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https://www.readbyqxmd.com/read/28209414/barriers-and-facilitators-to-the-implementation-of-evidence-based-practice-by-pediatric-surgeons
#1
Katrina J Sullivan, Carolyn Wayne, Andrea M Patey, Ahmed Nasr
BACKGROUND/PURPOSE: Evidence-based practice (EBP) has been identified as a foundation of mainstream medical practice, yet pediatric surgery has been slow in the acceptance and implementation of EBP. METHODS: Semi-structured interviews of 14 pediatric surgeons were conducted to determine barriers and facilitators to EBP. Resulting data were analyzed using a systematic 3-step approached of coding, generation of specific beliefs, and identification of domains relevant to practice change...
February 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185711/impact-of-gastroesophageal-reflux-and-delayed-gastric-emptying-on-pediatric-lung-transplant-outcomes
#2
Fei Jamie Dy, Dawn Freiberger, Enju Liu, Debra Boyer, Gary Visner, Rachel Rosen
BACKGROUND: Gastroesophageal reflux disease is thought to predispose to adverse lung allograft outcomes. However, little is known about the burden of gastroesophageal reflux (GER) and gastroparesis in pediatric patients. In this study we describe the burden of reflux and gastroparesis in children undergoing lung transplant, and evaluates their impact on allograft survival and rejection incidence. METHODS: This study is a retrospective analysis of pediatric lung transplant recipients who had combined pH and multichannel intraluminal impedance testing (pH-MII) and gastric-emptying scans (GES)...
January 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28157839/establishment-of-a-method-for-evaluating-endothelial-cell-injury-by-tnf-%C3%AE-in-vitro-for-clarifying-the-pathophysiology-of-virus-associated-acute-encephalopathy
#3
Kyohei Miyazaki, Koichi Hashimoto, Masatoki Sato, Masahiro Watanabe, Naoki Tomikawa, Shuto Kanno, Yukihiko Kawasaki, Nobuo Momoi, Mitsuaki Hosoya
BACKGROUND: Virus-associated acute encephalopathy (VAE) is a severe central nervous system complication caused by common viral infections in children. The pathophysiology of VAE is thought to be endothelial injury. This study was designed to establish an in vitro VAE model for evaluating endothelial injury caused by the proinflammatory cytokine TNF-α. METHODS: Transwell-grown human umbilical vein endothelial cells (HUVECs) monolayers were incubated with serially diluted TNF-α...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28146046/brazilian-specialists-perspectives-on-the-patient-referral-process
#4
Carmen Juliani, Maura MacPhee, Wilza Spiri
Since 1988, healthcare has been considered a citizen's right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world's fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo...
January 29, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28134656/photographs-of-daily-activities-phoda-youth-english-validating-a-targeted-assessment-of-worry-and-anticipated-pain
#5
Laura Simons, Melissa Pielech, Shannon McAvoy, Caitlin Conroy, Melinda Hogan, Jeanine Verbunt, Marielle Goossens
PHODA is an electronic measure that individualizes and guides treatment for individuals with chronic pain. Implicit in its design is recognition that pain-related fear is a driving force that impedes treatment progress. With this tool, patients visually rate their expectations about the harmful consequences of specific movements. The current study aimed to 1) develop and validate PHODA-Youth English (PHODA-YE) and 2) evaluate the potential impact of PHODA-YE assessment on treatment outcomes. Participants were 195 youth, age 8-20 years, who presented to an outpatient pain clinic for evaluation (n=99) or enrolled in an intensive pediatric pain rehabilitation program (PPRC; n=96)...
January 24, 2017: Pain
https://www.readbyqxmd.com/read/28097839/nutritional-assessment-of-a-population-with-a-history-of-childhood-craniopharyngioma-seen-at-hospital-prof-dr-juan-p-garrahan
#6
Carolina Caminiti, Carola Saure, Ilanit Bomer, Mercedes Brea, Javier González Ramos
INTRODUCTION: Craniopharyngiomas are histologically benign malformations located between the pituitary and hypothalamus that may affect key hormone secretion for endocrine regulation and satiety modulation. Although this is a relatively benign disease, the combination of severe hypothalamic obesity and associated comorbidities results in a reduced quality of life. OBJECTIVE: To assess the nutritional status of patients after craniopharyngioma surgery. POPULATION AND METHODS: Patients younger than 21 years old at the time of the study who required craniopharyngioma surgery at Hospital de Pediatr...
1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28086770/social-pediatrics-weaving-horizontal-and-vertical-threads-through-pediatric-residency
#7
Meta van den Heuvel, Maria Athina Tina Martimianakis, Rebecca Levy, Adelle Atkinson, Elizabeth Ford-Jones, Michelle Shouldice
BACKGROUND: Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. METHODS: A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28068876/tissue-engineered-model-of-human-osteolytic-bone-tumor
#8
Aranzazu Villasante, Alessandro Marturano-Kruik, Samuel T Robinson, Zen Liu, X Edward Guo, Gordana Vunjak-Novakovic
Ewing's sarcoma (ES) is a poorly differentiated pediatric tumor of aggressive behavior characterized by propensity to metastasize to bone. Interactions between the tumor and bone cells orchestrate a vicious cycle in which tumor cells induce osteoclast differentiation and activation to cause osteolytic lesions, broken bones, pain, and hypercalcemia. The lack of controllable models that can recapitulate osteolysis in ES impedes the development of new therapies and limits our understanding of how tumor cells invade bone...
February 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28062335/productivity-in-pediatric-palliative-care-measuring-and-monitoring-an-elusive-metric
#9
Erica C Kaye, Zachary R Abramson, Jennifer M Snaman, Sarah E Friebert, Justin N Baker
CONTEXT: Workforce productivity is poorly defined in health care. Particularly in the field of pediatric palliative care (PPC), the absence of consensus metrics impedes aggregation and analysis of data to track workforce efficiency and effectiveness. Lack of uniformly measured data also compromises the development of innovative strategies to improve productivity and hinders investigation of the link between productivity and quality of care, which are interrelated but not interchangeable...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28028956/assessment-of-clinical-symptoms-and-multichannel-intraluminal-impedance-and-ph-monitoring-in-children-after-thoracoscopic-repair-of-esophageal-atresia-and-distal-tracheoesophageal-fistula
#10
Barbara M Iwańczak, Agnieszka Kosmowska-Miśków, Anna Kofla-Dłubacz, Mateusz Palczewski, Michał Grabiński, Katarzyna Pawłowska, Krzysztof Matusiewicz, Dariusz Patkowski
BACKGROUND: Motility disturbances of the esophagus and gastroesophageal reflux disease (GERD) are observed frequently in children after repair of congenital esophageal atresia with distal tracheoesophageal fistula (EA/TEF). Recently, in many pediatric surgical centers, thoracoscopic repair was introduced, which theoretically would change the postoperative course. OBJECTIVES: The goal of the study was to assess physical development, disease symptoms, and GERD symptom frequency in children who underwent thoracoscopic surgery of congenital EA/TEF...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28002887/pediatric-rumination-subtypes-a-study-using-high-resolution-esophageal-manometry-with-impedance
#11
R Rosen, L Rodriguez, S Nurko
BACKGROUND: The differential diagnosis of intractable reflux in children includes rumination syndrome, but confirming the diagnosis using antroduodenal manometry is invasive, is costly, and requires anesthesia. High-resolution esophageal manometry with impedance (HRM-MII) overcomes these limitations, and the goal of this study is to validate the use of HRM-MII as a diagnostic tool for rumination and to describe the subtypes of pediatric rumination. METHODS: We reviewed the HRM-MII tracings of 21 children presenting with symptoms of intractable reflux in whom rumination was being considered...
December 21, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27920480/comparison-of-multichannel-intraluminal-impedance-ph-monitoring-and-reflux-scintigraphy-in-pediatric-patients-with-suspected-gastroesophageal-reflux
#12
Nuray Uslu Kızılkan, Murat Fani Bozkurt, Inci Nur Saltık Temizel, Hülya Demir, Aysel Yüce, Biray Caner, Hasan Özen
AIM: To evaluate the agreement of multichannel intraluminal impedance-pH monitoring (MII-pHM) and gastroesophageal reflux scintigraphy (GES) for the diagnosis of gastroesophageal reflux disease. METHODS: Seventy-five consecutive patients with suspected gastroesophageal reflux disease (GERD) underwent 24-h combined MII-pHM recording and one hour radionuclide scintigraphy during the course of the MII-pHM study. Catheters with 6 impedance channels and 1 pH sensor were placed transnasally...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27887911/does-perception-of-catheterization-limit-its-use-in-pediatric-uti
#13
Rachel E Selekman, Melissa T Sanford, Lauren N Ko, I Elaine Allen, Hillary L Copp
INTRODUCTION: Urinary tract infections (UTIs) affect 3-8% of febrile children annually, but correctly diagnosing UTI in young children can present a challenge. Diagnosis requires a non-contaminated urine sample, which requires catheterization or suprapubic aspiration in infants and young children that have not completed toilet training. To improve adherence to these guidelines, it is critical to understand the barriers to urine testing and catheterization. OBJECTIVE: The purpose of this study was to investigate parental perception of pediatric UTI evaluation to better understand factors that impede urine testing prior to treatment of suspected UTI...
October 20, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27878890/a-qualitative-exploration-of-anesthesia-trainees-experiences-during-transition-to-a-children-s-hospital
#14
Peter W Howe, Koshila Kumar
BACKGROUND: The stresses of starting a new job can make anyone feel tired and inefficient. In health care, this may impair the ability to learn at a time when there is most to learn, and increase the risk of error in a context where errors may lead to patient harm. AIM: The aim of this study was to understand issues which influence anesthesia trainees' transition to a pediatric setting. METHODS: This qualitative study utilized in-depth semi-structured interviews to gather data from 31 anesthesia trainees who had commenced work at a tertiary children's hospital between 4 and 6 weeks previously...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27861431/pediatric-artificial-lung-a-low-resistance-pumpless-artificial-lung-alleviates-an-acute-lamb-model-of-increased-right-ventricle-afterload
#15
Fares Alghanem, Benjamin S Bryner, Emilia M Jahangir, Uditha P Fernando, John M Trahanas, Hayley R Hoffman, Robert H Bartlett, Alvaro Rojas-Peña, Ronald B Hirschl
Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload.Five juvenile lambs (20-30 Kg) underwent PAL implantation in a pulmonary artery to left atrium configuration...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27855739/validation-of-polyvinylidene-fluoride-impedance-sensor-for-respiratory-event-classification-during-polysomnography-in-children
#16
Anne G Griffiths, Pallavi P Patwari, Darius A Loghmanee, Matthew J Balog, Irina Trosman, Stephen H Sheldon
STUDY OBJECTIVES: Polysomnography is the gold standard for diagnosis and characterization of severity of sleep-disordered breathing. Accuracy and reliability of the technology used are critical to the integrity of the study's interpretation. Strict criteria for obstructive sleep apnea in children are lacking and diagnosis often requires consideration of both frequency of respiratory events in addition to other measures. Current American Academy of Sleep Medicine recommendations for pediatric patients includes use of respiratory inductance plethysmography (RIP) belts, whereas polyvinylidene fluoride (PVDF) belts are currently only acceptable for use in adults...
November 14, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27842562/locomotor-training-through-a-novel-robotic-platform-for-gait-rehabilitation-in-pediatric-population-short-report
#17
C Bayón, S Lerma, O Ramírez, J I Serrano, M D Del Castillo, R Raya, J M Belda-Lois, I Martínez, E Rocon
BACKGROUND: Cerebral Palsy (CP) is a disorder of posture and movement due to a defect in the immature brain. The use of robotic devices as alternative treatment to improve the gait function in patients with CP has increased. Nevertheless, current gait trainers are focused on controlling complete joint trajectories, avoiding postural control and the adaptation of the therapy to a specific patient. This paper presents the applicability of a new robotic platform called CPWalker in children with spastic diplegia...
November 14, 2016: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/27832032/accuracy-and-efficiency-of-recording-pediatric-early-warning-scores-using-an-electronic-physiological-surveillance-system-compared-with-traditional-paper-based-documentation
#18
Gerri Sefton, Steven Lane, Roger Killen, Stuart Black, Max Lyon, Pearl Ampah, Cathryn Sproule, Dominic Loren-Gosling, Caitlin Richards, Jean Spinty, Colette Holloway, Coral Davies, April Wilson, Chung Shen Chean, Bernie Carter, E D Carrol
Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score...
November 9, 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27807915/barriers-to-participation-in-industry-sponsored-clinical-trials-in-pediatric-type-2-diabetes
#19
Ryan Farrell, Kathleen Bethin, Georgeanna Klingensmith, William V Tamborlane, Rose Gubitosi-Klug
BACKGROUND: The rapid emergence of type 2 diabetes (T2D) in the pediatric population has left pediatric endocrinologists with limited artillery in terms of management. While multiple medications are available for adults, Food and Drug Administration (FDA)-approved medications in children are limited to only metformin and insulin. Additional treatment options require randomized controlled trials, yet heretofore several barriers at the participant and institutional level have impeded these studies from proceeding in children and adolescents...
November 3, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27805260/can-subsyndromal-manifestations-of-major-depression-be-identified-in-children-at-risk
#20
M Uchida, M Fitzgerald, K Lin, N Carrellas, H Woodworth, J Biederman
OBJECTIVE: Children of parents with major depression are at significantly increased risk for developing major depression themselves; however, not all children at genetic risk will develop major depressive disorder (MDD). We investigated the utility of subsyndromal scores on the Child Behavior Checklist (CBCL) Anxiety/Depression scale in identifying children at the highest risk for pediatric MDD from among the pool of children of parents with MDD or bipolar disorder. METHOD: The sample was derived from two previously conducted longitudinal case-control family studies of psychiatrically and pediatrically referred youth and their families...
February 2017: Acta Psychiatrica Scandinavica
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