring and Computing
Laura L Bio, Brandon J Patterson, Sanchita Sen, Angela L Bingham, Jane F Bowen, Benjamin Ereshefsky, Laura A Siemianowski
Objective. To identify the temporal effect and factors associated with student pharmacist self-initiation of interventions during acute patient care advanced pharmacy practice experiences (APPE). Methods. During the APPE, student pharmacists at an academic medical center recorded their therapeutic interventions and who initiated the intervention throughout clinical rotations. At the end of the APPE student pharmacists completed a demographic survey. Results. Sixty-two student pharmacists were included. Factors associated with lower rates of self-initiated interventions were infectious diseases and pediatrics APPEs and an intention to pursue a postgraduate residency...
September 25, 2016: American Journal of Pharmaceutical Education
Jennifer D H Walthall, Aaron Burgess, Elizabeth Weinstein, Charles Miramonti, Thomas Arkins, Sarah Wiehe
OBJECTIVE: This study aimed to describe spatiotemporal correlates of pediatric violent injury in an urban community. METHODS: We performed a retrospective cohort study using patient-level data (2009-2011) from a novel emergency medical service computerized entry system for violent injury resulting in an ambulance dispatch among children aged 0 to 16 years. Assault location and patient residence location were cleaned and geocoded at a success rate of 98%. Distances from the assault location to both home and nearest school were calculated...
October 17, 2016: Pediatric Emergency Care
Todd P Chang, Sheree M Schrager, Alyssa J Rake, Michael W Chan, Phung K Pham, Grant Christman
Multimedia in assessing clinical decision-making skills (CDMS) has been poorly studied, particularly in comparison to traditional text-based assessments. The literature suggests multimedia is more difficult for trainees. We hypothesize that pediatric residents score lower in diagnostic skill when clinical vignettes use multimedia rather than text for patient findings. A standardized method was developed to write text-based questions from 60 high-resolution, quality multimedia; a series of expert panels selected 40 questions with both a multimedia and text-based counterpart, and two online tests were developed...
October 17, 2016: Advances in Health Sciences Education: Theory and Practice
Chen Zhan, Natalia Grundtvig, Bent Helmuth Klug
OBJECTIVES: Recent studies suggest that lung ultrasound is a good, radiation-free alternative to chest radiography in children with pneumonia. We investigated how bedside lung ultrasound performed by a pediatric resident compared with chest radiography in children with suspected pneumonia. METHODS: This was a prospective study comparing bedside lung ultrasound to chest radiography as the reference standard. Children aged 0 to 15 years with suspected pneumonia at a pediatric emergency department were included and underwent chest radiography and lung ultrasound...
October 4, 2016: Pediatric Emergency Care
Ruixue Miao, Zhiling Wang, Qin Guo, Yang Wen, Qiong Liao, Yu Zhu, Min Shu, Chaomin Wan
BACKGROUND: Visceral Leishmaniasis (VL) is a life-threatening parasitic infection transmitted by phlebotomine sandflies. We undertook this study to analyze the clinical features of pediatric VL in a population of Chinese children. METHODS: A retrospective study was performed with pediatric patients (≤14years) diagnosed with VL based on bone-marrow biopsy, serology and diagnosis based on clinical manifestation and the improvement after the experimental drug when negative bone marrow and serology results were shown...
September 30, 2016: Pediatric Infectious Disease Journal
Megan J Leonhard, Dagan A Wright, Rongwei Fu, David P Lehrfeld, Kathleen F Carlson
BACKGROUND: Traumatic brain injury (TBI) greatly contributes to morbidity and mortality in the pediatric population. We examined potential urban/rural disparities in mortality amongst Oregon pediatric patients with TBI treated in trauma hospitals. METHODS: We conducted a retrospective study of children ages 0-19 using the Oregon Trauma Registry for years 2009-2012. Geographic location of injury was classified using the National Center for Health Statistics Urban/Rural Classification Scheme...
December 2015: Injury Epidemiology
Ruchi Kaushik, Isabelle M Krisch, Darrell R Schroeder, Randall Flick, Michael E Nemergut
BACKGROUND: Head injuries are the leading cause of death among cyclists, 85 % of which can be prevented by wearing a bicycle helmet. This study aims to estimate the incidence of pediatric bicycle-related injuries in Olmsted County and assess differences in injuries between those wearing helmets vs. not. METHODS: Olmsted County, Minnesota residents 5 to 18 years of age with a diagnostic code consistent with an injury associated with the use of a bicycle between January 1, 2002, and December 31, 2011, were identified...
December 2015: Injury Epidemiology
Sarah E Velasquez, Enrique Chaves-Carballo, Eve-Lynn Nelson
BACKGROUND: Approximately 2.7 million individuals in the United States are affected by epilepsy. It is the fourth most common neurological disorder and affects people of all ages, races, and economic backgrounds. In many rural states, the few pediatric neurologists commonly practice in the metropolitan areas. The inadequate resources present challenges for families residing in rural areas or with limited transportation resources. One remedy for this situation is to deliver pediatric neurology services to rural areas through videoconferencing...
August 10, 2016: Pediatric Neurology
Isabelle Bragard, Marie-Christine Seghaye, Nesrine Farhat, Marie Solowianiuk, Mariane Saliba, Anne-Marie Etienne, Katharina Schumacher
OBJECTIVES: Residents beginning their specialization in pediatrics and emergency medicine (EM) are rapidly involved in oncall duties. Early acquisition of crisis resource management by novice residents is essential for patient safety, but traditional training may be insufficient. Our aim was to investigate the impact of a 2-day simulation-based course on residents to manage pediatric and neonatal patients. METHODS: First year residents participated in the course...
October 6, 2016: Pediatric Emergency Care
Marc A Auerbach, Marjorie Lee White, Sweta Bhargava, Pavan Zaveri, Elizabeth B Seelbach, Rebekah A Burns, Renuka Mehta, Brett McAninch, Daniel Fein, Todd P Chang, David O Kessler
OBJECTIVES: Few published studies describe graduating pediatric residents' procedural skills or success rates. This information would help guide supervisors' decisions about graduating residents' preparedness, training, and supervision needs. This study aimed to measure success rates for graduating pediatric residents performing infant lumbar puncture (LP) during the final months of their training and to describe their experiences performing and supervising infant LPs during the course of their training...
October 6, 2016: Pediatric Emergency Care
Mallory Taylor, Joseph R Hageman, Melanie Brown
Physician burnout is a topic of growing importance in today's health care system. Tangible interventions aimed at reducing burnout and promoting wellness are now necessary components of medical training and practice. A study examined the feasibility and impact of a brief mindfulness intervention using a free smartphone application with a resident population. Participants used a free smartphone application to complete a 10-day program in mindfulness meditation, and completed surveys at the end of the program...
October 1, 2016: Pediatric Annals
Katherine R Kavanagh, Valerie Cote, Yvonne Tsui, Simon Kudernatsch, Donald R Peterson, Tulio A Valdez
OBJECTIVE: Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible...
October 12, 2016: Laryngoscope
Samuel R Barber, Elliott D Kozin, Matthew Dedmon, Brian M Lin, Kyuwon Lee, Sumi Sinha, Nicole Black, Aaron K Remenschneider, Daniel J Lee
INTRODUCTION: Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator...
November 2016: International Journal of Pediatric Otorhinolaryngology
Piriyatharisini Thamilselvan, Krishna Raj Muthuraman, Jharna Mandal, Subash Chandra Parija
INTRODUCTION: Taenia solium is a common two-host parasitic cestode, residing in both humans (definitive) and pigs (intermediate). Invasion of this parasitic cyst into central nervous system leads to a condition known as neurocysticercosis (NCC). The World Health Organization (WHO) considers NCC as one of the "most neglected" tropical zoonotic diseases. The disease is presented with pleomorphic clinical manifestations, of which epilepsy is the most common. Diagnosis of NCC is carried out by serological tests and imaging methods...
July 2016: Tropical Parasitology
Leila Kheirandish-Gozal, David Gozal
Since the initial report 40 years ago on pediatric obstructive sleep apnea syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder...
October 6, 2016: Chest
M K Arevalo, J C Prieto, N Cost, G Nuss, B J Brown, L A Baker
INTRODUCTION: Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG)...
September 17, 2016: Journal of Pediatric Urology
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