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Quality pediatrics

Adrienne Schleisman, Elaine Mahon
Pediatric patients undergoing treatment for oncology diagnoses are likely to experience stress, anxiety, and social isolation. One role of a pediatric oncology nurse is to incorporate play into daily hospital routines. By using medical and normative play, nurses can decrease distress and promote normal growth and development. However, the use of play is not limited to pediatric patients. Oncology nurses who work with adults can incorporate similar strategies within their patient populations to reduce anxiety and stress and to improve quality of life...
April 1, 2018: Clinical Journal of Oncology Nursing
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Andrés Retamal C, Giancarlo Schiappacasse F, Lizbet Pérez M, Pablo Alvayay Q, Isabel Schild W
Pediatric cancer is the second cause of death in children older than 5 years in our country, after trauma. Positron emission tomography/computed tomography (PET/CT) is a hybrid technique that involves radiation, which has been used for some time in adults and is being progressively imple mented in children. This technique allows morphological and functional assessments of the body with applications in neoplastic and non-neoplastic pathology. Its main role in oncology is in the evaluation and control of lymphomas, sarcomas and neuroblastomas, among others...
December 2017: Revista Chilena de Pediatría
Bettina von Dessauer, Carmen Benavente, Emilia Monje, Jazmina Bongain, Nadia Ordenes
OBJECTIVE: Describe the frequency and characteristics of PICU patients who undergo a process of withholding or withdrawing life-sustaining treatment (LTSV), between 2004 y 2014. PATIENTS AND METHOD: A retrospective, observational descriptive study, using two documents for quality assessment in the PICU of Hospital Roberto del Río: 1) daily individual patient tracking log and 2) daily record of quality indicators, including LTSV, both updated daily at the morning visit...
December 2017: Revista Chilena de Pediatría
Sarah Mousseau, Annie Lapointe, Jocelyn Gravel
BACKGROUND: The CellScope Oto® is a smartphone otoscope attachment allowing physicians to share diagnostic-quality images of the ears. Our primary objective was to evaluate the residents' accuracy in diagnosing acute otitis media in children using the CellScope Oto® attachment compared to traditional otoscope. METHODS: A randomized crossover controlled trial was performed at a single, tertiary care, pediatric emergency department. Participants were a convenience sample of preschool children, consulting for fever and respiratory symptoms...
January 31, 2018: American Journal of Emergency Medicine
Diana Olvera, Rachel Stolzenfeld, Joan C Marini, Michelle S Caird, Kenneth M Kozloff
Osteogenesis imperfecta (OI) is a genetic disorder characterized by altered bone quality and imbalanced bone remodeling, leading to skeletal fractures which are most prominent during childhood. Treatments for OI have focused on restoring pediatric bone density and architecture to recover functional strength and consequently reduce fragility. Though antiresorptive agents like bisphosphonates (BP) are currently the most common intervention for the treatment of OI, a number of studies have shown efficacy of sclerostin antibody (SclAb) in inducing gains in bone mass and reducing fragility in OI mouse models...
March 15, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Cheryl Holly, Sallie Porter, Mercedes Echevarria, Margaret Dreker, Sevara Ruzehaji
The findings can facilitate earlier recognition and prevention of pediatric delirium. ABSTRACT: Purpose: The purpose of this study was to examine the evidence regarding the risk factors for and characteristics of acute pediatric delirium in hospitalized children. METHODS: The systematic review method within an epidemiological framework of person, place, and time was used. Fifty-two studies were selected for initial retrieval. Of these, after assessment for methodological quality, 21 studies involving 2,616 subjects were included in the review...
March 14, 2018: American Journal of Nursing
Cynthia M Rand, Stanley J Schaffer, Nui Dhepyasuwan, Aaron Blumkin, Christina Albertin, Janet R Serwint, Paul M Darden, Sharon G Humiston, Keith J Mann, William Stratbucker, Peter G Szilagyi
BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. METHODS: Staff and providers in 8 resident clinics participated in a 12-month QI study...
March 14, 2018: Pediatrics
Katarina Bojanić, Ruža Grizelj, Jurica Vuković, Lana Omerza, Marina Grubić, Tomislav Ćaleta, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: Patients with congenital diaphragmatic hernia (CDH) have a high residual morbidity rate. We compared self-reported health-related quality of life (HRQoL) between patients with CDH and healthy children. METHODS: Forty-five patients with CDH who were born from January 1, 1990, through February 15, 2015, were matched to healthy, age-matched control participants at a 1:2 ratio. The health records of the study participants were reviewed to determine comorbid conditions, and HRQoL was assessed by both the participants and their parents with the Pediatric Quality of Life Inventory (PedsQL)...
March 14, 2018: Health and Quality of Life Outcomes
Julia S Anixt, Jareen Meinzen-Derr, Halley Estridge, Laura Smith, William B Brinkman
OBJECTIVE: To describe the characteristics of treatment decisions to address challenging behaviors in children with autism spectrum disorder (ASD). METHODS: Parents of children aged 4 to 15 years with ASD seen in a developmental behavioral pediatric (DBP) clinic completed validated measures to characterize their child's behaviors and their own level of stress. Parents reported their treatment priority before the visit. During the visit, we assessed shared decision making (SDM) using the Observing Patient Involvement (OPTION) scale and alignment of the clinician's treatment plan with the parent's priority...
March 12, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
Jecca Rhea Steinberg, Janine S Bruce, Paloma Marin-Nevarez, Kimmy Phan, Sylvia Bereknyei Merrell, Lisa J Chamberlain
OBJECTIVE: School readiness by kindergarten entry is associated with increased high school graduation, decreased juvenile arrest, and better long-term health. Inadequate early childhood learning (ECL) disproportionately affects low-income children. Pediatricians have near-universal access to children younger than 5 years but remain an underused ECL resource. This study examined caregivers' perceptions of ECL, the role of the pediatrician and pediatric office, and the use of community-based ECL resources among diverse, low-income caregivers whose children were not enrolled in preschool...
March 13, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
Yunsoo Kim, Ho Ran Park
PURPOSE: This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary. METHODS: Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support...
February 2018: Journal of Korean Academy of Nursing
Dana E Niles, Jordan Duval-Arnould, Sophie Skellett, Lynda Knight, Felice Su, Tia T Raymond, Todd Sweberg, Anita I Sen, Dianne L Atkins, Stuart H Friess, Allan R de Caen, Hiroshi Kurosawa, Robert M Sutton, Heather Wolfe, Robert A Berg, Annemarie Silver, Elizabeth A Hunt, Vinay M Nadkarni
OBJECTIVES: Pediatric in-hospital cardiac arrest cardiopulmonary resuscitation quality metrics have been reported in few children less than 8 years. Our objective was to characterize chest compression fraction, rate, depth, and compliance with 2015 American Heart Association guidelines across multiple pediatric hospitals. DESIGN: Retrospective observational study of data from a multicenter resuscitation quality collaborative from October 2015 to April 2017. SETTING: Twelve pediatric hospitals across United States, Canada, and Europe...
March 10, 2018: Pediatric Critical Care Medicine
Federica Pederiva, Basem Khalil, Antonino Morabito, Sarah J Wood
BACKGROUND:  Short bowel syndrome (SBS) has an impact on children and their families not only physically, but also emotionally, mentally, and socially. This study aimed to evaluate quality of life and family impact in patients with SBS, using the Pediatric Quality of Life Inventory (PedsQL) measurement model. MATERIALS AND METHODS:  PedsQL questionnaires were administered to patients with SBS followed at the Pediatric Surgery of Royal Manchester Children's Hospital...
January 30, 2018: European Journal of Pediatric Surgery
Way-Seah Lee, Chun-Wei Tee, Zhong-Lin Koay, Tat-Seng Wong, Fatimah Zahraq, Hee-Wei Foo, Sik-Yong Ong, Shin-Yee Wong, Ruey-Terng Ng
AIM: To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center. METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks...
March 7, 2018: World Journal of Gastroenterology: WJG
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
M Colinart-Thomas, V Noël, G Roques, S Gordes-Grosjean, M Abely, C Pluchart
Sickle cell disease, a hemoglobin disorder with autosomal recessive transmission, is one of the most common genetic diseases screened in France. Thanks to early management, 95% of sickle cell patients reach adulthood and require transition from pediatric care to adult care. Through a retrospective study of records from serious sickle cell patients over 17 years old, followed in the hematology-oncology pediatric unit of Reims University Hospital Center in France, we analyzed transition conditions, compared pediatric and adult management, and proposed a plan for transition care...
March 9, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Akiyoshi Shimura, Sakai Hideo, Yoshikazu Takaesu, Ryota Nomura, Yoko Komada, Takeshi Inoue
OBJECTIVE: Sleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted. METHODS: A cross-sectional survey of 344 high school students (age range 15-17; 171 boys, 173 girls) in Tokyo, Japan was conducted in 2015. Complete responses were provided by 294 students. Demographic variables, Pittsburgh Sleep Quality Index (PSQI), diurnal type scale, Pediatric Daytime Sleepiness Scale (PDSS), and life habits such as dinnertime, viewing electronic displays, caffeine intake, sunlight in the morning, and the brightness of the room in the night were asked...
April 2018: Sleep Medicine
Francesc Torres-Andres, Ericka L Fink, Michael J Bell, Mahesh S Sharma, Eric J Yablonsky, Joan Sanchez-de-Toledo
OBJECTIVES: To identify patient- and disease-related factors related to survival and favorable outcomes for children who underwent extracorporeal cardiopulmonary resuscitation after a refractory cardiac arrest. DESIGN: Retrospective observational study with prospective assessment of long-term functional outcome. PATIENTS: Fifty-six consecutive children undergoing extracorporeal cardiopulmonary resuscitation at our institution from 2007 to 2015...
March 9, 2018: Pediatric Critical Care Medicine
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