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Sample records for canadian pediatric emergency

  1. Pediatric fractures – an educational needs assessment of Canadian pediatric emergency medicine residents

    Directory of Open Access Journals (Sweden)

    Dixon AC

    2015-06-01

    Full Text Available Andrew C Dixon Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Objectives: To determine the gaps in knowledge of Canadian pediatric emergency medicine residents with regards to acute fracture identification and management. Due to their predominantly medical prior training, fractures may be an area of weakness requiring a specific curriculum to meet their needs. Methods: A questionnaire was developed examining comfort level and performance on knowledge based questions of trainees in the following areas: interpreting musculoskeletal X-rays; independently managing pediatric fractures, physical examination techniques, applied knowledge of fracture management, and normal development of the bony anatomy. Using modified Dillman technique the instrument was distributed to pediatric emergency medicine residents at seven Canadian sites. Results: Out of 43 potential respondents, 22 (51% responded. Of respondents, mean comfort with X-ray interpretation was 69 (62–76 95% confidence interval [CI] while mean comfort with fracture management was only 53 (45–63 95% CI; mean comfort with physical exam of shoulder 60 (53–68 95% CI and knee 69 (62–76 95% CI was low. Less than half of respondents (47%; 95% CI 26%–69% could accurately identify normal wrist development, correctly manage a supracondylar fracture (39%; 95% CI 20%–61%, or identify a medial epicondyle fracture (44%; 95% CI 24%–66%. Comfort with neurovascular status of the upper (mean 82; 95% CI 75–89 and lower limb (mean 81; 95% CI 74–87 was high. Interpretation: There are significant gaps in knowledge of physical exam techniques, fracture identification and management among pediatric emergency medicine trainees. A change in our current teaching methods is required to meet this need. Keywords: pediatric, fractures, education, radiologic interpretation

  2. Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

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    Graham Ian D; O'Leary Kathy A; Osmond Martin H; Scott Shannon D; Grimshaw Jeremy; Klassen Terry

    2009-01-01

    Abstract Background Despite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers) in pediatric emergency departments (PEDs) for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs. Methods Using a comparative case study design, we cla...

  3. Addressing the emergence of pediatric vaccination concerns: recommendations from a Canadian policy analysis.

    Science.gov (United States)

    Wilson, Kumanan; Barakat, Meredith; Mills, Edward; Ritvo, Paul; Boon, Heather; Vohra, Sunita; Jadad, Alejandro R; McGeer, Allison

    2006-01-01

    Ever since the advent of pediatric vaccination, individuals have expressed concerns about both its risks and benefits. These concerns have once again resurfaced among some segments of the population and could potentially undermine national vaccination programs. The views of the public, however, must be considered and respected in the formulation of vaccination policy. We have conducted an analysis of the pediatric vaccination "debate" in the Canadian context. We believe that there is common ground between those who support pediatric vaccination and those who are concerned about these programs. Based on our findings, we believe that the goal of public health authorities should be to maintain trust in vaccines by continuing to meet certain reciprocal responsibilities. To do so, we recommend the following: 1) increased investment in adverse event reporting systems; 2) request for proposals for consideration of a no-fault compensation program; 3) developing pre-emptive strategies to deal with potential vaccine risks; 4) further examination of mechanisms to improve communication between physicians and parents concerned about vaccination. All of these approaches would require additional investment in pediatric vaccination. However, such an investment is easy to justify given the benefits offered by pediatric vaccination and the ramifications of failing to maintain confidence in vaccination programs or missing a vaccine-related adverse event.

  4. Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

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    Graham Ian D

    2009-10-01

    Full Text Available Abstract Background Despite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers in pediatric emergency departments (PEDs for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs. Methods Using a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs, and respiratory therapists (RTs, and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU categories of elements known to influence the uptake of innovations. Results One hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway. Conclusion Potential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.

  5. Abdominal emergencies in pediatrics.

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    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  6. Pediatric Ingestions: Emergency Department Management.

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    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies.

  7. Emerging Canadian QA standards for radiation therapy

    International Nuclear Information System (INIS)

    Full text: Canada operates a publicly funded health care system in which 70% of health care costs are paid by some level of government. Radiotherapy, indeed most cancer management, falls within the publicly funded realm of Canada's health care system. National legislation (the Canada Health Act) guarantees access to cancer services for all Canadians. However, the financial responsibility for these services is borne by the provinces. Most Canadian provinces manage the cancer management problem through central cancer agencies. In the past few decades, these provincial cancer agencies have formed the Canadian Association of Provincial Cancer Agencies (CAPCA). This association has adopted a broad mandate for cancer management in Canada (see www.capca.ca). Included in this mandate is the adoption of standards and guidelines for all aspects of cancer control. The complexity of radiation therapy has long underscored the need for cooperation at the international and national levels in defining programmes and standards. In recent decades formal quality assurance programme recommendations have emerged in the United States, Europe and Great Britain. When defining quality assurance programs, Canadian radiation treatment centres have referenced U.S. and other program standards since they have been available. Recently, under the leadership of the Canadian Association of Provincial Cancer Agencies (CAPCA), Canadian national quality assurance program recommendations are emerging. A CAPCA sponsored project to harmonize Canadian quality assurance processes has resulted in a draft document entitled 'Standards for Quality Assurance at Canadian Radiation Treatment Centres'. This document provides recommendations for the broad framework of radiation therapy quality assurance programs. In addition, detailed work is currently underway regarding equipment quality control procedures. This paper explores the historical and political landscape in which the quality assurance problem has

  8. Pediatric Dermatological Emergencies: An Overview

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    Hassan, Iffat; Anwar, Parvaiz

    2013-01-01

    Dermatological emergencies including those in pediatric age group comprise of dermatoses where there is severe alterations in structure and function of the skin. Some of these may result in acute skin failure that needs early recognition, and often hospitalization, with careful monitoring and at times management in intensive care unit on the pattern of 100% burns in order to minimize the associated morbidity and mortality. Multi-disciplinary approach with synchronized team of dermatologist, p...

  9. Emerging immunotherapy in pediatric lymphoma.

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    Erker, Craig; Harker-Murray, Paul; Burke, Michael J

    2016-01-01

    Hodgkin and non-Hodgkin lymphoma collectively are the third most common cancer diagnosed in children each year. For children who relapse or have refractory disease, outcomes remain poor. Immunotherapy has recently emerged as a novel approach to treat hematologic malignancies. The field has been rapidly expanding over the past few years broadening its armamentarium which now includes monoclonal antibodies, antibody-drug conjugates and cellular therapies including bispecific T-cell engagers and chimeric antigen receptor-engineered T cells. Many of these agents are in their infancy stages and only beginning to make their mark on lymphoma treatment while others have begun to show promising efficacy in relapsed disease. In this review, the authors provide an overview of current and emerging immunotherapies in the field of pediatric lymphoma. PMID:26616565

  10. Survey of Canadian hospitals radiation emergency plans

    International Nuclear Information System (INIS)

    This report documents the findings of a survey of Canadian hospitals conducted by Social Data Research Ltd. during the Spring and Summer, 1995. The main objective of the survey was to determine the state of readiness of Canadian hospitals in respect of radiation emergency planning. In addition, the AECB was interested in knowing the extent to which a report by the Group of Medical Advisors, 'GMA-3: Guidelines on Hospital Emergency Plans for the Management of Minor Radiation Accidents', which was sponsored and distributed in 1993, was received and was useful to hospital administrators and emergency personnel. A self-administered questionnaire was distributed to 598 acute care hospitals, and 274 responses were received. The main conclusion of this study is that, with the exception of a few large institutions, hospitals generally do not have specific action plans to handle minor radiation accidents. (author)

  11. Bedside ultrasound in pediatric emergency medicine.

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    Levy, Jason A; Noble, Vicki E

    2008-05-01

    Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians. As the modality advances and becomes more available, it will be important for primary care pediatricians to understand its uses and limitations and to ensure that pediatric emergency physicians have access to the proper training, equipment, and experience. This article is meant to review the current literature relating to emergency ultrasound in pediatric emergency medicine, as well as to describe potential pediatric applications.

  12. [Pediatric emergencies: Knowledge of basic measures for the emergency physician].

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    Meyer, S; Grundmann, U; Reinert, J; Gortner, L

    2015-11-01

    Life-threatening pediatric emergencies are relatively rare in the prehospital setting. Thus, the treating emergency physician may not always be familiar with and well trained in these situations. However, pediatric emergencies require early recognition and initiation of specific diagnostic and therapeutic interventions to prevent further damage. The treatment of pediatric emergencies follows current recommendations as detailed in published international guidelines. The aim of this review is to familiarize the emergency physician with general aspects pertinent to this topic-most importantly anatomical and physiological characteristics in this cohort. Also, specific information with regard to analgesia and sedation, which may be warranted in the prehospital setting, will be provided.

  13. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

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    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  14. Experience with Emergency Ultrasound Training by Canadian Emergency Medicine Residents

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    Daniel J. Kim

    2014-05-01

    Full Text Available Introduction: Starting in 2008, emergency ultrasound (EUS was introduced as a core competency to the Royal College of Physicians and Surgeons of Canada (Royal College emergency medicine (EM training standards. The Royal College accredits postgraduate EM specialty training in Canada through 5-year residency programs. The objective of this study is to describe both the current experience with and the perceptions of EUS by Canadian Royal College EM senior residents. Methods: This was a web-based survey conducted from January to March 2011 of all 39 Canadian Royal College postgraduate fifth-year (PGY-5 EM residents. Main outcome measures were characteristics of EUS training and perceptions of EUS. Results: Survey response rate was 95% (37/39. EUS was part of the formal residency curriculum for 86% of respondents (32/37. Residents most commonly received training in focused assessment with sonography for trauma, intrauterine pregnancy, abdominal aortic aneurysm, cardiac, and procedural guidance. Although the most commonly provided instructional material (86% [32/37] was an ultrasound course, 73% (27/37 of residents used educational resources outside of residency training to supplement their ultrasound knowledge. Most residents (95% [35/37] made clinical decisions and patient dispositions based on their EUS interpretation without a consultative study by radiology. Residents had very favorable perceptions and opinions of EUS. Conclusion: EUS training in Royal College EM programs was prevalent and perceived favorably by residents, but there was heterogeneity in resident training and practice of EUS. This suggests variability in both the level and quality of EUS training in Canadian Royal College EM residency programs.

  15. Implementation of a Pediatric Emergency Triage System in Xiamen, China

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    Lin, Gang-Xi; Yang, Yin-Ling; Kudirka, Denise; Church, Colleen; Yong, Collin K K; Reilly, Fiona; Zeng, Qi-Yi

    2016-01-01

    Background: Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale. Methods: In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system. Patients who visited our PER before (January 2013–June 2013) and after (January 2014–June 2014) the CPETS was implemented served as the control and experimental group, respectively. Patient flow, triage rates, triage accuracy, wait times (overall and for severe patients), and patient/family satisfaction were compared between the two groups. Results: Relative to the performance of the former system experienced by the control group, the CPETS experienced by the experimental group was associated with a reduced patient flow through the PER (Cox-Stuart test, t = 0, P rate (93.40% vs. 90.75%; χ2 = 801.546, P rates (94.23% vs. 92.21%; χ2 = 321.528, P < 0.001). Conclusions: Implementing the CPETS improved nurses’ abilities to triage severe patients and, thus, to deliver the urgent treatments more quickly. The system shunted nonurgent patients to outpatient care effectively, resulting in improved efficiency of PER health-care delivery. PMID:27748332

  16. Molecular characterization of rotavirus isolates from select Canadian pediatric hospitals

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    McDermid Andrew

    2012-11-01

    Full Text Available Abstract Background We report the first multi-site rotavirus genotype analysis in Canada. Prior to this study, there was a dearth of rotavirus G and P genotyping data in Canada. Publically funded universal rotavirus vaccination in Canada started in 2011 and has been introduced by four provinces to date. Uptake of rotavirus vaccines in Canada prior to 2012 has been very limited. The aim of this study was to describe the genotypes of rotavirus strains circulating in Canada prior to widespread implementation of rotavirus vaccine by genotyping samples collected from selected paediatric hospitals. Secondly we identified rotavirus strains that differed genetically from those included in the vaccines and which could affect vaccine effectiveness. Methods Stool specimens were collected by opportunity sampling of children with gastroenteritis who presented to emergency departments. Samples were genotyped for G (VP7 genotypes and P (VP4 genotypes by hemi-nested multiplex PCR methods. Phylogenetic analysis was carried out on Canadian G9 strains to investigate their relationship to G9 strains that have circulated in other regions of the world. Results 348 samples were collected, of which 259 samples were rotavirus positive and genotyped. There were 34 rotavirus antigen immunoassay negative samples genotyped using PCR-based methods. Over the four rotavirus seasons, 174 samples were G1P[8], 45 were G3P[8], 22 were G2P[4], 13 were G9P[8], 3 were G4P[8] and 2 were G9P[4]. Sequence analysis showed that all Canadian G9 isolates are within lineage III. Conclusions Although a limited number of samples were obtained from a median of 4 centres during the 4 years of the study, it appears that currently approved rotavirus vaccines are well matched to the rotavirus genotypes identified at these hospitals. Further surveillance to monitor the emergence of rotavirus genotypes in Canada is warranted.

  17. Medical Emergencies in Pediatric Dentistry

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    Jurković, Josipa; Jeličić, Jesenka; Balenović, Antonija; Stipančić, Gordana; Čuković-Bagić, Ivana

    2016-01-01

    Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system). For all the above conditions, guidelines have been established that need to be known. If complications occur or necessary measures are not taken, it can lead to cardiac and respiratory arrest. Therefore, cardiopulmonary resuscitation is needed. All procedures and dosages should be adapted to the age of the child.

  18. Pediatric Clinical Pharmacology and Child Health:A Canadian Perspective

    Institute of Scientific and Technical Information of China (English)

    Stuart Macleod

    2011-01-01

    @@ Introduction Canadian academic centres and children's hospitals have had a longstanding interest in the improvement of drug therapy for children through research conducted across the four pillars of activity identified as being of critical importance by the Canadian Institutes of Health Research(viz,basic research,clinical research,population health research,applied health and policy research)[1].

  19. External validation of the New Orleans Criteria (NOC), the Canadian CT Head Rule (CCHR) and the National Emergency X-Radiography Utilization Study II (NEXUS II) for CT scanning in pediatric patients with minor head injury in a non-trauma center

    International Nuclear Information System (INIS)

    Head CT scans are considered the imaging modality of choice to screen patients with head trauma for neurocranial injuries; however, widespread CT imaging is not recommended and much research has been conducted to establish objective clinical predictors of intracranial injury (ICI) in order to optimize the use of neuroimaging in children with minor head trauma. To evaluate whether a strict application of the New Orleans Criteria (NOC), Canadian CT Head Rule (CCHR) and National Emergency X-Radiography Utilization Study II (NEXUS II) in pediatric patients with head trauma presenting to a non-trauma center (level II) could reduce the number of cranial CT scans performed without missing clinically significant ICI. We conducted an IRB-approved retrospective analysis of pediatric patients with head trauma who received a cranial CT scan between Jan. 1, 2001, and Sept. 1, 2008, and identified which patients would have required a scan based on the criteria of the above listed decision instruments. We then determined the sensitivities, specificities and negative predictive values of these aids. In our cohort of 2,101 patients, 92 (4.4%) had positive head CT findings. The sensitivities for the NOC, CCHR and NEXUS II were 96.7% (95%CI 93.1-100), 65.2% (95%CI 55.5-74.9) and 78.3% (95%CI 69.9-86.7), respectively, and their negative predictive values were 98.7%, 97.6% and 97.2%, respectively. In contrast, the specificities for these aids were 11.2% (95%CI 9.8-12.6), 64.2% (95%CI 62.1-66.3) and 34.2% (95%CI 32.1-36.3), respectively. Therefore, in our population it would have been possible to scan at least 10.9% fewer patients. The number of cranial CT scans conducted in our pediatric cohort with head trauma would have been reduced had any of the three clinical decision aids been applied. Therefore, we recommend that further validation and adoption of pediatric head CT decision aids in non-trauma centers be considered to ultimately increase patient safety while reducing medical

  20. Emergence of the Canadian Research University

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    Wormald, Megan

    2013-01-01

    The emergence of a research university model in Canada has increased significantly over the past few decades. From institutions that focused primarily on education, universities are striving to become large, research-focused centres. These changes have brought increased prestige to universities, greater graduate education, and more funding…

  1. Diagnostic Emergency Ultrasound: Assessment Techniques In The Pediatric Patient.

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    Guttman, Joshua; Nelson, Bret P

    2016-01-01

    Emergency ultrasound is performed at the point of care to answer focused clinical questions in a rapid manner. Over the last 20 years, the use of this technique has grown rapidly, and it has become a core requirement in many emergency medicine residencies and in some pediatric emergency medicine fellowships. The use of emergency ultrasound in the pediatric setting is increasing due to the lack of ionizing radiation with these studies, as compared to computed tomography. Utilizing diagnostic ultrasound in the emergency department can allow clinicians to arrive at a diagnosis at the bedside rather than sending the patient out of the department for another study. This issue focuses on common indications for diagnostic ultrasound, as found in the pediatric literature or extrapolated from adult literature where pediatric evidence is scarce. Limitations, current trends, controversies, and future directions of diagnostic ultrasound in the emergency department are also discussed.

  2. Pediatric emergency medical services and their drawbacks

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    Abdullah Foraih Al-Anazi

    2012-01-01

    Full Text Available Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.

  3. Blog and Podcast Watch: Pediatric Emergency Medicine

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    Zaver, Fareen; Hansen, Michael; Leibner, Evan; Little, Andrew; Lin, Michelle

    2016-01-01

    Introduction By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. Methods The Approved Instructional Resources – Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3–5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35) points. An “Honorable Mention” label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. Results We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. PMID:27625713

  4. Blog and Podcast Watch: Pediatric Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Fareen Zaver

    2016-09-01

    Full Text Available Introduction: By critically appraising open access, educational blogs and podcasts in emergency medicine (EM using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM.    Methods: The Approved Instructional Resources – Professional (AIR-Pro series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35 points. An “Honorable Mention” label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. Results: We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion: The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians.

  5. Current and Emerging Surgical Therapies for Severe Pediatric Epilepsies.

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    Muh, Carrie R

    2016-05-01

    The use of epilepsy surgery in various medically resistant epilepsies is well established. For patients with intractable pediatric epilepsy, the role of intracranial electrodes, resective surgery, hemispherectomy, corpus callosotomy, neurostimulation, and multiple subpial transections continues to be very effective in select cases. Newer treatment and diagnostic methods include laser thermal ablation, minimally invasive surgeries, stereo electroencephalography, electrocorticography, and other emerging techniques. This article will review the established and emerging surgical therapies for severe pediatric epilepsies, their respective indications and overall efficacy. PMID:27544471

  6. Pediatric emergency room activities in Italy: a national survey

    OpenAIRE

    Longhi, Riccardo; Picchi, Raffaella; Minasi, Domenico; Di Cesare Merlone, Alessandra

    2015-01-01

    Background In Italy, the number of accesses to the Emergency Units has been growing for the past 30 years. This, together with a low coordination between hospital and peripheral pediatric services, has brought to an unnecessarily high number of hospital admissions. For this reason, it is essential to plan and implement strategies able to improve the appropriateness of hospital admissions. In the ’90s, the Short Stay Observation was extended to pediatric patients. As highlighted by the report ...

  7. Emergency medicine physicians performed ultrasound for pediatric intussusceptions

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    Yi-Jung Chang

    2013-08-01

    Full Text Available Background: Intussusception is the common acute abdomen in children with difficult clinical diagnosis. The routine ultrasound has recently been proposed as the initial diagnostic modality with high accuracy, but is not available for 24 h by gastroenterologists. We aimed to evaluate the validation of bedside ultrasound for intussusceptions performed by pediatric emergency physicians with ultrasound training during the night or holiday. Methods: A retrospective study was conducted in children with suspected intussusceptions when routine ultrasounds by gastroenterologists were not available over the period from July 2004 to July 2008. Patients were divided into two groups: those diagnosed by emergency physicians with ultrasound training and without training. The clinical characteristics and course for all patients were reviewed and compared for seeking the difference. Results: A total of 186 children were included. One hundred and thirteen (61% children were diagnosed by pediatric emergency physician with ultrasound training. The clinical symptoms were not statistically different between the two groups. The diagnostic sensitivity of the ultrasound training group was significantly higher (90% vs. 79%, p = 0.034. Children of the training group also had significantly shorter hospital stay duration at emergency departments before reduction (2.41 ± 2.01 vs. 4.58 ± 4.80 h, p = 0.002. Conclusion: Bedside ultrasound performed by pediatric emergency physicians with ultrasound training is a sensitive test for detecting intussusceptions. Knowledge and use of bedside ultrasound can aid the emergency physician in the diagnosis of pediatric intussusceptions with less delay in treatment.

  8. Leading teams during simulated pediatric emergencies: a pilot study

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    Coolen EH

    2015-01-01

    Full Text Available Ester H Coolen,1 Jos M Draaisma,2 Sabien den Hamer,3 Jan L Loeffen2 1Department of Pediatric Surgery, Amalia Children’s Hospital, Radboud University Medical Center, 2Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 3Department of Communication Science, Radboud University, Nijmegen, the Netherlands Purpose: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods: We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results: The coaching style (mean 54.5%, SD 7.8 is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1. This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion: The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. Keywords

  9. Emergency medicine in pediatric dentistry: preparation and management.

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    Malamed, Stanley F

    2003-10-01

    Medical emergencies can and do occur in the practice of dentistry. Although most emergencies take place in adults, serious problems can also develop in younger patients. The contemporary dentist must be prepared to manage expeditiously and effectively those few problems that do arise. Basic life support (as necessary) is all that is required to manage many emergency situations, with the addition of specific drug therapy in some others. Preparation of the office and staff includes basic life support (annually), pediatric advanced life support, development of an emergency team, consideration for emergency medical services, and the availability of emergency drugs and equipment with the ability to use these items effectively. As with the adult patient, effective management of pain (local anesthesia) and anxiety (behavioral management, conscious sedation) will minimize the development of medical emergencies.

  10. Characteristics of patients and families who make early return visits to the pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Logue EP

    2013-06-01

    Full Text Available Erin Patricia Logue,1 Samina Ali,2,3 Judith Spiers,4 Amanda S Newton,2,3 Janice A Lander4 1 Alberta Health Services, 2Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 3Women and Children’s Health Research Institute, 4Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada Objectives: The primary objective of this study was to identify reasons why parents make early return visits, within 72 hours of discharge from a tertiary care pediatric emergency department (PED. A secondary objective was to investigate associated demographic and diagnostic variables. Methods: A survey was conducted with a convenience sample of parents of children returning to the PED within 72 hours of discharge. A chart review was also completed for consented survey participants. Recruitment occurred from September 2005 to August 2006 at the Stollery Children's Hospital, Edmonton, Alberta, Canada. Results: A total of 264 parents were approached to participate. Overall, 231 surveys were returned and 212 (92% charts were reviewed. The overall rate of early return during the study period was 5.4%. More than half of parents stated that they returned because their child's condition worsened and many parents (66.7% reported feeling stressed. Patients were typically under 6 years of age (67.4%, and most frequently diagnosed with infectious diseases (38.0%. Patients triaged with the Canadian Emergency Department Triage and Acuity Scale (CTAS as CTAS 2 (emergent for initial visits were more likely to be admitted on return, regardless of age (P < 0.001. Conclusion: Variables associated with early returns included young age, diagnosis, triage acuity, and parental stress. Future variable definition should include a deeper exploration of modifiable factors such as parental stress and patient education. These next steps may help direct interventions and resources to address needs in this group and possibly pre-empt the need to return

  11. Emerging Antiepileptic Drugs for Severe Pediatric Epilepsies.

    Science.gov (United States)

    Mudigoudar, Basanagoud; Weatherspoon, Sarah; Wheless, James W

    2016-05-01

    The medical management of the epilepsy syndromes of early childhood (eg, infantile spasms, Dravet syndrome, and Lennox-Gastaut syndrome) is challenging; and requires careful evaluation, classification, and treatment. Pharmacologic therapy continues to be the mainstay of management for these children, and as such it is important for the clinician to be familiar with the role of new antiepileptic drugs. This article reports the clinical trial data and personal experience in treating the severe epilepsies of childhood with the recently Food and Drug Administration-approved new antiepileptic drugs (vigabatrin, rufinamide, perampanel, and clobazam) and those in clinical trials (cannabidiol, stiripentol, and fenfluramine). Genetic research has also identified an increasing number of pediatric developmental and seizure disorders that are possibly treatable with targeted drug therapies, focused on correcting underlying neural dysfunction. We highlight recent genetic advances, and how they affect our treatment of some of the genetic epilepsies, and speculate on the use of targeted genetic treatment (precision medicine) in the future. PMID:27544474

  12. Pediatric multiple sclerosis: Escalation and emerging treatments.

    Science.gov (United States)

    Chitnis, Tanuja; Ghezzi, Angelo; Bajer-Kornek, Barbara; Boyko, Alexey; Giovannoni, Gavin; Pohl, Daniela

    2016-08-30

    Over the last 20 years, there have been significant advances in multiple sclerosis (MS) therapeutics, with regulatory approval for 13 therapies in adults by the European Medicines Agency (EMA) and Food and Drug Administration. However, there is only limited approval for interferon-β and glatiramer acetate use in children 12 years and older by the EMA. Availability of disease-modifying therapies to children and adolescents with MS is variable by region, and is extremely limited in some regions of the world. Up to 30% of children experience breakthrough disease requiring therapies beyond traditional first-line agents. Recent legislation in both the United States and Europe has mandated clinical studies for all new therapeutics applicable to children. Several clinical trials in children are underway that will provide important information regarding the efficacy and safety of newer drugs. This review summarizes the current knowledge of breakthrough disease, escalation, and induction treatment approaches in children with MS, especially pertaining to disease course and disability outcomes in this group of patients. In addition, ongoing clinical trials and approaches and challenges in conducting clinical trials in the pediatric population are discussed. PMID:27572854

  13. Prevalence of otorhinolaryngologic diagnoses in the pediatric emergency room

    Directory of Open Access Journals (Sweden)

    Signorelli, Luiz Gabriel

    2013-01-01

    Full Text Available Introduction: Fever and pain, which are very common in ear, nose, and throat pathologies, are among the most frequent complaints recorded during emergency room pediatric patient treatment. Most of time, the pediatricians are called on to evaluate otorhinolaryngology disorders that requires specialist assessment. Aim: To determine the prevalence of otorhinolaryngologic diagnoses in a pediatric population in a reference hospital in the city of Itatiba, São Paulo. Methods: We evaluated 2,054 pediatric patients (age range, 0-12 years, 11 months in this descriptive, transversal observational (survey study. Data collection was performed by a single observer during 103 night shifts (07:00 p.m. to 07:00 a.m. between January and December 2011, and included documentation of the main diagnosis, and patient age and sex. The ethics committee and research institution approved study. Patients were divided into 2 groups based on diagnosis: Group A otorhinolaryngology disease and Group B included diagnoses not contained in Group A. Results: Of the total enrolled patients, 52.2% corresponded to Group A and 47.8% to Group B; 51.9% were male and 48.1% were female. The average age was 4.5 years (Group A, 3.93 years; Group B, 5.03 years. We compared the prevalence of the diagnostic hypotheses of the 2 groups. Conclusion: A large number of patients sought treatment at pediatric emergency rooms for otorhinolaryngologic diagnoses.

  14. [Ethics in pediatric emergencies: Care access, communication, and confidentiality].

    Science.gov (United States)

    Benoit, J; Berdah, L; Carlier-Gonod, A; Guillou, T; Kouche, C; Patte, M; Schneider, M; Talcone, S; Chappuy, H

    2015-05-01

    Children suffer most from today's increasing precariousness. In France, access to care is available for all children through various structures and existing measures. The support for foreign children is overseen by specific legislation often unfamiliar to caregivers. Pediatric emergencies, their location, organization, actors, and patient flow are a particular environment that is not always suitable to communication and may lead to situations of abuse. Communication should not be forgotten because of the urgency of the situation. The place of the child in the dialogue is often forgotten. Considering the triangular relationship, listening to the child and involving the parents in care are the basis for a good therapeutic alliance. Privacy and medical confidentiality in pediatric emergencies are governed by law. However, changes in treatments and medical practices along with the variety of actors involved imply both individual and collective limitations, to the detriment of medical confidentiality.

  15. Small magnet aspiration as a pediatric emergency: a case report.

    Science.gov (United States)

    Xu, Jiajian; Liu, Dabo; Huang, Zhenyun; Ke, Kengjian

    2015-01-01

    Tracheobronchial airway foreign body aspiration (FBA) in children is a common and serious pediatric medical emergency. With the increasing use of small magnets in home offices, in toys and the kitchen, inhalation of small magnets has become an increasing risk to children. We present a case of a 9-year-old boy who presented with cough and dyspnea three days following inhalation of an 3 cm-sized oval magnet. The history and the chest radiograph were important in planning for the removal of the aspirated foreign body. In this case, we removed the inhaled magnet using rigid bronchoscopy under general anesthetic. We herein reviewed the recent reports on the incidence and management of small foreign body aspiration as a pediatric emergency. PMID:26770610

  16. Diagnosis of Intussusception Using Bedside Ultrasound by a Pediatric Resident in the Emergency Department

    OpenAIRE

    Ramsey, Kara Wong; Halm, Brunhild M.

    2014-01-01

    The use of bedside ultrasound in the emergency department has been gaining favor among emergency medicine physicians and can be invaluable in the prompt diagnosis and treatment of acutely ill patients, especially when radiology evaluation is unavailable or delayed. Although pediatric ultrasound examinations are taught in some pediatric residency programs, they are not part of the required pediatric residency curriculum in the United States. This is the first case report of a pediatric residen...

  17. Improving outcomes for ill and injured children in emergency departments: protocol for a program in pediatric emergency medicine and knowledge translation science

    Directory of Open Access Journals (Sweden)

    Shaw Nicola

    2009-09-01

    Full Text Available Abstract Approximately one-quarter of all Canadian children will seek emergency care in any given year, with the two most common medical problems affecting children in the emergency department (ED being acute respiratory illness and injury. Treatment for some medical conditions in the ED remains controversial due to a lack of strong supporting evidence. The purpose of this paper is to describe a multi-centre team grant in pediatric emergency medicine (PEM that has been recently funded by the Canadian Institutes of Health Research (CIHR. This program of research integrates clinical research (in the areas of acute respiratory illness and injury and knowledge translation (KT. This initiative includes seven distinct projects that address the objective to generate new evidence for clinical care and KT in the pediatric ED. Five of the seven research projects in this team grant make significant contributions to knowledge development in KT science, and these contributions are the focus of this paper. The research designs employed in this program include: cross-sectional surveys, randomized controlled trials (RCTs, quasi-experimental designs with interrupted time-series analysis and staggered implementation strategies, and qualitative designs. This team grant provides unique opportunities for making important KT methodological developments, with a particular focus on developing a better theoretical understanding of the causal mechanisms and effect modifiers of different KT interventions.

  18. Managing Pediatric Pain in the Emergency Department.

    Science.gov (United States)

    Bailey, Benoit; Trottier, Evelyne D

    2016-08-01

    Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs. PMID:27260499

  19. Personal experience in pediatric emergency medicine training in Canada and China

    Institute of Scientific and Technical Information of China (English)

    LIN Gang-xi; LUO Yi-ming; Adam CHENG; YANG Shu-yu; WANG Jian-she; Ran-D Goldman

    2012-01-01

    Currently,pediatric emergency medicine (PEM) as practiced in many developed countries is different from ours in China.Chinese pediatric emergency medicine is just children's internal medicine and does not include general surgery,ear-nose-throat,etc.If children have an emergency condition that require specialized treatments they need to go to different departments.However in Canada,the pediatric emergency physicians will first treat the patients whatever the condition,then,if it is a complicated sub specialty problem,they will consult the specialist or let the patient see the specialist later.In addition,resuscitation is done in the pediatric intensive care unit (PICU) in China,but it is done in the emergency room in Canada.This article compares the differences in the pediatric emergency systems in Canada and China and also introduces the international standard system of pediatric triage.

  20. Small magnet aspiration as a pediatric emergency: a case report

    OpenAIRE

    Xu, Jiajian; Liu, Dabo; Huang, Zhenyun; Ke, Kengjian

    2015-01-01

    Tracheobronchial airway foreign body aspiration (FBA) in children is a common and serious pediatric medical emergency. With the increasing use of small magnets in home offices, in toys and the kitchen, inhalation of small magnets has become an increasing risk to children. We present a case of a 9-year-old boy who presented with cough and dyspnea three days following inhalation of an 3 cm-sized oval magnet. The history and the chest radiograph were important in planning for the removal of the ...

  1. Intestinal ascariasis at pediatric emergency room in a developed country.

    Science.gov (United States)

    Umetsu, Shuichiro; Sogo, Tsuyoshi; Iwasawa, Kentaro; Kondo, Takeo; Tsunoda, Tomoyuki; Oikawa-Kawamoto, Manari; Komatsu, Haruki; Inui, Ayano; Fujisawa, Tomoo

    2014-10-14

    Ascaris lumbricoides infection is rare among children in developed countries. Although large numbers of adult Ascaris in the small intestine can cause various abdominal symptoms, this infection remains asymptomatic until the number of worms in the intestine considerably increases in most cases. Ascaris causing bilious vomiting suggesting ileus is rare, especially in developed countries. A 6-year-old boy who lived in Japan, presented with abdominal colic, bilious vomiting at the pediatric emergency room. He appeared pale, and had no abdominal distention, tenderness, palpable abdominal mass, or findings of dehydration. He experienced bilious vomiting again during a physical examination. Laboratory tests showed mild elevation of white blood cells and C-reactive protein levels. Antigens of adenovirus, rotavirus, and norovirus were not detected from his stool, and stool culture showed normal flora. Ultrasonography showed multiple, round-shaped structures within the small intestine, and a tubular structure in a longitudinal scan of the small intestine. Capsule endoscopy showed a moving worm of Ascaris in the jejunum. Intestinal ascariasis should be considered as a cause of bilious vomiting in children, even at the emergency room in industrial countries. Ultrasound examination and capsule endoscopy are useful for diagnosis of pediatric intestinal ascariasis.

  2. Ozone: a trigger for hospital pediatric asthma emergency room visits.

    Science.gov (United States)

    Fauroux, B; Sampil, M; Quénel, P; Lemoullec, Y

    2000-07-01

    A time-series study was carried out in Paris from January 1 to December 31, 1988 with the aim of investigating the association between urban air pollution and daily emergency room visits for asthma in a pediatric hospital. Levels of black smoke, sulfur dioxide, nitrogen dioxide, and ozone were monitored throughout the study area, and meteorological data were collected. Influenza epidemics and pollen periods were identified. Health data were collected from a pediatric hospital emergency room. Case definition of asthma attacks was based on clinical diagnosis. Children were included in the study if: 1) they were 1 to 15 years old; 2) they had doctor-diagnosed asthma and were followed in our asthma outpatient clinic; and 3) they were residents in the Paris region. The relation between daily asthma visit counts and air pollution levels was assessed, using a multiple linear regression model and taking into account temporal variations and autocorrelation in the data. A thousand and twenty visits for asthma were observed during the study period. A positive statistical association was found between daily asthma visits and daily variations of ozone levels (1 day after exposure, relative risk = 1.52 [95% confidence interval: 1. 06-2.19]) after controlling for monthly and weekly variations, influenza epidemics, periods of pollen exposure, and daily mean temperature (2 days' lag). This study underlines the significant role of ozone as a trigger for asthma attacks in children. PMID:10862161

  3. First-attack pediatric hypertensive crisis presenting to the pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Yang Wen-Chieh

    2012-12-01

    Full Text Available Background Hypertensive crisis in children is a relatively rare condition presenting with elevated blood pressure (BP and related symptoms, and it is potentially life-threatening. The aim of this study was to survey children with first attacks of hypertensive crisis arriving at the emergency department (ED, and to determine the related parameters that predicted the severity of hypertensive crisis in children by age group. Methods This was a retrospective study conducted from 2000 to 2007 in pediatric patients aged 18 years and younger with a diagnosis of hypertensive crisis at the ED. All patients were divided into four age groups (infants, preschool age, elementary school age, and adolescents, and two severity groups (hypertensive urgency and hypertensive emergency. BP levels, etiology, severity, and clinical manifestations were analyzed by age group and compared between the hypertensive emergency and hypertensive urgency groups. Results The mean systolic/diastolic BP in the hypertensive crisis patients was 161/102 mmHg. The major causes of hypertensive crisis were essential hypertension, renal disorders and endocrine/metabolic disorders. Half of all patients had a single underlying cause, and 8 had a combination of underlying causes. Headache was the most common symptom (54.5%, followed by dizziness (45.5%, nausea/vomiting (36.4% and chest pain (29.1%. A family history of hypertension was a significant predictive factor for the older patients with hypertensive crisis. Clinical manifestations and severity showed a positive correlation with age. In contrast to diastolic BP, systolic BP showed a significant trend in the older children. Conclusions Primary clinicians should pay attention to the pediatric patients who present with elevated blood pressure and related clinical hypertensive symptoms, especially headache, nausea/vomiting, and altered consciousness which may indicate that appropriate and immediate antihypertensive medications are

  4. An Emerging Field of Research: Challenges in Pediatric Decision Making

    OpenAIRE

    Lipstein, Ellen A.; Brinkman, William B.; Fiks, Alexander G.; Hendrix, Kristin S.; Kryworuchko, Jennifer; Miller, Victoria A.; Prosser, Lisa A.; Ungar, Wendy J.; Fox, David

    2014-01-01

    There is growing interest in pediatric decision science, spurred by policies advocating for children’s involvement in medical decision making. Challenges specific to pediatric decision research include: the dynamic nature of child participation in decisions due to the growth and development of children, the family context of all pediatric decisions, and the measurement of preferences and outcomes that may inform decision making in the pediatric setting. The objectives of this manuscript are t...

  5. Innis and the Emergence of Canadian Communication/Media Studies

    Directory of Open Access Journals (Sweden)

    Robert E. Babe

    2008-01-01

    Full Text Available The discussion in this paper examines the influence of Harold Innis’ medium theory on contemporary media and communication scholarship in Canada and abroad. The methodological construction of Innis’ medium theory comprises several dimensions including: media bias; the exercising of power through the use and control of media; the bias of communication media toward favouring control over space and control through time; the role of governance in overcoming the bias inherent in media; a materialist understanding of civilizations; space-media outpacing time-media; and dialectics. In this paper particular attention is given to two issues. The first is the connections between Innis’ political economy approach and the work of Marshall McLuhan on the one hand, and the ecological studies of David Suzuki on the other. Both McLuhan and Suzuki, it is argued, may be seen as filling in important gaps in Innis’ work. The second focuses on the reasons why Innis’ medium theory has struck a chord with the Canadian psyche. This stands in stark contrast to the apparent neglect of Innis’ work within American media and communication scholarship.

  6. Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients

    Science.gov (United States)

    Tran, Dat; Science, Michelle; Dix, David; Portwine, Carol; Zelcer, Shayna; Johnston, Donna L.; Yanofsky, Rochelle; Gassas, Adam; Ethier, Marie‐Chantal; Sung, Lillian

    2012-01-01

    Please cite this paper as: Tran et al. (2012) Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients. Influenza and Other Respiratory Viruses 6(601), e105–e113. Background  The impact of pandemic H1N1 influenza (pH1N1) virus in pediatric cancer is uncertain. The objectives of this study were to characterize the clinical course of pH1N1 and identify factors associated with severe outcomes. Methods  We conducted a Canadian multicenter retrospective review of children with cancer and stem cell transplant (SCT) recipients who were diagnosed with laboratory‐confirmed pH1N1 infection between May 1, 2009 and January 31, 2010. Results  We identified 100 (19 in wave 1 and 81 in wave 2) cases of pH1N1 infection. Median age was 8·7 years. 71% had a hematologic malignancy, and 20% received SCT. Median duration of fever and illness was 2 and 12·5 days, respectively. 51 (51·5%) were hospitalized for a median of 5 days, with no deaths and only 1 requiring admission to the intensive care unit. Radiologically confirmed pneumonia was diagnosed in 10 (10%). Interruption of chemotherapy or conditioning occurred in 43 patients. In multivariable analyses, age 5 days) correlated with shortened duration of viral shedding (P = 0·041). Conclusions  pH1N1 infection in pediatric cancer and SCT patients infrequently caused complications but commonly interrupted cancer treatment. Persistent shedding of virus after illness resolution was common. Further research is needed to verify this finding as it could have implications for treatment guidelines and infection control practices. PMID:22417068

  7. Validity of different pediatric early warning scores in the emergency department

    NARCIS (Netherlands)

    N. Seiger (Nienke); I.K. MacOnochie (Ian); R. Oostenbrink (Rianne); H.A. Moll (Henriëtte)

    2013-01-01

    textabstractObjective: Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED. Methods: Ten different PEWS were evaluated in a large prospective cohort. We included chi

  8. A workflow model to analyse pediatric emergency overcrowding.

    Science.gov (United States)

    Zgaya, Hayfa; Ajmi, Ines; Gammoudi, Lotfi; Hammadi, Slim; Martinot, Alain; Beuscart, Régis; Renard, Jean-Marie

    2014-01-01

    The greatest source of delay in patient flow is the waiting time from the health care request, and especially the bed request to exit from the Pediatric Emergency Department (PED) for hospital admission. It represents 70% of the time that these patients occupied in the PED waiting rooms. Our objective in this study is to identify tension indicators and bottlenecks that contribute to overcrowding. Patient flow mapping through the PED was carried out in a continuous 2 years period from January 2011 to December 2012. Our method is to use the collected real data, basing on accurate visits made in the PED of the Regional University Hospital Center (CHRU) of Lille (France), in order to construct an accurate and complete representation of the PED processes. The result of this representation is a Workflow model of the patient journey in the PED representing most faithfully possible the reality of the PED of CHRU of Lille. This model allowed us to identify sources of delay in patient flow and aspects of the PED activity that could be improved. It must be enough retailed to produce an analysis allowing to identify the dysfunctions of the PED and also to propose and to estimate prevention indicators of tensions. Our survey is integrated into the French National Research Agency project, titled: "Hospital: optimization, simulation and avoidance of strain" (ANR HOST).

  9. Referral Criteria from Community Clinics to Pediatric Emergency Departments

    Directory of Open Access Journals (Sweden)

    Jacob Urkin

    2008-01-01

    Full Text Available Referral of patients to a pediatric emergency department (PED should be medically justified and the need for referral well communicated. The objectives of this paper were (1 to create a list of criteria for referral from the community to the PED, (2 to describe how community physicians categorize their need for referral, and (3 to determine agreement between the physician's referral letter and the selected criteria. We present a descriptive study of referrals to the PED of Soroka University Medical Center, Beer-Sheva, Israel, during February to April 2003. A list of 22 criteria for referral was created, using the Delphi method for reaching consensus. One or more criteria could be selected from this list for each referral, by the referring community physicians and, independently, based on the physicians' referral letters, by two consultants, and compared. There were 140 referrals included in the study. A total of 262 criteria for referral were selected by the referring community physicians. The criteria most frequently selected were: “Need for same-day consultation/laboratory/imaging result not available in the community” (32.1%, “Suspected life- or organ-threatening infection” (16.4%, and “Need for hospitalization” (15.7%. Rates of agreement regarding criteria for referral between the referring physicians and the two consultants, and a senior community pediatrician and a senior PED pediatrician, were 57.9 and 48.6%, respectively. We conclude that the standard referral letter does not convey in full the level of need for referral to the PED. A list of criteria for referral could augment efficient utilization of emergency department services and improve communication between community physicians and the PED.

  10. Essentials of Pediatric Emergency Medicine Fellowship: Part 4: Beyond Clinical Education.

    Science.gov (United States)

    Wolff, Margaret; Carney, Michele; Eldridge, Charles; Zaveri, Pavan; Kou, Maybelle

    2016-08-01

    This article is the third in a 7-part series that aims to comprehensively describe the current state and future directions of pediatric emergency medicine fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated upon program completion. This article focuses on the skills beyond clinical training required of pediatric emergency medicine physicians including teaching, leadership, teamwork, and communication. PMID:27490731

  11. Pediatric nonenvironmental hypothermia presenting to the emergency department: Episodic spontaneous hypothermia with hyperhidrosis.

    Science.gov (United States)

    Greenberg, Richard A; Rittichier, Kristine K

    2003-02-01

    Cases of pediatric nonenvironmental hypothermia are uncommon. When presenting to the emergency department, these patients are often evaluated for possible sepsis/shock, brain tumors, endocrine disorders, and drug ingestions. We report a case of a 5-year-old girl who presented to the pediatric emergency department on two occasions with hypothermia and lethargy. She was found to have an unusual cause of her symptoms: episodic spontaneous hypothermia with hyperhidrosis. PMID:12592112

  12. Comparison of Canadian versus United States Emergency Department Visits for Chronic Obstructive Pulmonary Disease Exacerbation

    OpenAIRE

    Rowe, Brian H; Rita K Cydulka; Chu-Lin Tsai; Sunday Clark; Douglas Sinclair; Camargo, Carlos A.

    2008-01-01

    INTRODUCTION: Despite the frequency of emergency department (ED) visits for chronic obstructive pulmonary disease (COPD) exacerbation, little is known about practice variation in EDs.OBJECTIVES: To examine the differences between Canadian and United States (US) COPD patients, and the ED management they receive.METHODS: A prospective multicentre cohort study was conducted involving 29 EDs in the US and Canada. Using a standard protocol, consecutive ED patients with COPD exacerbations were inte...

  13. Why and when to use CT in children: perspective of a pediatric emergency medicine physician

    Energy Technology Data Exchange (ETDEWEB)

    Frush, Karen [Duke University School of Medicine, DUMC, Department of Pediatrics, Box 3701, Durham, NC (United States)

    2014-10-15

    The Emergency Department is a risk-laden environment for clinicians caring for children. A number of factors can increase the risk of medical errors and adverse events, including lack of standardized medication dosing because of size variation in the pediatric age range, unique physical and developmental characteristics of children that affect treatment strategies, and the inability of young or non-verbal children to provide a medical history or to clearly communicate pain and other symptoms. The Emergency Department (ED) setting is often hectic and chaotic, with lots of interruptions. Many EDs lack the pediatric-specific supplies deemed essential for managing pediatric emergencies, and long hours or overnight shifts, while necessary for maintaining 24-hour emergency services, can cause provider fatigue that can lead to increased medical errors. It is in this environment that ED physicians make decisions about the use of CT scans in children, often without evidence-based guidelines to help them weigh risks and benefits. Although recent efforts have raised the awareness of the risk of exposure to radiation, many pediatric providers and families lack adequate information to guide decisions about the use of CT. Pediatricians and emergency physicians need to collaborate with radiologists to maintain current knowledge of the risks and benefits of CT scans, to advocate for pediatric protocols and evidence-based guidelines, and to engage families in decisions regarding the evaluation and treatment of pediatric patients in the Emergency Department. (orig.)

  14. Reducing Anxiety in the Pediatric Emergency Department: A Comparative Trial

    Science.gov (United States)

    Heilbrunn, Benjamin R.; Wittern, Rachael E.; Lee, Justin B.; Pham, Phung K.; Hamilton, Anita H.; Nager, Alan L.

    2014-01-01

    Background Anxiety among patients in a Pediatric Emergency Department (PED) can be significant but often goes unaddressed. Objective To determine whether exposure to Child Life (CL) or Hospital Clowning (HC) can reduce anxiety in children presenting to a PED. Methods Patients were randomized to CL, HC or control and assessed upon: entry to examination room (T1), prior to physician arrival (T2) and during physician examination (T3), using the modified Yale Preoperative Anxiety Scale (m-YPAS). CL and HC interventions occurred for 5–10 minutes prior to physician entry. Effects were analyzed using mixed ANOVA. Results m-YPAS scores ranged from 23 to 59, with a higher score indicating increased anxiety. Mixed ANOVA on the study sample (n=113) showed a significant interaction between groups (CL, HC, control) and time, p = .02. Further analyses indicated effect of group only at T2 (MCL = 23.8, 95% CI 23.2–24.5; MHC = 25.2, 95% CI 24.2–26.2; Mcontrol = 26.1, 95% CI 24.2–27.9), p = .02. Sub-analysis of patients with T1 m-YPAS score ≥ 28 (n=56) showed a significant interaction between group and time, p = .01. Further analysis showed effect of group only at T2 (MCL = 24.4, 95% CI 23.3–25.6; MHC = 27.0, 95% CI 25.2–28.7; Mcontrol = 29.2, 95% CI 25.6–32.7), p = .003. Conclusion CL services can reduce SA for patients presenting to a PED with heightened anxiety at baseline. This reduction occurred immediately following CL intervention, but was not observed in patients exposed to HC or during physician examination. PMID:25271180

  15. Clinical Characteristics of Pediatric Patients Hospitalized with Methicillin-Resistant Staphylococcus aureus in Canadian Hospitals from 2008 To 2010

    Directory of Open Access Journals (Sweden)

    Kirk Ryan Leifso

    2013-01-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA infections were uncommon in children in Canada until the 1990s. Using a standardized case report form, treating physicians reported children hospitalized due to MRSA infections in Canadian hospitals through the Canadian Pediatric Surveillance Program in a 24-month period (2008 to 2010. Of 155 cases reported, 70% were ≤4 years of age and approximately one-third had an underlying medical condition. The most common clinical infections involved skin and soft tissue (69%, the lower respiratory tract (12%, and bone and joint (10%. Almost one-third had had contact with the health care environment in the previous year and 18% had a known household member with MRSA. Initial therapy with a beta-lactam alone occurred in 65%, while 22% included vancomycin. No child in this cohort died but 14% required admission to the intensive care unit. Of 143 reports of individual isolates, 93% were reported susceptible to trimethoprim-sulfamethoxazole, 63% to clindamycin and 50% to mupirocin.

  16. Leading teams during simulated pediatric emergencies: a pilot study

    OpenAIRE

    Coolen, Ester

    2015-01-01

    Ester H Coolen,1 Jos M Draaisma,2 Sabien den Hamer,3 Jan L Loeffen2 1Department of Pediatric Surgery, Amalia Children’s Hospital, Radboud University Medical Center, 2Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 3Department of Communication Science, Radboud University, Nijmegen, the Netherlands Purpose: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or fail...

  17. Leading teams during simulated pediatric emergencies: a pilot study

    OpenAIRE

    Coolen EH; Draaisma JM; den Hamer S; Loeffen JL

    2015-01-01

    Ester H Coolen,1 Jos M Draaisma,2 Sabien den Hamer,3 Jan L Loeffen2 1Department of Pediatric Surgery, Amalia Children’s Hospital, Radboud University Medical Center, 2Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 3Department of Communication Science, Radboud University, Nijmegen, the Netherlands Purpose: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of t...

  18. Pediatric AIDS/HIV Infection: An Emerging Challenge to Pediatric Psychology.

    Science.gov (United States)

    Olson, Roberta A.; And Others

    1989-01-01

    The increasing number of cases of pediatric Acquired Immonodeficiency Syndrome (AIDS) presents unique issues for psychologists in the areas of prevention, clinical treatment, public education, research, neuropsychological effects, psychoneuroimmunology, and ethical concerns. (Author/DB)

  19. [An update of the diagnostic coding system by the Spanish Society of Pediatric Emergencies].

    Science.gov (United States)

    Benito Fernández, J; Luaces Cubells, C; Gelabert Colomé, G; Anso Borda, I

    2015-06-01

    The Quality Working Group of the Spanish Society of Pediatric Emergencies (SEUP) presents an update of the diagnostic coding list. The original list was prepared and published in Anales de Pediatría in 2000, being based on the International Coding system ICD-9-CM current at that time. Following the same methodology used at that time and based on the 2014 edition of the ICD-9-CM, 35 new codes have been added to the list, 15 have been updated, and a list of the most frequent references to trauma diagnoses in pediatrics have been provided. In the current list of diagnoses, SEUP reflects the significant changes that have taken place in Pediatric Emergency Services in the last decade.

  20. Policy and procedures for domestic violence patients in Canadian emergency departments: a national survey.

    Science.gov (United States)

    Hotch, D; Grunfeld, A; Mackay, K; Ritch, L

    1996-08-01

    A cross-sectional research survey aimed to obtain information concerning 1) the proportion of Canadian emergency departments with domestic violence intervention policies and procedures; 2) how hospitals identify and provide service to patients who have been abused; and 3) measures that have been problematic/helpful in implementing domestic violence protocols in emergency departments. The study sample included 230 Canadian hospitals with emergency departments. Results showed that 198 hospitals returned the questionnaires, of which 39% indicated that there were policies and procedures concerning domestic violence for the emergency departments. Large, major hospitals were more likely than smaller community hospitals to have policies or protocols in place. About 26 hospitals reported screening all patients for domestic violence and 61 hospitals provided referral services and 46 hospitals provided on-site counseling. Physicians were principally involved in the physical examination, referral and identification. Follow-up, emotional support, and safety planning were provided by social workers. Findings of this survey encourage hospitals and individual health care providers to adopt guidelines concerning domestic violence to ensure a widespread adoption and implementation.

  1. Failure of psychiatric referrals from the pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Delgado Sergio V

    2007-08-01

    Full Text Available Abstract Background Recognition of mental illness in the pediatric emergency department (PED followed by brief, problem oriented interventions may improve health-care seeking behavior and quality of life. The objective of this study was to compare the frequency of mental health follow up after an enhanced referral compared to a simple referral in children presenting to the PED with unrecognized mental health problems. Methods A prospective randomized control trial comparing an enhanced referral vs. simple referral in 56 families of children who were screened for mental health symptoms was performed in a large tertiary care PED. Children presenting to the PED with stable medical problems were approached every fourth evening for enrollment. After consent/assent was obtained, children were screened for a mental health problem using both child and parent reports of the DISC Predictive Scales. Those meeting cutoffs for a mental health problem by either parent or child report were randomized to 1 simple referral (phone number for mental health evaluation by study psychiatrist or 2 enhanced referral (short informational interview, appointment made for child, reminder 2 days before and day of interview for an evaluation by study psychiatrist. Data analysis included descriptive statistics and Chi-Square test to calculate the proportion of children with mental health problems who completed mental health follow-up with and without the enhanced referral. Results A total of 69 families were enrolled. Overall 56 (81% children screened positive for a mental health problem as reported by either the child (self report or mother (maternal report of child mental health problem. Of these, 33 children were randomized into the enhanced referral arm and 23 into the simple referral arm. Overall, only 6 families with children screening positive for a mental health problem completed the psychiatric follow up evaluation, 2 in the enhanced referral arm and 4 in the simple

  2. Epidemiology of Pediatric Bite/Sting Injuries. One-Year Study of a Pediatric Emergency Department in Israel

    Directory of Open Access Journals (Sweden)

    Michal Hemmo-Lotem

    2006-01-01

    Full Text Available Animal bite/sting injuries are a known source of morbidity with a significantly higher incidence among children who are most often bitten in the face, head, and neck. The objective of this study was to provide a better understanding of bite/sting injuries treated at the pediatric emergency department in order to guide preventive efforts.The sociodemographic, epidemiological, and clinical data on all bite/sting injuries treated in one representative pediatric emergency department in Israel over a 1-year period were retrieved and analyzed. Two hundred of the 9,309 pediatric trauma cases treated in the emergency department were bite/sting injuries (2.1%. Non-Jewish patients were under-represented in this subgroup. The majority of patients were males (61.5%. Age distribution from 0–12 years was fairly even, except for an unexplained peak at 8 years. Dogs inflicted 56%, cats 11%, and hornets 9.5% of the injuries. Limbs were affected in 64% and the head and neck in 27%. Specialists, mostly plastic surgeons, were consulted in 42 cases (21%. The incidence rate for hospitalization (7% was similar to that seen in other types of injuries. Children with scorpion or hornet stings and young age were more likely to be hospitalized. Preventive and educational aspects are discussed.

  3. Agents against pediatric diarrhea. Assessing the information companies supply to Canadian physicians.

    OpenAIRE

    Lexchin, J

    1994-01-01

    OBJECTIVE: To assess information on the safety and efficacy of medications that could be used to treat children who have acute infectious diarrhea. DESIGN: Survey of product monographs. Companies were asked to supply their best evidence that products were both safe and effective for treating children who have diarrhea and to supply any information on adverse effects among Canadian children related to use of the products. PARTICIPANTS: Companies making drugs identified in the Compendium of Pha...

  4. Leading teams during simulated pediatric emergencies: a pilot study

    NARCIS (Netherlands)

    Coolen, E.H.; Draaisma, J.M.T.; Hamer, S. den; Loeffen, J.L.C.M.

    2015-01-01

    PURPOSE: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often rep

  5. Accountability and pediatric physician-researchers: are theoretical models compatible with Canadian lived experience?

    Directory of Open Access Journals (Sweden)

    Czoli Christine

    2011-10-01

    Full Text Available Abstract Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth "model" that is independent from these three categories. These models frame the expectations placed upon physician-researchers by colleagues, regulators, patients and research participants. This paper examines the extent to which the data from semi-structured interviews with 30 physician-researchers at three major pediatric hospitals in Canada reflect these traditional models. It seeks to determine the extent to which existing models align with the described lived experience of the pediatric physician-researchers interviewed. Ultimately, we find that although some physician-researchers make references to something like the weak version of the similarity position, the pediatric-researchers interviewed in this study did not describe their dual roles in a way that tightly mirrors any of the existing theoretical frameworks. We thus conclude that either physician-researchers are in need of better training regarding the nature of the accountability relationships that flow from their dual roles or that models setting out these roles and relationships must be altered to better reflect what we can reasonably expect of physician-researchers in a real-world environment.

  6. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  7. Geothermal inversion of Canadian Arctic ground temperatures and effect of permafrost aggradation at emergent shorelines

    Science.gov (United States)

    Taylor, Alan E.; Wang, Kelin

    2008-07-01

    We apply traditional geothermal spectrum inversion to precision temperature logs and thermal conductivity from 10 wells in the Canadian Arctic Archipelago (75° to 81°N). Sites lie beyond the Holocene marine limit, and no effect of deep permafrost dynamics is expected. Ground surface temperature (GST) changes correlate with the Little Ice Age and Little Climatic Optimum with average amplitudes relative to 1980 of -2.7 K and +1.6 K, respectively. Results correlate broadly with similar reconstructions for this area and Greenland ice cap holes GRIP and Dye-3 to the southeast. An offshore site in 244 m water yields a Little Ice Age seabed temperature amplitude of -0.7 K, suggesting a moderated climate impact on regional ocean temperatures. Nearshore boreholes where permafrost is aggrading owing to glacioisostatic emergence are excluded; we demonstrate that traditional inversion codes without latent heat of phase change predict the magnitude of the emergence signal but a timing far too recent.

  8. Multiple Interventions Improve Analgesic Treatment of Supracondylar Fractures in a Pediatric Emergency Department

    Directory of Open Access Journals (Sweden)

    Robert N Porter

    2015-01-01

    Full Text Available BACKGROUND: Provision of appropriate and timely treatment for pain in the pediatric population has been challenging. Children with painful conditions commonly present to emergency departments (EDs, a setting in which it may be particularly difficult to consistently provide timely analgesic interventions.

  9. Assessing Psychosocial Impairment in the Pediatric Emergency Department: Child/Caregiver Concordance

    Science.gov (United States)

    Montano, Zorash; Mahrer, Nicole E.; Nager, Alan L.; Claudius, Ilene; Gold, Jeffrey I.

    2011-01-01

    The objective of this study was to examine the level of agreement between child- and caregiver-reports of the child's psychosocial problems presenting to a Pediatric Emergency Department (PED) using a validated screening tool. This was an anonymous, prospective, cross-sectional, multi-informant (child and caregiver) study assessing cognitive,…

  10. Emerging surgical therapies in the treatment of pediatric epilepsy.

    Science.gov (United States)

    Karsy, Michael; Guan, Jian; Ducis, Katrina; Bollo, Robert J

    2016-04-01

    In the approximately 1% of children affected by epilepsy, pharmacoresistance and early age of seizure onset are strongly correlated with poor cognitive outcomes, depression, anxiety, developmental delay, and impaired activities of daily living. These children often require multiple surgical procedures, including invasive diagnostic procedures with intracranial electrodes to identify the seizure-onset zone. The recent development of minimally invasive surgical techniques, including stereotactic electroencephalography (SEEG) and MRI-guided laser interstitial thermal therapy (MRgLITT), and new applications of neurostimulation, such as responsive neurostimulation (RNS), are quickly changing the landscape of the surgical management of pediatric epilepsy. In this review, the authors discuss these various technologies, their current applications, and limitations in the treatment of pediatric drug-resistant epilepsy, as well as areas for future research. The development of minimally invasive diagnostic and ablative surgical techniques together with new paradigms in neurostimulation hold vast potential to improve the efficacy and reduce the morbidity of the surgical management of children with drug-resistant epilepsy. PMID:27186523

  11. Development of an Asthma Management System in a Pediatric Emergency Department

    OpenAIRE

    Dexheimer, Judith W; Arnold, Donald H.; Abramo, Thomas J; Aronsky, Dominik

    2009-01-01

    Asthma is the leading chronic childhood disease with exacerbations resulting in urgent and emergency care visits. Guidelines adherence improves patient care but is suboptimal. A computerized guideline system can help improve compliance through automatic initiation and reminders to increase adherence. We designed a computerized management system for asthma care in the pediatric emergency department (ED). The system will be evaluated in two phases. The first phase evaluates a computerized diagn...

  12. Advanced training in pediatric emergency medicine in the United States, Canada, United Kingdom, and Australia : An international comparison and resources guide

    NARCIS (Netherlands)

    Babl, FE; Weiner, DL; Bhanji, F; Davies, F; Berry, K; Barnett, P

    2005-01-01

    Pediatric emergency medicine is an important subspecialty of pediatrics and emergency medicine. It is a well-established subspecialty in some countries and less well developed or evolving in others. We set out to develop a resource guide and document the current status of pediatric emergency medicin

  13. The case of the missing testicle: blunt scrotal trauma in the pediatric emergency department.

    Science.gov (United States)

    Pesch, Megan H; Bradin, Stuart

    2014-11-01

    Serious blunt scrotal trauma in the pediatric population is rare and can pose significant danger to the viability of the testes. The following case describes an adolescent boy who presented with a single testis in his scrotum after low-impact perineal trauma, consistent with testicular dislocation. The literature regarding scrotal trauma includes few cases of testicular dislocation from low-impact perineal trauma. Included is a brief review of the most recent data including epidemiology, differential diagnosis, acute management, and complications pertinent to the pediatric emergency clinician.

  14. Does Academic Blogging Enhance Promotion and Tenure? A Survey of US and Canadian Medicine and Pediatric Department Chairs

    Science.gov (United States)

    Varma, Manu; Adams, Martha; Jhaveri, Kenar D

    2016-01-01

    Background Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. Objective We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. Methods The authors surveyed 267 chairs of US and Canadian medicine and pediatric departments regarding their attitudes toward the role of faculty participation in e-learning and blogging in the promotion and tenure process. The survey completion rate was 22.8% (61/267). Results A majority of respondents (87%, 53/61) viewed educational scholarship as either important or very important for promotion. However, only 23% (14/61) perceived importance to faculty effort in producing content for journal-based blogs. If faculty were to participate in blog authorship, 72% (44/61) of surveyed chairs favored involvement in a journal-based versus a society-based or a personal (nonaffiliated) blog. We identified a “favorable group” of chairs (19/59, 32%), who rated leadership roles in e-learning tools as important or very important, and an “unfavorable group” of chairs (40/59, 68%), who rated leadership roles in e-learning tools as somewhat important or not important. The favorable group were more likely to be aware of faculty bloggers within their departments (58%, 11/19 vs 25%, 10/40), viewed serving on editorial boards of e-learning tools more favorably (79%, 15/19 vs 31%, 12/39), and were more likely to value effort spent contributing to journal-based blogs (53%, 10/19 vs 10%, 4/40). Conclusions Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value

  15. Clinical analysis of pediatric patients who visited Masan Samsung Emergency Center

    Directory of Open Access Journals (Sweden)

    Jae Wook Yoo

    2010-03-01

    Full Text Available Purpose : Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. Methods : We reviewed the medical records of 14,065 pediatric patients below 19 years of age. Results : The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%. The peak month was May (10.0%, the peak day of the week was Sunday (24.7%, and the peak time of day was 20:00&#8211;20:59 (8.5%. There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding (31.5%, and the most common symptom was fever (13.1%. Final outcomes were discharged (73.8%, admitted (25.7%, transferred (0.4%, and expired (0.1%. In adolescent patients aged 15&#8211;19 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%; the most common symptom was abdominal pain (9.6%. Conclusion : Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

  16. Streamlining Pediatric Emergency Medicine at a Tertiary-care Hospital of a Low- to Middle-income Country.

    Science.gov (United States)

    Bhimani, Salima Ahmed; Brown, Nick; Mian, Asad I

    2015-12-01

    The factors of integral importance to run any pediatric emergency department efficiently are the ability to process a high volume of patients quickly and a sensitive triage system that identifies the sickest children. Achieving these aims in a low- to middle-income country setting is more complex as a result of scarce resources and data on which to base systems. In this article, we discuss existing models of streamlining pediatric emergency department services that are most applicable to resource-limited countries, and present suggestions for streamlining pediatric emergency care in such countries. PMID:26713983

  17. CRONOBACTER SAKAZAKII: AN EMERGING CONTAMINANT IN PEDIATRIC INFANT MILK FORMULA

    Directory of Open Access Journals (Sweden)

    Adeel Arsalan

    2013-04-01

    Full Text Available Cronobacter sakazakii (C. sakazakii previously known as Enterobacter sakazakii is a motile, Gram-negative, non-sporing yellow pigmented rod, which belongs to lethal Enterobacteriaceae family. C. sakazakii is ubiquitously found in air, soil, floor drains, and dry product processing environment. It has been isolated from hospitals, clinical materials, and cutting fluids and is also present in cerebrospinal fluid (CSF, blood, sputum, throat, nose, stool, gut, skin, wounds, bone marrow, eye, ear and breast abscesses. C. sakazakii is a virulent pathogen and can adhere to silicon, latex, polycarbonate, and stainless steel. Therefore, Feeding-bottles or utensils used to prepare pediatric infant formula (PIF should be thoroughly cleaned to diminish the development of biofilms, which could be the source of infections. Due to its virulence, C. sakazakii causes life threatening infections such as septicemia, necrotizing enterocolitis, bacteriamia and meningitis. Hence, the regulatory authorities such as Food and Drug Administration (FDA, Food and Agriculture Organization/World Health Organization (FAO/WHO, Centers for Disease Control and Prevention (CDC and Health Canada strongly recommend breast-feeding over the bottle-feed to minimize the risk of infections caused by C. sakazakii.

  18. Waiting for the Next Train? An Assessment of the Emerging Canadian LNG Industry

    International Nuclear Information System (INIS)

    In February 2015, Canada counted 22 LNG liquefaction plant projects - of which 17 are located in British Columbia - representing a total design capacity of 325 mmtpa. Canada has the potential to become a major LNG exporter but no project has received Final Investment Decision (FID) so far. Competition with US brown field projects with innovative business models have limited the commercial appeal of many Canadian projects relying on oil indexing. More recently, plummeting oil prices have put into question their profitability and lead to several postponements of FID reviews. This paper discusses the potential for Canada to export LNG, looking at the initial enthusiasm and wide support by public authorities and local communities but also at the economic challenges and commercial issues that are slowing the progress of these projects. In 2013, Canada owned 2,028 Bcm of proved natural gas reserves and in 2012, remaining marketable gas resources were estimated to exceed 30,000 Bcm, located mainly in the Western Canada Sedimentary Basin. In 2013, natural gas consumption grew due to higher demand from the tar sands industry and reached 90 Bcm, while marketed production rebounded slightly to 145 Bcm after 10 years of continuous decline. Net exports to the United States, the only export market for Canadian gas, kept decreasing to 55 Bcm. In the future, consumption is expected to grow at a slower rate than production and net exports to the United States to keep declining. As a consequence, LNG appears to be an ideal solution to monetize gas and to unlock these large resources. However, CEDIGAZ does not expect material LNG exports to start before 2021, but they could reach 34 mmtpa by 2035. Since the very beginning of the wave of LNG project proposals, Canadian federal and provincial authorities have appeared very supportive. At the provincial level, the government of British Columbia has multiplied initiatives to favor the emergence of a LNG industry, including by lowering

  19. Management of Fever in Postpneumococcal Vaccine Era: Comparison of Management Practices by Pediatric Emergency Medicine and General Emergency Medicine Physicians

    Science.gov (United States)

    Goldman, David L.; Avner, Jeffrey R.

    2014-01-01

    Background. The primary objective of this study was to compare management practices of general emergency physicians (GEMPs) and pediatric emergency medicine physicians (PEMPs) for well-appearing young febrile children. Methods. We retrospectively reviewed the charts of well-appearing febrile children aged 3–36 months who presented to a large urban children's hospital (PED), staffed by PEMPs, or a large urban general emergency department (GED), staffed by GEMPs. Demographics, immunization status, laboratory tests ordered, antibiotic usage, and final diagnoses were collected. Results. 224 cases from the PED and 237 cases from the GED were reviewed. Children seen by PEMPs had significantly less CXRs (23 (10.3%) versus 51 (21.5%), P = 0.001) and more rapid viral testing done (102 (45%) versus 40 (17%), P GEMPs and highlight the need for standardization of care. PMID:24982807

  20. Temporal dynamics of emergency department and hospital admissions of pediatric asthmatics

    Science.gov (United States)

    Kimes, Daniel; Levine, Elissa; Timmins, Sidey; Weiss, Sheila R.; Bollinger, Mary E.; Blaisdell, Carol

    2004-01-01

    Asthma is a chronic disease that can result in exacerbations leading to urgent care in emergency departments (EDs) and hospitals. We examined seasonal and temporal trends in pediatric asthma ED (1997-1999) and hospital (1986-1999) admission data so as to identify periods of increased risk of urgent care by age group, gender, and race. All pediatric ED and hospital admission data for Maryland residents occurring within the state of Maryland were evaluated. Distinct peaks in pediatric ED and hospital asthma admissions occurred each year during the winter-spring and autumn seasons. Although the number and timing of these peaks were consistent across age and racial groups, the magnitude of the peaks differed by age and race. The same number, timing, and relative magnitude of the major peaks in asthma admissions occurred statewide, implying that the variables affecting these seasonal patterns of acute asthma exacerbations occur statewide. Similar gross seasonal trends are observed worldwide. Although several environmental, infectious, and psychosocial factors have been linked with increases in asthma exacerbations among children, thus far they have not explained these seasonal patterns of admissions. The striking temporal patterns of pediatric asthma admissions within Maryland, as described here, provide valuable information in the search for causes.

  1. The Ukrainian version of the pediatric Canadian acute respiratory illness and flu scale: a linguistic validation study

    Science.gov (United States)

    Gerasimov, Sergei V; Belova, Halyna A; Pavuk, Halyna L; Seniuk, Ihor M; Strekalina, Yulia I

    2014-01-01

    Background There is no internationally recognized outcome measure for the assessment of acute respiratory tract infections (ARTIs) in children. The only identifiable scale initially developed for pediatric application has been the Canadian acute respiratory illness and flu scale (CARIFS). The aim of our trial was to adapt the English version of the CARIFS to the Ukrainian language. Materials and methods We performed forward and backward translation of the original version of the CARIFS according to the recommended standard. Then, the final CARIFS-based Ukrainian questionnaires were given to 149 caregivers whose 3–12 years old children suffered from ARTI. The questionnaires were completed twice by a caregiver 3–6 hours apart and once by a physician just after the second completion by a caregiver. The database was analyzed to assess the consistency (the Cronbach’s α coefficient), sensitivity (the standardized response mean; the effect size), reliability (test–retest analysis), and validity (Pearson’s correlation) of the CARIFS in the Ukrainian language. Results The backward translation of the Ukrainian version of the CARIFS demonstrated its good correspondence to the English version. The Cronbach’s α coefficient was 0.805, and item to total correlation coefficients varied from 0.185 to 0.665. The standardized response mean was 1.73, and the effect size was 2.50 suggesting good sensitivity of the scale. In the test–retest reliability analysis of 99 questionnaires, the median CARIFS score for the first and the second measurement was 19.0 (interquartile range [IQR]: 14.5–25.0) and 19.0 (IQR: 15.0–25.0), respectively, with a median change of 0.0 (IQR: −1.0 to 0.0, P=0.996). The Pearson’s correlation coefficient between the CARIFS score completed by a responder and a physician was 0.832 (P=0.004). Conclusion The Ukrainian version of the CARIFS-based English questionnaire proved to be a consistent, sensitive, reliable, and valid instrument in the

  2. The Ukrainian version of the pediatric Canadian acute respiratory illness and flu scale: a linguistic validation study

    Directory of Open Access Journals (Sweden)

    Gerasimov SV

    2014-10-01

    Full Text Available Sergei V Gerasimov,1 Halyna A Belova,2 Halyna L Pavuk,2 Ihor M Seniuk,2 Yulia I Strekalina21Lviv National Medical University, Lviv City Children's Hospital, 2The Fifth Lviv Community Outpatient Clinic, Lviv, UkraineBackground: There is no internationally recognized outcome measure for the assessment of acute respiratory tract infections (ARTIs in children. The only identifiable scale initially developed for pediatric application has been the Canadian acute respiratory illness and flu scale (CARIFS. The aim of our trial was to adapt the English version of the CARIFS to the Ukrainian language.Materials and methods: We performed forward and backward translation of the original version of the CARIFS according to the recommended standard. Then, the final CARIFS-based Ukrainian questionnaires were given to 149 caregivers whose 3–12 years old children suffered from ARTI. The questionnaires were completed twice by a caregiver 3–6 hours apart and once by a physician just after the second completion by a caregiver. The database was analyzed to assess the consistency (the Cronbach's α coefficient, sensitivity (the standardized response mean; the effect size, reliability (test–retest analysis, and validity (Pearson's correlation of the CARIFS in the Ukrainian language.Results: The backward translation of the Ukrainian version of the CARIFS demonstrated its good correspondence to the English version. The Cronbach’s α coefficient was 0.805, and item to total correlation coefficients varied from 0.185 to 0.665. The standardized response mean was 1.73, and the effect size was 2.50 suggesting good sensitivity of the scale. In the test–retest reliability analysis of 99 questionnaires, the median CARIFS score for the first and the second measurement was 19.0 (interquartile range [IQR]: 14.5–25.0 and 19.0 (IQR: 15.0–25.0, respectively, with a median change of 0.0 (IQR: -1.0 to 0.0, P=0.996. The Pearson’s correlation coefficient between the

  3. Residents need focused teaching during pediatric emergency medicine rotation to optimize their educational objectives

    Directory of Open Access Journals (Sweden)

    Mohammed Alomar

    2014-08-01

    Full Text Available Pediatric Emergency Medicine (PEM rotation provides a unique training environment for rotating residents. We aim to assess the impact of PEM rotation on the scientific knowledge of residents from different specialties and training centers by comparing the pre- and post-rotation knowledge. PEM Departments of three major tertiary care training centers were selected. Rotating pediatric and emergency medicine residents were given pre-test with twenty multiple-choice type questions related to the scientific knowledge of PEM and then re-tested with the same questions towards the end of their rotation. The t-test was used to compare mean scores. Further comparison based on specialty and training center was also done. Seventy-three residents were approached and enrolled, 48 from Pediatrics and 25 from Emergency Medicine. The mean pre- and post-scores for all residents were 15.9/20 and 15.5/20, respectively. All residents’ score was less on the post-rotation compared to the pre-rotation in all centers. Pediatric residents at one center scored higher, but they were not statistically significant. There were no statistically significant differences in resident specialty. We found a statistical difference between the residents of two centers compared to the third with P=0.04 and 0.02 respectively. After one month of rotation in PEM, we observed a decrease in the post-rotation test scores as compared to the pre-rotation scores. Since the reasons for the lower scores could not be identified by this study, educational deficiencies should be identified and perhaps a focused teaching and allotted study time to optimize the residents educational objective could be advised.

  4. Caudal block and emergence delirium in pediatric patients: Is it analgesia or sedation?

    Directory of Open Access Journals (Sweden)

    Aparna Sinha

    2012-01-01

    Full Text Available Background: Emergence delirium (ED although a short-lived and self-limiting phenomenon, makes a child prone to injury in the immediate postoperative period and hence is a cause of concern not only to the pediatric anesthesiologist, surgeons, and post anesthesia care unit staff but also amongst parents. Additional medication to quieten the child offsets the potential benefits of rapid emergence and delays recovery in day care settings. There is conflicting evidence of influence of analgesia and sedation following anesthesia on emergence agitation. We hypothesized that an anesthetic technique which improves analgesia and prolongs emergence time will reduce the incidence of ED. We selected ketamine as adjuvant to caudal block for this purpose. Methods: This randomized, double blind prospective study was performed in 150 premedicated children ASA I, II, aged 2 to 8 years who were randomly assigned to either group B (caudal with bupivacaine, BK (bupivacaine and ketamine, or NC (no caudal, soon after LMA placement. Recovery characteristics and complications were recorded. Results: Emergence time, duration of pain relief, and Pediatric Anesthesia Emergence Delirium (PAED scores were significantly higher in the NC group (P<0.05. Duration of analgesia and emergence time were significantly more in group BK than groups B and NC. However, the discharge readiness was comparable between all groups. No patient in BK group required to be given any medication to treat ED. Conclusion: Emergence time as well as duration of analgesia have significant influence on incidence of emergence delirium. Ketamine, as caudal adjuvant is a promising agent to protect against ED in children, following sevoflurane anesthesia.

  5. Pediatric head trauma: the evidence regarding indications for emergent neuroimaging

    International Nuclear Information System (INIS)

    Traumatic brain injury (TBI) is a leading cause of childhood death and disability worldwide. In the United States, childhood head trauma results in approximately 3,000 deaths, 50,000 hospitalizations, and 650,000 emergency department (ED) visits annually. Children presenting to the ED with seemingly minor head trauma account for approximately one-half of children with documented TBIs. Despite the frequency and importance of childhood minor head trauma, there exists no highly accurate, reliable and validated clinical scoring system or prediction rule for assessing risk of TBI among those with minor head trauma. At the same time, use of CT scanning in these children in recent years has increased substantially. The major benefit of CT scanning is early identification (and treatment) of TBIs that might otherwise be missed and result in increased risk of morbidity and mortality. Unnecessary CT imaging, however, exposes the child needlessly to the risk of radiation-induced malignancies. What constitutes appropriate criteria for obtaining CT scans in children after minor blunt head trauma remains controversial. Current evidence to guide clinicians in this regard is limited; however, large studies performed in multi-center research networks have recently been conducted. These studies should provide the foundation of evidence to guide CT decisions by clinicians, help identify TBIs in a timely fashion, and reduce unnecessary radiation exposure. (orig.)

  6. Pediatric head trauma: the evidence regarding indications for emergent neuroimaging

    Energy Technology Data Exchange (ETDEWEB)

    Kuppermann, Nathan [UC Davis Medical Center, Department of Emergency Medicine, Sacramento, CA (United States); University of California, Davis School of Medicine, Departments of Emergency Medicine and Pediatrics, Davis, CA (United States)

    2008-11-15

    Traumatic brain injury (TBI) is a leading cause of childhood death and disability worldwide. In the United States, childhood head trauma results in approximately 3,000 deaths, 50,000 hospitalizations, and 650,000 emergency department (ED) visits annually. Children presenting to the ED with seemingly minor head trauma account for approximately one-half of children with documented TBIs. Despite the frequency and importance of childhood minor head trauma, there exists no highly accurate, reliable and validated clinical scoring system or prediction rule for assessing risk of TBI among those with minor head trauma. At the same time, use of CT scanning in these children in recent years has increased substantially. The major benefit of CT scanning is early identification (and treatment) of TBIs that might otherwise be missed and result in increased risk of morbidity and mortality. Unnecessary CT imaging, however, exposes the child needlessly to the risk of radiation-induced malignancies. What constitutes appropriate criteria for obtaining CT scans in children after minor blunt head trauma remains controversial. Current evidence to guide clinicians in this regard is limited; however, large studies performed in multi-center research networks have recently been conducted. These studies should provide the foundation of evidence to guide CT decisions by clinicians, help identify TBIs in a timely fashion, and reduce unnecessary radiation exposure. (orig.)

  7. How Much are Emergency Medicine Specialists’ Decisions Reliable in the Diagnosis and Treatment of Pediatric Fractures?

    Directory of Open Access Journals (Sweden)

    Mohsen Mardani-Kivi

    2016-01-01

    Full Text Available Background: Considering the importance of an early diagnosis and proper decision-making in regards to the treatment of pediatric distal radius and elbow fractures, this study examines emergency medicine specialists’ accuracy in the diagnosis and treatment of these patients. Methods: From 2012 and 2013, children less than 14 years old who were referred to an academic hospital emergency department with elbow or distal radius fractures were enrolled. Initially, patients were examined by an emergency medicine specialist and then they were referred to an orthopedic surgeon. Type of fracture and the proposed treatment of two specialists were compared. Results: In total, there were 108 patients (54 patients in each group with a mean age of 8.1+3.3 years. Identical diagnosis in 48 cases (88.9% of distal radius and 36 cases (66.7% of elbow trauma were observed. We found a difference between diagnosis of the two specialists in diagnosing lateral condyle of the humerus fracture in the elbow group and growth plate fracture in the distal radius fracture group, but the differences were not significant. Among 108 patients, 70 patients (64.8% received identical treatment. Conclusion: Although the emergency medicine specialists responded similarly to the orthopedic specialists in the diagnosis of pediatric distal radius and elbow fractures, diagnosis of more complicated fractures such as lateral condylar humoral fractures, distal radius growth plate and for choosing the proper treatment option, merits further education.

  8. Advanced Nursing Directives: Integrating Validated Clinical Scoring Systems into Nursing Care in the Pediatric Emergency Department

    Directory of Open Access Journals (Sweden)

    Erin Kate deForest

    2012-01-01

    Full Text Available In an effort to improve the quality and flow of care provided to children presenting to the emergency department the implementation of nurse-initiated protocols is on the rise. We review the current literature on nurse-initiated protocols, validated emergency department clinical scoring systems, and the merging of the two to create Advanced Nursing Directives (ANDs. The process of developing a clinical pathway for children presenting to our pediatric emergency department (PED with suspected appendicitis will be used to demonstrate the successful integration of validated clinical scoring systems into practice through the use of Advanced Nursing Directives. Finally, examples of 2 other Advanced Nursing Directives for common clinical PED presentations will be provided.

  9. Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

    Science.gov (United States)

    Yard, Ellen E; Knox, Christy L; Smith, Gary A; Comstock, R Dawn

    2007-08-01

    Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children mechanism of injury was being kicked (25.6%), followed by falling (20.6%) and kicking (18.0%). The majority of injuries occurred to the lower leg/foot/ankle (30.1%) and hand/wrist (24.5%). The most common injury diagnoses were sprains/strains (29.3%), contusions/abrasions (27.8%), and fractures (24.6%). Participants in judo sustained significantly higher proportions of shoulder/upper arm injuries than karate (IPR=4.31, 95% CI: 2.84-6.55) or taekwondo (IPR=9.75, 95% CI: 3.53-26.91) participants. There were also higher proportions of neck injuries sustained by judo participants compared to karate (IPR=4.73, 95% CI: 1.91-11.70) or taekwondo (IPR=4.17, 95% CI: 1.02-17.06) participants. Pediatric martial arts injuries differ by discipline. Understanding these injury patterns can assist with the development of discipline-specific preventive interventions. PMID:16914371

  10. Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

    Science.gov (United States)

    Yard, Ellen E; Knox, Christy L; Smith, Gary A; Comstock, R Dawn

    2007-08-01

    Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children judo sustained significantly higher proportions of shoulder/upper arm injuries than karate (IPR=4.31, 95% CI: 2.84-6.55) or taekwondo (IPR=9.75, 95% CI: 3.53-26.91) participants. There were also higher proportions of neck injuries sustained by judo participants compared to karate (IPR=4.73, 95% CI: 1.91-11.70) or taekwondo (IPR=4.17, 95% CI: 1.02-17.06) participants. Pediatric martial arts injuries differ by discipline. Understanding these injury patterns can assist with the development of discipline-specific preventive interventions.

  11. Development of an accommodative smartphone app for medical guidelines in pediatric emergencies.

    Science.gov (United States)

    Schmucker, Michael; Heid, Jörn; Haag, Martin

    2014-01-01

    One of the outcomes of a training concept for physicians and nurses concerning pediatric emergencies at the Heidelberg University Hospital was that the work and procedures in childhood emergencies could be simplified by replacing the existing paper-based guidelines with a smartphone app. Since the project funds for this were already used up, a group of students from the master program "Medical Informatics" of Heidelberg and Heilbronn Universities took over the development of the app. Particular attention was given to the need for compatibility with the variety of devices (device size and screen resolution) and platform independence. The guidelines themselves were scripted in HTML5, JavaScript and CSS (responsive web design); managed by a container programmed in Sencha Touch. Even though the app is not yet available in the App-Store due to the limited timeframe, the students gained a great deal of valuable experience in developing platform independent software for mobile devices. PMID:24825689

  12. Dental emergencies in a university-based pediatric dentistry postgraduate outpatient clinic: a retrospective study.

    Science.gov (United States)

    Agostini, F G; Flaitz, C M; Hicks, M J

    2001-01-01

    The purpose of this retrospective study was to determine the prevalence and types of dental emergencies occurring in a university-based, pediatric dentistry postgraduate outpatient clinic. All patients presenting for emergency dental care during scheduled clinic hours over a three year were identified, and their charts were retrieved. Each record was reviewed for demographic information, chief complaint and clinical diagnosis. Only those charts with both chief complaints and clinical diagnoses recorded were included in this study. A total of 816 patients received emergency care, representing 15.3 percent of all patient treated during the study period. The patient population had a slight female predilection (53 percent female, 47 percent male) and a mean age of 5.1 years (range 10 days to 15 years). Ethnicity (39 percent African-American, 36 percent Hispanic, 24 percent Caucasian space maintainers [10 percent]; and 6) lost restorations [2 percent]. Pain and bleeding were the most common reasons for seeking emergency dental care. Most causes for seeking outpatient emergency dental care are disease processes which may be avoided by infant oral health and preventive dentistry programs and early treatment intervention.

  13. Improvements in Pain Outcomes in a Canadian Pediatric Teaching Hospital Following Implementation of a Multifaceted, Knowledge Translation Initiative

    Directory of Open Access Journals (Sweden)

    Lisa M Zhu

    2012-01-01

    Full Text Available BACKGROUND: A previous audit performed at a tertiary/quaternary pediatric hospital in Toronto, Ontario, demonstrated suboptimal assessment and treatment of children’s pain. Knowledge translation (KT initiatives (education, reminders, audit and feedback were implemented to address identified care gaps; however, the impact is unknown.

  14. Comparison of two analgesia protocols for the treatment of pediatric orthopedic emergencies

    Directory of Open Access Journals (Sweden)

    Andrea Barcelos

    2015-08-01

    Full Text Available SummaryObjective:to compare the efficacy of two analgesia protocols (ketamine versus morphine associated with midazolam for the reduction of dislocations or closed fractures in children.Methods:randomized clinical trial comparing morphine (0.1mg/kg; max 5mg and ketamine (2.0mg/kg, max 70mg associated with midazolam (0.2mg/kg; max 10mg in the reduction of dislocations or closed fractures in children treated at the pediatrics emergency room (October 2010 and September 2011. The groups were compared in terms of the times to perform the procedures, analgesia, parent satisfaction and orthopedic team.Results:13 patients were allocated to ketamine and 12 to morphine, without differences in relation to age, weight, gender, type of injury, and pain scale before the intervention. There was no failure in any of the groups, no differences in time to start the intervention and overall procedure time. The average hospital stay time was similar (ketamine = 10.8+5.1h versus morphine = 12.3+4.4hs; p=0.447. The median pain (faces pain scale scores after the procedure was 2 in both groups. Amnesia was noted in 92.3% (ketamine and 83.3% (morphine (p=0.904. Parents said they were very satisfied in relation to the analgesic intervention (84.6% in the ketamine group and 66.6% in the morphine group; p=0.296. The satisfaction of the orthopedist regarding the intervention was 92.3% in the ketamine group and 75% in the morphine group (p=0.222.Conclusion:by producing results similar to morphine, ketamine can be considered as an excellent option in pain management and helps in the reduction of dislocations and closed fractures in pediatric emergency rooms.

  15. Factors Associated with First-Pass Success in Pediatric Intubation in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Tadahiro Goto, MD

    2016-03-01

    Full Text Available Introduction: The objective of this study was to investigate the factors associated with first-pass success in pediatric intubation in the emergency department (ED. Methods: We analyzed the data from two multicenter prospective studies of ED intubation in 17 EDs between April 2010 and September 2014. The studies prospectively measured patient’s age, sex, principal indication for intubation, methods (e.g., rapid sequence intubation [RSI], devices, and intubator’s level of training and specialty. To evaluate independent predictors of first-pass success, we fit logistic regression model with generalized estimating equations. In the sensitivity analysis, we repeated the analysis in children <10 years. Results: A total of 293 children aged ≤18 years who underwent ED intubation were eligible for the analysis. The overall first-pass success rate was 60% (95%CI [54%-66%]. In the multivariable model, age ≥10 years (adjusted odds ratio [aOR], 2.45; 95% CI [1.23-4.87], use of RSI (aOR, 2.17; 95% CI [1.31-3.57], and intubation attempt by an emergency physician (aOR, 3.21; 95% CI [1.78- 5.83] were significantly associated with a higher chance of first-pass success. Likewise, in the sensitivity analysis, the use of RSI (aOR, 3.05; 95% CI [1.63-5.70], and intubation attempt by an emergency physician (aOR, 4.08; 95% CI [1.92-8.63] were significantly associated with a higher chance of first-pass success. Conclusion: Based on two large multicenter prospective studies of ED airway management, we found that older age, use of RSI, and intubation by emergency physicians were the independent predictors of a higher chance of first-pass success in children. Our findings should facilitate investigations to develop optimal airway management strategies in critically-ill children in the ED.

  16. Efficacy of patient discharge instructions: A pointer toward caregiver friendly communication methods from pediatric emergency personnel

    Science.gov (United States)

    Al-Harthy, Nesrin; Sudersanadas, Kavita M.; Al-Mutairi, Mohammed; Vasudevan, Senthilvel; Bin Saleh, Ghada; Al-Mutairi, Malak; Hussain, Lenna W.

    2016-01-01

    Background: Discharge instructions are vital in postemergency patient care to help the caregiver understand the diagnosis and identify symptoms which require prompt readmission. In general, oral or written instructions are provided on discharge. However, there is a dearth of information on the efficacy of discharge instructions provided by physicians in KSA. Objectives: To evaluate the efficacy of discharge instructions for postpediatrics emergency visit. Materials and Methods: This observational cross-sectional survey conducted in the Department of Paediatric Emergency at King Abdul Aziz Medical City, Riyadh, KSA, included 173 literate adult caregivers who had given their consent. Those who had been on admission earlier and been discharged from the emergency department were excluded. Demographic data and variables like knowledge of medicine and treatment follow-up were collected using a structured questionnaire and analyzed using SPSS version 16. Results: Verbal only, written only, or both verbal and written discharge instructions were provided. Written and verbal instructions, when provided together, were the most effective modes of communication with caregivers. The majority of the respondents were unaware of the follow-up plan (64.16%), unable to identify problems that would necessitate a follow-up (58.96%), and unable to identify the signs and symptoms that would require a revisit (62.43%) irrespective of the mode of instruction. However, more attention is necessary because of the 34.68% of the subjects who left the hospital without discharge instructions. Conclusions: Instructions given both verbally and in writing were observed to be more effective than verbal only or written only. The effectiveness of discharge instructions was highly influenced by the level of education of the caregivers. Improved caregiver friendly methods of communication from the pediatric emergency health-care team are necessary for the delivery of discharge instructions. PMID:27625582

  17. Creation and Assessment of a Bad News Delivery Simulation Curriculum for Pediatric Emergency Medicine Fellows.

    Science.gov (United States)

    Chumpitazi, Corrie E; Rees, Chris A; Chumpitazi, Bruno P; Hsu, Deborah C; Doughty, Cara B; Lorin, Martin I

    2016-01-01

    Background  Bad news in the context of health care has been broadly defined as significant information that negatively alters people's perceptions of the present or future. Effectively delivering bad news (DBN) in the setting of the emergency department requires excellent communication skills. Evidence shows that bad news is frequently given inadequately. Studies show that trainees need to devote more time to developing this skill through formalized training. This program's objectives were to utilize trained standardized patients in a simulation setting to assist pediatric emergency medicine (PEM) fellows in the development of effective, sensitive, and compassionate communication with patients and family members when conveying bad news, and to recognize and respond to the patient/parent's reaction to such news. Methods PEM fellows participated in a novel curriculum utilizing simulated patients (SPs) acting as the patient's parent and immersive techniques in a realistic and supportive environment. A baseline survey was conducted to ascertain participant demographics and previous experience with simulation and DBN. Experienced, multi-disciplinary faculty participated in a training workshop with the SPs one week prior to course delivery. Three scenarios were developed for bad news delivery. Instructors watched via remote video feed while the fellows individually interacted with the SPs and then participated in a confidential debriefing. Fellows later joined for group debriefing. Fellow characteristics, experience, and self-perceived comfort pre/post-course were collected.   Results Baseline data demonstrated that 78% of fellows reported DBN two or more times per month. Ninety-three percent of fellows in this study were present during the delivery of news about the death of a child to a parent or family member in the six-month period preceding this course. Fellows' self-reported comfort level in DBN to a patient/family and dealing with patient and parent emotions

  18. Nonurgent Use of the Emergency Department by Pediatric Patients: A Theory-Guided Approach for Primary and Acute Care Pediatric Nurse Practitioners.

    Science.gov (United States)

    Ohns, Mary Jean; Oliver-McNeil, Sandra; Nantais-Smith, Leanne M; George, Nancy M

    2016-01-01

    Providing quality, cost-effective care to children and their families in the appropriate setting is the goal of nurse practitioners in primary and acute care. However, increased utilization of the emergency department (ED) for nonurgent care threatens cost-effective quality care, interrupts continuity of care, and contributes to ED overcrowding. To date, descriptive research has identified demographics of those using the ED for nonurgent care, the chief complaints of children seeking nonurgent care, the cost to the health care system of pediatric nonurgent care, and characteristics of associated primary care settings. Using Donabedian's Model of Quality of Healthcare and a Theory of Dependent Care by Taylor and colleagues, acute and primary care pediatric nurse practitioners can incorporate interventions that will channel care to the appropriate setting and educate caregivers regarding common childhood illnesses and the value of continuity of care. By using a theoretical framework as a guide, this article will help both acute and primary care pediatric nurse practitioners understand why parents seek nonurgent care for their children in the ED and actions they can take to ensure that care is provided in an optimal setting.

  19. Nonurgent Use of the Emergency Department by Pediatric Patients: A Theory-Guided Approach for Primary and Acute Care Pediatric Nurse Practitioners.

    Science.gov (United States)

    Ohns, Mary Jean; Oliver-McNeil, Sandra; Nantais-Smith, Leanne M; George, Nancy M

    2016-01-01

    Providing quality, cost-effective care to children and their families in the appropriate setting is the goal of nurse practitioners in primary and acute care. However, increased utilization of the emergency department (ED) for nonurgent care threatens cost-effective quality care, interrupts continuity of care, and contributes to ED overcrowding. To date, descriptive research has identified demographics of those using the ED for nonurgent care, the chief complaints of children seeking nonurgent care, the cost to the health care system of pediatric nonurgent care, and characteristics of associated primary care settings. Using Donabedian's Model of Quality of Healthcare and a Theory of Dependent Care by Taylor and colleagues, acute and primary care pediatric nurse practitioners can incorporate interventions that will channel care to the appropriate setting and educate caregivers regarding common childhood illnesses and the value of continuity of care. By using a theoretical framework as a guide, this article will help both acute and primary care pediatric nurse practitioners understand why parents seek nonurgent care for their children in the ED and actions they can take to ensure that care is provided in an optimal setting. PMID:26489793

  20. A matched-pair cluster design study protocol to evaluate implementation of the Canadian C-spine rule in hospital emergency departments: Phase III

    OpenAIRE

    Rowe Brian H; Lesiuk Howard J; Coyle Doug; Wells George A; Grimshaw Jeremy; Stiell Ian G; Brison Robert J; Schull Michael; Lee Jacques; Clement Catherine M

    2007-01-01

    Abstract Background Physicians in Canadian emergency departments (EDs) annually treat 185,000 alert and stable trauma victims who are at risk for cervical spine (C-spine) injury. However, only 0.9% of these patients have suffered a cervical spine fracture. Current use of radiography is not efficient. The Canadian C-Spine Rule is designed to allow physicians to be more selective and accurate in ordering C-spine radiography, and to rapidly clear the C-spine without the need for radiography in m...

  1. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  2. Alternative management of diabetic ketoacidosis in a Brazilian pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Savoldelli Roberta D

    2010-06-01

    Full Text Available Abstract DKA is a severe metabolic derangement characterized by dehydration, loss of electrolytes, hyperglycemia, hyperketonemia, acidosis and progressive loss of consciousness that results from severe insulin deficiency combined with the effects of increased levels of counterregulatory hormones (catecholamines, glucagon, cortisol, growth hormone. The biochemical criteria for diagnosis are: blood glucose > 200 mg/dl, venous pH 3 mmol/L and presence of ketonuria. A patient with DKA must be managed in an emergency ward by an experienced staff or in an intensive care unit (ICU, in order to provide an intensive monitoring of the vital and neurological signs, and of the patient's clinical and biochemical response to treatment. DKA treatment guidelines include: restoration of circulating volume and electrolyte replacement; correction of insulin deficiency aiming at the resolution of metabolic acidosis and ketosis; reduction of risk of cerebral edema; avoidance of other complications of therapy (hypoglycemia, hypokalemia, hyperkalemia, hyperchloremic acidosis; identification and treatment of precipitating events. In Brazil, there are few pediatric ICU beds in public hospitals, so an alternative protocol was designed to abbreviate the time on intravenous infusion lines in order to facilitate DKA management in general emergency wards. The main differences between this protocol and the international guidelines are: intravenous fluid will be stopped when oral fluids are well tolerated and total deficit will be replaced orally; if potassium analysis still indicate need for replacement, it will be given orally; subcutaneous rapid-acting insulin analog is administered at 0.15 U/kg dose every 2-3 hours until resolution of metabolic acidosis; approximately 12 hours after treatment initiation, intermediate-acting (NPH insulin is initiated at the dose of 0.6-1 U/kg/day, and it will be lowered to 0.4-0.7 U/kg/day at discharge from hospital.

  3. The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica

    Directory of Open Access Journals (Sweden)

    Rachel Gooden

    2014-12-01

    Full Text Available Background and objectives: Emergence delirium is a distressing complication of the use of sevoflurane for general anesthesia. This study sought to determine the incidence of emergence delirium and risk factors in patients at a specialist pediatric hospital in Kingston, Jamaica. Methods: This was a cross-sectional, observational study including pediatric patients aged 3-10 years, ASA I and II, undergoing general anesthesia with sevoflurane for elective day-case procedures. Data collected included patients' level of anxiety pre-operatively using the modified Yale Preoperative Anxiety Scale, surgery performed, anesthetic duration and analgesics administered. Postoperatively, patients were assessed for emergence delirium, defined as agitation with non-purposeful movement, restlessness or thrashing; inconsolability and unresponsiveness to nursing and/or parental presence. The need for pharmacological treatment and post-operative complications related to emergence delirium episodes were also noted. Results: One hundred and forty-five (145 children were included, with emergence delirium occurring in 28 (19.3%. Emergence delirium episodes had a mean duration of 6.9±7.8 min, required pharmacologic intervention in 19 (67.8% children and were associated with a prolonged recovery time (49.4±11.9 versus 29.7± 10.8 min for non-agitated children; p<0.001. Factors positively associated with emergence delirium included younger age (p = 0.01, OR 3.3, 95% CI 1.2-8.6 and moderate and severe anxiety prior to induction (p <0.001, OR 5.6, 95% CI 2.3-13.0. Complications of emergence delirium included intravenous line removal (n = 1, and surgical site bleeding (n = 3. Conclusion: Children of younger age with greater preoperative anxiety are at increased risk of developing emergence delirium following general anesthesia with sevoflurane. The overall incidence of emergence delirium was 19%.

  4. A matched-pair cluster design study protocol to evaluate implementation of the Canadian C-spine rule in hospital emergency departments: Phase III

    Directory of Open Access Journals (Sweden)

    Rowe Brian H

    2007-02-01

    Full Text Available Abstract Background Physicians in Canadian emergency departments (EDs annually treat 185,000 alert and stable trauma victims who are at risk for cervical spine (C-spine injury. However, only 0.9% of these patients have suffered a cervical spine fracture. Current use of radiography is not efficient. The Canadian C-Spine Rule is designed to allow physicians to be more selective and accurate in ordering C-spine radiography, and to rapidly clear the C-spine without the need for radiography in many patients. The goal of this phase III study is to evaluate the effectiveness of an active strategy to implement the Canadian C-Spine Rule into physician practice. Specific objectives are to: 1 determine clinical impact, 2 determine sustainability, 3 evaluate performance, and 4 conduct an economic evaluation. Methods We propose a matched-pair cluster design study that compares outcomes during three consecutive 12-months "before," "after," and "decay" periods at six pairs of "intervention" and "control" sites. These 12 hospital ED sites will be stratified as "teaching" or "community" hospitals, matched according to baseline C-spine radiography ordering rates, and then allocated within each pair to either intervention or control groups. During the "after" period at the intervention sites, simple and inexpensive strategies will be employed to actively implement the Canadian C-Spine Rule. The following outcomes will be assessed: 1 measures of clinical impact, 2 performance of the Canadian C-Spine Rule, and 3 economic measures. During the 12-month "decay" period, implementation strategies will continue, allowing us to evaluate the sustainability of the effect. We estimate a sample size of 4,800 patients in each period in order to have adequate power to evaluate the main outcomes. Discussion Phase I successfully derived the Canadian C-Spine Rule and phase II confirmed the accuracy and safety of the rule, hence, the potential for physicians to improve care. What

  5. Prevalence and predictors of hypoxemia in acute respiratory infections presenting to pediatric emergency department

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    Singhi S

    2003-01-01

    Full Text Available Rational & Objective: Early detection of hypoxemia and oxygen therapy improves the outcome of children with acute respiratory illnesses (ARI. However, facility to measure oxygen saturation (SpO2 is not available in many health facilities of resource poor countries. We have studied prevalence of hypoxemia in children with ARI and examined value of various clinical signs to predict hypoxemia. Subjects & Methods: Consecutive children, aged 2 months - 59 months, with respiratory symptom(s attending the pediatric emergency service between Oct 2001 to December 2002 were studied. Presence or absence of cough, nasal flaring, ability to feed/drink, cyanosis, chestwall indrawing, wheeze, tachypnoea (respiratory rate >50/min in children up to 11 months and >40/min up to 59 months, crepitations on auscultation and oxygen saturation (SpO2, by Nellcore™pulse oximeter and clinical diagnosis were recorded. Results: Of 2216 children studied 266 (11.9% had hypoxemia (SpO2 £90%. It was seen in 73.8% of 126 patients with WHO defined very severe pneumonia, 25.8% of 331 patients with severe pneumonia, 11% of 146 patients with bronochiolitis and 6.5% of 338 patients with acute asthma. Most sensitive indicators of hypoxemia were chestwall indrawing (sensitivity-90%, negative predictive value -98% and crepitations (sensitivity-75%, negative predictive value 95.7% while the best positive predictive value was seen with cyanosis (71.4% and inability to feed (47.6%. Nasal flaring had the good balance of sensitivity (64%, specificity (82% and positive predictive value (33% among the signs studied. Conclusion: None of the clinical signs of respiratory distress had all the attributes of a good predictors of hypoxemia. Chest wall indrawing was the most sensitive and 'inability to feed/ drink' was the most specific indicator.

  6. The Impact of High-Profile Sexual Abuse Cases in the Media on a Pediatric Emergency Department.

    Science.gov (United States)

    Flannery, Dustin D; Stephens, Clare L; Thompson, Amy D

    2016-01-01

    High-profile media cases of sexual abuse may encourage disclosures of abuse from victims of unrelated assaults and also influence parental concerns, leading to increased emergency department visits. In the region of the study authors' institution, there are two recent high-profile sexual abuse cases with media coverage: Earl Bradley, a Delaware pediatrician, and Jerry Sandusky, a Pennsylvania college football coach. This is a retrospective cohort study of children evaluated for sexual abuse at a pediatric emergency department. Patients were classified as either presenting during a media period or non-media period. The media periods were one-month periods immediately following breaking news reports, when the cases were highly publicized in the media. The non-media periods were the 12-month periods directly preceding the first reports. The median number of emergency department visits per month during a non-media period was 9 visits (interquartile range 6-10). There were 11 visits in the month following the Sandusky case and 13 visits following the Bradley case. There was no statistical difference in number of emergency department visits for sexual abuse between the periods (p = .09). These finding have implications regarding use of resources in pediatric EDs after high-profile sexual abuse cases.

  7. The Impact of High-Profile Sexual Abuse Cases in the Media on a Pediatric Emergency Department.

    Science.gov (United States)

    Flannery, Dustin D; Stephens, Clare L; Thompson, Amy D

    2016-01-01

    High-profile media cases of sexual abuse may encourage disclosures of abuse from victims of unrelated assaults and also influence parental concerns, leading to increased emergency department visits. In the region of the study authors' institution, there are two recent high-profile sexual abuse cases with media coverage: Earl Bradley, a Delaware pediatrician, and Jerry Sandusky, a Pennsylvania college football coach. This is a retrospective cohort study of children evaluated for sexual abuse at a pediatric emergency department. Patients were classified as either presenting during a media period or non-media period. The media periods were one-month periods immediately following breaking news reports, when the cases were highly publicized in the media. The non-media periods were the 12-month periods directly preceding the first reports. The median number of emergency department visits per month during a non-media period was 9 visits (interquartile range 6-10). There were 11 visits in the month following the Sandusky case and 13 visits following the Bradley case. There was no statistical difference in number of emergency department visits for sexual abuse between the periods (p = .09). These finding have implications regarding use of resources in pediatric EDs after high-profile sexual abuse cases. PMID:27561119

  8. Epidemiological and Survival Trends of Pediatric Cardiac Arrests in Emergency Departments in Korea: A Cross-sectional, Nationwide Report.

    Science.gov (United States)

    Ahn, Jae Yun; Lee, Mi Jin; Kim, Hyun; Yoon, Han Deok; Jang, Hye Young

    2015-09-01

    Cardiac arrest (CA) in children is associated with high mortality rates. In Korea, cohort studies regarding the outcomes of pediatric CAs are lacking, especially in emergency departments (EDs) or in-hospital settings. This study was conducted to examine the trends in epidemiology and survival outcomes in children with resuscitation-attempted CAs using data from a cross-sectional, national, ED-based clinical registry. We extracted cases in which cardiopulmonary resuscitation and/or manual defibrillation were performed according to treatment codes using the National Emergency Department Information System (NEDIS) from 2008 to 2012. The total number of ED visits registered in the NEDIS during the 5-yr evaluation period was 20,424,530; among these, there were 2,970 resuscitation-attempted CAs in children. The annual rates of pediatric CAs per 1,000 ED visits showed an upward trend from 2.81 in 2009 to 3.62 in 2012 (P for trend = 0.045). The median number of estimated pediatric CAs at each ED was 7.8 (25th to 75th percentile, 4 to 13) per year. The overall rates for admission survival and discharge survival were 35.2% and 12.8%, respectively. The survival outcome of adults increased substantially over the past 5 yr (11.8% in 2008, 11.7% in 2010, and 13.6% in 2012; P for trend = 0.001); however, the results for children did not improve (13.6% in 2008, 11.4% in 2010, and 13.7% in 2012; P for trend = 0.870). Conclusively, we found that the overall incidence of pediatric CAs in EDs increased substantially over the past 5 yr, but without significantly higher survival outcomes. PMID:26339179

  9. Variability of DKA Management Among Pediatric Emergency Room and Critical Care Providers: A Call for More Evidence-Based and Cost-Effective Care?

    OpenAIRE

    G Clark, Matthew; Dalabih, Abdallah

    2014-01-01

    Management protocols have been shown to be effective in the pediatric emergency medicine (PEM) and pediatric critical care (PCC) settings. Treatment protocols define clear goals which are achieved with consistency in implementation. Over the last decade, many new recommendations have been proposed on managing diabetic ketoacidosis (DKA). Although no perfect set of guidelines exist, many institutions are developing DKA treatment protocols. We sought to determine the variability between institu...

  10. Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

    Science.gov (United States)

    Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

    2010-01-01

    This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

  11. Strain Imaging: The Emergence of Speckle Tracking Echocardiography into Clinical Pediatric Cardiology.

    Science.gov (United States)

    Colquitt, John L; Pignatelli, Ricardo H

    2016-01-01

    Speckle tracking echocardiography measures myocardial strain and allows for the quantification of regional and global left and right ventricular function. A growing body of literature is supporting its transition from research into clinical practice. This article aims to provide a practical review of strain imaging as it applies to congenital and pediatric heart disease, with the goals of increasing literacy and advocating for greater clinical integration. PMID:26879728

  12. Markets for Canadian oil

    International Nuclear Information System (INIS)

    This conference presentation presented charts and graphs on the market for Canadian oil. Graphs included crude oil and natural gas prices and heavy oil discount differential. Graphs depicting heavy oil economics such as bitumen blending with condensate were also included along with global crude oil reserves by country. Information on oil sands projects in the Athabasca, Peace River, and Cold Lake deposits was presented along with graphs on oil sands supply costs by recovery type; Canadian production for conventional, oil sands and offshore oil; new emerging oil sands crude types; and 2003 market demand by crude type in the United States and Canada. Maps included Canada and United States crude oil pipelines; western Canadian crude oil markets; long term oil pipeline expansion projects; Canadian and United States crude oil pipeline alternatives; and potential tanker markets for Canadian oil sands production. Lastly, the presentation provided graphs on 2003 refinery crude demand and California market demand. tabs., figs

  13. Assessment of variation in the alberta context tool: the contribution of unit level contextual factors and specialty in Canadian pediatric acute care settings

    Directory of Open Access Journals (Sweden)

    Cummings Greta G

    2011-10-01

    Full Text Available Abstract Background There are few validated measures of organizational context and none that we located are parsimonious and address modifiable characteristics of context. The Alberta Context Tool (ACT was developed to meet this need. The instrument assesses 8 dimensions of context, which comprise 10 concepts. The purpose of this paper is to report evidence to further the validity argument for ACT. The specific objectives of this paper are to: (1 examine the extent to which the 10 ACT concepts discriminate between patient care units and (2 identify variables that significantly contribute to between-unit variation for each of the 10 concepts. Methods 859 professional nurses (844 valid responses working in medical, surgical and critical care units of 8 Canadian pediatric hospitals completed the ACT. A random intercept, fixed effects hierarchical linear modeling (HLM strategy was used to quantify and explain variance in the 10 ACT concepts to establish the ACT's ability to discriminate between units. We ran 40 models (a series of 4 models for each of the 10 concepts in which we systematically assessed the unique contribution (i.e., error variance reduction of different variables to between-unit variation. First, we constructed a null model in which we quantified the variance overall, in each of the concepts. Then we controlled for the contribution of individual level variables (Model 1. In Model 2, we assessed the contribution of practice specialty (medical, surgical, critical care to variation since it was central to construction of the sampling frame for the study. Finally, we assessed the contribution of additional unit level variables (Model 3. Results The null model (unadjusted baseline HLM model established that there was significant variation between units in each of the 10 ACT concepts (i.e., discrimination between units. When we controlled for individual characteristics, significant variation in the 10 concepts remained. Assessment of the

  14. Egypt emerges : with help from some Canadian companies, Alexandria is striving to grab a spot on the global LNG stage

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, A.

    2006-12-15

    Two new liquefied natural gas (LNG) plants recently built in Egypt are a testimony to the country's renewed natural gas industry. This article presented details of Canadian companies who are now operating in Egypt as a result of the Egyptian government's decision to include gas as a commodity from which foreign companies could earn a profit in the late 1980s. Apache negotiated a lease on a 2.2 million acre block southwest of Giza called the Qarun Block along with a partner called Phoenix Resources Companies Inc. in 1992, and has since made significant gas discoveries. In March 2006, the company posted record gross oil and gas production of 119,500 barrels per day and 501 million cubic feet per day. Egypt currently produces 3.5 billion cubic feet of natural gas per day. Approximately half is consumed locally and the balance is liquefied for export to Europe and Asian markets. The 2 LNG plants in Egypt currently process 700 million cubic feet and 1 billion cubic feet per day respectively. Egypt's Nile Delta is emerging as a world-class hydrocarbon basin, where companies such as BP have been exploring and producing since 1992. BP is confident that Egypt's potential reserves exceed 100 trillion cubic feet and that its aggressive exploration strategy is expected to form the foundation of a significant LNG business. Calgary-based company Centurion has established a presence in Egypt and has formed a partnership with Royal Dutch/Shell Group. The company has granted Shell 2 concessions in exchange for the construction of a gas train worth $1.5 billion capable of handling 500 million cubic feet per day of gas. It was concluded that while current global prices for natural gas are still too low to make it economical to ship Egyptian LNG to North America, higher prices may mean that LNG currently being transported to Europe may eventually end up in North American LNG terminals. 9 figs.

  15. A Simple Clinical Score “TOPRS” to Predict Outcome in Pediatric Emergency Department in a Teaching Hospital in India

    Directory of Open Access Journals (Sweden)

    2012-03-01

    Full Text Available Objective: To develop a simple clinical scoring system for severity of illness to help prioritize care and predict outcome in emergency department.Methods: Prospective hospital based observational study. Out of a total of 874 children who attended emergency department in one year, 777 were included in the study. Data was collected at the time ofadmission in emergency department. The baseline information like age, gender, etc and variables of ‘toprs’score viz temperature, oxygen saturation, pulse rate, respiratory rate, sensorium and seizures were recorded.Variables were categorized as normal (score zero or abnormal (score 1 based on systemic inflammatory response syndrome (SIRS criteria and criteria mentioned in advanced pediatric life support (APLS and the total scores were computed for each child. The outcome (death/discharge was correlated with the studyvariables and total score. The predictive ability of score was calculated using receiver operating characteristic (ROC curve analysis.Findings: Of the six variables, temperature, oxygen saturation and respiratory rate were found to be significantly associated with mortality. Mortality increased with the increase in the number of abnormal variables. Based on the regression coefficients, maximum possible score was 6.68. The predictive ability of score was 81.7 calculated using ROC curve. Maximum discrimination was observed at a score of 2.5.Conclusion: For triage in emergency, any patient with 2 or more abnormal variables should be closely monitored and evaluated. These patients require admission as they have a potential risk of death.

  16. Emergence of Non-Serotype b Encapsulated Haemophilus influenzae as a Cause of Pediatric Meningitis in Northwestern Ontario

    Directory of Open Access Journals (Sweden)

    Pouya Sadeghi-Aval

    2013-01-01

    Full Text Available Before the introduction of the conjugate vaccine, Haemophilus influenzae serotype b (Hib was the leading cause of bacterial meningitis in children. Although successful in reducing Hib cases, the vaccine confers no protection against other serotypes of H influenzae, such as a (Hia, or f (Hif. The emergence of invasive disease caused by non-Hib in northwestern Ontario (38 cases between 2002 and 2008 with predominance of Hia was previously reported by the authors. At that time, no cases of pediatric meningitis caused by H influenzae were recorded in the region. Continued surveillance identified 12 new cases of invasive non-Hib between January 2009 and July 2011. Among these cases, three young children developed meningitis with severe complications caused by Hia or Hif. The present article describes these cases along with the characteristics of recent H influenzae isolates from the region, (ie, their genetic background and antibiotic sensitivity. The findings point to the clonal nature of circulating Hia strains as well as to an increase in frequency and severity of pediatric invasive H influenzae infections in northwestern Ontario.

  17. Reasons behind non-adherence of healthcare practitioners to pediatric asthma guidelines in an emergency department in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Wahabi Hayfaa A

    2012-07-01

    Full Text Available Abstract Background The prevalence of childhood bronchial asthma in Saudi Arabia has increased in less than a decade from 8% to 23%. Innovations in the management of asthma led to the development of evidence based clinical practice guidelines and protocols to improve the patients’ outcomes. The objectives of this study are to examine the compliance of the healthcare providers in the Pediatrics Emergency Department, in King Khalid University Hospital, with the recommendations of the Pediatrics Asthma Management Protocol (PAMP, and to explore the reasons behind non-adherence. Methods This study is designed in 2 parts, a patients’ chart review and a focus group interview. The medical records of all the children who presented to the Pediatric Emergency Department (PED and were diagnosed as asthmatic, during the period from the 1st of January 2009 to the 31st of March 2009, were reviewed to investigate the compliance of healthcare providers (physicians and nurses with 8 recommendations of the PAMP which are considered to be frequently encountered evidence-practice gaps, and these are 1 documentation of asthma severity grading by the treating physician and nurse 2 limiting the prescription of Ipratropium for children with severe asthma 3 administration of Salbutamol through an inhaler and a spacer 4 documentation of parental education 5 prescription of systemic corticosteroids to all cases of acute asthma 6 limiting chest x-ray requisition for children with suspected chest infection 7 management of all cases of asthma as outpatients, unless diagnosed as severe or life threatening asthma 8 limiting prescription of antibiotics to children with chest infection. The second part of this study is a focus group interview designed to elicit the reasons behind non- adherence to the recommendations detected by the chart review. Two separate focus group interviews were conducted for 10 physicians and 10 nurses. The focus group interviews were tape

  18. Correlation of Ordered Cervical Spine X-rays in Emergency Department with NEXUS and Canadian C-Spine Rules; a Clinical Audit

    Directory of Open Access Journals (Sweden)

    Hamid Kariman

    2015-10-01

    Full Text Available Introduction: Evaluation of cervical spine injuries makes up a major part of trauma patient assessments. Based on the existing sources, more than 98% of the cervical spine X-rays show no positive findings. Therefore, the present clinical audit aimed to evaluate the correlation of ordered cervical spine X-rays in multiple trauma patients with NEXUS and Canadian c-spine clinical decision rules. Methods: The present clinical audit, evaluated the correlation of cervical spine imaging orders in multiple trauma patients presented to the emergency department, with NEXUS and Canadian c-spine rules. Initially, in a pilot study, the mentioned correlation was evaluated, and afterwards the results of this phase was analyzed. Since the correlation was low, an educational training was planned for all the physicians in charge. Finally, the calculated correlations for before and after training were compared using SPSS version 21. Results: Before and after training, cervical spine X-ray was ordered for 98 (62.82% and 85 (54.48% patients, respectively. Accuracy of cervical spine X-ray orders, based on the standard clinical decision rules, increased from 100 (64.1% cases before training, to 143 (91.7% cases after training (p < 0.001. Area under the receiver operating characteristic (ROC curve regarding the correlation also raised from 52 (95% confidence interval (CI: 43 – 61 to 92 (95% CI: 87 – 97. Conclusion: Teaching NEXUS and Canadian c-spine clinical decision rules plays a significant role in improving the correlation of cervical spine X-ray orders in multiple trauma patients with the existing standards.

  19. Pulmonary Function Tests in Emergency Department Pediatric Patients with Acute Wheezing/Asthma Exacerbation

    Directory of Open Access Journals (Sweden)

    Kathryn Giordano

    2012-01-01

    Full Text Available Background. Pulmonary function tests (PFT have been developed to analyze tidal breathing in patients who are minimally cooperative due to age and respiratory status. This study used tidal breathing tests in the ED to measure asthma severity. Design/Method. A prospective pilot study in pediatric patients (3 to 18 yrs with asthma/wheezing was conducted in an ED setting using respiratory inductance plethysmography and pneumotachography. The main outcome measures were testing feasibility, compliance, and predictive value for admission versus discharge. Results. Forty patients were studied, of which, 14 (35% were admitted. Fifty-five percent of the patients were classified as a mild-intermittent asthmatic, 30% were mild-persistent asthmatics, 12.5% were moderate-persistent asthmatics, and 2.5% were severe-persistent. Heart rate was higher in admitted patients as was labored breathing index, phase angle, and asthma score. Conclusions. Tidal breathing tests provide feasible, objective assessment of patient status in the enrolled age group and may assist in the evaluation of acute asthma exacerbation in the ED. Our results demonstrate that PFT measurements, in addition to asthma scores, may be useful in indicating the severity of wheezing/asthma and the need for admission.

  20. Dental emergencies in a university pediatric dentistry clinic: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ayah Qassem Shqair

    2012-02-01

    Full Text Available A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%, pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%. Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used.

  1. Evaluation and Monitoring of a Child With Hydrocarbon Pneumonitis Using Point-of-Care Lung Ultrasound in the Pediatric Emergency Department.

    Science.gov (United States)

    Vazquez, Michelle; Paul, Audrey Z; Tay, Ee Tein; Tsung, James W

    2016-09-01

    A well-appearing 3-year-old boy presented to the pediatric emergency department 2 hours after a presumed hydrocarbon ingestion. He was referred to the emergency department by his pediatrician after consultation with the local poison control center after possibly ingesting ylang ylang (Cananga odorata) fragrance oil. The child was asymptomatic with a normal physical examination. Point-of-care lung ultrasound identified focal hydrocarbon pneumonitis in the right lung and demonstrated resolution of these findings. Utilization of point-of-care ultrasound resulted in a shorter emergency department length of stay and the avoidance of radiation exposure from serial chest x-rays. PMID:26890296

  2. Pediatric oncologists' coping strategies for dealing with patient death.

    Science.gov (United States)

    Granek, Leeat; Barrera, Maru; Scheinemann, Katrin; Bartels, Ute

    2016-01-01

    This research examined pediatric oncologists coping strategies when their patients died of cancer. Twenty-one pediatric oncologists at 2 Canadian pediatric academic hospitals were interviewed about their coping strategies when patients died or were in the process of dying. The grounded theory method of data collection and data analysis were used. Line-by-line coding was used to establish codes and themes and constant comparison was used to establish relations among emerging codes and themes. Pediatric oncologists used engagement coping strategies with primary and secondary responses including emotional regulation (social support and religion), problem solving (supporting families at end of life), cognitive restructuring (making a difference and research), and distraction (breaks, physical activity, hobbies and entertainment, spending time with own children). They also used disengagement coping strategies that included voluntary avoidance (compartmentalization and withdrawing from families at end of life). Given the chronic nature of patient death in pediatric oncology and the emotionally difficult nature of this work, medical institutions such as hospitals have a responsibility to assist pediatric oncologists in coping with this challenging aspect of their work. Future research is needed to evaluate how best to implement these changes on the institutional level to help oncologists cope with patient death and the effect of using these strategies on their quality of life. PMID:26865337

  3. Pediatric oncologists' coping strategies for dealing with patient death.

    Science.gov (United States)

    Granek, Leeat; Barrera, Maru; Scheinemann, Katrin; Bartels, Ute

    2016-01-01

    This research examined pediatric oncologists coping strategies when their patients died of cancer. Twenty-one pediatric oncologists at 2 Canadian pediatric academic hospitals were interviewed about their coping strategies when patients died or were in the process of dying. The grounded theory method of data collection and data analysis were used. Line-by-line coding was used to establish codes and themes and constant comparison was used to establish relations among emerging codes and themes. Pediatric oncologists used engagement coping strategies with primary and secondary responses including emotional regulation (social support and religion), problem solving (supporting families at end of life), cognitive restructuring (making a difference and research), and distraction (breaks, physical activity, hobbies and entertainment, spending time with own children). They also used disengagement coping strategies that included voluntary avoidance (compartmentalization and withdrawing from families at end of life). Given the chronic nature of patient death in pediatric oncology and the emotionally difficult nature of this work, medical institutions such as hospitals have a responsibility to assist pediatric oncologists in coping with this challenging aspect of their work. Future research is needed to evaluate how best to implement these changes on the institutional level to help oncologists cope with patient death and the effect of using these strategies on their quality of life.

  4. Effects of a Web-based Educational Module on Pediatric Emergency Medicine Physicians’ Knowledge, Attitudes, and Behaviors Regarding Youth Violence

    Directory of Open Access Journals (Sweden)

    Tracy E. Madsen

    2014-08-01

    Full Text Available Introduction: Youth seen in the emergency department (ED with injuries from youth violence (YV have increased risk for future violent injury and death. Pediatric emergency medicine (PEM physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians’ knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED. Methods: We invited all PEM fellows and attendings at an urban Level I pediatric trauma center to complete an interactive web-based education module (and 1-month booster with information on YV’s public health impact and how to screen, counsel and refer YV-involved patients. Consenting subjects completed electronic assessments of YV prevention knowledge and attitudes (using validated measures when possible before and after the initial module and after the booster. To measure behavior change, chart review identified use of YV-specific discharge instructions in visits by YV-injured PEM patients (age 12–17; identified by E codes 6 months before and after the intervention. We analyzed survey data were analyzed with Fisher’s exact for binary outcomes and Kruskal-Wallis for Likert responses. Proportion of patients given YV discharge instructions before and after the intervention was compared using chi-square. Results: Eighteen (67% of 27 PEM physicians participated; 1 was lost at post-module assessment and 5 at 1 month. Module completion time ranged from 15–30 minutes. At baseline, 50% of subjects could identify victims’ re-injury rate; 28% were aware of ED YV discharge instructions. After the initial module and at 1 month, there were significant increases in knowledge (p,0.001 and level of confidence speaking with patients about avoiding YV (p¼0.01, df¼2. Almost all (94% said the module would change future management. In pre-intervention visits, 1.6% of patients with YV injuries were discharged with

  5. Anesthetic management of a pediatric patient with hypohidrotic ectodermal dysplasia undergoing emergency surgery

    Directory of Open Access Journals (Sweden)

    Elif Oral Ahiskalioglu

    2015-12-01

    Full Text Available ABSTRACT Ectodermal dysplasias are rare conditions with a triad of hypotrichosis, anodontia and anhidrosis. In literature review there have been only a few reports of anesthetic management of patients with ectodermal dysplasias. Hyperthermia is a very serious risk which may occur due to the defect of sweat glands. The present case involves a 10-year-old child with ectodermal dysplasia who presented with an acute abdomen and was considered for an emergency surgery. Our aim was to demonstrate the successful management of this case using a combination of general and epidural anesthesia. It is important for anesthesiologist to have information about this syndrome in case of emergency operations, since it can prevent serious complications and even save lives.

  6. Emergency in pediatric and adolescent psychiatry. Note taking for the primary health assistance.

    OpenAIRE

    Zenaida María Sáez

    2003-01-01

    The psyquiatric emergences in children and adolescents are usually manifested as alterations of the feelings, behavior or in the school efficiency and its origin is found in the physical tensions, contradictions in the breeding, marital conflicts, bad interpersonal relationships, negligence, loss of the significant model at home, etc. It is important to address that there is no direct relationship between the causal factor and the onset of the symptoms. This largely depends on variables such ...

  7. Optimizing Simulated Multidisciplinary Team Training of Pediatric Emergencies: An Evaluation of Prerequisites for Transfer of Skills to Clinical Practice

    Directory of Open Access Journals (Sweden)

    E. H. A. J. Coolen

    2015-01-01

    Full Text Available Introduction. Multidisciplinary simulation-based team training (STT provides a powerful training method to train technical and team skills during emergencies. Effectiveness of STT depends on transfer of learned skills to clinical practice. In this study we examined three important prerequisites to enhance transfer from STT into clinical practice, intervention readiness, realism, and performance self-efficacy. Methods. For the quantitative part of the study, 131 participants (pediatric nurses and physicians were asked to fill out an online questionnaire before and after training. For the qualitative part of the study we organized three one-hour focus group sessions in which participants were interviewed on attitude, realism, and self-efficacy. Results. Providing adequate preparation material and extensive debriefing of scenarios is important in creating this positive learning experience. The perspective of realism depends strongly on setting and learning goals. During STT team assembly and role playing can become more important to participants, while physical aspects become less important. Performance self-efficacy for all participants increases significantly (P<0.05 regarding team skills. Conclusions. STT can be a very positive multidisciplinary learning experience, which creates the possibility of enhancing confidence, skills, and team performance within the clinical context. STT combines three important prerequisites for transfer of training to take place.

  8. Diagnóstico pouco frequente de dor abdominal em unidade de emergência infantil Unusual diagnosis of abdominal pain in pediatric emergency unit

    Directory of Open Access Journals (Sweden)

    Suelen Bianca S. Martins

    2010-06-01

    Full Text Available OBJETIVO: Relatar um caso de doença péptica na infância em escolar, com queixa inicial de dor abdominal aguda e palidez. DESCRIÇÃO DO CASO: Escolar de nove anos procurou pronto-socorro infantil com queixa de dor abdominal súbita e palidez. Não apresentava outros sintomas ou sinais ao exame físico além de mucosas descoradas e hemograma com nível baixo de hemoglobina. Durante a observação intra-hospitalar, apresentou episódio de melena. Foi realizada endoscopia digestiva alta, sendo observadas gastrite erosiva de antro e úlcera duodenal, com Helicobacter pylori positivo. O paciente foi tratado com esquema tríplice (inibidor de bomba de prótons e dois antimicrobianos por uma semana e, posteriormente, acompanhado ambulatorialmente. COMENTÁRIOS: O caso em questão descreve uma doença rara em unidade de emergência pediátrica. O paciente referia dor abdominal e observou-se palidez confirmada por baixo nível de hemoglobina, que se manteve nos exames subsequentes durante a observação no pronto-socorro infantil, dificultando o diagnóstico de sangramento ativo. Porém, a presença de melena na evolução facilitou e propiciou a condução do caso para se chegar à hipótese de sangramento digestivo alto. Realizada endoscopia digestiva alta, que confirmou o diagnóstico de gastrite erosiva de antro e úlcera duodenal H. pylori positiva, sendo, então, necessário tratamento específico, inclusive para erradicação da bactéria.OBJECTIVE: To report a case of peptic disease in a school child whose first symptoms were acute abdominal pain and paleness. CASE DESCRIPTION: A nine-year-old school child presented to a pediatric emergency unit with acute abdominal pain and sudden pallor. There were no other symptoms or signs on physical examination, except for discolored mucous and a low hemoglobin level. During hospital observation he presented one episode of melena. The esophagogastroduodenoscopy showed erosive antrum gastritis and

  9. Twitter and Canadian Educators

    Science.gov (United States)

    Cooke, Max

    2012-01-01

    An emerging group of leaders in Canadian education has attracted thousands of followers. They've made Twitter an extension of their lives, delivering twenty or more tweets a day that can include, for example, links to media articles, research, new ideas from education bloggers, or to their own, or simply a personal thought. At their best,…

  10. Inhaled Foreign Bodies In Pediatric Patients: Proven Management Techniques In The Emergency Department.

    Science.gov (United States)

    Maraynes, Megan; Agoritsas, Konstantinos

    2015-10-01

    Foreign body inhalation affects thousands of children every year, and it remains a significant cause of morbidity and mortality in children. Inhaled organic or inorganic foreign bodies can become lodged in the posterior nasopharynx, larynx, trachea, or bronchi. Presentation of foreign body inhalation can range from nonspecific respiratory symptoms to respiratory failure associated with a choking episode. In this issue, an in-depth review of the etiology, pathophysiology, diagnosis, and treatment of inhaled foreign bodies is presented. Risk factors for foreign body inhalation and clinical clues to diagnosis, as well as emergent management of inhaled foreign bodies are reviewed. A systematic approach, as described in this issue, will aid in timely and accurate diagnosis and treatment of inhaled foreign bodies, thereby limiting future complications and morbidity. PMID:26510331

  11. Improving the Treatment and Assessment of Moderate and Severe Pain in a Pediatric Emergency Department

    Directory of Open Access Journals (Sweden)

    Roger Chafe

    2016-01-01

    Full Text Available Background. The Janeway Children’s Hospital previously enacted a number of measures to improve pain management for patients in its emergency department (ED. While improvements were demonstrated, rates for the timely assessment and treatment of pain remain below standards of care. Objectives. The study objectives are to investigate the impact of the previous attempts to improve the treatment of pain and to explore ways to further improve pain management in the ED. Methods. Key informant interviews and a focus group were conducted with nurses, physicians, and parents whose children were identified as having severe pain. Results. Interviews were conducted with 31 parents or children, 9 physicians, and 8 nurses. The focus group was attended by 15 nurses. Previous initiatives were viewed as improvements. Continued barriers include difficulties in accurately capturing the level of pain, issues in treating pain for specific types of patients, and inadequacy in addressing patients in severe pain. Conclusion. Changes in pain treatment protocols can result in positive impacts but are likely insufficient on their own to achieve desired standards of care. Consistent measurement and engagement with staff can identify additional opportunities for improving pain management within an ED setting.

  12. Emergency in pediatric and adolescent psychiatry. Note taking for the primary health assistance.

    Directory of Open Access Journals (Sweden)

    Zenaida María Sáez

    2003-04-01

    Full Text Available The psyquiatric emergences in children and adolescents are usually manifested as alterations of the feelings, behavior or in the school efficiency and its origin is found in the physical tensions, contradictions in the breeding, marital conflicts, bad interpersonal relationships, negligence, loss of the significant model at home, etc. It is important to address that there is no direct relationship between the causal factor and the onset of the symptoms. This largely depends on variables such as temperament, levels of development, nature and duration of the stress, past experience and family capacity/ability of the family to get adapted to new situations.Parents frequently come to visit General Comprehensive doctor because they are worried about their children´s behaviors, i.e.; if they are normal or require certain intervention.In the current review we make reference to the psychosocial issues that may bring about psychopathological manifestations which need a timely intervention. Otherwise, there is a risk for the physical integrity of the kid, adolescent or another people which may result into a remarkable complications and suffering for the patients or their relatives. We are going to make reference to the abuse of some substances, adoption, nervous anorexia, suicide attempt, infant abuse, fire provocation and mourning reaction.We are making emphasis on the clinical assessment of the risk factors which contribute to the appearance of these issues and the management in the primary level of assistance to prevent further complications.

  13. Acesso vascular por via intraóssea em emergências pediátricas Vascular access through the intraosseous route in pediatric emergencies

    Directory of Open Access Journals (Sweden)

    Ricardo Américo Ribeiro de Sá

    2012-12-01

    Full Text Available A obtenção do acesso venoso em crianças gravemente enfermas é um procedimento essencial para o restabelecimento da volemia e a administração de fármacos nas emergências pediátricas. A primeira opção para obtenção de acesso vascular é pela punção de uma veia periférica. Quando essa via não pode ser utilizada ou sua obtenção se torna demorada, a via intraóssea consiste em efetiva opção para obtenção de um acesso venoso rápido e seguro. O presente estudo possui caráter descritivo e exploratório, realizado por meio de pesquisa bibliográfica, com o objetivo de descrever os princípios técnicos, as atribuições profissionais e os cuidados relacionados à obtenção do acesso venoso pela via intraóssea em emergências pediátricas. Foram selecionados 22 artigos disponibilizados nas bases de dados LILACS e MEDLINE e na biblioteca eletrônica SciELO, publicados entre o período de 2000 a 2011, além do protocolo vigente de ressuscitação cardiopulmonar da American Heart Association, de 2010. Após a leitura das publicações, os dados foram agrupados, possibilitando a construção de cinco categorias de análise: aspectos históricos e princípios fisiológicos; indicações, vantagens e contraindicações; atribuições dos profissionais; princípios técnicos; cuidados com o acesso; e possíveis complicações. Os resultados desse estudo mostraram que a via intraóssea consolida-se, hoje, como uma segunda opção de acesso vascular no atendimento a emergências, por ser uma técnica de fácil e rápida execução, apresentar vários sítios de punção não colapsáveis e permitir que a administração de fármacos e a reposição volêmica sejam rápidas e eficazes.Obtaining venous access in critically ill children is an essential procedure to restore blood volume and administer drugs during pediatric emergencies. The first option for vascular access is through a peripheral vein puncture. If this route cannot be used

  14. Modification of the effect of ambient air pollution on pediatric asthma emergency visits: susceptible subpopulations

    Science.gov (United States)

    Strickland, Matthew J; Klein, Mitchel; Flanders, W Dana; Chang, Howard H; Mulholland, James A; Tolbert, Paige E; Darrow, Lyndsey A

    2016-01-01

    Background Children may have differing susceptibility to ambient air pollution concentrations depending on various background characteristics of the children. Methods Using emergency department (ED) data linked with birth records from Atlanta, Georgia, we identified ED visits for asthma or wheeze among children aged 2–16 years from 1 January 2002 through 30 June 2010 (n=109,758). We stratified by preterm delivery, term low birth weight, maternal race, Medicaid status, maternal education, maternal smoking, delivery method, and history of a bronchiolitis ED visit. Population-weighted daily average concentrations were calculated for 1-hour maximum carbon monoxide and nitrogen dioxide; 8-hour maximum ozone; and 24-hour average particulate matter less than 10 microns in diameter, particulate matter less than 2.5 microns in diameter (PM2.5), and the PM2.5 components sulfate, nitrate, ammonium, elemental carbon, and organic carbon, using measurements from stationary monitors. Poisson time-series models were used to estimate rate ratios for associations between three-day moving average pollutant concentrations and daily ED visit counts and to investigate effect-measure modification by the stratification factors. Results Associations between pollutant concentrations and asthma exacerbations were larger among children born preterm and among children born to African American mothers. Stratification by race and preterm status together suggested that both factors affected susceptibility. The largest estimated effect size (for an interquartile-range increase in pollution) was observed for ozone among preterm births to African American mothers: rate ratio=1.138 (95% confidence interval=1.077–1.203). In contrast, the rate ration for the ozone association among full-term births to mothers of other races was 1.025 (0.970–1.083). Conclusions Results support the hypothesis that children vary in their susceptibility to ambient air pollutants. PMID:25192402

  15. Rapid emergence of free-riding behavior in new pediatric immunization programs.

    Directory of Open Access Journals (Sweden)

    Chris T Bauch

    Full Text Available BACKGROUND: Mathematical models have formalized how free-rider effects can threaten the stability of high vaccine coverage levels under established voluntary vaccination programs. However, little research has addressed the question of when free-riding begins to develop when a new vaccine is first introduced in a population. METHODOLOGY/PRINCIPAL FINDINGS: Here, we combine a game theoretical model of vaccinating behavior with an age-structured compartmental model to analyze rational vaccinating behavior in the first years of a universal immunization program, where a new vaccine is free to all children of a specified age. The model captures how successive birth cohorts face different epidemiological landscapes that have been shaped by the vaccinating decisions of previous birth cohorts, resulting in a strategic interaction between individuals in different birth cohorts. The model predicts a Nash equilibrium coverage level of for the first few birth cohorts under the new program. However, free-riding behavior emerges very quickly, with the Nash equilibrium vaccine coverage dropping significantly within 2-5 years after program initiation. Subsequently, a rich set of coupled dynamics between infection prevalence and vaccinating behaviors is possible, ranging from relatively stable (but reduced coverage in later birth cohorts to wide fluctuations in vaccine coverage from one birth cohort to the next. Individual tolerance for vaccine risk also starts out at relatively high levels before dropping significantly within a few years. CONCLUSIONS/SIGNIFICANCE: These results suggest that even relatively new immunization programs can be vulnerable to drops in vaccine coverage caused by vaccine scares and exacerbated by herd immunity effects, necessitating vigilance from the start.

  16. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

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    Steven Hawken

    Full Text Available OBJECTIVE: We investigated the association between a child's birth order and emergency room (ER visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. METHODS: We included all children born in Ontario between April 1(st, 2006 and March 31(st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI of events among 1(st-born and later-born children using relative incidence ratios (RIR. RESULTS: For the 2-month vaccination, the RIR for 1(st-borns versus later-born children was 1.37 (95% CI: 1.19-1.57, which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99, representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st vs. later-borns was 1.27 (95% CI: 1.09-1.48, or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21, or 249 excess events/100,000 vaccinated. CONCLUSIONS: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st-born children had significantly higher relative incidence of events compared to later-born children.

  17. The Respiratory Presentation of Severe Combined Immunodeficiency in Two Mennonite Children at a Tertiary Centre Highlighting the Importance of Recognizing This Pediatric Emergency

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    Simon Lam

    2014-01-01

    Full Text Available Severe combined immunodeficiency (SCID is considered to be a pediatric emergency, with respiratory distress being the most common presenting symptom. The authors present two cases of SCID in children <4 months of age with respiratory distress at a tertiary care centre due to a recently described homozygous CD3 delta mutation found only in the Mexican Mennonite population. Failure to respond to broad-spectrum antibiotics prompted investigation for possible SCID. Bronchial alveolar lavage fluid from both patients grew Pneumocystis jiroveci, and flow cytometry revealed absent T cells. The CD3 delta gene is believed to be important in T cell differentiation and maturation. The present article reminds pediatricians and pediatric respirologists that the key to diagnosing SCID is to have a high index of suspicion if there is poor response to conventional therapies.

  18. The 2015 Academic College of Emergency Experts in Indias INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India.

    Science.gov (United States)

    Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

    2015-12-01

    The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine in Emergency Medicine as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3 year superspeciality course after completion of MD Diplomate of National Board (DNB) Pediatrics or MD DNB in EM. The National Board of Examinations that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG ACEE India) gives its recommendations for starting 3 year DM DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children.

  19. Radiotherapy for oncologic emergencies on weekends: examining reasons for treatment and patterns of practice at a Canadian cancer centre

    OpenAIRE

    Mitera, G.; Swaminath, A.; Wong, S.; Goh, P.; Robson, S.; Sinclair, E.; Danjoux, C.; Chow, E.

    2009-01-01

    Purpose Radiotherapy for oncologic emergencies is an important aspect of the management of cancer patients. These emergencies—which include malignant spinal cord compression, brain metastases, superior vena cava obstruction, and uncontrolled tumour hemorrhage —may require treatment outside of hospital hours, particularly on weekends and hospital holidays. To date, there remains no consensus among radiation oncologists regarding the indications and appropriateness of radiotherapy treatment on ...

  20. Emergency wounds treated with cyanoacrylate and long-term results in pediatrics: a series of cases; what are the advantages and boards?

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    Gursoy Sonnur

    2009-07-01

    Full Text Available Abstract Background Ethyl-2-cyanoacrylate (ECA is a tissue adhesive material applied to close superficial wounds. The aim of this study was to explore the benefits of cyanoacrylates in the emergency department in children with current application with regard to cost-effectiveness, satisfaction and long follow up. Findings Patients were treated after assignment of the consent with an explanation by the relatives in a tertiary emergency department (ED, 2007. The evaluation was based on different superficial wound repairs due to blunt trauma within a 2-hour time period ( A total of 9 patients were evaluated and followed for 6 months. Except for one, all children were treated without any serious complications. ECA was cost-effective, time-saving, and provided successful repair satisfaction by a blinded plastic surgeon and patient/parents. Conclusion This report displayed the pediatric effective use of cyanoacrylates, even in non- traditional repairs in the emergency departments.

  1. Seeing Oneself in a Book: The Changing Face of Canadian Children's Literature.

    Science.gov (United States)

    Bainbridge, Joyce; Fayjean, Janet

    2000-01-01

    Takes a look at children's literature over time, and its recent emergence as a respected body of literary work. Discusses what is Canadian about Canadian children's literature. Annotates six picture books. Notes that Canadian literature reflects the diversity of the Canadian population, the vast differences in the Canadian landscape, and the…

  2. Prophylactic Use of Oral Acetaminophen or IV Dexamethasone and Combination of them on Prevention Emergence Agitation in Pediatric after Adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Parvin Sajedi

    2014-01-01

    Full Text Available Background: The present study was aimed to evaluate the efficacy of acetaminophen plus dexamethasone on post-operative emergence agitation in pediatric adenotonsillectomy. Methods: A total of 128 patients were randomized and assigned among four groups as: Intravenous (IV dexamethasone, oral acetaminophen, IV dexamethasone plus oral acetaminophen, placebo. Group 1 received 0.2 mg/kg dexamethasone plus 0.25 mg/kg strawberry syrup 2 h before surgery. Group 2 received 20 mg/kg oral acetaminophen (0.25 ml/kg with 0.05 ml/kg IV normal saline. Group 3 received 20 mg/kg acetaminophen and 0.2 mg/kg dexamethasone intravenously. Group 4 received 0.25 ml/kg strawberry syrup and 0.05 ml/kg normal saline. Agitation was measured according to Richmond agitation sedation score in the post anesthetic care unit (PACU after admission, 10, 20 and 30 min after extubation. Pain score was measured with FACE scale. Nurse satisfaction was measured with verbal analog scale. If agitation scale was 3 ≥ or pain scale was 4 ≥ meperidine was prescribed. If symptoms did not control wit in 15 min midazolam was prescribed. Patients were discharged from PACU according Modified Alderet Score. Data were analyzed with ANOVA, Chi-square, and Kruskal-Wallis among four groups. P < 0.05 was considered statistically significant. Results: A total of 140 patients were recruited in the study, which 12 of them were excluded. Thus, 128 patients were randomized and assigned among four groups. The four treatment groups were generally matched at baseline data. Median of pain score in 0, 10, 20 and 30 min after extubation were different between each study group with the control group (<0.001, 0.003 respectively. Also median of agitation score in 0, 10, 20 and 30 min after extubation were different between each study group with the control group (<0.001. Incidence of pain and incidence of agitation after extubation were not statistically identical among groups (P < 0.001 and P = 0

  3. Development and Testing of a Computerized Decision Support System to Facilitate Brief Tobacco Cessation Treatment in the Pediatric Emergency Department: Proposal and Protocol

    Science.gov (United States)

    Dexheimer, Judith W; Khoury, Jane C; Miller, Julie A; Gordon, Judith S

    2016-01-01

    Background Tobacco smoke exposure (TSE) is unequivocally harmful to children's health, yet up to 48% of children who visit the pediatric emergency department (PED) and urgent care setting are exposed to tobacco smoke. The incorporation of clinical decision support systems (CDSS) into the electronic health records (EHR) of PED patients may improve the rates of screening and brief TSE intervention of caregivers and result in decreased TSE in children. Objective We propose a study that will be the first to develop and evaluate the integration of a CDSS for Registered Nurses (RNs) into the EHR of pediatric patients to facilitate the identification of caregivers who smoke and the delivery of TSE interventions to caregivers in the urgent care setting. Methods We will conduct a two-phase project to develop, refine, and integrate an evidence-based CDSS into the pediatric urgent care setting. RNs will provide input on program content, function, and design. In Phase I, we will develop a CDSS with prompts to: (1) ASK about child TSE and caregiver smoking, (2) use a software program, Research Electronic Data Capture (REDCap), to ADVISE caregivers to reduce their child's TSE via total smoking home and car bans and quitting smoking, and (3) ASSESS their interest in quitting and ASSIST caregivers to quit by directly connecting them to their choice of free cessation resources (eg, Quitline, SmokefreeTXT, or SmokefreeGOV) during the urgent care visit. We will create reports to provide feedback to RNs on their TSE counseling behaviors. In Phase II, we will conduct a 3-month feasibility trial to test the results of implementing our CDSS on changes in RNs’ TSE-related behaviors, and child and caregiver outcomes. Results This trial is currently underway with funding support from the National Institutes of Health/National Cancer Institute. We have completed Phase I. The CDSS has been developed with input from our advisory panel and RNs, and pilot tested. We are nearing completion of

  4. Canadian petroleum industry review

    International Nuclear Information System (INIS)

    A wide ranging discussion about the factors that have influenced oil and natural gas prices, the differences of the Canadian market from international markets, the differences between eastern and western Canadian markets, and shareholders' perspectives on recent commodity price developments was presented. Developments in the OPEC countries were reviewed, noting that current OPEC production of 25 mmbbls is about 60 per cent higher than it was in 1985. It is expected that OPEC countries will continue to expand capacity to meet expected demand growth and the continuing need created by the UN embargo on Iraqi oil sales. Demand for natural gas is also likely to continue to rise especially in view of the deregulation of the electricity industry where natural gas may well become the favored fuel for incremental thermal generation capacity. Prices of both crude oil and natural gas are expected to hold owing to unusually low storage levels of both fuels. The inadequacy of infrastructure, particularly pipeline capacity as a key factor in the Canadian market was noted, along with the dynamic that will emerge in the next several years that may have potential consequences for Canadian production - namely the reversal of the Sarnia to Montreal pipeline. With regard to shareholders' expectations the main issues are (1) whether international markets reach back to the wellhead, hence the producer's positioning with respect to transportation capacity and contract portfolios, and (2) whether the proceeds from increased prices are invested in projects that are yielding more than the cost of capital. 28 figs

  5. Adapting protocols of CT imaging in a pediatric emergency department. Evaluation of image quality and dose; Adaptacion de los protocolos de adquisicion de imagenes de TC pediatricos en un servicio de urgencia. Valoracion de la calidad de imagen y dosis

    Energy Technology Data Exchange (ETDEWEB)

    Batista Arce, A.; Gonzalez Lopez, S.; Catalan Acosta, A.; Casares Magaz, O.; Hernandez Armas, O.; Hernandez Armas, J.

    2011-07-01

    The purpose of this study was to assess qualitatively the picture quality in relation to the radiation dose delivered in CT studies of computer tomograph Pediatric Emergency Department of Hospital Universitario de Canarias (HUC) in order to optimize the technical parameters used these radiological examinations so as to obtain optimal image quality at the lowest possible dose.

  6. Prospective study about the incidence of B lactamase producing bacteriae in otitis media in the population of the emergency room of the University Pediatric Hospital.

    Science.gov (United States)

    Colón, I; García, H

    1990-05-01

    The purpose of the study is to determine the incidence of beta-lactamase producing pathogens causing otitis media (O.M.) in the Emergency Room population of the University Pediatric Hospital. In our first four months of study, 22 patients, between the ages of 6 months to 13 y/o have been evaluated. Middle ear secretion cultures were obtained by tympanocentesis. The organisms recovered from cultures were S. epidermidis 3 (14%), S. pneumoniae 2 (9%) H. influenzae 1 (5%), mix flora 1 (5%) and 13 (59%) with no growth. None of these organisms were beta-lactamase producers. Up to 64% of the patients had history of 2 to 5 OM episodes during the last six months. Interesting is the association of bronchial asthma, sinusitis and allergy history with OM. Final study results will be presented in a near future. PMID:2375816

  7. A randomized controlled trial of sucrose and/or pacifier as analgesia for infants receiving venipuncture in a pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Vandermeer Ben

    2007-07-01

    Full Text Available Abstract Background Although sucrose has been accepted as an effective analgesic agent for procedural pain in neonates, previous studies are largely in the NICU population using the procedure of heel lance. This is the first report of the effect of sucrose, pacifier or the combination thereof for the procedural pain of venipuncture in infants in the pediatric emergency department population. Methods The study design was a double (sucrose and single blind (pacifier, placebo-controlled randomized trial – factorial design carried out in a pediatric emergency department. The study population was infants, aged 0 – 6 months. Eighty-four patients were randomly assigned to one of four groups: a sucrose b sucrose & pacifier c control d control & pacifier. Each child received 2 ml of either 44% sucrose or sterile water, by mouth. The primary outcome measure: FLACC pain scale score change from baseline. Secondary outcome measures: crying time and heart rate change from baseline. Results Sucrose did not significantly reduce the FLACC score, crying time or heart rate. However sub-group analysis revealed that sucrose had a much greater effect in the younger groups. Pacifier use reduced FLACC score (not statistically significant, crying times (statistically significant but not heart rate. Subgroup analysis revealed a mean crying time difference of 76.52 seconds (p 3 months pacifier did not have any significant effect on crying time. Age adjusted regression analysis revealed that both sucrose and pacifier had significant effects on crying time. Crying time increased with both increasing age and increasing gestational age. Conclusion Pacifiers are inexpensive, effective analgesics and are easy to use in the PED for venipuncture in infants aged 0–3 months. The benefits of sucrose alone as an analgesic require further investigation in the older infant, but sucrose does appear to provide additional benefit when used with a pacifier in this age group. Trial

  8. A Simple Clinical Score “TOPRS” to Predict Outcome in Pediatric Emergency Department in a Teaching Hospital in India

    OpenAIRE

    Ravinder Kumar Soni; Bains, Harmesh S.

    2012-01-01

    Objective: To develop a simple clinical scoring system for severity of illness to help prioritize care and predict outcome in emergency department.Methods: Prospective hospital based observational study. Out of a total of 874 children who attended emergency department in one year, 777 were included in the study. Data was collected at the time of admission in emergency department. The baseline information like age, gender, etc and variables of ‘toprs’ score viz temperature, oxygen saturation, ...

  9. Cytogenetic studies of Brazilian pediatric myelodysplastic syndrome cases: challenges and difficulties in a large and emerging country

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    E.D.R.P. Velloso

    2013-01-01

    Full Text Available Myelodysplastic syndromes (MDS and juvenile myelomonocytic leukemia (JMML are rare hematopoietic stem cell diseases affecting children. Cytogenetics plays an important role in the diagnosis of these diseases. We report here the experience of the Cytogenetic Subcommittee of the Brazilian Cooperative Group on Pediatric Myelodysplastic Syndromes (BCG-MDS-PED. We analyzed 168 cytogenetic studies performed in 23 different cytogenetic centers; 84 of these studies were performed in patients with confirmed MDS (primary MDS, secondary MDS, JMML, and acute myeloid leukemia/MDS+Down syndrome. Clonal abnormalities were found in 36.9% of the MDS cases and cytogenetic studies were important for the detection of constitutional diseases and for differential diagnosis with other myeloid neoplasms. These data show the importance of the Cooperative Group for continuing education in order to avoid a late or wrong diagnosis.

  10. Psychosocial Issues in Pediatric Oncology

    OpenAIRE

    Marcus, Joel

    2012-01-01

    Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology.

  11. Prevalence of hypoxemia in under-five children with pneumonia in an emergency pediatrics hospital in Sudan

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    Elmuntasir Taha Salah

    2015-01-01

    Full Text Available Context: Hypoxemia is a common and potentially lethal complication of acute respiratory infection in children under-five, particularly among those with severe disease. Aims: The aim of this study was to determine the prevalence of hypoxemia in under-five Sudanese children with pneumonia. Settings and Design: A cross-sectional study conducted in a pediatrics hospital in a developing country. Subjects and Methods: Data were collected using structured questionnaire and oxygen saturation was measured using a pulse oximeter. Hypoxemia was defined as arterial blood oxygen saturation <90%. Results: Of 150 studied patients, 86 (57.3% were males and 46 (32% were in the age group 2 to ≤12 months. Of the total number, 42.7% had hypoxemia (with pulse oximeter oxygen saturation <90%, out of them 36 (56.25% were in the age group <2 months. Of the hypoxic patients, 30 (46.88% had severe pneumonia, and 7 (10.94 had very severe pneumonia (P < 0.001. Conclusions: The prevalence of hypoxemia was 42.7% among the studied population. There was a significant association between the hypoxemia and small age group and very severe pneumonia. In limited resource settings pulse oximeter can be used to correctly identify hypoxemia in under-five children particularly among those diagnosed clinically as very severe pneumonia.

  12. Pediatric Asthma

    Science.gov (United States)

    ... MD Dept. of Pediatrics View full profile Pediatric Asthma: Overview For some children with asthma, their first ... Calendar Read the News View Daily Pollen Count Asthma Treatment Program At National Jewish Health, we offer ...

  13. Pediatric Injury

    Science.gov (United States)

    ... Ballesteros, M. F., Sleet, D. A. (2008). CDC childhood injury report: patterns of unintentional injuries among 0-19 ... American Academy of Pediatrics. (2008). Management of pediatric trauma. Pediatrics, 121 , 849–854. [top] How many people are ... may slightly increase childhood risk of neurological impairment, NIH study suggests All ...

  14. Dental fitness classification in the Canadian forces.

    Science.gov (United States)

    Groves, Richard R

    2008-01-01

    The Canadian Forces Dental Services utilizes a dental classification system to identify those military members dentally fit for an overseas deployment where dental resources may be limited. Although the Canadian Forces Dental Services dental classification system is based on NATO standards, it differs slightly from the dental classification systems of other NATO country dental services. Data collected by dental teams on overseas deployments indicate a low rate of emergency dental visits by Canadian Forces members who were screened as dentally fit to deploy. PMID:18277717

  15. Unintentional Childhood Injury Patterns, Odds, and Outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit

    Directory of Open Access Journals (Sweden)

    Emilio Ovuga

    2011-01-01

    Full Text Available BACKGROUND: Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. METHODS: Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years. RESULTS: A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. CONCLUSIONS: Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention

  16. Integrative Pediatrics: Looking Forward

    Directory of Open Access Journals (Sweden)

    Hilary McClafferty

    2015-01-01

    Full Text Available Increase in the prevalence of disease and illness has dramatically altered the landscape of pediatrics. As a result, there is a demand for pediatricians with new skills and a sharper focus on preventative health. Patient demand and shifting pediatric illness patterns have accelerated research in the field of pediatric integrative medicine. This emerging field can be defined as healing-oriented medicine that considers the whole child, including all elements of lifestyle and family health. It is informed by evidence and carefully weighs all appropriate treatment options. This Special Issue of Children, containing a collection of articles written by expert clinicians, represents an important educational contribution to the field. The goal of the edition is to raise awareness about integrative topics with robust supporting evidence, and to identify areas where more research is needed.

  17. Les fonds communs de placement canadiens et l’émergence d’une finance de masse Canadian Mutual Funds and the Emergence of Mass Finance

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    Maxime Lefrançois

    2011-11-01

    Full Text Available Cet article cherche à rendre compte de deux transformations de nature socio-économique qu’implique la montée fulgurante du secteur des fonds communs de placement (FCP canadiens, tout en contribuant à leur conceptualisation du point de vue de la sociologie de l’économique. La première de ces transformations renvoie à l’affectation de l’épargne des ménages. Dans la perspective d’une analyse de la financiarisation, un portrait du secteur des FCP indique comment il favorise un déplacement de l’épargne depuis les dépôts bancaires et les obligations vers des formes de placements plus actifs, notamment sur les marchés d’actions. Dans un deuxième temps, l’analyse se tourne vers la généralisation des rapports sociaux de placement et l’entrée de nouvelles catégories d’investisseurs sur les marchés financiers découlant de la marchandisation des FCP. Tandis que les observateurs y voient généralement soit une démocratisation de la finance, soit un redéploiement de l’antagonisme capital/travail, il est ici indiqué en quoi il pourrait plutôt d’abord s’agir d’un processus de massification.The rapid growth of Canadian mutual funds entails socio-economic transformations related to 1 the allocation of savings, and 2 the social diffusion of investment. This paper discusses the nature of these two changes, and contributes to their economical and sociological conceptualisation from a “financialisation analysis” perspective. First, mutual funds provoke a shift in savings, from bonds and bank deposits to more active investments - namely in stocks. Second, due to the commodification of mutual funds, new categories of investors enter financial markets; these new actors therefore modify the social diffusion of investment at a more general level. Observers generally understand such changes as either a step in the democratization of finance, or as a reformulation of the capital/labour antagonism. In this paper, we

  18. 210例小儿急诊惊厥病因分析%Pathogeny analysis of 210 pediatric convulsions cases in emergency treatment

    Institute of Scientific and Technical Information of China (English)

    赵永强; 苏艳琦

    2016-01-01

    目的 探讨小儿急诊惊厥的病因,为急诊儿科提供诊断思路.方法 采用回顾性分析法,收集210例惊厥患儿的临床资料,并根据病史、性别、初发年龄、脑脊液、脑电图、体温、影像学检查等进行分析.结果 210例患儿中,不伴发热48例(22.86%),伴发热162例(77.14%);伴咳嗽、流涕137例(65.24%),伴腹泻、呕吐26例(12.38%),意识障碍或昏迷12例(5.71%),反复惊厥发作并智力发育迟缓7例(3.33%),惊厥持续状态4例(1.90%),既往已确诊癫痫3例(1.43%).体格检查神经系统阳性体征51例(24.29%).对27例伴有意识障碍疑似颅内感染的患儿进行脑脊液检查,发现其中有8例出现异常;对55例白细胞明显增加的患儿进行血培养检查,发现其中有9例出现细菌生长;对113例患儿进行脑电图检查,发现有61例患儿出现异常.64例患儿行头颅CT检查,9例异常,分别为颅内出血6例、脑干多发低密度灶1例、脑室增宽1例、颅内占位病变1例.210例患儿中最常见症状为热性惊厥、癫痫和颅内感染.其中,1~28 d新生儿惊厥多为颅内出血所致;28 d~3岁婴幼儿期惊厥病因主要为热性惊厥,其次为癫痫和颅内感染;3~6岁学龄前儿童的惊厥仍以热性惊厥为主;>6岁后,病因则以癫痫为主.结论 因儿童发生惊厥的病因呈多样化、复杂化,在对患儿的惊厥病因进行确诊时,不仅需根据患儿的过往病史、年龄段等进行辅助分析,更需要应用诸如头颅CT、脑电图等辅助检查工具,以达到快速确诊、及早治疗、预防复发和减轻患儿脑损伤、杜绝患儿后遗症发生的效果.%Objective To investigate pathogeny of pediatric convulsions in emergency treatment, and to provide diagnosis basis for pediatric emergency treatment.Methods A retrospective analysis was made on clinical data of 210 children with convulsions, along with their medical history, gender, onset age, cerebrospinal fluid, electroencephalogram, body

  19. 细节管理在儿科门急诊留置针使用过程的运用%Application of Detail Management in the Course of the Indwelling Needle for Pediatric Emergency

    Institute of Scientific and Technical Information of China (English)

    唐慧; 李爱连

    2014-01-01

    目的:探讨细节管理在提高儿科门急诊留置针使用过程的作用。方法将细节管理应用在儿科门急诊留置针使用中的每一个环节进行分析、整改、落实,进一步提高儿科门急诊留置针实用的安全性,提高护理工作效率,提高患儿治疗的满意度。结果细节管理运用于儿科门诊留置针管理,完善了门急诊留置针使用的流程,进一步规范了留置针使用的操作细节,减少了居家带管的风险,有效的保证了护理安全。结论细节管理值得在门急诊留置针使用时运用。%Objective To investigate the effect of detail management in the course of the indwelling needle in pediatric emergency department.Methods To analysis, rectify and perform each step of detail management in the course of the indwelling needle application. Results The process of indwelling needle application in pediatric emergency department is normalized by using detail management.Detail management reduces the risk of indwelling needle at home, ensuring patient’s safety.Conclusion Detail management is helpful for improving quality of indwelling needle application in Pediatric Emergency department.

  20. 儿科急诊6463例疾病谱特征调查分析%Survey and analyze the disease spectrum characteristics of 6 463 cases of pediatric emergency disease

    Institute of Scientific and Technical Information of China (English)

    周永东; 梁冰; 许震宇

    2013-01-01

    目的:了解儿科急诊疾病谱特点,提高儿科急诊医师的诊治水平和抢救成功率.方法:对2010-05-2011-05在我院儿科急诊就诊,随机选择诊断明确的6 463例进行回顾性分析.结果:普通急诊患儿6 172例(95.5%),发病年龄集中在28 d~3岁,共4 532例(73.43%),位列前五位疾病是上呼吸道感染4 222例(68.41%),支气管炎623例(10.09%),腹泻病411例(6.66%),胃肠炎271 (4.39%),支气管肺炎262例(4.24%).重症急诊患儿291例(4.50%),发病年龄也集中在28 d~3岁,共245例(84.19%),位列前5位疾病是重症肺炎99例(33.68%),惊厥67例(23.02%),腹泻病并脱水31例(11.00%),哮喘持续状态1 6例(5.5%),肺炎伴先心13例(4.47%).结论:儿科急诊疾病谱以呼吸系统和消化系统常见的感染性疾病为主,发病年龄以婴幼儿居多,重症常继发休克、心力衰竭、呼吸衰竭而危及生命.应引起儿科急诊医生注意.%Objective:To analyze the disease spectrum characteristics of pediatric emergency disease,and to improve the diagnosis and treatment of pediatric emergency physicians and the success rate of rescue. Method: From May 2010 ~ May 2011,6 463 patients who visited the pediatric emergency department of our hospital were retrospectively analyzed. Result:There were 6172 cases of children with ordinary emergency (95. 5%). The age of onset is concentrated in 28 days of ~ 3 years with a total of 4532 cases (73. 43%). The top five diseases were upper re-spiratory tract infection in 4222 cases (68. 41%),bronchitis in 623 cases (10. 09%) ,diarrheal diseases in 411 cases (6. 66%) , gastroenteritis in 271 (4. 39%), bronchial pneumonia in 262 cases (4. 24%). There were 291 cases of children with severe emergency (4. 50%). The age of onset is concentrated in 28 day of ~3 years with a total of 245 cases (84. 19%). The top five diseases were severe pneumonia in 99 cases (33. 68%) ,seizure in 67 cases (23. 02%) ,diarrhea and dehydration in 31 cases

  1. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  2. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Assistant™ Last revised on February 12, 2016 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  3. Pediatric integrative medicine: pediatrics' newest subspecialty?

    Directory of Open Access Journals (Sweden)

    Vohra Sunita

    2012-08-01

    Full Text Available Abstract Background Integrative medicine is defined as relationship-centered care that focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing, including evidence-based complementary and alternative medicine. Pediatric integrative medicine (PIM develops and promotes this approach within the field of pediatrics. We conducted a survey to identify and describe PIM programs within academic children’s hospitals across North America. Key barriers and opportunities were identified for the growth and development of academic PIM initiatives in the US and Canada. Methods Academic PIM programs were identified by email and eligible for inclusion if they had each of educational, clinical, and research activities. Program directors were interviewed by telephone regarding their clinical, research, educational, and operational aspects. Results Sixteen programs were included. Most (75% programs provided both inpatient and outpatient services. Seven programs operated with less than 1 FTE clinical personnel. Credentialing of complementary and alternative medicine (CAM providers varied substantially across the programs and between inpatient and outpatient services. Almost all (94% programs offered educational opportunities for residents in pediatrics and/or family medicine. One fifth (20% of the educational programs were mandatory for medical students. Research was conducted in a range of topics, but half of the programs reported lack of research funding and/or time. Thirty-one percent of the programs relied on fee-for-service income. Conclusions Pediatric integrative medicine is emerging as a new subspecialty to better help address 21st century patient concerns.

  4. The current situation of construction and development of pediatric emergency and critical care system in China%我国儿童急救体系建设现状与发展思考

    Institute of Scientific and Technical Information of China (English)

    陆国平; 任晓旭; 宋国维

    2012-01-01

    通过分析儿童急危重症院前急救、急诊及重症医学科、急救护理、急救培训和急救科研现状,阐述我国儿童急救体系建设存在的问题,提出发展思路和建设建议.%Through analyzing the children's pre-hospital transport,emergency medicine,intensive care medicine,nursing,professional training and research,we reviewed the current status of construction and issues of pediatric emergency and critical care system,then put forward recommendations of its development.

  5. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

    OpenAIRE

    Luisa Galli; Laura Lancella; Chiara Tersigni; Elisabetta Venturini; Elena Chiappini; Barbara Maria Bergamini; Margherita Codifava; Cristina Venturelli; Giulia Tosetti; Caterina Marabotto; Laura Cursi; Elena Boccuzzi; Silvia Garazzino; Pier Angelo Tovo; Michele Pinon

    2016-01-01

    Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, lat...

  6. [Pediatric advanced life support].

    Science.gov (United States)

    Muguruma, Takashi

    2011-04-01

    Important changes or points of emphasis in the recommendations for pediatric advanced life support are as follows. In infants and children with no signs of life, healthcare providers should begin CPR unless they can definitely palpate a pulse within 10 seconds. New evidence documents the important role of ventilations in CPR for infants and children. Rescuers should provide conventional CPR for in-hospital and out-of-hospital pediatric cardiac arrests. The initial defibrillation energy dose of 2 to 4J/kg of either monophasic or biphasic waveform. Both cuffed and uncuffed tracheal tubes are acceptable for infants and children undergoing emergency intubation. Monitoring capnography/capnometry is recommended to confirm proper endotracheal tube position.

  7. The Canadian Astronomy Data Centre

    Science.gov (United States)

    Ball, Nicholas M.; Schade, D.; Astronomy Data Centre, Canadian

    2011-01-01

    The Canadian Astronomy Data Centre (CADC) is the world's largest astronomical data center, holding over 0.5 Petabytes of information, and serving nearly 3000 astronomers worldwide. Its current data collections include BLAST, CFHT, CGPS, FUSE, Gemini, HST, JCMT, MACHO, MOST, and numerous other archives and services. It provides extensive data archiving, curation, and processing expertise, via projects such as MegaPipe, and enables substantial day-to-day collaboration between resident astronomers and computer specialists. It is a stable, powerful, persistent, and properly supported environment for the storage and processing of large volumes of data, a condition that is now absolutely vital for their science potential to be exploited by the community. Through initiatives such as the Common Archive Observation Model (CAOM), the Canadian Virtual Observatory (CVO), and the Canadian Advanced Network for Astronomical Research (CANFAR), the CADC is at the global forefront of advancing astronomical research through improved data services. The CAOM aims to provide homogeneous data access, and hence viable interoperability between a potentially unlimited number of different data collections, at many wavelengths. It is active in the definition of numerous emerging standards within the International Virtual Observatory, and several datasets are already available. The CANFAR project is an initiative to make cloud computing for storage and data-intensive processing available to the community. It does this via a Virtual Machine environment that is equivalent to managing a local desktop. Several groups are already processing science data. CADC is also at the forefront of advanced astronomical data analysis, driven by the science requirements of astronomers both locally and further afield. The emergence of 'Astroinformatics' promises to provide not only utility items like object classifications, but to directly enable new science by accessing previously undiscovered or intractable

  8. Pediatric rosacea.

    Science.gov (United States)

    Kellen, Roselyn; Silverberg, Nanette B

    2016-07-01

    Because rosacea is uncommon in the pediatric population, care must be taken to exclude other papulopustular disorders. Children can present with vascular, papulopustular, and/or ocular findings. Importantly, ocular symptoms can appear before the cutaneous symptoms of rosacea, leading to misdiagnosis. Rosacea is a clinical diagnosis, but histopathologic examination typically reveals dilated vessels, perivascular lymphohistiocytic infiltrates in the upper dermis, elastosis, and disorganization of the upper dermal connective tissue. Treatment involves avoiding known triggers and utilizing topical and/or systemic therapies. Although treatment can control flares, pediatric rosacea often persists into adulthood. PMID:27529708

  9. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    Science.gov (United States)

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice.

  10. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    Science.gov (United States)

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice. PMID:26714808

  11. Indigenous populations health protection: A Canadian perspective

    Directory of Open Access Journals (Sweden)

    Richardson Katya L

    2012-12-01

    Full Text Available Abstract The disproportionate effects of the 2009 H1N1 pandemic on many Canadian Aboriginal communities have drawn attention to the vulnerability of these communities in terms of health outcomes in the face of emerging and reemerging infectious diseases. Exploring the particular challenges facing these communities is essential to improving public health planning. In alignment with the objectives of the Pandemic Influenza Outbreak Research Modelling (Pan-InfORM team, a Canadian public health workshop was held at the Centre for Disease Modelling (CDM to: (i evaluate post-pandemic research findings; (ii identify existing gaps in knowledge that have yet to be addressed through ongoing research and collaborative activities; and (iii build upon existing partnerships within the research community to forge new collaborative links with Aboriginal health organizations. The workshop achieved its objectives in identifying main research findings and emerging information post pandemic, and highlighting key challenges that pose significant impediments to the health protection and promotion of Canadian Aboriginal populations. The health challenges faced by Canadian indigenous populations are unique and complex, and can only be addressed through active engagement with affected communities. The academic research community will need to develop a new interdisciplinary framework, building upon concepts from ‘Communities of Practice’, to ensure that the research priorities are identified and targeted, and the outcomes are translated into the context of community health to improve policy and practice.

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  13. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  14. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  15. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  16. Pediatric scoliosis

    OpenAIRE

    Mo, Fred; Cunningham, Matthew E.

    2011-01-01

    Pediatric scoliosis is a relatively uncommon condition typically first noticed due to altered stature or by routine spine screenings by a school nurse or pediatrician. The formal diagnosis is made with spine radiographs, with coronal curvature measurement of 10° or greater. Treatment may consist of serial observation, bracing until skeletal maturity, or surgery for correction and fusion/stabilization of severe or progressive deformity. Overall success for non-operative management of scoliosis...

  17. Find a Pediatric Dentist

    Science.gov (United States)

    ... Resources AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Policies & ...

  18. O trabalho dos pediatras em um serviço público de urgências: fatores intervenientes no atendimento Pediatric practice in public emergency services and factors affecting care

    Directory of Open Access Journals (Sweden)

    Egléa Maria da Cunha Melo

    2007-12-01

    Full Text Available Este estudo qualitativo de base empírica apresenta as condições materiais e organizacionais do trabalho dos pediatras em um serviço público de urgências pediátricas, com vistas a identificar fatores que estejam interferindo no atendimento. Realizou-se um estudo do trabalho por meio de entrevistas coletivas e observações diretas da atividade. Os resultados foram tratados de maneira articulada aos dados estatísticos e históricos obtidos de uma pesquisa documental. Foram entrevistados 44 médicos pertencentes a sete equipes de pediatras, entre os quais, sete pediatras foram observados em situação real de trabalho, buscando analisar a atividade realizada. Viu-se que a fragilidade do sistema de referência e contra-referência é fator determinante do volume de atendimentos. O ambiente marcado pela aglomeração de pacientes gera pressão temporal com interferências diretas sobre o ato pediátrico praticado. Os autores identificaram as estratégias informais construídas e implementadas pelos sujeitos visando garantir a qualidade do atendimento segundo os preceitos da pediatria.This qualitative empirical study discusses the material and organizational conditions of work by pediatricians in a public emergency service, with the aim of identifying factors that affect care. The work was studied using group interviews and direct observation in the emergency unit. The results were compared with statistical and historical data from documental research. Forty-four pediatricians from seven teams were interviewed, and seven of the pediatricians were observed while on duty. The precarious referral and counter-referral system was a determinant factor leading to the heavy demand on the emergency unit. Agglomeration of patients and families at the entrance to the emergency service led to time pressure and interfered directly in the pediatric care. The study identified informal strategies devised and implemented by these physicians in attempts to

  19. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin

    2012-09-01

    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  20. 右美托咪定用于预防小儿全麻苏醒期躁动的应用进展%Progress in the application of dexmedetomidine in preventing the emergence agitation of pediatric general anaesthesia

    Institute of Scientific and Technical Information of China (English)

    于威威; 赵平

    2013-01-01

    Dexmedetomidine is the active d-isomer of medetomidine, a midazole compounds, a protent α2 -ad-renoceptor agonist with higher dosages depended sedetation, analgesia, antianxiety effects without respiratory depression. It has well cooperativity with other analgesics and sedatives that will reduce the dosage abused. So dexmedetomidine has the unique advantage in preventing the emergence agitation of pediatric general anaesthesia. This study reviews the application of dexmedetomidine in preventing the emergence agitation of children.%右美托咪定(Dexmedetomidine,DEX)是美托咪定的右旋异构体,为咪唑类衍生物,是一种高选择性α2肾上腺素能受体激动剂,其具有较强的剂量依赖性的镇静、镇痛、抗焦虑且无明显呼吸抑制等作用,该药与其他镇静镇痛药物合用有良好的协同性,能明显减少其他镇痛镇静药物的用量,在预防小儿全麻苏醒期躁动方面具有独特的优势.本文就DEX在预防小儿苏醒期躁动中的应用研究进行综述.

  1. Canadian beef quality audit.

    OpenAIRE

    Van Donkersgoed, J; Jewison, G; M. Mann; Cherry, B; Altwasser, B; Lower, R; Wiggins, K; Dejonge, R; Thorlakson, B; Moss, E.; C. Mills; Grogan, H

    1997-01-01

    A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) wa...

  2. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  3. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Silverman, F.N.

    1982-01-01

    A literature review with 186 references of diagnostic pediatric radiology, a speciality restricted to an age group rather than to an organ system or technique of examination, is presented. In the present chapter topics follow the basic organ system divisions with discussions of special techniques within these divisions. The diagnosis of congenital malformations, infectious diseases and neoplasms are a few of the topics discussed for the head and neck region, the vertebrae, the cardiovascular system, the respiratory system, the gastrointestinal tract, the urinary tract, and the skeleton. (KRM)

  4. Pediatric radiology

    International Nuclear Information System (INIS)

    A literature review with 186 references of diagnostic pediatric radiology, a speciality restricted to an age group rather than to an organ system or technique of examination, is presented. In the present chapter topics follow the basic organ system divisions with discussions of special techniques within these divisions. The diagnosis of congenital malformations, infectious diseases and neoplasms are a few of the topics discussed for the head and neck region, the vertebrae, the cardiovascular system, the respiratory system, the gastrointestinal tract, the urinary tract, and the skeleton

  5. Pediatric vitiligo.

    Science.gov (United States)

    Silverberg, Nanette B

    2014-04-01

    Vitiligo is a disease of pigment loss. Most investigators currently consider vitiligo to be a disorder that occurs as a result of autoimmune destruction of melanocytes, supported by identification of antimelanocyte antibodies in many patients, and the presence of comorbid autoimmune disease in patients with and family members of individuals with vitiligo. One-half of vitiligo cases are of childhood onset. This article presents a current overview of pediatric vitiligo including comorbidities of general health, psychological factors, therapeutic options, and long-term health considerations.

  6. Canadian heavy water production

    International Nuclear Information System (INIS)

    The paper reviews Canadian experience in the production of heavy water, presents a long-term supply projection, relates this projection to the anticipated long-term electrical energy demand, and highlights principal areas for further improvement that form the bulk of our research and development program on heavy water processes

  7. Canadian hydrogen safety program

    International Nuclear Information System (INIS)

    The Canadian hydrogen safety program (CHSP) is a project initiative of the Codes and Standards Working Group of the Canadian transportation fuel cell alliance (CTFCA) that represents industry, academia, government, and regulators. The Program rationale, structure and contents contribute to acceptance of the products, services and systems of the Canadian Hydrogen Industry into the Canadian hydrogen stakeholder community. It facilitates trade through fair insurance policies and rates, effective and efficient regulatory approval procedures and accommodation of the interests of the general public. The Program integrates a consistent quantitative risk assessment methodology with experimental (destructive and non-destructive) failure rates and consequence-of-release data for key hydrogen components and systems into risk assessment of commercial application scenarios. Its current and past six projects include Intelligent Virtual Hydrogen Filling Station (IVHFS), Hydrogen clearance distances, comparative quantitative risk comparison of hydrogen and compressed natural gas (CNG) refuelling options; computational fluid dynamics (CFD) modeling validation, calibration and enhancement; enhancement of frequency and probability analysis, and Consequence analysis of key component failures of hydrogen systems; and fuel cell oxidant outlet hydrogen sensor project. The Program projects are tightly linked with the content of the International Energy Agency (IEA) Task 19 Hydrogen Safety. (author)

  8. Reform in Canadian Universities.

    Science.gov (United States)

    Small, J. M.

    1994-01-01

    A survey of 67 Canadian university vice presidents and 66 deans concerning reform in recent years found that the many changes reported were modest and reactive rather than bold and proactive. Most common changes involved strategic planning, retrenchment, curriculum expansion, response to enrollment changes, administrative restructuring, and more…

  9. Principles of disaster planning for the pediatric population.

    Science.gov (United States)

    Allen, Gwenn M; Parrillo, Steven J; Will, Jean; Mohr, Johnathon A

    2007-01-01

    Unique physiological, developmental, and psychological attributes of children make them one of the more vulnerable populations during mass-casualty incidents. Because of their distinctive vulnerabilities, it is crucial that pediatric needs are incorporated into every stage of disaster planning. Individuals, families, and communities can help mitigate the effects of disasters on pediatric populations through ongoing awareness and preventive practices. Mitigation efforts also can be achieved through education and training of the healthcare workforce. Preparedness activities include gaining Emergency Medical Services for Children Pediatric Facility Recognition, conducting pediatric disaster drills, improving pediatric surge capacity, and ensuring that the needs of children are incorporated into all levels of disaster plans. Pediatric response can be improved in a number of ways, including: (1) enhanced pediatric disaster expertise; (2) altered decontamination protocols that reflect pediatric needs; and (3) minimized parent-child separation. Recovery efforts at the pediatric level include promoting specific mental health therapies for children and incorporating children into disaster relief and recovery efforts. Improving pediatric emergency care needs should be at the forefront of every disaster planner's agenda. PMID:18709943

  10. Principles of disaster planning for the pediatric population.

    Science.gov (United States)

    Allen, Gwenn M; Parrillo, Steven J; Will, Jean; Mohr, Johnathon A

    2007-01-01

    Unique physiological, developmental, and psychological attributes of children make them one of the more vulnerable populations during mass-casualty incidents. Because of their distinctive vulnerabilities, it is crucial that pediatric needs are incorporated into every stage of disaster planning. Individuals, families, and communities can help mitigate the effects of disasters on pediatric populations through ongoing awareness and preventive practices. Mitigation efforts also can be achieved through education and training of the healthcare workforce. Preparedness activities include gaining Emergency Medical Services for Children Pediatric Facility Recognition, conducting pediatric disaster drills, improving pediatric surge capacity, and ensuring that the needs of children are incorporated into all levels of disaster plans. Pediatric response can be improved in a number of ways, including: (1) enhanced pediatric disaster expertise; (2) altered decontamination protocols that reflect pediatric needs; and (3) minimized parent-child separation. Recovery efforts at the pediatric level include promoting specific mental health therapies for children and incorporating children into disaster relief and recovery efforts. Improving pediatric emergency care needs should be at the forefront of every disaster planner's agenda.

  11. Pediatric tracheomalacia.

    Science.gov (United States)

    Fraga, Jose Carlos; Jennings, Russell W; Kim, Peter C W

    2016-06-01

    Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment. This article examines the published pediatric literature on TM, discusses the details of clinical presentation, evaluation, diagnosis, and a variety of treatments. PMID:27301602

  12. The ethics of animal research: a survey of pediatric health care workers

    OpenAIRE

    Ari R. Joffe; Bara, Meredith; Anton, Natalie; Nobis, Nathan

    2014-01-01

    Introduction Pediatric health care workers (HCW) often perform, promote, and advocate use of public funds for animal research (AR). We aim to determine whether HCW consider common arguments (and counterarguments) in support (or not) of AR convincing. Design After development and validation, an e-mail survey was sent to all pediatricians and pediatric intensive care unit nurses and respiratory therapists (RTs) affiliated with a Canadian University. We presented questions about demographics, su...

  13. Clinical application of emergency bedside-echocardiography in pediatric intensive care unit%急诊床旁超声心动图在儿童重症监护室的应用价值

    Institute of Scientific and Technical Information of China (English)

    陶子瑜; 张育才; 谢利剑; 沈捷; 肖婷婷; 张永为; 张儒舫; 许云峰

    2012-01-01

    目的 探讨急诊床旁超声心动图(EB-Echo)在儿童重症监护室检查中的临床应用价值.方法 应用便携式超声诊断仪和超声心动图诊断仪对1028例患儿进行EB-Echo探查.结果 1028例患儿检查发现异常者624例,占60.7%,经EB-Echo及时诊断治疗后好转出院511例,有效率达81.9%.结论 EB-Echo能迅速评价和监测危重症患儿心脏结构和功能,检测药物疗效和判断预后.%Objective To evaluate the clinical value of emergency bedside- echocardiography ( EB - Echo ) in the examination of pediatric intensive care unit (PICU). Methods SonoSite Micromax and Philips iE 33 ultrasonic systems were employed for EB-Echo in 1028 children. Results The positive rate of EB-Echo examination was 60.7% (624/1028). Five hundred and eleven children were correctly diagnosed and received treatment. The diagnostic accordance rate was 81.9%. Conclusion EB-Echo echocardiography can be used to evaluate and monitor cardiac structure and function, test the therapeutic effect of drugs and judge the prognosis.

  14. News on pediatric urology

    Directory of Open Access Journals (Sweden)

    Giuseppe Masnata

    2015-10-01

    Full Text Available Pediatric urology is a pediatric speciality dedicated to the diagnosis and treatment of congenital and acquired genitourinary tract diseases. It is a speciality that is rapidly changing, thanks to the technological development that has been emerging in recent years. There have been important diagnostic and therapeutic news.Congenital anomalies of the kidneys and urinary tract (CAKUT include various entities of structural malformations that result from defects in their morphogenesis. Clinical research and genetic studies on the origins of CAKUT are quickly evolving, with significant growth of high-quality research.Management goals of CAKUT include prevention of febrile urinary tract infections (UTIs in newborns and toddles and renal injury, while minimizing the morbidity of treatment and follow-up. Treatment options include observation with or without continuous antibiotic prophylaxis (CAP and surgical correction. Now, randomized controlled studies show that children with normal urinary tracts or low-grade vesicoureteral reflux (VUR do not benefit from prophylaxis.All children with known mechanical or functional obstructions of the urinary tract are considered to have UTI. Functional obstruction often results from lower urinary tract dysfunction (LUTD of either neurogenic or non-neurogenic origin and dilating VUR.The role of bladder and bowel dysfunction (BBD in children with UTI and the long-term risk of renal scarring have shed new light on treatment strategies. Often it is BBD, rather than reflux, that causes UTI in children older than 2 years.Pediatric urology has evolved in recent years, with a greater focus on bladder and renal function, minimally invasive treatment, evidence-based interventions, and guideline adherence. Other topics in pediatric urology include urinary incontinence in children with special needs and the use of robot-assisted laparoscopic surgery (RALS in children, with advantages over conventional laparoscopic surgery

  15. Financing Canadian international operations

    International Nuclear Information System (INIS)

    A primer on financing international operations by Canadian corporations was provided. Factors affecting the availability to project finance (location, political risk), the various forms of financing (debt, equity, and combinations), the main sources of government backed financing to corporations (the International Finance Corporation) (IFC), the European Bank for Reconstruction and Development (EBRD), the Asian Development Bank (ADB), the Overseas Property Insurance Corporation (OPIC), government or agency guarantees, political risk coverage, the use of offshore financial centres, and the where, when and how these various organizations operate, were reviewed. Examples of all of the above, taken from the experiences of Canadian Occidental Petroleum of Calgary in the U.S., in South America, in the Middle and Far East, and in Kazakhstan, were used as illustrations. figs

  16. Canadian Mathematical Congress

    CERN Document Server

    1977-01-01

    For two weeks in August, 1975 more than 140 mathematicians and other scientists gathered at the Universite de Sherbrooke. The occasion was the 15th Biennial Seminar of the Canadian Mathematical Congress, entitled Mathematics and the Life Sciences. Participants in this inter­ disciplinary gathering included researchers and graduate students in mathematics, seven different areas of biological science, physics, chemistry and medical science. Geographically, those present came from the United States and the United Kingdom as well as from academic departments and government agencies scattered across Canada. In choosing this particular interdisciplinary topic the programme committee had two chief objectives. These were to promote Canadian research in mathematical problems of the life sciences, and to encourage co-operation and exchanges between mathematical scientists" biologists and medical re­ searchers. To accomplish these objective the committee assembled a stim­ ulating programme of lectures and talks. Six ...

  17. Canadian petroleum history bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Cass, D.

    2003-09-27

    The Petroleum History Bibliography includes a list of more than 2,000 publications that record the history of the Canadian petroleum industry. The list includes books, theses, films, audio tapes, published articles, company histories, biographies, autobiographies, fiction, poetry, humour, and an author index. It was created over a period of several years to help with projects at the Petroleum History Society. It is an ongoing piece of work, and as such, invites comments and additions.

  18. Tuberculosis in Aboriginal Canadians

    Directory of Open Access Journals (Sweden)

    Vernon H Hoeppner

    2000-01-01

    Full Text Available Endemic tuberculosis (TB was almost certainly present in Canadian aboriginal people (aboriginal Canadians denotes status Indians, Inuit, nonstatus Indians and metis as reported by Statistics Canada before the Old World traders arrived. However, the social changes that resulted from contact with these traders created the conditions that converted endemic TB into epidemic TB. The incidence of TB varied inversely with the time interval from this cultural collision, which began on the east coast in the 16th century and ended in the Northern Territories in the 20th century. This relatively recent epidemic explains why the disease is more frequent in aboriginal children than in Canadian-born nonaboriginal people. Treatment plans must account for the socioeconomic conditions and cultural characteristics of the aboriginal people, especially healing models and language. Prevention includes bacillus Calmette-Guerin vaccination and chemoprophylaxis, and must account for community conditions, such as rates of suicide, which have exceeded the rate of TB. The control of TB requires a centralized program with specifically directed funding. It must include a program that works in partnership with aboriginal communities.

  19. Emergency radiology - survive the night duty

    International Nuclear Information System (INIS)

    The book includes the following chapters: (1) General remarks concerning radiological examination and general fracture indications; (2): Head; (3) Thorax; (4) Abdomen; (5) Limbs; (6) Spinal cord; (7) Multiple traumata; (8) Vascular emergency cases; (9) Pediatric emergency radiology.

  20. Pediatric Celiac Disease

    Science.gov (United States)

    ... of Pediatric Gastroenterology and Nutrition Nurses Print Share Celiac Disease Many kids have sensitivities to certain foods, and ... protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, consuming gluten ...

  1. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement of nurses in the art and science of pediatric endocrinology nursing. Learn More ...

  2. National Pediatric Program Update

    International Nuclear Information System (INIS)

    The book of the National Pediatric Program Update, issued by the Argentina Society of Pediatrics, describes important issues, including: effective treatment of addictions (drugs); defects of the neural tube; and the use of radiation imaging in diagnosis.

  3. The effect of ketamine versus fentanyl on the incidence of emergence agitation after sevoflurane anesthesia in pediatric patients undergoing tonsillectomy with or without adenoidectomy

    Directory of Open Access Journals (Sweden)

    Ashraf Arafat Abdelhalim

    2013-01-01

    Full Text Available Background: Emergence agitation (EA has been documented as a common side-effect of sevoflurane anesthesia. This prospective, randomized, double-blind, placebo-controlled study was designed to compare the effects of ketamine versus fentanyl, administered 10 min before the end of surgery on the development of EA. Methods: A total of 120 children aged 3-7 years of American Society of Anesthesiologists I-II physical status were randomly assigned to one of three equal groups receiving either ketamine 0.5 mg/kg (Group K, fentanyl 1 μg/kg (Group F or saline (Group C at 10 min before the end of surgery. Post-operative EA was assessed with Aono′′s four point scale. Recovery times, the post-operative pain and adverse reactions were assessed. Results: There was no significant difference between the three groups regarding recovery and discharge times from post-anesthesia care unit. The incidence of EA was significantly low in Group K and Group F (15% and 17.5%, respectively compared to the control group (42.5%, with no significant difference between Group K and Group F. There were no significant differences in Children′s Hospital of Eastern Ontario Pain Scale between the three groups. The incidence of nausea or vomiting was significantly more in Group F compared to that in other two groups. However, no complications such as somnolence, oxygen desaturation or respiratory depression occurred during the study period and there were no episodes of hallucinations or bad dreams in the ketamine group. Conclusion: The intravenous administration of either ketamine 0.5 mg/kg or fentanyl 1 μg/kg before the end of surgery in sevoflurane-anesthetized children undergoing tonsillectomy with or without adenoidectomy reduces the incidence of post-operative agitation without delaying emergence.

  4. Canadian identity: Implications for international social work by Canadians

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder

    2011-01-01

    This paper is in response to recent calls to conceptualize and articulate Canadian perspectives and experiences in international social work, given that the Canadian standpoint has been lacking in international social work literature. This paper contends that it is imperative, first of all...

  5. Proton Radiotherapy for Pediatric Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Ladra, Matthew M.; Yock, Torunn I., E-mail: tyock@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114 (United States)

    2014-01-14

    Pediatric sarcomas represent a distinct group of pathologies, with approximately 900 new cases per year in the United States alone. Radiotherapy plays an integral role in the local control of these tumors, which often arise adjacent to critical structures and growing organs. The physical properties of proton beam radiotherapy provide a distinct advantage over standard photon radiation by eliminating excess dose deposited beyond the target volume, thereby reducing both the dose of radiation delivered to non-target structures as well as the total radiation dose delivered to a patient. Dosimetric studies comparing proton plans to IMRT and 3D conformal radiation have demonstrated the superiority of protons in numerous pediatric malignancies and data on long-term clinical outcomes and toxicity is emerging. In this article, we review the existing clinical and dosimetric data regarding the use of proton beam radiation in malignant bone and soft tissue sarcomas.

  6. Canadian advanced life support capacities and future directions

    Science.gov (United States)

    Bamsey, M.; Graham, T.; Stasiak, M.; Berinstain, A.; Scott, A.; Vuk, T. Rondeau; Dixon, M.

    2009-07-01

    Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada's contribution of the Higher Plant Compartment of the European Space Agency's MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity

  7. Canadian photovoltaic industry directory

    International Nuclear Information System (INIS)

    This directory has been prepared to help potential photovoltaic (PV) customers identify Canadian-based companies who can meet their needs, and to help product manufacturers and distributors identify potential new clients and/or partners within the PV industry for new and improved technologies. To assist the reader, an information matrix is provided that identifies the product and service types offered by each firm and its primary clients served. A list of companies by province or territory is also included. The main section lists companies in alphabetical order. Information presented for each includes address, contact person, prime activity, geographic area served, languages in which services are offered, and a brief company profile

  8. The Canadian safeguards program

    International Nuclear Information System (INIS)

    In support of the Treaty on the Non-Proliferation of Nuclear Weapons Canada provides technical support to the International Atomic Energy Agency for the development of safeguards relevant to Canadian designed and built nuclear facilities. Some details of this program are discussed, including the philosophy and development of CANDU safeguards systems; the unique equipment developed for these systems; the provision of technical experts; training programs; liaison with other technical organizations; research and development; implementation of safeguards systems at various nuclear facilities; and the anticipated future direction of the safeguards program

  9. Resources for pediatric drug information.

    Science.gov (United States)

    Zenk, K E

    1990-10-01

    Finding information on the use of drugs fro infants and children is becoming easier with the publication of excellent resources for pediatric and neonatal drug information. Useful pediatric texts and journals are listed. Texts are graded A and B. Category A books would be useful to include in a basic pharmacy library; Category B books are more comprehensive but expensive, or texts that are not as highly recommended as those in Category A. Some of the resources listed include: (1) Pediatrics--Nelson Textbook of Pediatrics, Rudolph's Pediatrics, Current Pediatric Diagnosis and Treatment, Manual of Pediatric Therapeutics; (2) Dosage Guides--The Pediatric Drug Handbook, Harriet Lane Handbook, Problems in Pediatric Drug THerapy; (3) Intensive Care--Textbook of Pediatric Intensive Care; (4) Infectious Disease--Report of the Committee on Infectious Diseases, Pocketbook of Pediatric Antimicrobial Therapy; (5) Poisoning--Handbook of Poisoning, Medical Toxicology; (6) Parenteral Nutrition--Manual of Pediatric Parenteral Nutrition; (7) Pregnancy and Lactation--Drugs in Pregnancy and Lactation; (8) Compounding--Handbook on Extemporaneous Formulation; (9) IV Administration--Guidelines for Administration of Intravenous Medications to Pediatric Patients; (1) Neonatology--Schaffers Diseases of the Newborn, Neonatology, Basic Management, On-Call Problems, Diseases, Drugs, Drug Therapy in Infants; (11) Pediatric Journals--Pediatrics, Journal of Pediatrics, American Journal of Diseases of Children, Pediatric Infectious Disease Journal, Pediatric Alert, Clinics in Perinatology, Pediatric Clinics of North America, Pediatric Clinical Oncology Journal, and Pediatric Surgery.

  10. On Realities of Canadian Multiculturalism

    Institute of Scientific and Technical Information of China (English)

    李梦辰

    2013-01-01

    Canada is a multicultural country which was mainly established by immigrants. Just because of that, Canadian govern⁃ment has carried out the policy of multiculturalism since1970s. However, it has encountered many problems such as policy con⁃flicts, national identity, democracy-inquiry and racial discrimination, etc. Hence the Canadian multiculturalism has been in a di⁃lemma.

  11. Canadians, nuclear weapons, and the Cold War security dilemma

    International Nuclear Information System (INIS)

    This dissertation provides a history of Canadian ideas about nuclear weapons from the late 1950s until the end of the Trudeau era in 1984. Throughout this period, Canadians reacted to the insecurity they felt in the world around them by expressing many conflicting, often irreconcilable views about a range of nuclear weapon issues, including Canada's acquisition of nuclear warheads in 1963, the U.S. ABM program in the 1960s and early 1970s, the role of Canadian nuclear technology in the development of India's first nuclear explosion, and the Trudeau government's decision to allow the U.S. military to test cruise missiles in northern Canada The dissertation concludes with an examination of the emergence of a broadly-based, increasingly mainstream and influential anti-nuclear movement in the early 1980s, the clearest manifestation of the insecurity Canadians experienced at the time. .The nuclear debates examined in this dissertation reveal that Canadians were divided over nuclear weapons, nuclear strategy, the arms race, proliferation, and arms control and disarmament. In particular, they came to fundamentally different conclusions about how Canada's nuclear weapon policies, and its support for the nuclear policies of its alliances, would contribute to international stability and order. Some believed that their security rested on the maintenance of a strong Western nuclear deterrent and supported Canada contributing to its credibility; others believed that the constant modernisation of nuclear arsenals fuelled by the superpower arms race posed a serious threat to their security. This conceptual dilemma-the security through nuclear strength argument versus the fear that the quest for security through quantitative and qualitative improvements of nuclear stockpiles increased the likelihood of nuclear war-left Canadians divided over the value and utility of nuclear weapons and the strategies developed around them. At the same time, Canadians' ideas about nuclear weapons

  12. Canadian beef quality audit.

    Science.gov (United States)

    Van Donkersgoed, J; Jewison, G; Mann, M; Cherry, B; Altwasser, B; Lower, R; Wiggins, K; Dejonge, R; Thorlakson, B; Moss, E; Mills, C; Grogan, H

    1997-01-01

    A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) was observed on 34% of the cattle. Bruises were found on 78% of the carcasses, 81% of which were minor in severity. Fifteen percent of the bruises were located on the round, 29% on the loin, 40% on the rib, 16% on the chuck, and 0.02% on the brisket. Grubs were observed in 0.02% of the steers, and injection sites were observed in 1.3% of whole hanging carcasses. Seventy percent of the livers were passed for human food and 14% for pet food; 16% were condemned. Approximately 71% of the liver condemnations were due to liver abscesses. Four percent of the heads, 6% of the tongues, and 0.2% of whole carcasses were condemned. The pregnancy rate in female cattle was approximately 6.7%. The average hot carcass weight was 357 kg (s = 40) in steers, 325 kg (s = 41) in heifers, 305 kg (s = 53) in cows, 388 kg (s = 62) in virgin bulls and 340 kg (s = 39) in mature bulls. The average ribeye area in all cattle was 84 cm2 (s = 12); range 29 cm2 to 128 cm2. Grade fat was highly variable and averaged 9 mm (s = 4) for steers and heifers, 6 mm (s = 6) for cows, 5 mm (s = 1) for virgin bulls, and 4 mm (s = 0.5) for mature bulls. The average lean meat yield was 59.7% in cattle (s = 3.4); range 39% to 67%. One percent of the carcasses were devoid of marbling, 1% were dark cutters, and 0.05% of the steer carcasses were staggy. Six percent of the carcasses had poor conformation, 3.7% were underfinished, and 0.7% were overfinished. Yellow fat was observed in 4% of the carcasses; 10% of carcasses were

  13. Pediatric Migraine

    Directory of Open Access Journals (Sweden)

    Ubaid Hameed Shah

    2009-01-01

    Full Text Available Migraine is the most common cause of acute recurrent headaches in children. The pathophysiological concepts have evolved from a purely vascular etiology to a neuroinflammatory process. Clinical evaluation is the mainstay of diagnosis and should also include family history. Investigations help to rule out secondary causes. The role of new drugs in treatment of migraine is discussed and trials are quoted from literature. Indications for starting prophylaxis should be evaluated based on frequency of attacks and influence on quality of life. For management of acute attacks of migraine both acetaminophen and ibuprofen are recommended for use in children. Many drugs like antiepileptic drugs (AED, calcium channel blockers, and antidepressants have been used for prophylaxis of migraine in children. The data for use of newer drugs for migraine in children is limited, though AEDs are emerging a popular choice. Biofeedback and other nonmedicinal therapies are being used with promising results.

  14. Pediatric intestinal motility disorders

    OpenAIRE

    Gfroerer, Stefan; Rolle, Udo

    2015-01-01

    Pediatric intestinal motility disorders affect many children and thus not only impose a significant impact on pediatric health care in general but also on the quality of life of the affected patient. Furthermore, some of these conditions might also have implications for adulthood. Pediatric intestinal motility disorders frequently present as chronic constipation in toddler age children. Most of these conditions are functional, meaning that constipation does not have an organic etiology, but i...

  15. Pediatric facial nerve rehabilitation.

    Science.gov (United States)

    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  16. Efficacy of extracorporeal shock wave lithotripsy in the emergency treatment of pediatric ureteral calculi with renal colic%急诊冲击波碎石术治疗小儿绞痛性输尿管结石的临床研究

    Institute of Scientific and Technical Information of China (English)

    桂西青; 孙华宾; 郭振宇; 苗永青; 周少朋

    2008-01-01

    Objective To study efficacy of pediatric ureteral calculi with renal colic by the emergency treatment of extracorporeal shock wave lithotripsy (ESWL). Methods We reviewed the treatment and out-come of 31 pediatric patients with renal colic for ureteral calculi in the emergency treatment of ESWL over a 10-year period (1997~2007). Results 25 cases underwent one ESWL session;5 cases had two ESWLses-sions; 1 case underwent other treatment procedures after failure of 3 ESWL sessions. The stone-free rate was 96.8% (30/31).The renal coli of 28 cases (90.3%) relieved apparently in the one ESWL session. No severe complication was found. 19 cases required intravenous general anesthesia in the ESWL. Conclusion The e-mergency treatment of ESWL is an efficient and safe modality for pediatric ureteral calculi with renal colic.%目的 评价急诊体外冲击波碎石术(ESWL)治疗小儿绞痛性输尿管结石之效果.方法 回顾1997年1月至2007年12月32例小儿输尿管结石伴急性肾绞痛的急诊ESWL的治疗资料.结果 1次ESWL 25例;2次ESWL 5例;1例3次ESWL治疗失败后改其他治疗,总结石排净率为96.8%(30/31).首次ESWL治疗后,28例肾绞痛完全缓解(90.3%).ESWL术中,静脉全麻19例,镇静加止痛剂者12例.术后无严重并发症.结论 急诊ESWL治疗小儿绞痛性输尿管结石安全快捷、疗效肯定.

  17. Canadian National Vegetation Classification (CNVC)

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The mandate of the CNVC is to comprehensively classify and describe natural and semi-natural Canadian vegetation in an ecologically meaningful manner. The...

  18. PET imaging in pediatric neuroradiology: current and future applications

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sunhee [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Salamon, Noriko [UCLA David Geffen School of Medicine at UCLA, Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA (United States); Jackson, Hollie A.; Blueml, Stefan [Keck School of Medicine of USC, Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Keck School of Medicine of USC, Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)

    2010-01-15

    Molecular imaging with positron emitting tomography (PET) is widely accepted as an essential part of the diagnosis and evaluation of neoplastic and non-neoplastic disease processes. PET has expanded its role from the research domain into clinical application for oncology, cardiology and neuropsychiatry. More recently, PET is being used as a clinical molecular imaging tool in pediatric neuroimaging. PET is considered an accurate and noninvasive method to study brain activity and to understand pediatric neurological disease processes. In this review, specific examples of the clinical use of PET are given with respect to pediatric neuroimaging. The current use of co-registration of PET with MR imaging is exemplified in regard to pediatric epilepsy. The current use of PET/CT in the evaluation of head and neck lymphoma and pediatric brain tumors is also reviewed. Emerging technologies including PET/MRI and neuroreceptor imaging are discussed. (orig.)

  19. Canadian hydrocarbon transportation system : transportation assessment

    International Nuclear Information System (INIS)

    This document provided an assessment of the Canadian hydrocarbon transportation system. In addition to regulating the construction and operation of Canada's 45,000 km of pipeline that cross international and provincial borders, Canada's National Energy Board (NEB) regulates the trade of natural gas, oil and natural gas liquids. The ability of pipelines to delivery this energy is critical to the country's economic prosperity. The pipeline system includes large-diameter, cross-country, high-pressure natural gas pipelines, low-pressure crude oil and oil products pipelines and small-diameter pipelines. In order to assess the hydrocarbon transportation system, staff at the NEB collected data from pipeline companies and a range of publicly available sources. The Board also held discussions with members of the investment community regarding capital markets and emerging issues. The assessment focused largely on evaluating whether Canadians benefit from an efficient energy infrastructure and markets. The safety and environmental integrity of the pipeline system was also evaluated. The current adequacy of pipeline capacity was assessed based on price differentials compared with firm service tolls for major transportation paths; capacity utilization on pipelines; and, the degree of apportionment on major oil pipelines. The NEB concluded that the Canadian hydrocarbon transportation system is working effectively, with an adequate capacity in place on existing natural gas pipelines, but with a tight capacity on oil pipelines. It was noted that shippers continue to indicate that they are reasonably satisfied with the services provided by pipeline companies and that the NEB-regulated pipeline companies are financially stable. 14 refs, 11 tabs., 28 figs., 4 appendices

  20. Teaching Prevention in Pediatrics.

    Science.gov (United States)

    Cheng, Tina L.; Greenberg, Larrie; Loeser, Helen; Keller, David

    2000-01-01

    Reviews methods of teaching preventive medicine in pediatrics and highlights innovative programs. Methods of teaching prevention in pediatrics include patient interactions, self-directed learning, case-based learning, small-group learning, standardized patients, computer-assisted instruction, the Internet, student-centered learning, and lectures.…

  1. Canadian leadership in energy

    International Nuclear Information System (INIS)

    Canada's energy is complex and an important resource as it fuels and funds the economy. The unique character of Canada's energy production and consumption provides strength to the country. The purpose of this booklet was to highlight Canada's energy production and consumption and to demonstrate Canada's rank globally with other major global energy players. The document also presented information on the value of Canada's energy exports, Canada's relationship with the United States, and Canada's energy-related carbon dioxide emissions. Specifically, the document discussed Canada's energy in a global context; the value of Canada's energy exports; domestic value of energy; Canada's unique energy mix; Canada's electricity mix; Canada's carbon dioxide emissions; energy strategies; and the importance of energy to Canadians. It was concluded that there are 14 federal, provincial and territorial jurisdictions managing their respective energy resources. All of these regions, with the exception of Saskatchewan have produced an energy strategy document or a climate change action plan focusing on 8 areas of action, notably awareness; benefit; efficiency; development; diversification; electricity; and emissions. refs., tabs., figs.

  2. The role of simulation in teaching pediatric resuscitation: current perspectives

    Directory of Open Access Journals (Sweden)

    Lin Y

    2015-03-01

    Full Text Available Yiqun Lin,1 Adam Cheng2 1KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada; 2KidSIM-ASPIRE Research Program, Department of Pediatrics, Division of Emergency Medicine, University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada Abstract: The use of simulation for teaching the knowledge, skills, and behaviors necessary for effective pediatric resuscitation has seen widespread growth and adoption across pediatric institutions. In this paper, we describe the application of simulation in pediatric resuscitation training and review the evidence for the use of simulation in neonatal resuscitation, pediatric advanced life support, procedural skills training, and crisis resource management training. We also highlight studies supporting several key instructional design elements that enhance learning, including the use of high-fidelity simulation, distributed practice, deliberate practice, feedback, and debriefing. Simulation-based training is an effective modality for teaching pediatric resuscitation concepts. Current literature has revealed some research gaps in simulation-based education, which could indicate the direction for the future of pediatric resuscitation research. Keywords: simulation, pediatric resuscitation, medical education, instructional design, crisis resource management, health care

  3. Gut Microbiome and Kidney Disease in Pediatrics: Does Connection Exist?

    OpenAIRE

    Tetyana L. Vasylyeva; Singh, Ruchi

    2016-01-01

    Child development is a unique and continuous process that is impacted by genetics and environmental factors. Gut microbiome changes with development and depends on the stage of gut maturation, nutrition, and overall health. In spite of emerging data and active study in adults, the gut-renal axis in pediatrics has not been well considered and investigated. This review will focus on the current knowledge of gut microbiota impacts on kidney disease with extrapolation to the pediatric population.

  4. Canadian resources of uranium and thorium

    International Nuclear Information System (INIS)

    Canada has been one of the world's leading producers of uranium since the metal became important as a raw material in the development and production of atomic energy. One of the largest known deposits in the world is in Canada where present reserves represent about 37 per cent of the total among those countries that have published reserve statistics. The production of uranium has been characterized by features which are unique in Canadian mining, because the industry was created by the government at a time of emergency and, unlike other minerals, the sale of its product is controlled by the state. The rapid growth of the uranium-mining industry since World War II has been a remarkable achievement. In 1958, Canada was the world's leading producer of uranium and the value of U3O8 produced in both 1958 and 1959 exceeded the value of any other Canadian-produced metal. As an export commodity, uranium ranked fourth in value in 1959 following newsprint, wheat, and lumber. Production from 25 mines in that year was 14 462 tonnes of U3O8 valued at $345 million (all monetary values are in U.S. dollars). Since 1959, however, the decline in production, resulting from declining export markets, has been almost as rapid as the spectacular rise from 1953 to 1959. At the end of 1963 only seven mines were in production and by the end of 1965 only two mines are expected to remain in operation. (author)

  5. Harvey Cushing's Canadian connections.

    Science.gov (United States)

    Feindel, William

    2003-01-01

    During his surgical career between 1896 and 1934, Harvey Cushing made eight visits to Canada. He had a broad impact on Canadian medicine and neurosurgery. Cushing's students Wilder Penfield and Kenneth McKenzie became outstanding leaders of the two major centers in Canada for neurosurgical treatment and training. On his first trip to Canada, shortly after completing his surgical internship in August 1896, Cushing traveled with members of his family through the Maritime Provinces and visited hospitals in Quebec and Montreal. Eight years later, in February 1904, as a successful young neurosurgeon at the Johns Hopkins Hospital, he reported to the Montreal Medico-Chirurgical Society on his surgical experience in 20 cases of removal of the trigeminal ganglion for neuralgia. In 1922, as the Charles Mickle Lecturer at the University of Toronto, Cushing assigned his honorarium of $1000 to support a neurosurgical fellowship at Harvard. This was awarded to McKenzie, then a general practitioner, for a year's training with Cushing in 1922-1923. McKenzie returned to initiate the neurosurgical services at the Toronto General Hospital, where he developed into a master surgeon and teacher. On Cushing's second visit to McGill University in October 1922, he and Sir Charles Sherrington inaugurated the new Biology Building of McGill's Medical School, marking the first stage of a Rockefeller-McGill program of modernization. In May 1929, Cushing attended the dedication of the Osler Library at McGill. In September 1934, responding to the invitation of Penfield, Cushing presented a Foundation Lecture-one of his finest addresses on the philosophy of neurosurgery-at the opening of the Montreal Neurological Institute. On that same trip, Cushing's revisit to McGill's Osler Library convinced him to turn over his own treasure of historical books to Yale University.

  6. Canadian physical activity guidelines for adults: are Canadians aware?

    Science.gov (United States)

    Dale, Leila Pfaeffli; LeBlanc, Allana G; Orr, Krystn; Berry, Tanya; Deshpande, Sameer; Latimer-Cheung, Amy E; O'Reilly, Norm; Rhodes, Ryan E; Tremblay, Mark S; Faulkner, Guy

    2016-09-01

    The present study evaluated awareness of the Canadian Society for Exercise Physiology's 2011 Canadian Physical Activity Guidelines for Adults and assessed correlates. Reported awareness of the physical activity (PA) guidelines was 12.9% (204/1586) of the total sample surveyed. More than half (55%) self-reported meeting PA guidelines of ≥ 150 min of moderate to vigorous PA per week. Awareness of PA guidelines was significantly related to participants' level of PA (χ(2) (1) = 30.63, p < 0.001, φ = -0.14), but not to any demographic variables. PMID:27560541

  7. Evaluation of the medication process in pediatric patients: a meta-analysis

    OpenAIRE

    Despina Koumpagioti; Christos Varounis; Eleni Kletsiou; Charalampia Nteli; Vasiliki Matziou

    2014-01-01

    OBJECTIVE: to meta-analyze studies that have assessed the medication errors rate in pediatric patients during prescribing, dispensing, and drug administration. SOURCES: searches were performed in the PubMed, Cochrane Library, and Trip databases, selecting articles published in English from 2001 to 2010. SUMMARY OF THE FINDINGS: a total of 25 original studies that met inclusion criteria were selected, which referred to pediatric inpatients or pediatric patients in emergency department...

  8. Responsible Canadian energy progress report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The Canadian Association of Petroleum Producers (CAPP) represents oil and gas companies throughout Canada; its members produce over 90% of Canada's natural gas and crude oil output. The aim of the Association is to improve the economics of the Canadian upstream petroleum sector in an environmentally and socially responsible way. The aim of this Responsible Canadian Energy report is to present the performance data of CAPP's members for the year 2009. Data, trends, and performance analyses are provided throughout the document. This analysis makes it possible to determine where progress has been made and where performance improvement is necessary. It also presents success stories and best practices so that other companies can learn from them how to improve their own performance. This paper provides useful information on the performance of the upstream petroleum industry in Canada and highlights where the focus should be for further improvement in its performance.

  9. Political Affiliation of Canadian Professors

    Directory of Open Access Journals (Sweden)

    M. Reza Nakhaie

    2008-01-01

    Full Text Available The social role of universities has been the subject of a lengthy debate as to whether those who teach in the academy are system-legitimizing conservatives or radicals helping to generate critical thinking that challenges the status quo. The aim of this paper is to evaluate political affiliations of Canadian university professors based on a national survey conducted in 2000. The study shows that Canadian professors’ political affiliation can be identified as either left or right depending on how the political orientation of political parties is conceptualized. University professors tend to vote more for the Liberal Party than other parties, and view it as centrist party. Moreover, the study highlights a complex and non-monolithic picture of the Canadian academy. University professors are not politically homogenous and party vote depends on the prestige of their university, their discipline, gender, ethnicity, marital status, generation, and agreement with liberalism.

  10. Chernobyl - a Canadian technical perspective

    International Nuclear Information System (INIS)

    In this report we present the design review done to date in Canada by AECL. From the Canadian point of view it covers: 1) relevant information on the Chernobyl design and the accident, both as presented by the Soviets at the Post-Accident Review Meeting (PARM) held in Vienna from August 25-29, 1986, and as deduced from publicly available Soviet documentation; and 2) details of AECL's technical review of the CANDU PHWR (Pressurized Heavy Water Reactor) against the background of the Chernobyl accident, and implications of the Chernobyl accident. Reviews of operational aspects are underway by the Canadian electrical utilities and a review by the Canadian regulatory agency (the Atomic Energy Control Board) is near completion

  11. [Robotics in pediatric surgery].

    Science.gov (United States)

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  12. Hypnosis in pediatrics: applications at a pediatric pulmonary center

    Directory of Open Access Journals (Sweden)

    Anbar Ran D

    2002-12-01

    Full Text Available Abstract Background This report describes the utility of hypnosis for patients who presented to a Pediatric Pulmonary Center over a 30 month period. Methods Hypnotherapy was offered to 303 patients from May 1, 1998 – October 31, 2000. Patients offered hypnotherapy included those thought to have pulmonary symptoms due to psychological issues, discomfort due to medications, or fear of procedures. Improvement in symptoms following hypnosis was observed by the pulmonologist for most patients with habit cough and conversion reaction. Improvement of other conditions for which hypnosis was used was gauged based on patients' subjective evaluations. Results Hypnotherapy was associated with improvement in 80% of patients with persistent asthma, chest pain/pressure, habit cough, hyperventilation, shortness of breath, sighing, and vocal cord dysfunction. When improvement was reported, in some cases symptoms resolved immediately after hypnotherapy was first employed. For the others improvement was achieved after hypnosis was used for a few weeks. No patients' symptoms worsened and no new symptoms emerged following hypnotherapy. Conclusions Patients described in this report were unlikely to have achieved rapid improvement in their symptoms without the use of hypnotherapy. Therefore, hypnotherapy can be an important complementary therapy for patients in a pediatric practice.

  13. PET-CT imaging in pediatric oncology

    OpenAIRE

    McCarville, M. Beth

    2009-01-01

    Abstract Positron emission tomography (PET)-computed tomography (CT) is emerging as a valuable tool for assessing a wide variety of pediatric malignancies, including lymphomas, soft-tissue tumors, and bone sarcomas. PET-CT may provide information that is not apparent on conventional imaging performed to stage these diseases and monitor their response to treatment. The use of PET-CT in children requires an awareness of the technical and logistical issues unique to this patient population. In a...

  14. A Topography for Canadian Curriculum Theory.

    Science.gov (United States)

    Chambers, Cynthia

    1999-01-01

    Presents challenges to Canadian curriculum theorists: (1) to create curriculum languages and genres that represent all of Canada; (2) to use Canadian scholars and indigenous languages to find these curriculum languages and genres; (3) to seek interpretive tools to understand what it means to be Canadian; and (4) to create curriculum theory that…

  15. Toward Enteral Nutrition in the Treatment of Pediatric Crohn Disease in Canada: A Workshop to Identify Barriers and Enablers

    Directory of Open Access Journals (Sweden)

    Johan Van Limbergen

    2015-01-01

    Full Text Available The treatment armamentarium in pediatric Crohn disease (CD is very similar to adult-onset CD with the notable exception of the use of exclusive enteral nutrition (EEN [the administration of a liquid formula diet while excluding normal diet], which is used more frequently by pediatric gastroenterologists to induce remission. In pediatric CD, EEN is now recommended by the pediatric committee of the European Crohn’s and Colitis Organisation and the European Society for Paediatric Gastroenterology Hepatology and Nutrition as a first-choice agent to induce remission, with remission rates in pediatric studies consistently >75%. To chart and address enablers and barriers of use of EEN in Canada, a workshop was held in September 2014 in Toronto (Ontario, inviting pediatric gastroenterologists, nurses and dietitians from most Canadian pediatric IBD centres as well as international faculty from the United States and Europe with particular research and clinical expertise in the dietary management of pediatric CD. Workshop participants ranked the exclusivity of enteral nutrition; the health care resources; and cost implications as the top three barriers to its use. Conversely, key enablers mentioned included: standardization and sharing of protocols for use of enteral nutrition; ensuring sufficient dietetic resources; and reducing the cost of EEN to the family (including advocacy for reimbursement by provincial ministries of health and private insurance companies. Herein, the authors report on the discussions during this workshop and list strategies to enhance the use of EEN as a treatment option in the treatment of pediatric CD in Canada.

  16. Hot spots analysis of Chinese Pediatric Emergency Medicine based on co-words cluster analysis%采用共词聚类法分析近6年《中国小儿急救医学》杂志研究热点

    Institute of Scientific and Technical Information of China (English)

    李巍; 张薇; 王晓茵

    2013-01-01

    目的 研究《中国小儿急救医学》近年发表文献的研究热点.方法 选取万方数据库收录的《中国小儿急救医学》2006年至2011年发表的论文为基本数据来源,挑选有关键词的1194篇文献,从中逐一抽出4054个关键词.采用书目共现分析系统对关键词进行词频统计和共现分析,利用SPSS 11.5软件对共词矩阵进行聚类分析.结果 新生儿、早产儿、手足口病、机械通气、脓毒症、先天性心脏病是排在前10位的高频关键词.聚类分析关系图显示,《中国小儿急救医学》近6年发表文章的研究热点主要集中在以下8个方面:手足口病、脓毒性休克的预后影响因素、急性肺损伤和急性呼吸窘迫综合征、新生儿窒息导致的缺氧缺血性脑病、早产儿疾病、婴幼儿先天性心脏病合并重症肺炎及心力衰竭的治疗、儿童重症监护病房内获得性感染的病原菌及耐药性分析、脓毒症.结论 通过关键词共词聚类分析法,探明了我刊近6年发表论文的主体研究规律和方向.%Objective To investigate the literature research focus of Chinese Pediatric Emergency Medicine.Methods The papers published in Chinese Pediatric Emergency Medicine from 2006 to 2011 and indexed by wanfang database served as the basic data sources.Four thousands and fifty-four keywords were collected from 1194 literature.Keyword frequency statistics and the co-occurrence analysis were made by using bibliographic item co-occurrence matrix builder,and cluster analysis was made using SPSS 11.5 software.Results Newborns,premature,hand,foot and mouth disease,mechanical ventilation,sepsis,congenital heart disease was the top 10 high-frequency keywords.Cluster analysis diagram showed the research focus from articles published in Chinese Pediatric Emergency Medicine for the past six years,which included:(1) hand,foot and mouth disease; (2) prognostic factors for septic shock; (3) acute lung injury and acute

  17. [Problems introducing a pediatric poisoning treatment set].

    Science.gov (United States)

    Brockstedt, M

    2004-01-01

    Between 1995 and 1998 the Berlin poison center conducted a case-control study supported by the Ministry of Science and Technology, the Berlin Medical Association, a health insurance company, and the Berlin Pediatric Society to test the efficacy of a pediatric poisoning treatment set. The aim of the study was to induce parents of small children to call the poison center immediately in cases of unintentional poisonings at home and to administer activated charcoal if advised to do so by the poison center specialist. This was achieved by handling over a so-called "emergency kit" to 24,000 parents during the regular pediatric office check-up when the children were 10-12 months of age. When an accident occurred, parents with an emergency kit at hand were able to give activated charcoal within 14 min compared to 51 min without this aid. Problems arose when attempts were undertaken to introduce the emergency kit into the routine counseling sessions throughout the country: restrictions imposed by the pharmaceutical law, lack of interest shown by pharmaceutical companies, and diverging responsibilities at county and federal political levels and between different health insurance companies have hitherto prevented the realization of this evidence-based method. PMID:15205817

  18. Pediatric transesophageal echocardiography

    NARCIS (Netherlands)

    O.F.W. Stümper (Oliver)

    1991-01-01

    textabstractIn face of several limitations of precordial ultrasound investigations in children with congenital heart disease, it was attempted to defme the additional value of pediatric transesophageal echocardiography. Its comparative value, firstly, in the preoperative diagnosis of congenital hear

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Videos related to Children's (Pediatric) Nuclear Medicine About this Site RadiologyInfo.org is produced by: Please note ... you can search the ACR-accredited facilities database . This website does not provide cost information. The costs ...

  20. NIH Pediatric Rheumatology Clinic

    Science.gov (United States)

    ... patients without discrimination on the basis of race, religion, ethnic group, citizenship, or residence. We can provide ... studies to help understand pediatric rheumatic diseases. Natural history studies, for example, are designed to study how ...

  1. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... to make progress in “immunogenomics” Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  2. Pediatric radiology; Kinderradiologie

    Energy Technology Data Exchange (ETDEWEB)

    Staatz, G. [Erlangen-Nuernberg Univ., Erlangen (Germany). Kinderradiologie; Honnef, D. [Universitaetsklinikum der RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Piroth, W. [HELIOS Klinikum Wuppertal Universitaetsklinik Witten/Herdecke, Wuppertal (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Radkow, T. [Erlangen-Nuernberg Univ., Erlangen (Germany). Radiologisches Inst.

    2007-07-01

    The book covers the actual knowledge on radiotherapy in pediatrics. The book contains 99 contributions in the following chapters: lungs and mediastinum, heart and cardiovascular system, neck, gastrointestinal tract, urogenital tract, musculoskeletal system, central nervous system.

  3. Pediatric inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Karen A Diefenbach; Christopher K Breuer

    2006-01-01

    Inflammatory bowel disease is an important cause of gastrointestinal pathology in children and adolescents.The incidence of pediatric inflammatory bowel disease is increasing; therefore, it is important for the clinician to be aware of the presentation of this disease in the pediatric population. Laboratory tests, radiology studies,and endoscopic procedures are helpful in diagnosing inflammatory bowel disease and differentiating between Crohn's disease and ulcerative colitis. Once diagnosed,the goal of medical management is to induce remission of disease while minimizing the side effects of the medication. Specific attention needs to be paid to achieving normal growth in this susceptible population.Surgical management is usually indicated for failure of medical management, complication, or malignancy.Algorithms for diagnostic evaluation and treatment of pediatric inflammatory bowel disease are presented.The specific psychosocial issues facing these patients are also discussed in this review as are the future goals of research in the complex problem of pediatric inflammatory bowel disease.

  4. Pediatric Seborrheic Dermatitis

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Seborrheic Dermatitis (Pediatric) A parent's guide for infants and babies A A A Seborrheic dermatitis (cradle cap) often causes cracking and scaling in ...

  5. Pediatric liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Marco Spada; Silvia Riva; Giuseppe Maggiore; Davide Cintorino; Bruno Gridelli

    2009-01-01

    In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of improvements in medical, surgical and anesthetic management, organ availability, immunosuppression, and identification and treatment of postoperative complications. The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients. Newer immunosuppression regimens, including induction therapy, have had a significant impact on graft and patient survival. Future developments of pediatric liver transplantation will deal with long-term followup, with prevention of immunosuppression-related complications and promotion of as normal growth as possible. This review describes the state-of-the-art in pediatric liver transplantation.

  6. Pediatric palliative care

    OpenAIRE

    Trapanotto Manuela; Spizzichino Marco; Benini Franca; Ferrante Anna

    2008-01-01

    Abstract The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pedi...

  7. Pediatric Palliative Care

    OpenAIRE

    Johnston, Donna L.; Hentz, Tracy A.; Friedman, Debra L.

    2005-01-01

    Pediatric palliative care provides benefit to children living with life-threatening or terminal conditions. Palliative care should be available to all seriously ill children. Palliative care includes the treatment of symptoms such as pain, nausea, dyspnea, constipation, anorexia, and sialorrhea. This care can occur in a variety of settings, from home to hospice to hospital, and must include bereavement care and follow up after the death of a child. There are many challenges in pediatric palli...

  8. Pediatric Invasive Aspergillosis

    Directory of Open Access Journals (Sweden)

    Rachel L. Wattier

    2016-06-01

    Full Text Available Invasive aspergillosis (IA is a disease of increasing importance in pediatrics due to growth of the immunocompromised populations at risk and improvements in long-term survival for many of these groups. While general principles of diagnosis and therapy apply similarly across the age spectrum, there are unique considerations for clinicians who care for children and adolescents with IA. This review will highlight important differences in the epidemiology, clinical manifestations, diagnosis, and therapy of pediatric IA.

  9. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  10. Pediatric vascular access

    International Nuclear Information System (INIS)

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  11. Pediatric vascular access

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, James S. [Northwestern University, Feinberg School of Medicine, Department of Medical Imaging, Children' s Memorial Hospital, Chicago, IL (United States)

    2006-05-15

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  12. Identification of pediatric patient

    Directory of Open Access Journals (Sweden)

    Ioannis Koutelekos

    2012-07-01

    Full Text Available Identification of pediatric patient consists a dynamic alternative complex procedure that includes many and various dimensions which may define up to some extent the life of each individual and even the outcome of the disease. Aim: The aim of the present study was to review the literature about the identification of pediatric patient. The method of this study included bibliographic research of the literature from reviews and researches, mainly in the PubMed data base, which referred to the identification of pediatric patient. Results: According to the literature, many factors influence the identification of pediatric patient, of which the main are the body image and the age that the patients experience this change. Another factor that affects significantly the configuration of the identification of pediatric patient is the extent to which society influences the daily life of the patient, the perceptions and attitudes of health professionals as well as the religiosity in the way it is expressed in the clinical environment. Conclusions: Design of protocols of care based on the identification of pediatric patient including spirituality will contribute to the most effective satisfaction of patients' needs.

  13. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I. [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  14. Canadian contributions studies for the WFIRST instruments

    Science.gov (United States)

    Lavigne, J.-F.; Rowlands, N.; Grandmont, F. J.; Lafrenière, D.; Marois, C.; Daigle, O.; Thibault, S.; Schade, D.; Artigau, É.; Brousseau, D.; Maire, J.; Cretot-Richert, G.; Ducharme, M.-È.; Levesque, L. E.; Laurin, D.; Dupuis, J.

    2016-07-01

    WFIRST-AFTA is the NASA's highest ranked astrophysics mission for the next decade that was identified in the New World, New Horizon survey. The mission scientific drivers correspond to some of the deep questions identified in the Canadian LRP2010, and are also of great interest for the Canadian scientists. Given that there is also a great interest in having an international collaboration in this mission, the Canadian Space Agency awarded two contracts to study a Canadian participation in the mission, one related to each instrument. This paper presents a summary of the technical contributions that were considered for a Canadian contribution to the coronagraph and wide field instruments.

  15. Art Therapy with Pediatric Cancer Patients: Helping Normal Children Cope with Abnormal Circumstances.

    Science.gov (United States)

    Councill, Tracy

    1993-01-01

    Notes that art therapy with pediatric cancer patients addresses emotional and developmental needs of normal population under extreme stress. Reviews literature on the problems likely to be encountered by pediatric cancer patient and presents case examples to illustrate the emergence of these issues and their management in art therapy. (Author/NB)

  16. Universal values of Canadian astronauts

    Science.gov (United States)

    Brcic, Jelena; Della-Rossa, Irina

    2012-11-01

    Values are desirable, trans-situational goals, varying in importance, that guide behavior. Research has demonstrated that universal values may alter in importance as a result of major life events. The present study examines the effect of spaceflight and the demands of astronauts' job position as life circumstances that affect value priorities. We employed thematic content analysis for references to Schwartz's well-established value markers in narratives (media interviews, journals, and pre-flight interviews) of seven Canadian astronauts and compared the results to the values of National Aeronautics and Space Administration (NASA) and Russian Space Agency (RKA) astronauts. Space flight did alter the level of importance of Canadian astronauts' values. We found a U-shaped pattern for the values of Achievement and Tradition before, during, and after flight, and a linear decrease in the value of Stimulation. The most frequently mentioned values were Achievement, Universalism, Security, and Self-Direction. Achievement and Self Direction are also within the top 4 values of all other astronauts; however, Universalism was significantly higher among the Canadian astronauts. Within the value hierarchy of Canadian astronauts, Security was the third most frequently mentioned value, while it is in seventh place for all other astronauts. Interestingly, the most often mentioned value marker (sub-category) in this category was Patriotism. The findings have important implications in understanding multi-national crew relations during training, flight, and reintegration into society.

  17. Canadian Postcolonialism: Recovering British Roots

    Science.gov (United States)

    Doughty, Howard A.

    2005-01-01

    The field of Postcolonial Studies is one of the academic fashions that has arisen in an attempt to amend or replace radical theories of social power since the alleged discrediting of Marxism. The Canadian case is more ambiguous. Postcolonialism, already an essentially contested concept, is especially conflicted where Canada is concerned. Canada…

  18. Canadian Government Electronic Information Policy.

    Science.gov (United States)

    Nilsen, Kirsti

    1993-01-01

    Examines development and evolution of Canadian government information policy in response to issues of preservation of data, information industry involvement in government data development and marketing, role of Crown copyright, and public access to government information in electronic formats. Six key information policy instruments are also…

  19. Nuclear regulation - the Canadian approach

    International Nuclear Information System (INIS)

    Although the Atomic Energy Control Board was established 35 years ago the basic philosophy of nuclear regulation in Canada and the underlying principles of the regulatory process remain essentially unchanged. This paper outlines the Canadian approach to nuclear regulation and explains in practical terms how the principles of regulation are applied. (author)

  20. The influence of continuous infusion of dexmedetomidine on pediatric postoperative emergence agitation%右美托咪定持续输注对小儿全麻术后躁动的影响

    Institute of Scientific and Technical Information of China (English)

    沈婷; 王英伟

    2013-01-01

    目的 探讨在小儿全麻手术中使用右美托咪定(dexmedetomidine,Dex)持续输注对术后躁动的影响. 方法 选取美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级、72名4岁~10岁在全麻下行骨折切开复位内固定手术的患儿,采用完全随机分组法随机分为4组(每组18例),分别采用丙泊酚复合Dex(0.5 μg· kg-1·h-1)(PD组)及七氟醚复合Dex(SD组),丙泊酚复合生理盐水(PN组)及七氟醚复合生理盐水(SN组).分别记录患儿泵注Dex前(T1)、泵注后10(T2)、20(T3)、30 min(T4)及拔管时(T5)的心率(heart rate,HR)、平均动脉压(mean artery pressure,MAP)、脑电双频指数(bispectral index,BIS);测定停止麻醉药物至拔管时间、睁眼时间;对术后患儿躁动及疼痛程度进行评分;计算患儿苏醒期躁动的发生率. 结果 ①PD组与PN组比较、SD组与SN组比较,拔管时间[(7.1±2.6)min vs(4.4±2.1) min、(7.3±2.1)min vs (4.9±2.0) min]及睁眼时间[(16±6) min vs(10±3)min、(13±6)min vs (9±5) min]显著延长(P<0.05),但PD组与SD组比较差异无统计学意义(P>0.05).②PD组与PN组、SD组与SN组比较,术后躁动评分(1分vs 2分、3分vs 4分)及术后患儿疼痛程度评分(CHIPPS评分)(2.5分vs 3分、4分vs 7分)下降(P<0.01).SD组术后躁动发生率显著下降[SD组(5.6%)vs SN组(33.3%)](P<0.05).PD组的躁动评分低于SD组(P<0.05). 结论 Dex虽会造成术后苏醒时间延长,但可以降低小儿麻醉术后躁动评分及术后即刻疼痛评分,并且显著降低七氟醚麻醉术后躁动发生率,使患儿苏醒期更加平稳.%Objective To observe the influence of continuous infusion of dexmedetomidine (Dex) on pediatric postoperative emergence agitation.Methods Seventy two patients,ASA Ⅰ-Ⅱ,aged 4 y-10 y,scheduled for orthopedic surgery under general,were randomly allocated to four groups.Group PD received propofol and Dex (0.5 μg·kg-1·h-1),group PN received propofol and sodium chloride,group SD received

  1. Why do Chinese Canadians not consult mental health services: health status, language or culture?

    Science.gov (United States)

    Chen, Alice W; Kazanjian, Arminée; Wong, Hubert

    2009-12-01

    Data from the Canadian Community Health Survey Cycle 1.1 showed that Chinese immigrants to Canada and Chinese individuals born in Canada were less likely than other Canadians to have contacted a health professional for mental health reasons in the previous year in the province of British Columbia. The difference persisted among individuals at moderate to high risk for depressive episode. Both immigrant and Canadian-born Chinese showed similar characteristics of mental health service use. The demographic and health factors that significantly affected their likelihood to consult mental health services included Chinese language ability, restriction in daily activities, frequency of medical consultations, and depression score. Notwithstanding lower levels of mental illness in ethnic Chinese communities, culture emerged as a major factor explaining differences in mental health consultation between Chinese and non-Chinese Canadians.

  2. Pediatric Body Magnetic Resonance Imaging.

    Science.gov (United States)

    Kandasamy, Devasenathipathy; Goyal, Ankur; Sharma, Raju; Gupta, Arun Kumar

    2016-09-01

    Magnetic resonance imaging (MRI) is a radiation-free imaging modality with excellent contrast resolution and multiplanar capabilities. Since ionizing radiation is an important concern in the pediatric population, MRI serves as a useful alternative to computed tomography (CT) and also provides additional clues to diagnosis, not discernible on other investigations. Magnetic resonance cholangiopancreatography (MRCP), urography, angiography, enterography, dynamic multiphasic imaging and diffusion-weighted imaging provide wealth of information. The main limitations include, long scan time, need for sedation/anesthesia, cost and lack of widespread availability. With the emergence of newer sequences and variety of contrast agents, MRI has become a robust modality and may serve as a one-stop shop for both anatomical and functional information. PMID:26916887

  3. Perspective on the current realities confronting Canadian energy policy

    International Nuclear Information System (INIS)

    The importance of the Canadian energy sector is indicated by the large proportion of energy investments in the economy, the significant contribution of energy exports to total exports, the major role of the energy sector in Canada's regional economies, the high per-capita energy consumption, and the high contribution of fossil fuels to Canadian greenhouse gas emissions. The history of Canadian energy policy is characterized by three relatively distinct periods: a period of strong growth and development in the energy sector starting in the late 1940s, a crisis management period starting with the oil crises in the 1970s, and a market orientation in the early 1980s which reduced the role of government in the energy sector. Energy policy has generally focused on two main themes: assuring access to competitively priced energy supplies, and ensuring maximum economic benefit from energy developments. A third theme, environmental responsibility, has emerged since the late 1980s. Current pressures on Canadian energy policies include the increasing integration of energy markets in North America, the influence of international conditions on energy prices, and environmental quality concerns relating to the costs and uncertainties of environmental assessment, climate change, and sustainable development. Further constraints and influences on energy policy come from multilateral agreements with other countries and international agencies, and the need for cooperation among the different levels of Canadian governments. Economic regulation has fallen out of favor with most governments, industry, and the public, and the increased use of regulation to pursue environmental goals in the energy sector seems likely to continue

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the abdomen ... limitations of Abdominal Ultrasound Imaging? What is Abdominal Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  5. What Is a Pediatric Neurosurgeon?

    Science.gov (United States)

    ... training in neurological surgery Additional training in pediatric neurosurgery Certification from the American Board of Neurological Surgery ... and facilities specifically designed for children. Most pediatric neurosurgery offices are arranged and decorated with children in ...

  6. Canadian consumer battery baseline study : final report

    International Nuclear Information System (INIS)

    This report provided information about the estimated number of consumer and household batteries sold, re-used, stored, recycled, and disposed each year in Canada. The report discussed the ways in which different batteries posed risks to human health and the environment, and legislative trends were also reviewed. Data used in the report were obtained from a literature review as well as through a series of interviews. The study showed that alkaline batteries are the most common primary batteries used by Canadians, followed by zinc carbon batteries. However, lithium primary batteries are gaining in popularity, and silver oxide and zinc air button cell batteries are also used in applications requiring a flat voltage and high energy. Secondary batteries used in laptop computers, and cell phones are often made of nickel-cadmium, nickel-metal-hydroxide, and lithium ion. Small sealed lead batteries are also commonly used in emergency lighting and alarm systems. Annual consumption statistics for all types of batteries were provided. Results of the study showed that the primary battery market is expected to decline. Total units of secondary batteries are expected to increase to 38.6 million units by 2010. The report also used a spreadsheet model to estimate the flow of consumer batteries through the Canadian waste management system. An estimated 347 million consumer batteries were discarded in 2004. By 2010, it is expected that an estimated 494 million units will be discarded by consumers. The study also considered issues related to lead, cadmium, mercury, and nickel disposal and the potential for groundwater contamination. It was concluded that neither Canada nor its provinces or territories have initiated legislative or producer responsibility programs targeting primary or secondary consumer batteries. 79 refs., 37 tabs., 1 fig

  7. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg

    2009-10-01

    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  8. Designing a Pediatric Severe Sepsis Screening Tool

    Directory of Open Access Journals (Sweden)

    Robert eSepanski

    2014-06-01

    Full Text Available We sought to create a screening tool with improved predictive value for pediatric severe sepsis and septic shock that can be incorporated into the electronic medical record and actively screen all patients arriving at a pediatric Emergency Department (ED. Gold standard severe sepsis cases were identified using a combination of coded discharge diagnosis and physician chart review from 7,402 children who visited a pediatric ED over two months. The tool’s identification of severe sepsis was initially based on International Consensus Conference on Pediatric Sepsis (ICCPS parameters that were refined by an iterative, virtual process that allowed us to propose successive changes in sepsis detection parameters in order to optimize the tool’s predictive value based on receiver operating curve (ROC characteristics. Age-specific normal and abnormal values for heart rate (HR and respiratory rate (RR were empirically derived from 143,603 children seen in a second pediatric ED over three years. Univariate analyses were performed for each measure in the tool to assess its association with severe sepsis and to characterize it as an early or late indicator of severe sepsis. A split-sample was used to validate the final, optimized tool. The final tool incorporated age-specific thresholds for abnormal HR and RR and employed a linear temperature correction for each category. The final tool’s positive predictive value was 48.7%, a significant, nearly three-fold improvement over the original ICCPS tool. False positive Systemic Inflammatory Response Syndrome (SIRS identifications were nearly six-fold lower.

  9. The prospects for Canadian uranium

    International Nuclear Information System (INIS)

    The 1980s have seen a decline in markets for uranium concentrate, largely as a result of falling estimates for reactor fuel requirements and rising inventories. Spot market prices fell to $44 in September 1982, but have since risen back to $60. World production also fell in 1982 and is not expected to increase significantly before 1990. Some opportunities exist for Canadian producers with new low-cost deposits to replace high-cost producers in Canada and other countries, particularly the United States. There will be strong competition between Canadian producers as well as from Australia. Australia's reserves are somewhat larger than Canada's, although the reported ore grades tend to be lower than those of Saskatchewan

  10. Nelson Textbook of Pediatrics.

    Science.gov (United States)

    Pomerance, Herbert H

    1997-03-01

    The dedication of this volume states:To the physicians and nurses who care for children in many different circumstances throughout the world and who, by their efforts and commitment, make the world a better place for children.I have used the Nelson Textbook of Pediatrics since its third edition. It remains a source of amazement to me, as I witness the evolution of the book and of the knowledge that dictates its scope. From the days when a textbook was written by 1 or 2 authors, we have progressed to the point where this would be impossible. Three editors preside over this volume; they are also counted among the 212 contributors that lend special expertise to the work, continuing the volume as one of the traditions of pediatrics.The tremendous and rapid explosion in the amount of knowledge in pediatrics made a revision of the total material and even of.

  11. Pediatric nuclear medicine

    International Nuclear Information System (INIS)

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base

  12. Pediatric perspective on pharmacogenomics.

    Science.gov (United States)

    Stevens, Adam; De Leonibus, Chiara; Hanson, Daniel; Whatmore, Andrew; Murray, Philip; Donn, Rachelle; Meyer, Stefan; Chatelain, Pierre; Clayton, Peter

    2013-11-01

    The advances in high-throughput genomic technologies have improved the understanding of disease pathophysiology and have allowed a better characterization of drug response and toxicity based on individual genetic make up. Pharmacogenomics is being recognized as a valid approach used to identify patients who are more likely to respond to medication, or those in whom there is a high probability of developing severe adverse drug reactions. An increasing number of pharmacogenomic studies are being published, most include only adults. A few studies have shown the impact of pharmacogenomics in pediatrics, highlighting a key difference between children and adults, which is the contribution of developmental changes to therapeutic responses across different age groups. This review focuses on pharmacogenomic research in pediatrics, providing examples from common pediatric conditions and emphasizing their developmental context.

  13. Pediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  14. Pediatric nuclear cardiology

    International Nuclear Information System (INIS)

    Nuclear cardiology methods have had less impact upon pediatric cardiology than upon adult cardiology. Most pediatric heart disease results from congenital malformations of the heart and great vessels, which is usually discovered in infancy, and is most often treated definitively in infancy or early childhood. Unfortunately, nuclear medicine techniques are limited in their spatial resolution - structures that overlie each other are separated with difficulty. As a result, nuclear cardiology is usually of limited value in the anatomic characterization of the congenital heart abnormalities. Nevertheless, it has been useful in the detection and quantification of the pathophysiologic consequences of many congenital cardiac malformations. The authors review application of nuclear medicine in pediatric cardiology, and attempt to assess each in terms of its clinical utility

  15. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2014-11-01

    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  16. Exogenic poisoning in children assisted in a pediatric emergency unit Intoxicaciones exógenas en niños atendidos en una unidad de emergencia pediátrica Intoxicações exógenas em crianças atendidas em uma unidade de emergência pediátrica

    Directory of Open Access Journals (Sweden)

    Juliana Lourenço

    2008-01-01

    Full Text Available OBJECTIVE: To describe the epidemiological characteristics of all exogenic poisoning cases in children assisted in a pediatric emergency unit in Recife, State of Pernambuco, Brazil, from April to September 2006. METHODS: This is a descriptive study of exogenic poisoning in 0-12 aged children treated at Centro de Assistência Toxicológica de Pernambuco (Pernambuco Toxicological Assistance Center. The data were collected through interviews and by consulting patients' records. RESULTS: 26 cases of accidental exogenic poisoning were registered, mainly males (65.4%. Regarding age, children under five years old were the most affected (65.4%. Medication was involved in 50.0% of the cases. CONCLUSION: Accidental exogenic poisoning affecting children younger than five years of age stands out as a significant public health problem. As a member of a multiprofessional health team, the nurse plays an important role in health education and in the measures to prevent child poisoning.OBJETIVO: Describir las características epidemiológicas de los casos de intoxicaciones exógenas en niños atendidos en una unidad de emergencia pediátrica de Recife (PE, en el período de abril a setiembre del 2006. MÉTODOS: Se trata de un estudio descriptivo de los casos de intoxicaciones exógenas ocurridos en niños del grupo etáreo de 0 a 12 años de edad notificados en el Centro de Asistencia Toxicológica de Pernambuco. Los datos fueron recolectados a través de entrevistas y consultas a las fichas de atención hospitalaria. RESULTADOS: Fueron registrados 26 casos de intoxicación exógena accidental. Predominó el sexo masculino (65,4% siendo el grupo etáreo de menores de cinco años de edad el más afectado (65,4%. Los medicamentos estaban involucrados en el 50,0% de los casos. CONCLUSIÓN: La intoxicación exógena accidental de niños, sobre todo en menores de cinco años es un problema de salud pública que requiere medidas preventivas para evitar que ocurra en

  17. Exporting the Canadian licensing program

    International Nuclear Information System (INIS)

    This paper deals with the problems of an overseas regulatory agency in licensing a Canadian-supplied nuclear plant which is referenced to a plant in Canada. Firstly, the general problems associated with the use of a reference plant are discussed. This is followed by a discussion of specific problems which arise from the licensing practices in Canada. The paper concludes with recommendations to simplify the task of demonstrating the licensability of an overseas CANDU plant

  18. Congestion pricing of Canadian airports

    OpenAIRE

    Joseph I. Daniel

    2011-01-01

    Under congestion pricing, Canadian airports would annually save between $72 and $105 million. Social costs per landing and takeoff decrease about $300 at Toronto and Vancouver and $50 at Calgary and Montreal. Slot constraints fail to eliminate this airport congestion. Congestion prices are lower on average than existing weight-based prices. Current airport capacity accommodates at least five more years of traffic growth before congestion reaches current levels. Substantial welfare gains occur...

  19. Canadian Content in Video Games

    OpenAIRE

    Paul, Leonard

    2005-01-01

    THEME: Internationalism: Worlds at Play Topics: Internationalism, Identity in Gaming and Learning to Play Abstract: How does Canada fit into the global cultural context of video games? This paper investigates the culture being reflected in video games being produced in Canada as Canada is one of the world's leading producers of video games. It examines the how Canadian culture is represented in current new media artistic output against the culture, or lack of culture, being represented in vid...

  20. Providing cleaner air to Canadians

    International Nuclear Information System (INIS)

    This booklet is designed to explain salient aspects of the Ozone Annex, negotiated and signed recently by Canada and the United States, in a joint effort to improve air quality in North America. By significantly reducing the transboundary flows of air pollutants that cause smog, the Ozone Annex will benefit some 16 million people in central and eastern Canada and provide an example for a future round of negotiations to address concerns of the millions of Canadians and Americans who live in the border area between British Columbia and Washington State. The brochure provide summaries of the Canadian and American commitments, focusing on transportation, monitoring and reporting. The Ozone Annex complements other air quality initiatives by the Government of Canada enacted under the Environmental Protection Act, 1999. These measures include regulations to reduce sulphur content to 30 parts per million by Jan 1, 2005; proposing to restrict toxic particulate matter (PM) to less than 10 microns; establishing daily smog forecasts in the Maritimes and committing to a national program built upon existing smog advisories and forecasts in Quebec, Ontario and British Columbia; and investing in more clean air research through the newly created Canadian Foundation for Climate and Atmospheric Sciences

  1. Canadian fusion fuels technology project

    International Nuclear Information System (INIS)

    The Canadian Fusion Fuels Technology Project was launched in 1982 to coordinate Canada's provision of fusion fuels technology to international fusion power development programs. The project has a mandate to extend and adapt existing Canadian tritium technologies for use in international fusion power development programs. 1985-86 represents the fourth year of the first five-year term of the Canadian Fusion Fuels Technology Project (CFFTP). This reporting period coincides with an increasing trend in global fusion R and D to direct more effort towards the management of tritium. This has resulted in an increased linking of CFFTP activities and objectives with those of facilities abroad. In this way there has been a continuing achievement resulting from CFFTP efforts to have cooperative R and D and service activities with organizations abroad. All of this is aided by the cooperative international atmosphere within the fusion community. This report summarizes our past year and provides some highlights of the upcoming year 1986/87, which is the final year of the first five-year phase of the program. AECL (representing the Federal Government), the Ministry of Energy (representing Ontario) and Ontario Hydro, have given formal indication of their intent to continue with a second five-year program. Plans for the second phase will continue to emphasize tritium technology and remote handling

  2. Conference summaries. Canadian Nuclear Association 29. annual conference; Canadian Nuclear Society 10. annual conference

    International Nuclear Information System (INIS)

    Separate abstracts were prepared for 15 papers from the twenty-ninth Annual Conference of the Canadian Nuclear Association. Abstracts were also prepared for the 102 papers from the tenth Annual Conference of the Canadian Nuclear Society

  3. Pediatric Extranodal Lymphoma.

    Science.gov (United States)

    Chung, Ellen M; Pavio, Michael

    2016-07-01

    Lymphoma is the third most common pediatric neoplasm. Non-Hodgkin lymphoma (NHL) accounts for nearly half of cases and commonly involves extranodal sites. Compared with adults, this histologic spectrum of pediatric NHL is very narrow and consists of aggressive tumors. Patients typically present with widespread disease. Generally, NHL occurring in children includes Burkitt lymphoma, lymphoblastic lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma. Staging and assessment of therapeutic response are usually based on FDG-PET/CT. Due to the increased susceptibility of young patients to the effects of ionizing radiation, alternative methods of imaging are being explored. PMID:27265605

  4. Psychological issues in pediatric obesity

    Directory of Open Access Journals (Sweden)

    Gurvinder Kalra

    2012-01-01

    Full Text Available Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

  5. entering the postindustrial society: the canadian case

    OpenAIRE

    Matejko, Alexander J.

    1986-01-01

    abstract: the canadian federation is based on the substantial autonomy of the provinces constituting it, the welfare orientation of central bodies, the volunteer activities at the grass-root level, and the external policy open to the world. there are no any doubts about the genuinely democratic character of canadian internal politics or the commitment of canadians to the world peace. the economic prosperity of the country is secured by the mineral resources, good agriculture, and the intensiv...

  6. Environmental catalysis: the Canadian situation

    Energy Technology Data Exchange (ETDEWEB)

    Aye, T.; Christensen, D.; Gostick, J.; Mogharei, A.; Oskin, G. O.; Won, W.; Aida, T. [Waterloo Univ. ON (Canada)

    2000-10-01

    The Canadian situation with respect to research in environmental catalysis was investigated by analyzing catalysis papers appearing in the 1999 and 2000 issues of major journals devoted to research in catalysis (Journal of Catalysis; Catalysis Today; Applied Catalysis A: General and B: Environmental). A total of 2150 papers were surveyed; of these 34 were by Canadian authors, with Canada ranking twentieth in the world in terms of research in this field. About 40 per cent of the catalysis papers were related to the environment, with nitrogen and sulphur emissions being the most important topics and energy conversion second. Hydrodesulphurization of petroleum oil, use of low sulphur coal and flue gas desulphurization are the principal processes for controlling sulfur emissions into the air, while nitrogen oxides emissions in automobiles are ccontrolled bt three-way catalysts. In power generation, selective catalytic reduction is the preferred method, although not in Canada, where installing low-NOx burners or using low nitrogen fuels such as natural gas are favored. The control of volatile organic compounds is also a serious problem. The two most promising processes for the Canadian situation are adsorption by activated carbon and catalysis using low-temperature catalysts. Water treatment of textile mill effluents, a favorite topics by Canadian authors, includes photocatalytic oxidation with titanium oxide photocatalyst, ozonation with activated carbons and a combination of photocatalysis and biological treatment. Carbon dioxide conversion was also a favoured topic by Canadian researchers; not surprising in view if the fact that Canada is the highest per capita producer of carbon dioxide emissions. Nearly two-thirds of the carbon dioxide emissions is due to the transportation and energy production sectors, therefore, any carbon dioxide mitigation strategies should be applied initially in these areas. Catalytic conversion of carbon dioxide into methanol, which then

  7. What do we know about Canadian involvement in medical tourism? A scoping review

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Kingsbury, Paul

    2011-01-01

    Background Medical tourism, the intentional pursuit of elective medical treatments in foreign countries, is a rapidly growing global industry. Canadians are among those crossing international borders to seek out privately purchased medical care. Given Canada’s universally accessible, single-payer domestic health care system, important implications emerge from Canadians’ private engagement in medical tourism. Methods A scoping review was conducted of the popular, academic, and business literature to synthesize what is currently known about Canadian involvement in medical tourism. Of the 348 sources that were reviewed either partly or in full, 113 were ultimately included in the review. Results The review demonstrates that there is an extreme paucity of academic, empirical literature examining medical tourism in general or the Canadian context more specifically. Canadians are engaged with the medical tourism industry not just as patients but also as investors and business people. There have been a limited number of instances of Canadians having their medical tourism expenses reimbursed by the public medicare system. Wait times are by far the most heavily cited driver of Canadians’ involvement in medical tourism. However, despite its treatment as fact, there is no empirical research to support or contradict this point. Discussion Although medical tourism is often discussed in the Canadian context, a paucity of data on this practice complicates our understanding of its scope and impact. PMID:22046228

  8. Development of a Pediatric Fall Risk And Injury Reduction Program.

    Science.gov (United States)

    Kramlich, Debra L; Dende, Denise

    2016-01-01

    Fall prevention programs that include reliable, valid, and clinically tested screening tools have demonstrated more positive effects for adult and geriatric populations than those not including such assessment. In contrast, because falling is a natural part of growth and development for pediatric patients, progression toward effective prevention programs for this population has proven to be a challenge; a significant impediment is the lack of definition regarding what constitutes a reportable fall. This project explored pediatric health care providers' perceptions of patient falls in order to define a reportable pediatric fall and inform development of a prevention program. A concept analysis of defining attributes, antecedents, and consequences of pediatric falls from literature formed the basis for a set of questions; a convenience sample of 28 pediatric health care providers in an acute care hospital in New England participated in six moderated focus groups. Constant comparison method was used to code the qualitative data and develop themes. Participants unanimously agreed on several points; as expected, their years of experience in pediatric practice provided valuable insight. Three major themes emerged: patient characteristics, caregiver characteristics, and environmental characteristics. Based on factors identified by staff, a screening tool was adopted and integrated into the electronic medical record. Staff were actively engaged in developing definitions, selecting tools, and identifying next steps toward a comprehensive fall reduction program for their patients. As a result, they have embraced changes and advocated successfully for endorsement by the organization.

  9. [On the rehabilitation of pediatric burn patients in China].

    Science.gov (United States)

    Jia, Chi-yu

    2013-02-01

    Rehabilitation medicine is an emerging discipline. At present, there are many problems in rehabilitation of pediatric burn patients in China, including idea lag, weak technical force, lack of standardized technology, disunity in evaluation indexes, etc. The new era of reformation of health system and development and flourish of medical insurance business bring good opportunity for the development of rehabilitation medicine.

  10. Pediatric parechovirus infections

    NARCIS (Netherlands)

    Esposito, Susanna; Rahamat-Langendoen, Janette; Ascolese, Beatrice; Senatore, Laura; Castellazzi, Luca; Niesters, Hubert G. M.

    2014-01-01

    Human parechoviruses (HPeVs) are members of the large and growing family of Picornaviridae. Although 16 types have been described on the basis of the phylogenetic analyses of the VP1 encoding region, the majority of published reports relate to the HPeV types 1-8. In pediatrics, HPeV1, HPeV2 and HPeV

  11. Pediatric Low Vision

    Science.gov (United States)

    ... Asked Questions Español Condiciones Chinese Conditions Pediatric Low Vision What is Low Vision? Partial vision loss that cannot be corrected causes ... and play. What are the signs of Low Vision? Some signs of low vision include difficulty recognizing ...

  12. Pharmacotherapy of Pediatric Insomnia

    Science.gov (United States)

    Owens, Judith A.

    2009-01-01

    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos News Physician ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  14. Update on pediatric hyperhidrosis.

    Science.gov (United States)

    Gordon, Jennifer R S; Hill, Samantha E

    2013-01-01

    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications. PMID:24552408

  15. Pitfalls in pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Engelkemier, Dawn R. [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States); Kern Radiology, Bakersfield, CA (United States); Taylor, George A. [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2015-06-15

    This essay depicts some of the diagnostic errors identified in a large academic pediatric imaging department during a 13-year period. Our aim is to illustrate potential situations in which errors are more likely to occur and more likely to cause harm, and to share our difficult cases so other radiologists might learn without having to experience those situations themselves. (orig.)

  16. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  17. Pediatric brainstem oligodendroglioma

    Directory of Open Access Journals (Sweden)

    Sandeep Mohindra

    2012-01-01

    Full Text Available The authors present the first report of pediatric brainstem oligodendroglioma, infiltrating midbrain, and medulla oblongata. The report details clinical features, radiological findings, and surgical steps. As this entity is exceedingly uncommon, the overall epidemiology, prognosis, and long-term outcome remain far from established.

  18. Canadian digitization: radical beginning and pragmatic follow-on

    Science.gov (United States)

    Grant, Terrill K.

    2000-08-01

    The Canadian Army, like most Western armies, spent a lot of time soul-searching about the application of technology to its Command and Control processes during the height of the Cold War in the 70's and 80's. In the late 1980's, these efforts were formalized in a program called the Tactical Command, Control and Communications System (TCCCS). As envisioned, the project would replace in one revolutionary Big Bang all of the tactical communications employed in the Canadian field forces. It would also add significant capabilities such as a long range satellite communications system, a universal tactical e-mail system, and a command and control system for the commander and his staff from division to unit HQ. In 1989, the project was scaled back due to budgetary constraints by removing the divisional trunk communications system and the command and control system. At this point a contract was let to Computing Devices Canada for the core communications functionality. During the next 6 years, the Canadian Army expanded on this digitization effort by amending the contract to add in a trunk system and a situational awareness system. As well, in 1996, Computing Devices received a contract to develop and integrate a C2 system with the communications system thereby restoring the final two Cs of TCCCS. This paper discusses the architecture and implementation of the TCCCS as the revolutionary enabler of the Canadian Army's digitization effort for the early 2000 era. The choice of a hybrid approach of using commercial standards supplemented by appropriate NATO communications standards allowed for an easy addition of the trunk system. As well, conformance to the emerging NATO Communications architecture for Land Tactical Communications in the Post 2000 era will enhance interoperability with Canada's allies. The paper also discusses the pragmatic approach taken by the Canadian Army in inserting C2 functionally into TCCCS, and presents the ultimate architecture and functionality. This

  19. Literary Research and Canadian Literature: Strategies and Sources. Literary Research--Strategies and Sources #10

    Science.gov (United States)

    Reznowski, Gabriella

    2011-01-01

    Canada's rich literary heritage, dominated by a multicultural and multilingual presence, reflects the country's unique history and experience. In addition, an emerging body of new writers is redefining both the geographic and metaphorical boundaries of Canadian literature. Coupled with the propagation of digital technologies, Canada's burgeoning…

  20. Experimental Injury Biomechanics of the Pediatric Head and Brain

    Science.gov (United States)

    Margulies, Susan; Coats, Brittany

    Traumatic brain injury (TBI) is a leading cause of death and disability among children and young adults in the United States and results in over 2,500 childhood deaths, 37,000 hospitalizations, and 435,000 emergency department visits each year (Langlois et al. 2004). Computational models of the head have proven to be powerful tools to help us understand mechanisms of adult TBI and to determine load thresholds for injuries specific to adult TBI. Similar models need to be developed for children and young adults to identify age-specific mechanisms and injury tolerances appropriate for children and young adults. The reliability of these tools, however, depends heavily on the availability of pediatric tissue material property data. To date the majority of material and structural properties used in pediatric computer models have been scaled from adult human data. Studies have shown significant age-related differences in brain and skull properties (Prange and Margulies 2002; Coats and Margulies 2006a, b), indicating that the pediatric head cannot be modeled as a miniature adult head, and pediatric computer models incorporating age-specific data are necessary to accurately mimic the pediatric head response to impact or rotation. This chapter details the developmental changes of the pediatric head and summarizes human pediatric properties currently available in the literature. Because there is a paucity of human pediatric data, material properties derived from animal tissue are also presented to demonstrate possible age-related differences in the heterogeneity and rate dependence of tissue properties. The chapter is divided into three main sections: (1) brain, meninges, and cerebral spinal fluid (CSF); (2) skull; and (3) scalp.

  1. An Examination of Charitable Meal Programs in Five Canadian cities.

    Science.gov (United States)

    Pettes, Tyler; Dachner, Naomi; Gaetz, Stephen; Tarasuk, Valerie

    2016-01-01

    While there has recently been considerable research and public investment in strategies to address homelessness in Canada, food charity remains the primary response to hunger, with little evaluation of current efforts and no initiatives to develop more effective approaches. Using data from a 2010-2011 survey of charitable food assistance in five Canadian cities, this study was undertaken to describe charitable meal provisioning in each city and to compare the relative roles of emergency programs and multi-service agencies and their capacity to meet food needs. Most meals were provided by multi-service agencies, but like emergency programs, these agencies were heavily dependent on donations and they were more likely than emergency programs to report constraints and service interruptions because demands exceeded available supplies. Our findings underscore the resource-limited and often fragile nature of charitable meal programs in Canada and highlight the need for more effective models of response to problems of hunger. PMID:27524769

  2. REGIONAL CHARACTERISTICS OF CANADIAN ENGLISH

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Modern English is an international language inthe world.Besides Great Britain,English is spokenas first language in 39 countries.These countries arelocated in different regions with different naturalfeatures,history development and cultural character-istics.Thus,English used in these different regionscarries its own regional character—forming Englishregional varieties.The main English regional varieties are:BritishEnglish,American English,Canadian English andSouth African English.Canada is a rich country inNorth America with its own characteristics,which of

  3. Theoretical Analysis of Canadian Lifelong Education Development

    Directory of Open Access Journals (Sweden)

    Mukan Natalia

    2014-12-01

    Full Text Available In the article, the problem of Canadian lifelong education development has been studied. The main objectives of the article are defined as theoretical analysis of scientific and pedagogical literature which highlights different aspects of the research problem; periods of lifelong education development; and determination of lifelong learning role and importance in modern Canadian society.

  4. Rural Canadian Youth Exposed to Physical Violence

    Science.gov (United States)

    Laye, Adele M.; Mykota, David B.

    2014-01-01

    Exposure to physical violence is an unfortunate reality for many Canadian youth as it is associated with numerous negative psychosocial effects. The study aims to assist in understanding resilience in rural Canadian youth exposed to physical violence. This is accomplished by identifying the importance of protective factors, as measured by the…

  5. The Canadian Hospital Executive Simulation System (CHESS).

    Science.gov (United States)

    Pink, G H; Knotts, U A; Parrish, L G; Shields, C A

    1991-01-01

    The Canadian Hospital Executive Simulation System (CHESS) is a computer-based management decision-making game designed specifically for Canadian hospital managers. The paper begins with an introduction on the development of business and health services industry-specific simulation games. An overview of CHESS is provided, along with a description of its development and a discussion of its educational benefits. PMID:10109530

  6. DATA MINING IN CANADIAN LYNX TIME SERIES

    Directory of Open Access Journals (Sweden)

    R.Karnaboopathy

    2012-01-01

    Full Text Available This paper sums up the applications of Statistical model such as ARIMA family timeseries models in Canadian lynx data time series analysis and introduces the method of datamining combined with Statistical knowledge to analysis Canadian lynx data series.

  7. Canadian biodosimetry capacity for response to radiation emergencies

    International Nuclear Information System (INIS)

    In December 2001, Canada's response to the international political climate was launched by the creation of the Chemical, Biological, Radiological/Nuclear Research and Technology Initiative (CRTI). The National Biological Dosimetry Response Plan (NBDRP), established through partnering the expertise of three federal departments and one university, was created in response to this initiative. The NBDRP objectives were to develop a network of laboratories with expertise to perform biological dosimetry by cytogenetics and to investigate new technologies that may be applicable in the development of the new biodosimetry program. Since the creation of the NBDRP, Canada has made significant progress in enhancing expertise and resources to be better prepared for radiological/nuclear events. Through participation in exercises, the existing capacities were tested and recommendations for improvements were made. This paper describes the results from two exercises. The first exercise was designed to test the culturing, analysis, and reporting procedures within a single laboratory, and the second exercise was intended to test the capacity of the NBDRP. Future exercises will further challenge the network resulting in an improved national response capability

  8. Pediatric neurocysticercosis: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Singhi P

    2016-03-01

    Full Text Available Pratibha Singhi, Arushi Gahlot SainiDepartment of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaAbstract: Neurocysticercosis (NCC is an acquired infection of the nervous system caused by encysted larvae of Taenia solium. It is a major cause of epilepsy in the tropics and the commonest cause of focal seizures in North Indian children. T. solium teniasis-cysticercosis is considered a parasitic “Neglected Tropical Diseases” endemic throughout Southeast Asia. NCC in children has pleomorphic manifestations depending on the location, number and viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.Keywords: neurocysticercosis, children, epilepsy, ring enhancing lesions, pigs

  9. Medical cannabis – the Canadian perspective

    Science.gov (United States)

    Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M

    2016-01-01

    Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts. PMID:27757048

  10. Chronic kidney disease - pediatric risk factors.

    Science.gov (United States)

    Tasic, Velibor; Janchevska, Aleksandra; Emini, Nora; Sahpazova, Emilija; Gucev, Zoran; Polenakovic, Momir

    2016-01-01

    The knowledge about the progression of chronic kidney disease is an important issue for every pediatric nephrologist and pediatrician in order to implement appropriate measures to prevent wasting of renal function and the final consequence - end stage renal disease with the need for the dialysis and transplantation. Therefore it is important to know, treat or ameliorate the standard risk factors such as hypertension, proteinuria, anemia, hyperparathyroidism etc. In this review devoted to the World Kidney Day 2016 we will pay attention to the low birth parameters, obesity, hyperuricemia and smoking which emerged as particularly important risk factors for children and adolescent with chronic kidney disease. PMID:27442412

  11. What Is a Pediatric Infectious Diseases Specialist?

    Science.gov (United States)

    ... Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If your child ... teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists are medical ...

  12. What Is a Pediatric Sports Medicine Specialist?

    Science.gov (United States)

    ... Size Email Print Share What is a Pediatric Sports Medicine Specialist? Page Content Article Body If your ... and teens. What Kind of Training Do Pediatric Sports Medicine Specialists Have? Pediatric sports medicine specialists are ...

  13. Resuscitation of a Pediatric Drowning in Hypothermic Cardiac Arrest.

    Science.gov (United States)

    Dragann, Brendan N; Melnychuk, Eric M; Wilson, Christopher J; Lambert, Richard L; Maffei, Frank A

    2016-01-01

    The prognosis of pediatric patients who require prolonged resuscitation after ice water drowning and hypothermic cardiac arrest remains guarded. We report a case of successful prolonged resuscitation of a pediatric patient in hypothermic cardiac arrest who showed severe metabolic derangements and went on to make a rapid and full neurologic recovery without the use of extracoproreal rewarming or mechanical cardiac support. Many ground and air medical emergency medical service programs have policies against interfacility transfer of patients in hypothermic cardiac arrest, calling into question the need to revise current protocols. PMID:27021675

  14. Advances in Imaging of the Pediatric Pituitary Gland.

    Science.gov (United States)

    Bou-Ayache, Jad M; Delman, Bradley N

    2016-06-01

    High-resolution MRI of the pediatric sella can help identity or confirm clinical abnormalities, assess pituitary gland size and structure, and reveal acquired lesions. This article reviews contemporary techniques for imaging of the sella and associated structures in this population. Strengths and weaknesses of conventional imaging are discussed, as are techniques that can enhance yield. Some new and emerging technologies are discussed, including MR elastography, perfusion imaging, spectroscopy, and diffusion-weighted and diffusion-tensor imaging. It is expected that this overview will provide insight as to where pediatric sella imaging is currently and where it may head in the future. PMID:27241974

  15. Pediatric robotic urologic surgery-2014.

    Science.gov (United States)

    Kearns, James T; Gundeti, Mohan S

    2014-07-01

    We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide. PMID:25197187

  16. Current use of intraosseous infusion in Danish emergency departments: a cross-sectional study

    DEFF Research Database (Denmark)

    Molin, Rune; Hallas, Peter; Brabrand, Mikkel;

    2010-01-01

    Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs).......Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs)....

  17. Lung Emergencies

    Science.gov (United States)

    ... Emergencies Cardiac Emergencies Eye Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at ... should be considered an emergency. Symptoms of sudden lung collapse (pneumothorax) Symptoms of a sudden lung collapse ...

  18. Pediatric imaging. Rapid fire questions and answers

    Energy Technology Data Exchange (ETDEWEB)

    Quattromani, F.; Lampe, R. (eds.) [Texas Tech Univ. Health Sciences Center, School of Medicine, Lubbock, TX (United States); Handal, G.A. [Texas Tech Univ. Health Sciences Center, School of Medicine, El Paso, TX (United States)

    2008-07-01

    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies.

  19. Metachronous contralateral pediatric inguinal hernia

    OpenAIRE

    Mahomed, Anies

    2010-01-01

    RM Nataraja, AA MahomedDepartment of Pediatric Surgery and Urology, Royal Alexandra Children’s Hospital, Brighton, UKDate of preparation: April 20, 2010. Conflict of interest: None declaredClinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia?Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4% in both genders. Sixteen contralateral groin explorations n...

  20. Benign Pediatric Salivary Gland Lesions.

    Science.gov (United States)

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions.

  1. Psychological issues in pediatric obesity

    OpenAIRE

    Gurvinder Kalra; Avinash De Sousa; Sushma Sonavane; Nilesh Shah

    2012-01-01

    Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the...

  2. Hippocrates on Pediatric Dermatology.

    Science.gov (United States)

    Sgantzos, Markos; Tsoucalas, Gregory; Karamanou, Marianna; Giatsiou, Styliani; Tsoukalas, Ioannis; Androutsos, George

    2015-01-01

    Hippocrates of Kos is well known in medicine, but his contributions to pediatric dermatology have not previously been examined. A systematic study of Corpus Hippocraticum was undertaken to document references of clinical and historical importance of pediatric dermatology. In Corpus Hippocraticum, a variety of skin diseases are described, along with proposed treatments. Hippocrates rejected the theory of the punishment of the Greek gods and supported the concept that dermatologic diseases resulted from a loss of balance in the body humors. Many of the terms that Hippocrates and his pupils used are still being used today. Moreover, he probably provided one of the first descriptions of skin findings in smallpox, Henoch-Schönlein purpura (also known as anaphylactoid purpura, purpura rheumatica, allergic purpura), and meningococcal septicemia. PMID:26058689

  3. Acupuncture for Pediatric Pain

    Directory of Open Access Journals (Sweden)

    Brenda Golianu

    2014-08-01

    Full Text Available Chronic pain is a growing problem in children, with prevalence as high as 30.8%. Acupuncture has been found to be useful in many chronic pain conditions, and may be of clinical value in a multidisciplinary treatment program. The basic principles of acupuncture are reviewed, as well as studies exploring basic mechanisms of acupuncture and clinical efficacy. Conditions commonly treated in the pediatric pain clinic, including headache, abdominal pain, fibromyalgia, juvenile arthritis, complex regional pain syndrome, cancer pain, as well as perioperative pain studies are reviewed and discussed. Areas in need of further research are identified, and procedural aspects of acupuncture practice and safety studies are reviewed. Acupuncture can be an effective adjuvant in the care of pediatric patients with painful conditions, both in a chronic and an acute setting. Further studies, including randomized controlled trials, as well as trials of comparative effectiveness are needed.

  4. Helicobacter pylori in pediatrics.

    Science.gov (United States)

    Homan, Matjaž; Hojsak, Iva; Kolaček, Sanja

    2012-09-01

    This review summarizes important pediatric studies published from April 2011 up to March 2012. Proteomics profile of ulcerogenic Helicobacter pylori strains was defined in the most interesting study of the last year. The antigen stool test is becoming the "gold standard" in prevalence studies, and according to the last epidemiologic studies, the prevalence of H. pylori infection in childhood is not decreasing any more in the developed world. The resistance rate of H. pylori strains is high in children. Therefore, among other important issues concerning H. pylori in pediatrics, guidelines published by ESPGHAN and NASPGHAN last year also recommended culture and susceptibility testing before first-line treatment in areas with high or unknown antibiotic resistance rates.

  5. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

    Science.gov (United States)

    Galli, Luisa; Lancella, Laura; Tersigni, Chiara; Venturini, Elisabetta; Chiappini, Elena; Bergamini, Barbara Maria; Codifava, Margherita; Venturelli, Cristina; Tosetti, Giulia; Marabotto, Caterina; Cursi, Laura; Boccuzzi, Elena; Garazzino, Silvia; Tovo, Pier Angelo; Pinon, Michele; Le Serre, Daniele; Castiglioni, Laura; Lo Vecchio, Andrea; Guarino, Alfredo; Bruzzese, Eugenia; Losurdo, Giuseppe; Castagnola, Elio; Bossi, Grazia; Marseglia, Gian Luigi; Esposito, Susanna; Bosis, Samantha; Grandolfo, Rita; Fiorito, Valentina; Valentini, Piero; Buonsenso, Danilo; Domenici, Raffaele; Montesanti, Marco; Salvini, Filippo Maria; Riva, Enrica; Dodi, Icilio; Maschio, Francesca; Abbagnato, Luisa; Fiumana, Elisa; Fornabaio, Chiara; Ballista, Patrizia; Portelli, Vincenzo; Bottone, Gabriella; Palladino, Nicola; Valenzise, Mariella; Vecchi, Barbara; Di Gangi, Maria; Lupi, Carla; Villani, Alberto; de Martino, Maurizio

    2016-01-01

    Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries. PMID:27322255

  6. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

    Directory of Open Access Journals (Sweden)

    Luisa Galli

    2016-06-01

    Full Text Available Tuberculosis (TB is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1% children had active TB, 594 (14.0% latent TB and 3086 (72.9% were uninfected. Among children with active TB, 481 (86.8% patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534 of the cases. Overall, 210 (39.3% out of these 534 children were treated with three and 216 (40.4% with four first-line drugs. Second-line drugs where used in 87 (16.3% children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7% children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

  7. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis.

    Science.gov (United States)

    Galli, Luisa; Lancella, Laura; Tersigni, Chiara; Venturini, Elisabetta; Chiappini, Elena; Bergamini, Barbara Maria; Codifava, Margherita; Venturelli, Cristina; Tosetti, Giulia; Marabotto, Caterina; Cursi, Laura; Boccuzzi, Elena; Garazzino, Silvia; Tovo, Pier Angelo; Pinon, Michele; Le Serre, Daniele; Castiglioni, Laura; Lo Vecchio, Andrea; Guarino, Alfredo; Bruzzese, Eugenia; Losurdo, Giuseppe; Castagnola, Elio; Bossi, Grazia; Marseglia, Gian Luigi; Esposito, Susanna; Bosis, Samantha; Grandolfo, Rita; Fiorito, Valentina; Valentini, Piero; Buonsenso, Danilo; Domenici, Raffaele; Montesanti, Marco; Salvini, Filippo Maria; Riva, Enrica; Dodi, Icilio; Maschio, Francesca; Abbagnato, Luisa; Fiumana, Elisa; Fornabaio, Chiara; Ballista, Patrizia; Portelli, Vincenzo; Bottone, Gabriella; Palladino, Nicola; Valenzise, Mariella; Vecchi, Barbara; Di Gangi, Maria; Lupi, Carla; Villani, Alberto; de Martino, Maurizio

    2016-01-01

    Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries. PMID:27322255

  8. Pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Poussaint, Tina Y. [Department of Radiology, Boston, MA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Huisman, Thierry A.G.M. [Charlotte R. Bloomberg Children' s Center, Johns Hopkins Hospital, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD (United States)

    2015-09-15

    Among all causes of death in children from solid tumors, pediatric brain tumors are the most common. This article includes an overview of a subset of infratentorial and supratentorial tumors with a focus on tumor imaging features and molecular advances and treatments of these tumors. Key to understanding the imaging features of brain tumors is a firm grasp of other disease processes that can mimic tumor on imaging. We also review imaging features of a common subset of tumor mimics. (orig.)

  9. Pediatric Burn Resuscitation.

    Science.gov (United States)

    Palmieri, Tina L

    2016-10-01

    Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management. PMID:27600126

  10. Pediatric cerebral artery aneurysms

    OpenAIRE

    Koroknay-Pál, PÀivi

    2012-01-01

    Objectives. Intracranial aneurysms in children are rare and population-based long-term follow-up studies are limited. In this study, a large clinical and angiographic long-term follow-up was carried out. The special characteristics of the patients and their aneurysms were assessed together with factors affecting early and long-term morbidity and mortality. Materials and Methods. All pediatric (≀18 years) aneurysm patients treated at the Department of Neurosurgery in Helsinki during 193...

  11. Pediatric palliative care

    Directory of Open Access Journals (Sweden)

    Trapanotto Manuela

    2008-12-01

    Full Text Available Abstract The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pediatric patients experience all the clinical, psychological, ethical and spiritual problems that severe, irreversible disease and death entail. The international literature indicates a prevalence of incurable disease annually affecting 10/10,000 young people from 0 to 19 years old, with an annual mortality rate of 1/10,000 young people from birth to 17 years old. The needs of this category of patients, recorded in investigations conducted in various parts of the world, reveal much the same picture despite geographical, cultural, organizational and social differences, particularly as concerns their wish to be treated at home and the demand for better communications between the professionals involved in their care and a greater availability of support services. Different patient care models have been tested in Italy and abroad, two of institutional type (with children staying in hospitals for treating acute disease or in pediatric hospices and two based at home (the so-called home-based hospitalization and integrated home-based care programs. Professional expertise, training, research and organization provide the essential foundations for coping with a situation that is all too often underestimated and neglected.

  12. Acupuncture for Pediatric Pain

    OpenAIRE

    Brenda Golianu; Ann Ming Yeh; Meredith Brooks

    2014-01-01

    Chronic pain is a growing problem in children, with prevalence as high as 30.8%. Acupuncture has been found to be useful in many chronic pain conditions, and may be of clinical value in a multidisciplinary treatment program. The basic principles of acupuncture are reviewed, as well as studies exploring basic mechanisms of acupuncture and clinical efficacy. Conditions commonly treated in the pediatric pain clinic, including headache, abdominal pain, fibromyalgia, juvenile arthritis, complex re...

  13. Introduction to pediatric oncology

    Energy Technology Data Exchange (ETDEWEB)

    McWhirter, W.R.; Masel, J.P.

    1987-01-01

    This book covers the varied and complex aspects of management in pediatric oncology. Emphasis is placed on a team approach and on establishing and maintaining an individualized, humanistic relationships with the patient. Numerous illustrations show modern imaging techniques that are proving most valuable in the investigation of suspected or confirmed childhood cancer. Physical and psychological side effects of short-term and long-term treatment are also discussed.

  14. Pediatric salivary gland imaging

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Zachary T. [University of Missouri-Kansas City School of Medicine, Kansas City, MO (United States); Goud, Asha R. [University of California Irvine Medical Center, Department of Radiology, Orange, CA (United States); Lowe, Lisa H. [Children' s Mercy Hospitals and Clinics and the University of Missouri-Kansas City, Department of Radiology, Kansas City, MO (United States); Shao, Lei [Children' s Mercy Hospitals and Clinics and the University of Missouri-Kansas City, Department of Pathology, Kansas City, MO (United States)

    2009-07-15

    A variety of lesions occur in the pediatric salivary glands. With modern imaging techniques such as Doppler sonography, helical CT, and MRI, identification of a specific etiology is often possible. Knowledge of clinical information, normal anatomy, and imaging characteristics of salivary gland pathology are essential for appropriate radiologic evaluation. This review illustrates the various congenital, neoplastic, and inflammatory entities that can occur within the parotid, submandibular, and sublingual spaces. (orig.)

  15. Pediatric transesophageal echocardiography

    OpenAIRE

    Stümper, Oliver

    1991-01-01

    textabstractIn face of several limitations of precordial ultrasound investigations in children with congenital heart disease, it was attempted to defme the additional value of pediatric transesophageal echocardiography. Its comparative value, firstly, in the preoperative diagnosis of congenital heart disease had to be determined (Chapters 4-8), secondly, its place as an intraoperative monitoring technique in the surgery of congenital heart disease had to be assessed (Chapter 9), and thirdly, ...

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  17. Moral Dilemmas in Pediatric Orthopedics.

    Science.gov (United States)

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y

    2015-12-01

    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result.

  18. Primary pediatric gastrointestinal lymphoma

    Directory of Open Access Journals (Sweden)

    Ranjana Bandyopadhyay

    2011-01-01

    Full Text Available Background: Primary non-Hodgkin′s lymphoma (NHL of the gastrointestinal (GI tract is the most common extranodal lymphoma in pediatric age group. Yet, the overall incidence is very low. The rarity of the disease as well as variable clinical presentation prevents early detection when the possibility of cure exists. Materials and Methods: We studied six cases of primary GI NHL in pediatric age group with reference to their clinical presentation, anatomic distribution and histopathologic characteristics. Results: All were males except one. Intestinal obstruction was the presenting feature in 50%. Half the cases showed ileocaecal involvement, while large bowel was involved in 16%. Histology showed four cases of diffuse large B-cell lymphoma (DLBCL, one case of Burkitt lymphoma, and one Burkitt-like lymphoma. Immunohistochemistry for Tdt, CD20, CD3, CD30, bcl2, bcl6 confirmed the morphological diagnosis. Conclusion: Pediatric GI lymphoma commonly involves the ileocaecal region and presents with intestinal obstruction. A higher prevalence of DLBCL is found compared to other series. A high proliferative index is useful in differentiating Burkitt-like lymphoma from DLBCL.

  19. [Pediatric neurology in rehabilitation].

    Science.gov (United States)

    Kurihara, Mana

    2007-07-01

    There are some criteria for administering pediatric rehabilitation, such as (1) plasticity of the child's brain sometimes plays an enormous roles in recovery, (2) on the other hand, break-down of the child's brain is sometimes worse than expected, (3) rehabilitation should be continued with the prospect that child grows and develops everyday, (4) family members should join their child's rehabilitation. The team approach is very effective for pediatric rehabilitation. The pediatric neurologist will be one of the best members of the team because he/she can manage a disabled child and his/her family members well, and is familiar with a normal child's development. Rehabilitation should be performed appropriates, which means that the child is evaluated first, a rehabilitation program is developed and rehabilitation is implemented. The World Health Organization published the International Classification of Functioning, Disability and Health (ICF), which moves away from being a "consequence of disease" classification to "components of health". The concept of disability is changing.

  20. Tissue Engineering for the Neonatal and Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Amulya K. Saxena

    2012-01-01

    Full Text Available Of all the surgical specialties, the remit of the pediatric surgeon encompasses the widest range of organ systems and includes disorders from the fetus to the adolescent. As such, the recent emergence of tissue engineering is of particular interest to the pediatric surgical community. The individual challenges of tissue engineering depend largely on the nature and function of the target tissue. In general, the main issues currently under investigation include the sourcing of an appropriate cell source, design of biomaterials for guided tissue growth, provision of a biomolecular stimulus to enhance cellular functions and the development of bioreactors to allow for prolonged periods of cell culture under specific physiological conditions. This review aims to provide a general overview of tissue engineering in the major organ systems, including the cardiovascular, digestive, urinary, respiratory, musculoskeletal, nervous, integumentary and lymphatic systems. Special attention is paid to pediatrics as well as recent clinical applications.

  1. Colonial Fantasies, Narrative Borders, and the Canadian North in the Works of Germany's Colin Ross(1885-1945

    Directory of Open Access Journals (Sweden)

    Nicole Pissowotzki

    2009-03-01

    Full Text Available This paper argues that the Canadian North is a discursive construction, within which German colonial fantasies emerge. In particular, I argue that it is through bordering that colonial fantasies of German Lebensraum ("living space" in the Canadian North are brought into being. I further argue that the German biologist and geographer Friedrich Ratzel (1844-1904, with his view of the "organic state," provides the ideological framework for colonial fantasies in the travel writings of Colin Ross.I focus on the writer's colonial imagination and his perception of borders, and on how both relate to the Canadian North. I show that seemingly bare geographical information and demographical data, provided in Ross' travelogues, carry colonial fantasies of German spaces in the Canadian North. Those spaces are bordered by "shared histories" and "narrative boundaries," thus constructing a collective German colonial identity (cf. Eder 2006, 255-257.

  2. Humanitarian power : Canadian electrical techies help hurricane relief in Honduras

    International Nuclear Information System (INIS)

    A review of the emergency assistance provided to Honduras by Canada following Hurricane Mitch that struck the country with a ferocity not seen in 200 years, was described. Thousands of Hondurans were killed and three million were left homeless as vast regions of the country were literally washed away. The secondary effects of the storm - famine and disease - set in to claim even more lives. The Canadian Forces' Disaster Response Team (DART) was dispatched to conduct emergency relief operations for up to 40 days in order to bridge the gap until members of the international community arrive to provide long-term help. DART focused on providing medical care, clean drinking water, an engineering capability, and reliable communications. The medical team consisting of a small field hospital with a staff of 45 provided care for up to 500 outpatients and 30 inpatients daily, depending on the severity of injuries. The engineering team of about 40 provided a wide range of services, such as water purification, using a reverse osmosis water purification unit, fresh water distribution and power generation. The communications unit provided contact with headquarters in Honduras, and communicated with bases back in Canada. The operation was a great success, and well received by the Honduran people. This was the first deployment of DART, a team initially conceived after the Canadian Forces participated in relief efforts in Rwanda in 1994 and 1995

  3. Humanitarian power : Canadian electrical techies help hurricane relief in Honduras

    Energy Technology Data Exchange (ETDEWEB)

    Mallett, N.

    1999-04-01

    A review of the emergency assistance provided to Honduras by Canada following Hurricane Mitch that struck the country with a ferocity not seen in 200 years, was described. Thousands of Hondurans were killed and three million were left homeless as vast regions of the country were literally washed away. The secondary effects of the storm - famine and disease - set in to claim even more lives. The Canadian Forces` Disaster Response Team (DART) was dispatched to conduct emergency relief operations for up to 40 days in order to bridge the gap until members of the international community arrive to provide long-term help. DART focused on providing medical care, clean drinking water, an engineering capability, and reliable communications. The medical team consisting of a small field hospital with a staff of 45 provided care for up to 500 outpatients and 30 inpatients daily, depending on the severity of injuries. The engineering team of about 40 provided a wide range of services, such as water purification, using a reverse osmosis water purification unit, fresh water distribution and power generation. The communications unit provided contact with headquarters in Honduras, and communicated with bases back in Canada. The operation was a great success, and well received by the Honduran people. This was the first deployment of DART, a team initially conceived after the Canadian Forces participated in relief efforts in Rwanda in 1994 and 1995.

  4. Challenging issues in pediatric oncology

    Science.gov (United States)

    Pui, Ching-Hon; Gajjar, Amar J.; Kane, Javier R.; Qaddoumi, Ibrahim A.; Pappo, Alberto S.

    2011-01-01

    Improvements in protocol-driven clinical trials and supportive care for children and adolescents with cancer have reduced mortality rates by more than 50% over the past three decades. Overall, the 5-year survival rate for pediatric cancer patients has increased to approximately 80%. Recognition of the biological heterogeneity within specific subtypes of cancer, the discovery of genetic lesions that drive malignant transformation and cancer progression, and improved understanding of the basis of drug resistance will undoubtedly catalyze further advances in risk-directed treatments and the development of targeted therapies, boosting the cure rates further. Emerging new treatments include novel formulations of existing chemotherapeutic agents, monoclonal antibodies against cancer-associated antigens, and molecular therapies that target genetic lesions and their associated signaling pathways. Recent findings that link pharmacogenomic variations with drug exposure, adverse effects, and efficacy should accelerate efforts to develop personalized therapy for individual patients. Finally, palliative care should be included as an essential part of cancer management to prevent and relieve the suffering and to improve the quality of life of patients and their families. PMID:21709698

  5. Drug repurposing in pediatrics and pediatric hematology oncology.

    Science.gov (United States)

    Blatt, Julie; Corey, Seth J

    2013-01-01

    Drug 'repurposing', that is, using old drugs for new indications, has been proposed as a more efficient strategy for drug development than the current standard of beginning with novel agents. In this review, we explore the scope of drug repurposing in pediatric hematology oncology and in pediatrics in general. Drugs commonly used in children were identified using the Harriet Lane Handbook (HLH) and searched in PubMed for different uses. Additional drugs were identified by searching PubMed and Google.com for 'drug repurposing' or 'drug repositioning'. Almost 10% of drugs with primary uses in pediatrics have been repurposed in pediatric hematology oncology or pediatrics. The observant clinician, pharmacologist and translational bioinformatician, as well as structural targeting, will have a role in discovering new repurposing opportunities.

  6. A perspective on Canadian shale gas

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Mike; Davidson, Jim; Mortensen, Paul

    2010-09-15

    In a relatively new development over just the past few years, shale formations are being targeted for natural gas production. Based on initial results, there may be significant potential for shale gas in various regions of Canada, not only in traditional areas of conventional production but also non-traditional areas. However, there is much uncertainty because most Canadian shale gas production is currently in experimental or early developmental stages. Thus, its full potential will not be known for some time. If exploitation proves to be successful, Canadian shale gas may partially offset projected long-term declines in Canadian conventional natural gas production.

  7. Tritium technology. A Canadian overview

    International Nuclear Information System (INIS)

    An overview of the various tritium research and operational activities in Canada is presented. These activities encompass tritium processing and recovery, tritium interactions with materials, and tritium health and safety. Many of these on-going activities form a sound basis for the tritium use and handling aspects of the ITER project. Tritium management within the CANDU heavy water reactor, associated detritiation facilities, research and development facilities, and commercial industry and improving the understanding of tritium behaviour in humans and the environment remain the focus of a long-standing Canadian interest in tritium. While there have been changes in the application of this knowledge and experience over time, the operating experience and the supporting research and development continue to provide for improved plant and facility operations, an improved understanding of tritium safety issues, and improved products and tools that facilitate tritium management. (author)

  8. THE CANADIAN POLITICAL BUSINESS CYCLE

    Directory of Open Access Journals (Sweden)

    Barbara Libby

    2000-01-01

    Full Text Available This paper will discuss the existence of a Canadian Political Business Cycle (PBC during the period 1946-1989. Logit analysis was used to determine if changes in the unemployment rate, growth of real GNE and the rate of inflation are significantly different in the period before an election than during the rest of the electoral term. It was found that the rate of growth in the unemployment rate declines and the rate of growth of real GNP increases in the four quarters before an election. The behavior of these variables reverses in the period after an election. These findings are consistent with a political business cycle. Policy variables, under a majority government, also behave in a manner associated with a PBC, with the government stimulating the economy approximately two years into its term so that good economic news will occur before it has to call an election. Minority governments tend to simulate the economy immediately after taking office.

  9. Chinese Feelings Cherished By Canadians

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>On March 30, "The Chinese Feelings Across the Pacific-The Century Exhibition of the Old Photos Treasured by the Canadians" was open in the Lu Xun Museum in Beijing. The exhibition lasted for one week. At the exhibition some old photos taken in the early 20th century were on display, showing James G. Endicott, envoy of world peace, together with Mao Zedong and Zhou Enlai; the family of O. L. Kilborn, one of the founders of West China Union University, together with Chinese women with bound feet: O. L. Kilborn treating the wounded soldiers during the Revolution of 1911; Leslie Earl Willmott in Chinese tunic suit and his wife reluctant to bid farewell to China, as well as photos of Ashley Woodward Lindesay, founder of China’s modern

  10. Tritium technology. A Canadian overview

    Energy Technology Data Exchange (ETDEWEB)

    Hemmings, R.L. [Canatom NPM (Canada)

    2002-10-01

    An overview of the various tritium research and operational activities in Canada is presented. These activities encompass tritium processing and recovery, tritium interactions with materials, and tritium health and safety. Many of these on-going activities form a sound basis for the tritium use and handling aspects of the ITER project. Tritium management within the CANDU heavy water reactor, associated detritiation facilities, research and development facilities, and commercial industry and improving the understanding of tritium behaviour in humans and the environment remain the focus of a long-standing Canadian interest in tritium. While there have been changes in the application of this knowledge and experience over time, the operating experience and the supporting research and development continue to provide for improved plant and facility operations, an improved understanding of tritium safety issues, and improved products and tools that facilitate tritium management. (author)

  11. Terrorism threats and preparedness in Canada: the perspective of the Canadian public.

    Science.gov (United States)

    Gibson, Stacey; Lemyre, Louise; Clément, Mélanie; Markon, Marie-Pierre L; Lee, Jennifer E C

    2007-06-01

    Although Canada has not experienced a major terrorist attack, an increased global pending threat has put preparedness at the top of the Canadian government's agenda. Given its strong multicultural community and close proximity to the recently targeted United States, the Canadian experience is unique. However, minimal research exists on the public's reactions to terrorism threats and related preparedness strategies. In order for response initiatives to be optimally effective, it is important that the public's opinions regarding terrorism and preparedness be considered. This qualitative study examined perceptions of terrorism threats among Canadians living in Central and Eastern Canada (N = 75) in the fall of 2004. Conceptualizations of terrorism threat, psychosocial impacts, and sense of preparedness were explored in a series of qualitative interviews. Findings revealed that the majority of Canadians did not feel overly threatened by terrorist attacks, due in part to a perception of terrorist threats as related to global sociopolitical events and a positive Canadian identity. In addition, while most respondents did not feel they were individually affected by the threat of terrorism, there was some concern regarding larger societal impacts, such as increased paranoia, discrimination, and threats to civil liberties. Participants' views on preparedness focused largely on the utility of emergency preparedness strategies and the factors that could mitigate or inhibit preparedness at the individual and institutional levels, with a specific focus on education. Finally, the significant relevance of these findings in shaping terrorism preparedness, both in Canada and generally, is discussed.

  12. Pediatric Idiopathic Intracranial Hypertension: A Case Report

    Directory of Open Access Journals (Sweden)

    Divya Nandwani, OD

    2015-08-01

    Full Text Available Background: Idiopathic intracranial hypertension (IIH presents differently in prepubertal children as compared to postpubertal children and adults. In adults, IIH is most common in obese women of child-bearing age. However, when occurring in prepubertal children, IIH has been shown to have no predilection for gender and does not correlate with obesity. This case report exemplifies the rare occurrence of IIH in a pediatric patient. Case Report: A five-year-old Hispanic female patient was seen at the University Eye Center for a longstanding hypotropia secondary to a likely congenital fourth nerve palsy with an exotropia component. After a strabismus surgery and a series of follow-up visits, bilateral swollen optic nerves were observed, and a prompt referral to the emergency room was made. Consequently, she was diagnosed with IIH. A treatment regimen of acetazolamide was initiated with subsequent improvement of the clinical presentation of increased intracranial pressure, confirmed by the reduction of swelling of her optic nerves. Conclusions: Bilateral swelling of the optic nerves can be an emergency, especially in children. It is important urgently to rule out causes for increased intracranial pressure. If treatment is significantly delayed, or if no treatment is given to a patient with this condition, loss of visual function may occur. In addition to reporting a rare circumstance of pediatric idiopathic intracranial hypertension, this case report serves to remind eye care practitioners of the importance of monitoring the ocular health of patients closely, even in young, healthy children.

  13. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses ... of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  14. Group Intervention in Pediatric Rehabilitation

    Science.gov (United States)

    LaForme Fiss, Alyssa

    2012-01-01

    Group intervention in pediatric physical and occupational therapy is an alternative to individual intervention allowing the therapist to meet the needs of multiple children at one time. Survey research indicates that approximately 40% to 60% of pediatric physical and occupational therapists use group intervention at least occasionally in practice,…

  15. 78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-08-08

    ... HUMAN SERVICES Food and Drug Administration Pediatric Ethics Subcommittee of the Pediatric Advisory... Administration (FDA). The meeting will be open to the public. Name of Subcommittee: Pediatric Ethics Subcommittee... recommendations to the Pediatric Advisory Committee on pediatric ethical issues. Date and Time: The meeting...

  16. A survey of program evaluation practices in family-centered pediatric rehabilitation settings.

    Science.gov (United States)

    Moreau, Katherine A; Cousins, J Bradley

    2014-04-01

    Program evaluation is becoming increasingly important in pediatric rehabilitation settings that adhere to the family-centered service (FCS) philosophy. However, researchers know little about the specific evaluation activities occurring in these settings or the extent to which evaluators/service providers uphold FCS in their program evaluation activities. Through a questionnaire survey, this study aimed to document evaluators/service providers' perceptions of the level of program evaluation occurring in their Canadian pediatric rehabilitation centers. It also investigated the extent to which evaluators/service providers perceive program evaluation practices at their centers to be consistent with the FCS context of Canadian pediatric rehabilitation settings. The findings suggested that the amount of evaluation activities occurring within the respondents' centers is variable; that the majority of individuals working in program evaluation do not have formal training in it; and that the respondents' centers have limited resources for evaluation. The study also showed that staff members believe their centers' evaluation activities are somewhat consistent with FCS philosophy, but that improvements are needed.

  17. Assessment of Financial Burden as a Standard of Care in Pediatric Oncology.

    Science.gov (United States)

    Pelletier, Wendy; Bona, Kira

    2015-12-01

    Family financial hardship has emerged as a burden of pediatric cancer treatment with negative implications for family well-being. As part of an extensive project to create evidence-based standards for the psychosocial care of children with cancer, we performed a literature review of pediatric cancer-associated financial hardship utilizing six databases, and identified 24 publications for incorporation into this review. Financial hardship during childhood cancer was found to affect a significant proportion of the population and to negatively impact family well-being. Existing literature supports a strong recommendation for assessment of financial hardship as a component of comprehensive psychosocial care in pediatric oncology.

  18. Pediatric lymphomas in Brazil

    Directory of Open Access Journals (Sweden)

    Gabriela Gualco

    2010-01-01

    Full Text Available OBJECTIVE: This study provides the clinical pathological characteristics of 1301 cases of pediatric/adolescent lymphomas in patients from different geographic regions of Brazil. METHODS: A retrospective analyses of diagnosed pediatric lymphoma cases in a 10-year period was performed. We believe that it represents the largest series of pediatric lymphomas presented from Brazil. RESULTS: Non-Hodgkin lymphomas represented 68% of the cases, including those of precursor (36% and mature (64% cell origin. Mature cell lymphomas comprised 81% of the B-cell phenotype and 19% of the T-cell phenotype. Hodgkin lymphomas represented 32% of all cases, including 87% of the classical type and 13% of nodular lymphocyte predominant type. The geographic distribution showed 38.4% of the cases in the Southeast region, 28.7% in the Northeast, 16.1% in the South, 8.8% in the North, and 8% in the Central-west region. The distribution by age groups was 15-18 years old, 33%; 11-14 years old, 26%; 6-10 years old, 24%; and 6 years old or younger, 17%. Among mature B-cell lymphomas, most of the cases were Burkitt lymphomas (65%, followed by diffuse large B-cell lymphomas (24%. In the mature T-cell group, anaplastic large cell lymphoma, ALK-positive was the most prevalent (57%, followed by peripheral T-cell lymphoma, then not otherwise specified (25%. In the group of classic Hodgkin lymphomas, the main histological subtype was nodular sclerosis (76%. Nodular lymphocyte predominance occurred more frequently than in other series. CONCLUSION: Some of the results found in this study may reflect the heterogeneous socioeconomical status and environmental factors of the Brazilian population in different regions.

  19. Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF).

    Science.gov (United States)

    Schnell, David; Azoulay, Elie; Benoit, Dominique; Clouzeau, Benjamin; Demaret, Pierre; Ducassou, Stéphane; Frange, Pierre; Lafaurie, Matthieu; Legrand, Matthieu; Meert, Anne-Pascale; Mokart, Djamel; Naudin, Jérôme; Pene, Frédéric; Rabbat, Antoine; Raffoux, Emmanuel; Ribaud, Patricia; Richard, Jean-Christophe; Vincent, François; Zahar, Jean-Ralph; Darmon, Michael

    2016-12-01

    Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis.

  20. Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF).

    Science.gov (United States)

    Schnell, David; Azoulay, Elie; Benoit, Dominique; Clouzeau, Benjamin; Demaret, Pierre; Ducassou, Stéphane; Frange, Pierre; Lafaurie, Matthieu; Legrand, Matthieu; Meert, Anne-Pascale; Mokart, Djamel; Naudin, Jérôme; Pene, Frédéric; Rabbat, Antoine; Raffoux, Emmanuel; Ribaud, Patricia; Richard, Jean-Christophe; Vincent, François; Zahar, Jean-Ralph; Darmon, Michael

    2016-12-01

    Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis. PMID:27638133

  1. Responsiveness of the Canadian Occupational Performance Measure

    NARCIS (Netherlands)

    I.C.J.M. Eyssen; M.P.M. Steultjens; T.A.M. Oud; E.M. Bolt; A. Maasdam; J. Dekker

    2011-01-01

    This study evaluated the responsiveness of the Canadian Occupational Performance Measure (COPM), an individualized, client-centered outcome measure for the identification and evaluation of self-perceived occupational performance problems. We recruited 152 consecutive patients with various diagnoses,

  2. Canadian Business Schools: Going out of Business?

    Science.gov (United States)

    Dobni, Dawn; Dobni, Brooke

    1996-01-01

    Using Porter's five-forces model (potential entrants, suppliers, buyers, rivalry, substitutes) to analyze competition in Canadian university business schools, the authors conclude that schools are becoming increasingly vulnerable to competitive pressures and that strategic reorientation is necessary. (SK)

  3. Canadian media representations of mad cow disease.

    Science.gov (United States)

    Boyd, Amanda D; Jardine, Cynthia G; Driedger, S Michelle

    2009-01-01

    A Canadian case of bovine spongiform encephalopathy (BSE) or "mad cow disease" was confirmed in May, 2003. An in-depth content analysis of newspaper articles was conducted to understand the portrayal of BSE and variant Creutzfeldt-Jakob disease (vCJD) in the Canadian media. Articles in the "first 10 days" following the initial discovery of a cow with BSE in Canada on May 20, 2003, were examined based on the premise that these initial stories provide the major frames that dominate news media reporting of the same issue over time and multiple occurrences. Subsequent confirmed Canadian cases were similarly analyzed to determine if coverage changed in these later media articles. The results include a prominence of economic articles, de-emphasis of health aspects, and anchoring the Canadian outbreak to that of Britain's crisis. The variation in media representations between those in Canada and those documented in Britain are explored in this study. PMID:19697246

  4. Canadian used fuel disposal concept review

    International Nuclear Information System (INIS)

    A federal government environmental assessment review of the disposal concept developed under the Canadian Nuclear Fuel Waste Management Program is currently underway. The Canadian concept is, simply stated, the placement of used fuel (or fuel waste) in long-lived containers at a depth between 500 m and 1000 m in plutonic rock of the Canadian Shield. Atomic Energy of Canada Limited submitted an Environmental Impact Statement in 1994 and the public hearing aspect of the concept review is in its final phase. A unique aspect of the Canadian situation is that government has stipulated that site selection can not commence until the concept has been approved. Hence, the safety and acceptability of the concept is being reviewed in the context of a generic site. Some comments and lessons learned to date related to the review process are discussed. (author)

  5. Canadian Law Schools: In Search of Excellence.

    Science.gov (United States)

    Trakman, Leon E.

    1980-01-01

    Academically, Canadian education is at the crossroads between formalism and functionalism, with the latter prevailing in recent years. There now arises a demand for a more integrated approach, linking legal theory with legal practice. (MSE)

  6. Pediatric cerebral aneurysms.

    Science.gov (United States)

    Gemmete, Joseph J; Toma, Ahmed K; Davagnanam, Indran; Robertson, Fergus; Brew, Stefan

    2013-11-01

    Childhood intracranial aneurysms differ from those in the adult population in incidence and gender prevalence, cause, location, and clinical presentation. Endovascular treatment of pediatric aneurysms is the suggested approach because it offers both reconstructive and deconstructive techniques and a better clinical outcome compared with surgery; however, the long-term durability of endovascular treatment is still questionable, therefore long-term clinical and imaging follow-up is necessary. The clinical presentation, diagnosis, and treatment of intracranial aneurysms in children are discussed, and data from endovascular treatments are presented.

  7. Pediatric transplantation: preventing thrombosis.

    Science.gov (United States)

    Robertson, J D

    2015-06-01

    Due to progressive advances in surgical techniques, immunosuppressive therapies, and supportive care, outcomes from both solid organ transplantation and hematopoietic stem cell transplantation continue to improve. Thrombosis remains a challenging management issue in this context, with implications for both graft survival and long-term quality of life. Unfortunately, there remains a general paucity of pediatric-specific data regarding thrombosis incidence, risk stratification, and the safety or efficacy of preventative strategies with which to guide treatment algorithms. This review summarizes the available evidence and rationale underlying the spectrum of current practices aimed at preventing thrombosis in the transplant recipient, with a particular focus on risk factors, pathophysiology, and described antithrombotic regimens.

  8. Pediatric sinonasal tumors

    International Nuclear Information System (INIS)

    This paper demonstrates the pathology and imaging characteristics of pediatric sinonasal tumors, which are distinctly different from those found in adults. The medical records, radiologic studies, and pathologic findings in 51 patients, aged 18 years or younger, with sinonasal tumors were retrospectively reviewed. CT images and histopathologic correlation were available in all 51 cases, angiography in 17, and MR in 3. The majority of lesions were benign (33/51), with juvenile angiofibroma being the most common (10/33), followed by fibro-osseous lesions (9/33)

  9. Presumed levothyroxine-induced pseudotumor cerebri in a pediatric patient being treated for congenital hypothyroidism

    OpenAIRE

    Strickler, Crystal; Pilon, Andrew F

    2007-01-01

    Papilledema is considered a neuro-ophthalmic emergency because of its capacity to induce irreversible end-organ damage and the often grave nature of its precipitating factor. Even more concern is warranted when papilledema presents in a pediatric setting. After excluded the contributions of intracranial masses, congenital malformations, ischemic insults and acute infections, the investigation must focus on determining the contributions of other uncharacteristic causes of pediatric pseudotumor...

  10. Emergency use of extracorporeal membrane oxygenation in pediatric critically ill patients%体外膜肺氧合在儿科危重病急救中的应用

    Institute of Scientific and Technical Information of China (English)

    林茹; 张晨美; 谈林华; 施丽萍; 熊启星; 张泽伟; 舒强; 杜立中

    2012-01-01

    目的 总结体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)在儿科危重病急救中应用的管理经验.方法 回顾性分析2007年7月至2011年5月,浙江大学医学院附属儿童医院应用ECMO抢救12例多种原因所致严重心肺功能衰竭患儿的临床情况.结果 12例,男7例,女5例;年龄6d~11岁;体重2.8~35(17.21 ±11.64)kg,其中4例小于60 d.肺部感染并发急性呼吸窘迫(Acute Respiratory Distress Syndrome,ARDS)致呼吸衰竭2例,心脏术后低心排不能脱离体外循环直接转ECM0 4例,暴发性心肌炎3例,右心室心肌病反复心跳骤停4次1例,完全性大动脉转位术前严重低氧血症1例,过敏性休克并发大量肺出血,严重低氧血症1例.12例中有3例为心肺复苏胸外按压(cardiopulmonary resuscitation,CPR)同时建立ECMO (E-CPR).平均ECMO支持时间为151.75(15 ~572)h,12例中7例脱离ECMO,脱机率58.33%,存活出院6例,存活率50.00%,死亡6例.机械并发症:膜肺渗漏更换有2例,溶血更换系统3例,膜肺氧合不佳更换2例,膜肺血栓形成1例;机体并发症:伤口出血6例、二次开胸止血2例、急性肾衰2例、感染3例,高胆红素血症2例、下肢缺血1例、高血糖3例、弥漫性血管内凝血 1例.随访半年至4年半,1例因下肢缺血运动障碍,出院后1年行肢体矫形术,功能得到基本恢复;其余5例生活质量、社会功能良好,无任何智力、神经系统障碍.结论 ECMO可以有效地为可逆性严重心肺衰竭患儿提供呼吸循环支持治疗.%Objective The history of clinical application of extracorporeal membrane oxygenation (ECMO) has been more than 30 years. But in China,there were only a few ECMO centers with limited successful cases reported by the end of twentieth century. The high morbidities and mortalities in current pediatric ECMO practice are noted in China. Therefore,it is necessary to review the experience on rescue use of ECMO in critically ill pediatric

  11. How Canadians feel about nuclear energy

    International Nuclear Information System (INIS)

    A survey conducted by Decima Research in April 1989 showed that 50% of Canadians were somewhat or strongly in favour of nuclear energy, the percentage varying from 37% in British Columbia to 65% in Ontario. A majority (56%) questioned the nuclear industry's ability to handle its waste safely, but 45% believed that it was working hard to solve the problem. It was evident that an advertising campaign by the Canadian Nuclear Association had an effect

  12. Canadian National Identity and Anti-Americanism

    Institute of Scientific and Technical Information of China (English)

    谭万宏

    2015-01-01

    Canadian national identity is closely related to antiAmericanism and for Canadians,comparing with America has become the main way to identify themselves.So some scholars argue that Canada lacks a real national identity and this is the main reason of its anti-American tradition.However,the author remarks Canada has its national identity.In this paper,the author will present three reasons to support her view.

  13. Canadian National Identity and Anti-Americanism

    Institute of Scientific and Technical Information of China (English)

    谭万宏

    2015-01-01

    Canadian national identity is closely related to anti-Americanism and for Canadians,comparing with America has become the main way to identify themselves.So some scholars argue that Canada lacks a real national identity and this is the main reason of its anti-American tradition.However,the author remarks Canada has its national identity.In this paper,the author will present three reasons to support her view.

  14. Canadian experience with structured clinical examinations.

    OpenAIRE

    Grand'Maison, P.; Lescop, J; Brailovsky, C. A.

    1993-01-01

    The use of structured clinical examinations to improve the evaluation of medical students and graduates has become significantly more common in the past 25 years. Many Canadian medical educators have contributed to the development of this technique. The Canadian experience is reviewed from the introduction of simulated-standardized patients and objective-structured clinical examinations to more recent developments and the use of such examinations for licensure and certification.

  15. Canadian Art Partnership Program in Finland

    OpenAIRE

    Ketovuori, Mikko Mr.

    2011-01-01

    This article is about a multidisciplinary R&D project in which a Canadian Learning Through The Arts (LTTA) program was imported to Finland in 2003–2004. Cultural differences in arts education in Finland and Canada are discussed. While Finland has a national school curriculum with all the arts included. Canada relies more on partnerships to ensure arts education for children in the schools. Despite the fact that Canadian learning methods appeared to be quite similar to the ones Finnish teacher...

  16. Why did the Bank of Canada Emerge in 1935?

    OpenAIRE

    Bordo, Michael D.; Angela Redish

    1986-01-01

    Three possible explanations for the emergence of the Canadian central bank in 1935 are examined: that it reflected the need of competitive banking systems for a lender of the last resort; that it was necessary to anchor the unregulated Canadian monetary system after the abandonment of the gold standard in 1929; and that it was a response to political rather than purely economic pressures. Evidence from a variety of sources (contemporary statements to a Royal Commission, the correspondence of ...

  17. Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of nephrotic syndrome in children.

    Science.gov (United States)

    Samuel, Susan; Bitzan, Martin; Zappitelli, Michael; Dart, Allison; Mammen, Cherry; Pinsk, Maury; Cybulsky, Andrey V; Walsh, Michael; Knoll, Greg; Hladunewich, Michelle; Bargman, Joanne; Reich, Heather; Humar, Atul; Muirhead, Norman

    2014-03-01

    The KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for management of glomerulonephritis was recently released. The Canadian Society of Nephrology convened a working group to review the recommendations and comment on their relevancy and applicability to the Canadian context. A subgroup of pediatric nephrologists reviewed the guideline statements for management of childhood nephrotic syndrome and agreed with most of the guideline statements developed by KDIGO. This commentary highlights areas in which there is lack of evidence and areas in need of translation of evidence into clinical practice. Areas of controversy or uncertainty, including the length of corticosteroid therapy for the initial presentation and relapses, definitions of steroid resistance, and choice of second-line agents, are discussed in more detail. Existing practice variation is also addressed.

  18. Pediatric DXA: clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Larry A. [Columbus Children' s Hospital, Department of Radiology, Columbus, OH (United States); Sparke, Paul [Capital University, Department of Chemistry, Columbus, OH (United States); Henwood, Maria J. [Columbus Children' s Hospital, Department of Endocrinology, Columbus, OH (United States)

    2007-07-15

    Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation. (orig.)

  19. Pediatric contact dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Vinod

    2010-01-01

    Full Text Available Allergic contact dermatitis (ACD in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.

  20. Seminar Pediatrics. Medical and Technical Applications

    International Nuclear Information System (INIS)

    The Association of Biology and Nuclear Medicine has organized the 'Seminar Pediatrics - Medical and Technical Applications', held in Buenos Aires in May 2012, in order to collaborate with the scientific growth of nuclear medicine in pediatrics. The main topics covered were: management of pediatric patients and medical application in childhood, dosimetry in pediatric nuclear medicine, scope of radioisotope - studies in nephrourological pathologies, PET in pediatrics, among others.

  1. Pediatric drug development: formulation considerations.

    Science.gov (United States)

    Ali, Areeg Anwer; Charoo, Naseem Ahmad; Abdallah, Daud Baraka

    2014-10-01

    Absence of safe, effective and appropriate treatment is one of the main causes of high mortality and morbidity rates among the pediatric group. This review provides an overview of pharmacokinetic differences between pediatric and adult population and their implications in pharmaceutical development. Different pediatric dosage forms, their merits and demerits are discussed. Food and Drug Administration Act of 1997 and the Best Pharmaceuticals for Children Act 2002 added 6 months patent extension and exclusivity incentives to pharmaceutical companies for evaluation of medicinal products in children. Prescription Drug User Fee Act and Food and Drug Administration Amendments Act of 2007 made it mandatory for pharmaceutical companies to perform pediatric clinical studies on new drug products. Drug development program should include additional clinical bridge studies to evaluate differences in pharmacokinetics and pharmacodynamics of drugs in adult and child populations. Additionally, pharmaceutical development should consider ease of administration, palatability, appropriate excipients, stability and therapeutic equivalency of pediatric dosage forms. Pediatric population is diverse with individual preferences and demand for custom made dosage formulations. Practically it is not feasible to have different pharmaceutical dosage forms for each group. Hence, an appropriate dosage form that can be administered across pediatric population is warranted. PMID:24483293

  2. Metachronous contralateral pediatric inguinal hernia

    Directory of Open Access Journals (Sweden)

    RM Nataraja

    2010-08-01

    Full Text Available RM Nataraja, AA MahomedDepartment of Pediatric Surgery and Urology, Royal Alexandra Children’s Hospital, Brighton, UKDate of preparation: April 20, 2010. Conflict of interest: None declaredClinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia?Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4% in both genders. Sixteen contralateral groin explorations need to be done to prevent one metachronous contralateral pediatric inguinal hernia.Implementation:• Routine exploration of the asymptomatic contralateral groin is not recommended.• Infants less than one month old with an inguinal hernia should receive immediate specialist referral.• Older infants and children with a reducible hernia should be referred to the pediatric surgical outpatient department.• Pediatric patients with an original left-sided hernia or who were less than six months old at the time of the first hernia repair should receive regular follow-up in the primary health care setting.Keywords: metachronous contralateral pediatric inguinal hernia, exploration

  3. Environmental contaminants and human health in the Canadian Arctic.

    Science.gov (United States)

    Donaldson, S G; Van Oostdam, J; Tikhonov, C; Feeley, M; Armstrong, B; Ayotte, P; Boucher, O; Bowers, W; Chan, L; Dallaire, F; Dallaire, R; Dewailly, E; Edwards, J; Egeland, G M; Fontaine, J; Furgal, C; Leech, T; Loring, E; Muckle, G; Nancarrow, T; Pereg, D; Plusquellec, P; Potyrala, M; Receveur, O; Shearer, R G

    2010-10-15

    The third Canadian Arctic Human Health Assessment conducted under the Canadian Northern Contaminants Program (NCP), in association with the circumpolar Arctic Monitoring and Assessment Programme (AMAP), addresses concerns about possible adverse health effects in individuals exposed to environmental contaminants through a diet containing country foods. The objectives here are to: 1) provide data on changes in human contaminant concentrations and exposure among Canadian Arctic peoples; 2) identify new contaminants of concern; 3) discuss possible health effects; 4) outline risk communication about contaminants in country food; and 5) identify knowledge gaps for future contaminant research and monitoring. The nutritional and cultural benefits of country foods are substantial; however, some dietary studies suggest declines in the amount of country foods being consumed. Significant declines were found for most contaminants in maternal blood over the last 10 years within all three Arctic regions studied. Inuit continue to have the highest levels of almost all persistent organic pollutants (POPs) and metals among the ethnic groups studied. A greater proportion of people in the East exceed Health Canada's guidelines for PCBs and mercury, although the proportion of mothers exceeding these guidelines has decreased since the previous assessment. Further monitoring and research are required to assess trends and health effects of emerging contaminants. Infant development studies have shown possible subtle effects of prenatal exposure to heavy metals and some POPs on immune system function and neurodevelopment. New data suggest important beneficial effects on brain development for Inuit infants from some country food nutrients. The most successful risk communication processes balance the risks and benefits of a diet of country food through input from a variety of regional experts and the community, to incorporate the many socio-cultural and economic factors to arrive at a risk

  4. Canadian Attitudes toward Labour Market Issues: A Survey of Canadian Opinion. Final Report

    Science.gov (United States)

    Human Resources and Social Development Canada, 2008

    2008-01-01

    In 2007, Human Resources and Social Development Canada commissioned Environics Research Group Limited to conduct a public opinion survey on labour market issues among 3,000 adult Canadians. The objective of the public opinion survey was to better understand the perceptions of Canadians regarding labour market challenges and opportunities in order…

  5. Canadian asthma consensus report, 1999

    OpenAIRE

    Boulet, L. P.; A. Becker; Bérubé, D; Beveridge, R.; Ernst, P

    1999-01-01

    OBJECTIVES: To provide physicians with current guidelines for the diagnosis and optimal management of asthma in children and adults, including pregnant women and the elderly, in office, emergency department, hospital and clinic settings. OPTIONS: The consensus group considered the roles of education, avoidance of provocative environmental and other factors, diverse pharmacotherapies, delivery devices and emergency and in-hospital management of asthma. OUTCOMES: Provision of the best control o...

  6. Canadian photovoltaic industry directory --1998

    International Nuclear Information System (INIS)

    The directory is intended to help potential PV customers identify Canadian-based companies who can meet their needs, and to help product manufacturers and distributors identify potential new clients and/or partners within the PV industry for new and improved technologies leading to greater end-use customer satisfaction. The principal feature of the directory is an information matrix that identifies the product and service types offered by each firm and the primary clients served. There is also a list of companies by province and territory, followed by an alphabetical listing of all companies, with detailed information including, mailing address, contact person, prime activity, geographic area served, languages in which services are provided, and a brief company profile. Additional information provided by the companies themselves, dealing with items such as number of systems sold, the total installed capacity, etc., is included in an 'experience matrix' for each firm. Sources of additional information on photovoltaic systems are included in a list at the end of the directory

  7. Canadian landmine detection research program

    Science.gov (United States)

    McFee, John E.; Das, Yogadhish; Faust, Anthony A.

    2003-09-01

    Defence R&D Canada (DRDC), an agency within the Department of National Defence, has been conducting research and development (R&D) on the detection of landmines for countermine operations and of unexploded ordnance (UXO) for range clearance since 1975. The Canadian Centre for Mine Action Technologies (CCMAT), located at DRDC Suffield, was formed in 1998 to carry out R&D related to humanitarian demining. The lead group responsible for formulating and executing both countermine and humanitarian R&D programs in detection is the Threat Detection Group at DRDC Suffield. This paper describes R&D for both programs under the major headings of remote minefield detection, close-in scanning detection, confirmation detection and teleoperated systems. Among DRDC's achievements in landmine and UXO detection R&D are pioneering work in electromagnetic and magnetic identification and classification; the first military-fielded multisensor, teleoperated vehicle-mounted landmine detection system; pioneering use of confirmation detectors for multisensor landmine detection systems; the first fielded thermal neutron activation landmine confirmation sensor; the first detection of landmines using a real-time hyperspectral imager; electrical impedance imaging detection of landmines and UXO and a unique neutron backscatter landmine imager.

  8. Pediatric intracranial gunshot wounds: the Memphis experience.

    Science.gov (United States)

    DeCuypere, Michael; Muhlbauer, Michael S; Boop, Frederick A; Klimo, Paul

    2016-05-01

    OBJECTIVE Penetrating brain injury in civilians is much less common than blunt brain injury but is more severe overall. Gunshot wounds (GSWs) cause high morbidity and mortality related to penetrating brain injury; however, there are few reports on the management and outcome of intracranial GSWs in children. The goals of this study were to identify clinical and radiological factors predictive for death in children and to externally validate a recently proposed pediatric prognostic scale. METHODS The authors conducted a retrospective review of penetrating, isolated GSWs sustained in children whose ages ranged from birth to 18 years and who were treated at 2 major metropolitan Level 1 trauma centers from 1996 through 2013. Several standard clinical, laboratory, and radiological factors were analyzed for their ability to predict death in these patients. The authors then applied the St. Louis Scale for Pediatric Gunshot Wounds to the Head, a scoring algorithm that was designed to provide rapid prognostic information for emergency management decisions. The scale's sensitivity, specificity, and positive and negative predictability were determined, with death as the primary outcome. RESULTS Seventy-one children (57 male, 14 female) had a mean age of 14 years (range 19 months to 18 years). Overall mortality among these children was 47.9%, with 81% of survivors attaining a favorable clinical outcome (Glasgow Outcome Scale score ≥ 4). A number of predictors of mortality were identified (all p base deficit Based on data from the 71 patients in this study, the positive predictive value of the St. Louis scale in predicting death (score ≥ 5) was 78%. CONCLUSIONS This series of pediatric cranial GSWs underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision(s). Based on our population, the St. Louis Scale seems to be more useful as a predictor of who will survive than who will succumb to

  9. Epidemiology of acute otitis in pediatric patients

    Directory of Open Access Journals (Sweden)

    Maddalena Perotti

    2011-03-01

    Full Text Available Introduction. Acute otitis is one of the most common pediatric infectious diseases that requires an accurate diagnosis in order to direct appropriate therapy to reduce the risk of complications. In this study pathogens collected from pediatric patients and their antibiotic susceptibility patterns were evaluated. Methods. Between May 2009 and May 2010, 739 samples (swabs taken from nasopharynx in case of acute otitis media and/or from ears in case of acute external otitis, collected from 680 patients, suffering of otalgia, admitted to the emergency department of our Hospital were studied.The specimens were submitted for routine bacterial cultures and the susceptibility tests were performed according to Clinical Laboratory Standards. Nitrocefin was used to detect ß-lactamase activity. Results. 316 samples (42.8% of 739 were negative, 102 (13.8% were positive for Streptococcus pneumoniae, 97 (13.1% for Moraxella catarrhalis, 68 (9.2% for Haemophilus influenzae, 62 (8.4% for Pseudomonas aeruginosa, 49 (6.6% for Staphylococcus aureus, 36 (4.9% for Streptococcus pyogenes, 5 (0.7% for Gram negative and 4 (0.5% for Candida spp. Antibiotic susceptibility tests showed that amikacin, ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam were active against all Gram negative strains isolated.We found one strain of MRSA. Of 102 Streptococcus pneumoniae, 5 (4.9% were penicillin resistant and 25 (24.5% were erythromycin resistant, showing the prevalence of constitutive phenotype (80%. All M. catarrhalis strains were ß-lactamase producers while all H. influenzae were ß-lactamase negatives. Conclusions. The prevalent etiological agents in pediatric acute otitis are S. pneumoniae, M. catharralis, and H. influenzae, as reported in literature. In external acute otitis P. aeruginosa prevails in particular in summer.

  10. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  11. Factors Associated with Chronic Noncancer Pain in the Canadian Population

    Directory of Open Access Journals (Sweden)

    Saifudin Rashiq

    2009-01-01

    Full Text Available Chronic noncancer pain (CNCP is a prevalent health problem with pervasive negative effects on the individual’s quality of life. Previous epidemiological studies of CNCP have suggested a number of individual biological, psychological and societal correlates of CNCP, but it has rarely been possible to simultaneously compare the relative strengths of many such correlates in a Canadian population sample. With data provided by the 1996/1997 Canadian National Population Health Survey, ordinal logistic regression was used to examine the extent to which a number of population variables are associated with CNCP in a large (n=69,365 dataset. The analysis revealed cross-sectional correlations of varying strengths between CNCP and 27 factors. Increasing age, low income, low educational achievement, daily cigarette smoking, physical inactivity and abstention from alcohol were among the factors found to increase CNCP risk. The considerable impact of distress and depression on CNCP are also highlighted. A number of comorbid medical illnesses increased CNCP risk, including some (such as chronic obstructive pulmonary disease, epilepsy and thyroid disease that have not hitherto been associated with pain. White race and the affirmation of an important role for spirituality or faith reduced CNCP risk. In contrast to some previous studies, female sex did not emerge as an independent CNCP risk. The present exploratory analysis describes associations between CNCP and a number of characteristics from several domains, thus suggesting many areas for further research.

  12. Pediatric norovirus diarrhea in Nicaragua.

    Science.gov (United States)

    Bucardo, Filemon; Nordgren, Johan; Carlsson, Beatrice; Paniagua, Margarita; Lindgren, Per-Eric; Espinoza, Felix; Svensson, Lennart

    2008-08-01

    Information about norovirus (NoV) infections in Central America is limited. Through a passive community and hospital pediatric diarrhea surveillance program, a total of 542 stool samples were collected between March 2005 and February 2006 in León, Nicaragua. NoV was detected in 12% (65/542) of the children; of these, 11% (45/409) were in the community and 15% (20/133) were in the hospital, with most strains (88%) belonging to genogroup II. NoV infections were age and gender associated, with children of <2 years of age (P < 0.05) and girls (P < 0.05) being most affected. Breast-feeding did not reduce the number of NoV infections. An important proportion (57%) of NoV-infected children were coinfected with diarrheagenic Escherichia coli. A significant proportion (18/31) of NoV-positive children with dehydration required intravenous rehydration. Nucleotide sequence analysis (38/65) of the N-terminal and shell region in the capsid gene revealed that at least six genotypes (GI.4, GII.2, GII.4, GII.7, GII.17, and a potentially novel cluster termed "GII.18-Nica") circulated during the study period, with GII.4 virus being predominant (26/38). The majority (20/26) of those GII.4 strains shared high nucleotide homology (99%) with the globally emerging Hunter strain. The mean viral load was approximately 15-fold higher in children infected with GII.4 virus than in those infected with other G.II viruses, with the highest viral load observed for the group of children infected with GII.4 and requiring intravenous rehydration. This study, the first of its type from a Central American country, suggests that NoV is an important etiological agent of acute diarrhea among children of <2 years of age in Nicaragua.

  13. Pediatric Norovirus Diarrhea in Nicaragua▿

    Science.gov (United States)

    Bucardo, Filemon; Nordgren, Johan; Carlsson, Beatrice; Paniagua, Margarita; Lindgren, Per-Eric; Espinoza, Felix; Svensson, Lennart

    2008-01-01

    Information about norovirus (NoV) infections in Central America is limited. Through a passive community and hospital pediatric diarrhea surveillance program, a total of 542 stool samples were collected between March 2005 and February 2006 in León, Nicaragua. NoV was detected in 12% (65/542) of the children; of these, 11% (45/409) were in the community and 15% (20/133) were in the hospital, with most strains (88%) belonging to genogroup II. NoV infections were age and gender associated, with children of <2 years of age (P < 0.05) and girls (P < 0.05) being most affected. Breast-feeding did not reduce the number of NoV infections. An important proportion (57%) of NoV-infected children were coinfected with diarrheagenic Escherichia coli. A significant proportion (18/31) of NoV-positive children with dehydration required intravenous rehydration. Nucleotide sequence analysis (38/65) of the N-terminal and shell region in the capsid gene revealed that at least six genotypes (GI.4, GII.2, GII.4, GII.7, GII.17, and a potentially novel cluster termed “GII.18-Nica”) circulated during the study period, with GII.4 virus being predominant (26/38). The majority (20/26) of those GII.4 strains shared high nucleotide homology (99%) with the globally emerging Hunter strain. The mean viral load was approximately 15-fold higher in children infected with GII.4 virus than in those infected with other G.II viruses, with the highest viral load observed for the group of children infected with GII.4 and requiring intravenous rehydration. This study, the first of its type from a Central American country, suggests that NoV is an important etiological agent of acute diarrhea among children of <2 years of age in Nicaragua. PMID:18562593

  14. Emergency Department Crowding and Time to Antibiotic Administration in Febrile Infants

    OpenAIRE

    Light, Jennifer K.; Hoelle, Robyn M.; Herndon, Jill Boylston; Hou, Wei; Elie, Marie-Carmelle; Jackman, Kelly; Tyndall, J. Adrian; Carden, Donna Lynne

    2013-01-01

    Introduction: Early antibiotic administration is recommended in newborns presenting with febrile illness to emergency departments (ED) to avert the sequelae of serious bacterial infection. Although ED crowding has been associated with delays in antibiotic administration in a dedicated pediatric ED, the majority of children that receive emergency medical care in the U.S. present to EDs that treat both adult and pediatric emergencies. The purpose of this study was to examine the relationship be...

  15. Moral Hazard in Pediatrics.

    Science.gov (United States)

    Brunnquell, Donald; Michaelson, Christopher M

    2016-07-01

    "Moral hazard" is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties. PMID:27292845

  16. Targeted therapy for pediatric glioma

    NARCIS (Netherlands)

    A.K. Olow

    2015-01-01

    This thesis assesses molecular underpinnings of responses to promising targeted agents for pediatric tumors of Central Nervous System (CNS), incorporating preclinical testing of novel and translatable combination therapies to define the best therapy for each tumor cell specific molecular aberration.

  17. What Is a Pediatric Gastroenterologist?

    Science.gov (United States)

    ... Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & ... including cystic fibrosis) and pancreatitis Nutritional problems (including malnutrition, failure to thrive, and obesity) Feeding disorders Pediatric ...

  18. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Videos related to Children's (Pediatric) Ultrasound - Abdomen About this Site RadiologyInfo.org is produced by: Please note ... you can search the ACR-accredited facilities database . This website does not provide cost information. The costs ...

  19. Nutrition for the pediatric athlete.

    Science.gov (United States)

    Unnithan, Viswanath B; Goulopoulou, Styliani

    2004-08-01

    A paucity of literature exists with regard to research on nutrition for the pediatric athlete. This lack of research makes the development of specific nutritional recommendations for young athletes problematic. This issue is made difficult by the macro- and micronutrient intake required for growth and development in conjunction with that required for sports. Exogenous carbohydrate drinks could be considered for the young athlete engaged in both endurance exercise and high-intensity exercise. Monitoring of the energy intake during resistance training in the pediatric athlete needs to be considered, as there is evidence to suggest that energy deficits may occur. If decrements in exercise performance are noted, then serum ferritin and hemoglobin concentrations should be monitored, as nonanemic iron deficiency is prevalent in the pediatric athlete. The pediatric athlete exercising in the heat is susceptible to voluntary dehydration and evidence exists to suggest that a carbohydrate-electrolyte drink will abolish this phenomenon.

  20. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed ...

  1. Pediatric musculoskeletal computed radiography

    International Nuclear Information System (INIS)

    Background. In conventional radiography, a film-screen system serves as the X-ray detector and the film also functions as an archival and display medium. Unlike film-screen radiography, these functions are uncoupled in computed radiography (CR). CR uses conventional radiographic equipment to expose an image on a storage phosphor plate instead of a film-screen combination. Objective. To review the basic concepts of CR and to provide a background for discussion of specific musculoskeletal applications of CR in children. Materials and methods. Various aspects of musculoskeletal CR in children are presented based on our 4 years' experience and a review of the literature. Results. A greater amount of scatter capture occurs with storage phosphor CR than with a film-screen system in the 70- to 120-kVp range. This is attributed to a lower K-absorption edge of barium in the barium fluorohalide (BaFBr) compound used in the imaging plate. A significant reduction of scatter to primary radiation, improvement in bony trabecular sharpness, and improvement in line pair resolution can be achieved in pediatric musculoskeletal imaging using an air gap without an increase in the skin entrance dose as compared to the non-grid table top technique. With CR, in addition to proper radiographic exposure technique, one needs to preprogram and select the optimal processing technique for each anatomic region, projection and age group of the child. Conclusion. The main advantages of CR in pediatric musculoskeletal imaging consist of a reduction in radiation dose for many applications, improved contrast resolution, near elimination of repeat radiographs related to exposure errors, and digital processing capabilities for image enhancement, storage, retrieval, display and transmission. The current limitations of CR include the moderately high start-up cost, the long learning curve to produce optimal films, and the reduced spatial resolution. (orig.). With 8 figs., 2 tabs

  2. Canadian environmental sustainability indicators: highlights 2005

    International Nuclear Information System (INIS)

    Canadians' health and their social and economic well-being are fundamentally linked to the quality of their environment. Recognizing this, in 2004 the Government of Canada committed to establishing national indicators of freshwater quality, air quality and greenhouse gas emissions. The goal of these new indicators is to provide Canadians with more regular and reliable information on the state of their environment and how it is linked with human activity. Canadians need clearly defined environmental indicators - measuring sticks that can track the results that have been achieved through the efforts of governments, industries and individuals to protect and improve the environment. Environment Canada, Statistics Canada and Health Canada are working together to further develop and communicate these indicators. Reflecting the joint responsibility for environmental management in Canada, this effort has benefited from the cooperation and input of the provinces and territories. The indicators are: air quality; greenhouse gas emissions; and, freshwater quality. Air quality tracks Canadians' exposure to ground-level ozone - a key component of smog. The indicator measures one of the most common, harmful air pollutants to which people are exposed. The use of the seasonal average of ozone concentrations reflects the potential for long-term health effects. Greenhouse gas emissions tracks the annual releases of the six greenhouse gases that are the major contributors to climate change. The indicator comes directly from the greenhouse gas inventory report prepared by Environment Canada for the United Nations Framework Convention on Climate Change (UNFCCC) and the Kyoto Protocol. The data are widely used to report on progress toward Canada's Kyoto target for reduced emissions. Freshwater quality reports the status of surface water quality at selected monitoring sites across the country. For this first report, the focus of the indicator is on the protection of aquatic life, such as

  3. What is a pediatric tumor?

    Directory of Open Access Journals (Sweden)

    Mora J

    2012-11-01

    Full Text Available Jaume Mora1,21Department of Oncology, 2Developmental Tumor Biology Laboratory, Hospital Sant Joan de Deu, Fundacio Sant Joan de Deu, Barcelona, SpainAbstract: Working together with medical oncologists, the question of whether a Ewing sarcoma in a 25-year-old is a pediatric tumor comes up repeatedly. Like Ewing's, some tumors present characteristically at ages that cross over what has been set as the definition of pediatrics (15 years, 18 years, or 21 years?. Pediatric oncology textbooks, surprisingly, do not address the subject of defining a pediatric tumor. They all begin with an epidemiology chapter defining the types of tumors appearing at distinct stages of childhood, adolescence, and young adulthood. Describing the epidemiology of tumors in relation to age, it becomes clear that the disease is related to the phenomenon of aging. The question, however, remains: is there a biological definition of what pediatric age is? And if so, will tumors occurring during this period of life have anything to do with such biological definition? With the aim of finding an objective definition, the fundamental concepts of what defines "pediatrics" was reviewed and then the major features of tumors arising during development were analyzed. The tumors were explored from the perspective of a host immersed in the normal process of growth and development. This physiological process, from pluripotential and undifferentiated cells, makes possible the differentiation, maturation, organization, and function of tissues, organs, and apparatus. A biological definition of pediatric tumors and the infancy–childhood–puberty classification of developmental tumors according to the infancy–childhood–puberty model of normal human development are proposed.Keywords: growth and development, pediatric tumor, infant, childhood and adolescence, pubertal tumors

  4. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  5. Burnout Syndrome in Pediatric Practice

    OpenAIRE

    Al-Youbi, Reem A.; Jan, Mohammed M.

    2013-01-01

    Objectives: Burnout is a common work-related syndrome consisting of emotional exhaustion, depersonalization and diminished feelings of personal accomplishment. Burnout influences the performance and efficiency of the healthcare professionals and therefore the quality of the care provided. This study aims to assess the burnout rates and potential determinants in pediatrics.Methods: A cross-sectional, descriptive study involving physicians practicing pediatrics in the Jeddah area of Saudi Arabi...

  6. VLF propagation measurements in the Canadian Arctic

    Science.gov (United States)

    Lauber, Wilfred R.; Bertrand, Jean M.

    1993-05-01

    For the past three years, during a period of high sun spot numbers, propagation measurements were made on the reception of VLF signals in the Canadian Arctic. Between Aug. and Dec. 1989, the received signal strengths were measured on the Canadian Coast Guard icebreaker, John A. MacDonald in the Eastern Canadian Arctic. Between Jul. 1991 and Jun. 1992, the received signal strengths were measured at Nanisivik, Baffin Island. The purposes of this work were to check the accuracy and estimate variances of the Naval Ocean Systems Center's (NOSC) Long Wave Propagation Capability (LWPC) predictions in the Canadian Arctic and to gather ionospheric storm data. In addition, the NOSC data taken at Fort Smith and our data at Nanisivik were used to test the newly developed Longwave Noise Prediction (LNP) program and the CCIR noise predictions, at 21.4 and 24.0 kHz. The results of the work presented and discussed in this paper show that in general the LWPC predicts accurate values of received signal strength in the Canadian Arctic with standard deviations of 1 to 2 dB over several months. Ionospheric storms can gauge the received signal strengths to decrease some 10 dB for a period of several hours or days. However, the effects of these storms are highly dependent on the propagation path. Finally the new LNP atmospheric noise model predicts lower values of noise in the Arctic than the CCIR model and our limited measurements tend to support these lower values.

  7. Use of inhaled medications and urgent care services. Study of Canadian asthma patients.

    OpenAIRE

    Joyce, D P; McIvor, R. A.

    1999-01-01

    OBJECTIVE: To determine asthma patients' patterns of disease and knowledge of asthma. DESIGN: Telephone survey of patients with diagnosed asthma. SETTING: Residences in 10 Canadian provinces. PARTICIPANTS: Patients with asthma diagnosed by a doctor: 829 men and women with a mean age of 38 +/- 7 years. MAIN OUTCOME MEASURES: Classes of asthma medications, patterns of use, frequency and severity of asthma symptoms use of emergency departments and urgent medical services, participation in asthma...

  8. The Impact of Legislative Reforms to Canadian Federalism on Toronto’s Ability to Reduce Poverty

    OpenAIRE

    Schabas, Jake

    2011-01-01

    In the past decade, the Canadian city of Toronto has undergone radical internal shifts in its socioeconomic geography and governance structure while simultaneously emerging on the world stage as an extremely livable and financially successful city. These trends have been accompanied by growing poverty concentrated in the inner suburbs at the municipality’s boundaries. In 2006, the provincial government passed the Stronger City of Toronto for a Strong Ontario Act explicitly recognizing Toronto...

  9. Medical disinterestedness: an archaeology of scientificness and morality in the Canadian medical profession

    OpenAIRE

    Kang, Helen Hyunji

    2013-01-01

    In this dissertation I consider the emergence of and the shifts in the scientific and moral standards in the Canadian medical profession, or what I call medical disinterestedness. I examine editorial content from medical journals as a discursive space in which professional norms are constituted. I draw on the works of Pierre Bourdieu in order to argue that doctors are enmeshed in a unique system of rewards that cannot be explained by an economic model based on profit. I investigate three c...

  10. Parallel alternatives: Chinese-Canadian farmers and the Metro Vancouver local food movement

    OpenAIRE

    Gibb, Natalie Ruth

    2011-01-01

    This thesis explores how food system localisation efforts in Metro Vancouver, Canada intersect with one of the tensions in the global agri-food system: racial inequalities. Drawing on archival research, participant observation of local food marketing and policy-making, and interviews with local food movement participants, policy-makers, and Chinese-Canadian farmers, I argue that the history of anti-Chinese racism in Canada is linked to the emergence of a food system comprised of parallel net...

  11. Canadian STARS-Rated Campus Sustainability Plans: Priorities, Plan Creation and Design

    OpenAIRE

    Lauri Lidstone; Tarah Wright; Kate Sherren

    2015-01-01

    The use of integrated sustainability plans is an emerging trend in higher education institutions (HEIs) to set sustainability priorities and to create a work plan for action. This paper analyses the sustainability plans of 21 Canadian HEIs that have used the Sustainability Tracking, Assessment and Rating System (STARS) from the Association for the Advancement of Sustainability in Higher Education (AASHE). The plans were coded thematically with a focus on the sustainability goals, process of p...

  12. What Is New Since the Last (1999) Canadian Asthma Consensus Guidelines?

    OpenAIRE

    Louis-Philippe Boulet; Bai, Tony R; Allan Becker; Denis Bérubé; Robert Beveridge; Dennis M Bowie; Chapman, Kenneth R; Johanne Côté; Donald Cockcroft; Ducharme, Francine M; Pierre Ernst; J Mark FitzGerald; Thomas Kovesi; Hodder, Richard V; Paul O’Byrne

    2001-01-01

    The objective of the present document is to review the impact of new information on the recommendations made in the last (1999) Canadian Asthma Consensus Guidelines. It includes relevant published studies and observations or comments regarding what are considered to be the main issues in asthma management in children and adults in office, emergency department, hospital and clinical settings. Asthma is still insufficiently controlled in a large number of patients, and practice guidelines need ...

  13. Canadian Consumer's Willingness-To-Pay For Pesticide Free Food Products: An Ordered Probit Analysis

    OpenAIRE

    Cranfield, John A.L.; Magnusson, Erik

    2003-01-01

    A new crop production system has emerged in western Canada. Pesticide Free ProductionTM (PFPTM) emphasizes reduced pesticide use in conjunction with increased reliance on producer knowledge of agronomic practices that mitigate weed, insect and disease pressure. A contingent valuation survey was undertaken to determine if Canadian consumers would pay a premium for PFPTM food products. Over 65 percent of respondents would be willing to pay a one to ten percent premium relative to a conventional...

  14. Backcountry Travel Emergencies in Arctic Canada: A Pilot Study in Public Health Surveillance

    OpenAIRE

    Young, Stephanie K.; Taha B. Tabish; Pollock, Nathaniel J.; Kue Young, T.

    2016-01-01

    Residents in the Canadian Arctic regularly travel in remote, backcountry areas. This can pose risks for injuries and death, and create challenges for emergency responders and health systems. We aimed to describe the extent and characteristics of media-reported backcountry travel emergencies in two Northern Canadian territories (Nunavut and Northwest Territories). A case-series of all known incidents between 2004 and 2013 was established by identifying events in an online search of two media o...

  15. JUDGING SELECTION: APPOINTING CANADIAN JUDGES

    Directory of Open Access Journals (Sweden)

    Peter McCormick

    2015-05-01

    Full Text Available Since the 1970s, the appointment of trial judges in Canada has generally involved an arms-length committee of professionals, although the structure of these committees and their role in the process has varied from province to province, as well as evolving over time. Yet these “new” structures and “new” processes did not prevent a major judicial appointment scandal in the province of Quebec in 2010, culminating in the formation of the Bastarache Committee to recommend changes. This paper summarizes the forty-year history of Canadian judicial appointment committees, identifies the major challenges that face those committees, and suggests the basic values toward which reforms to the appointment process might be directed. Depuis les années 1970, la nomination des juges de première instance au Canada a généralement mis à contribution un comité de professionnels indépendants, bien que la structure de ce comité et son rôle dans le processus de nomination aient varié d’une province à l’autre et évolué avec le temps. Ces « nouvelles » structures et « nouveaux » processus n’ont certes pas empêché l’éclatement du scandale sur la nomination des juges au Québec en 2010. Ce scandale a donné lieu à la formation de la Commission Bastarache qui avait notamment le mandat de recommander des changements. La présent document résume les quarante ans d’histoire des comités canadiens de nomination des juges, recense les principaux défis que ces comités doivent relever, et propose les valeurs fondamentales qui devraient inspirer les réformes du processus de nomination.

  16. Policy statement--The future of pediatrics: mental health competencies for pediatric primary care.

    Science.gov (United States)

    2009-07-01

    Pediatric primary care clinicians have unique opportunities and a growing sense of responsibility to prevent and address mental health and substance abuse problems in the medical home. In this report, the American Academy of Pediatrics proposes competencies requisite for providing mental health and substance abuse services in pediatric primary care settings and recommends steps toward achieving them. Achievement of the competencies proposed in this statement is a goal, not a current expectation. It will require innovations in residency training and continuing medical education, as well as a commitment by the individual clinician to pursue, over time, educational strategies suited to his or her learning style and skill level. System enhancements, such as collaborative relationships with mental health specialists and changes in the financing of mental health care, must precede enhancements in clinical practice. For this reason, the proposed competencies begin with knowledge and skills for systems-based practice. The proposed competencies overlap those of mental health specialists in some areas; for example, they include the knowledge and skills to care for children with attention-deficit/hyperactivity disorder, anxiety, depression, and substance abuse and to recognize psychiatric and social emergencies. In other areas, the competencies reflect the uniqueness of the primary care clinician's role: building resilience in all children; promoting healthy lifestyles; preventing or mitigating mental health and substance abuse problems; identifying risk factors and emerging mental health problems in children and their families; and partnering with families, schools, agencies, and mental health specialists to plan assessment and care. Proposed interpersonal and communication skills reflect the primary care clinician's critical role in overcoming barriers (perceived and/or experienced by children and families) to seeking help for mental health and substance abuse concerns

  17. Pediatric robotic urologic surgery-2014

    Directory of Open Access Journals (Sweden)

    James T Kearns

    2014-01-01

    Full Text Available We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide.

  18. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

    There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

  19. 患儿家长健康素养与儿科急诊就诊率关系的系统评价%The relationship between parent health literacy and pediatric emergency department utilization:a systematic review

    Institute of Scientific and Technical Information of China (English)

    齐艳; 孙文霞; 孙丽娟

    2015-01-01

    Objective To evaluate the relationship between parental health literacy and emergency department utili-zation,and if can reduce the rate of emergency department utilization for parents with low health literacy eliminate illiteracy in-tervention.Methods The related literature were searched in PubMed,CINAHL,CNKI.Literatures were screening and the date were extracted in accordance with inclusion criteria.Statistical analyses were performed by Stata 12.0.Results A total of 17 articles met the full criteria and were included for review,a median of 30% (range 10.5% -48.8%)of parents in the ED possesses low health literacy.Low health literacy of parents of patients with asthma was associated with a higher number of ED visits in children.Meta analysis showed it was effectively that low literacy interventions targeted at parents with low health literacy.DerSimonian and Laird test revealed significant heterogeneity (Chi-square =427.76,df=5,P <0.001).A pooled OR was calculated using a random effects model,given the heterogeneity (OR =0.35,95% CI:0.15 -0.81).Conclusion 1 in 3 parents with their children at the ED have low health literacy,influence their ability to process,make medical deci-sions,and understand for their children.A relationship exists between low health literacy and increased ED utilization.Low lit-eracy interventions targeted at parents who have low health literacy result in decreased ED utilization.%目的:评价患儿家长健康素养与儿科急诊就诊率关系,以及针对低健康素养患儿家长的扫盲干预能否降低急诊就诊率。方法检索 PubMed、CINAHL、CNKI 等数据库中相关文章,按照纳入和排除标准进行文献筛选,提取纳入研究的特征信息。数据分析采用 Stata 12.0软件。结果17篇文献符合纳入标准文献,患儿家长低健康素养发生率在10.5%~48.8%,中位数在30%;哮喘患儿家长低健康素养与急诊就诊有关;Meta 分析显示针对低健康素养患儿

  20. The potential for bio-mediators and biomarkers in pediatric traumatic brain injury and neurocritical care

    Directory of Open Access Journals (Sweden)

    Patrick M. Kochanek

    2013-04-01

    Full Text Available The use of biomarkers of brain injury in pediatric neurocritical care has been explored for at least 15 years. Two general lines of research on biomarkers in pediatric brain injury have been pursued, 1 studies of bio-mediators in cerebrospinal fluid (CSF of children after traumatic brain injury (TBI to explore the components of the secondary injury cascades in an attempt to identify potential therapeutic targets and 2 studies of the release of structural proteins into the CSF, serum, or urine in order to diagnose, monitor, and/or prognosticate in patients with TBI or other pediatric neurocritical care conditions. Unique age-related differences in brain biology, disease processes, and clinical applications mandate the development and testing of brain injury bio-mediators and biomarkers specifically in pediatric neurocritical care applications. Finally, although much of the early work on biomarkers of brain injury in pediatrics has focused on TBI, new applications are emerging across a wide range of applications specifically for pediatric neurocritical care including abusive head trauma, cardiopulmonary arrest, septic shock, extracorporeal membrane oxygenation, hydrocephalus, and cardiopulmonary bypass. The potential scope of the utility of biomarkers in pediatric neurocritical care is thus also discussed.

  1. The use of triptans for pediatric migraines.

    Science.gov (United States)

    Eiland, Lea S; Hunt, Melissa O

    2010-12-01

    Migraine headaches frequently occur in the pediatric population, with a prevalence of 3% in children 2-7 years of age, 4-11% in children 7-11 years of age, and 8-23% in children 11 years of age and older. Migraine without aura is more than twice as common as migraine with aura in children. Headaches are the third leading cause of emergency room referrals and rank in the top five health problems of children. The 2004 American Academy of Neurology's treatment parameter for migraine in children and adolescents recommended that nasal sumatriptan be considered for acute treatment; however, data were lacking to make a decision regarding the available oral triptans at that time. The more recently released European guidelines discuss three different triptans for use in children but no specific triptan was recommended. Currently, six of the seven available triptans have been studied for efficacy and safety in the pediatric population; however, only a few well controlled clinical studies have been conducted. Sumatriptan has the most available data on outcomes in general, with nasal sumatriptan showing the most positive results. Nasal sumatriptan is approved in children older than 12 years of age in Europe. Oral sumatriptan does not show any clinical benefit versus placebo in children. Rizatriptan and zolmitriptan have conflicting efficacy and safety data, with most studies favoring the use of oral rizatriptan and nasal zolmitriptan. Almotriptan is the first triptan to obtain a US FDA indication in adolescents with migraines lasting 4 or more hours. This approval was based upon two studies, one large clinical trial and one very small, open-label, pilot study. At this time, there are insufficient data to recommend naratriptan and eletriptan for first- or second-line use in pediatric patients with migraines. There are currently no efficacy data for frovatriptan in pediatric patients, which limits its use in this population. Adverse effects of triptans and pharmacokinetic data

  2. Canadian energy supply and demand 1993 - 2010: Trends and issues

    International Nuclear Information System (INIS)

    The National Energy Board has since 1959 prepared and maintained projections of energy supply requirements and has from time to time published reports on them. The objectives of this report are to provide a comprehensive 'all energy' market analysis and outlook to service as a standard of reference for all parties interested in Canadian energy issues; to provide a framework for public discussion on emerging energy issues of national importance and to monitor the prospects for the supply, demand and price of natural gas in Canada pursuant to the Market-Based Procedure for regulating. The focus being on the broad outlines of prospective energy market developments under different underlying assumptions about key variables. 7 tabs., 60 figs

  3. Canadian energy supply and demand 1993 - 2010: Technical report

    International Nuclear Information System (INIS)

    The National Energy Board has since 1959 prepared and maintained projections of energy supply requirements and has from tine to time published reports on them. The objectives of this report are to provide a comprehensive 'all energy' market analysis and outlook to service as a standard of reference for all parties interested in Canadian energy issues; to provide a framework for public discussion on emerging energy issues of national importance and to monitor the prospects for the supply, demand and price of natural gas in Canada pursuant to the Market-Based Procedure for regulating. The focus of the technical report provides detailed descriptions of the analytical methods used and the quantitative results. The quantitative analysis will be of value to users who wish to develop their own views of prospects or to have a detailed assessment of the impact of alternative assumptions. 106 tabs., 171 figs

  4. Canadian Petroleum Products Inst. annual report, 1991

    International Nuclear Information System (INIS)

    The Canadian Petroleum Products Institute (CPPI) was created in 1989 as a nonprofit association of Canadian refiners and marketers of petroleum products. In 1991, the Atlantic Petroleum Association, the Quebec Petroleum Association, the Ontario Petroleum Association, the Canada West Petroleum Association, and the Petroleum Association for Conservation of the Canadian Environment (PACE) were integrated into the CPPI. The objective of the CPPI is to serve and represent the refining and marketing sectors of the petroleum industry with respect to environment, health and safety, and business issues. An industry overview is provided, as well as highlights of environmental achievements and challenges, and economics and operations for the year. Lists of CPPI publications, standing committees, and officers are also included. 9 figs

  5. A Roadmap for Canadian Submillimetre Astronomy

    CERN Document Server

    Webb, Tracy; Di Francesco, James; Matthews, Brenda; Murray, Norm; Scott, Douglas; Wilson, Christine

    2013-01-01

    We survey the present landscape in submillimetre astronomy for Canada and describe a plan for continued engagement in observational facilities to ~2020. Building on Canada's decadal Long Range Plan process, we emphasize that continued involvement in a large, single-dish facility is crucial given Canada's substantial investment in ALMA and numerous PI-led submillimetre experiments. In particular, we recommend: i) an extension of Canadian participation in the JCMT until at least the unique JCMT Legacy Survey program is able to realize the full scientific potential provided by the world-leading SCUBA-2 instrument; and ii) involvement of the entire Canadian community in CCAT, with a large enough share in the partnership for Canadian astronomers to participate at all levels of the facility. We further recommend continued participation in ALMA development, involvement in many focused PI-led submillimetre experiments, and partnership in SPICA.

  6. Chemotherapy drug shortages in pediatric oncology: a consensus statement.

    Science.gov (United States)

    Decamp, Matthew; Joffe, Steven; Fernandez, Conrad V; Faden, Ruth R; Unguru, Yoram

    2014-03-01

    Shortages of essential drugs, including critical chemotherapy drugs, have become commonplace. Drug shortages cost significant time and financial resources, lead to adverse patient outcomes, delay clinical trials, and pose significant ethical challenges. Pediatric oncology is particularly susceptible to drug shortages, presenting an opportunity to examine these ethical issues and provide recommendations for preventing and alleviating shortages. We convened the Working Group on Chemotherapy Drug Shortages in Pediatric Oncology (WG) and developed consensus on the core ethical values and practical actions necessary for a coordinated response to the problem of shortages by institutions, agencies, and other stakeholders. The interdisciplinary and multiinstitutional WG included practicing pediatric hematologist-oncologists, nurses, hospital pharmacists, bioethicists, experts in emergency management and public policy, legal scholars, patient/family advocates, and leaders of relevant professional societies and organizations. The WG endorsed 2 core ethical values: maximizing the potential benefits of effective drugs and ensuring equitable access. From these, we developed 6 recommendations: (1) supporting national polices to prevent shortages, (2) optimizing use of drug supplies, (3) giving equal priority to evidence-based uses of drugs whether they occur within or outside clinical trials, (4) developing an improved clearinghouse for sharing drug shortage information, (5) exploring the sharing of drug supplies among institutions, and (6) developing proactive stakeholder engagement strategies to facilitate prevention and management of shortages. Each recommendation includes an ethical rationale, action items, and barriers that must be overcome. Implemented together, they provide a blueprint for effective and ethical management of drug shortages in pediatric oncology and beyond.

  7. Pediatric hypertension: recent trends and accomplishments, future challenges.

    Science.gov (United States)

    Flynn, Joseph T

    2008-06-01

    Publication of the Fourth Report on high blood pressure (BP) in children and adolescents by the National High BP Education Program (NHBPEP) in 2004 has been followed by a remarkable increase in interest in pediatric hypertension. New data have emerged on the epidemiology of hypertension in the young, the influence of the childhood obesity epidemic on BP, how ambulatory BP monitoring (ABPM) can be used in evaluating elevated BP and the extent of hypertensive target-organ damage in the pediatric age group. Exciting new information on drug treatment of pediatric hypertension has been produced by industry-sponsored clinical trials of antihypertensive medications spurred by the FDA Modernization Act (FDAMA) and successor legislation. Despite these trends, recognition of elevated BP in children and adolescents by primary care providers remains problematic. This article will highlight these and other aspects of pediatric hypertension, hopefully providing a snapshot of where we are in early 2008, and pointing out areas where further work is needed in order to reduce the future burden of adult cardiovascular disease. PMID:18437129

  8. Mifepristone Treatment of Cushing's Syndrome in a Pediatric Patient.

    Science.gov (United States)

    Banerjee, Ronadip R; Marina, Neyssa; Katznelson, Laurence; Feldman, Brian J

    2015-11-01

    Cushing's syndrome (CS) in the pediatric population is challenging to diagnose and treat. Although next-generation medical therapies are emerging for adults with CS, none are currently approved or used in children. Here we describe the first use of mifepristone, a glucocorticoid receptor antagonist, to treat CS in a pediatric subject. The patient, a 14-year-old girl with an 18-month history of metastatic neuroendocrine carcinoma, suffered from fatigue, profound myopathy, irritability, and depression. She was found to have hypertension, hypokalemia, and worsening control of her preexisting type 1 diabetes. In this report, we detail our clinical evaluation that confirmed CS caused by an ectopic adrenocorticotropic hormone secreting tumor. Surgical and radiation therapies were not pursued because of her poor functional status and limited life expectancy, and medical treatment of CS was indicated for symptom relief. Mifepristone treatment provided rapid improvement in glycemic control, insulin resistance, and hypertension as well as significant diminishment of her myopathy and fatigue. Hypokalemia was managed with an oral potassium replacement and dose escalation of spironolactone; no other significant adverse effects were observed. Despite successful palliation of Cushing's signs and symptoms, the patient died of progression of her cancer. This case demonstrates the safety and efficacy of mifepristone treatment in a pediatric patient with symptomatic, ectopic CS. We conclude that, in appropriate pediatric patients with CS, glucocorticoid receptor antagonism with mifepristone should be considered to control the effects of hypercortisolism and to improve quality of life. PMID:26459648

  9. Emergency transport of pediatric critical care in primary hospital 128 cases reports%基层医院小儿危重症的急救转运128例报道

    Institute of Scientific and Technical Information of China (English)

    饶袖珍; 杨海红; 谢云菲

    2011-01-01

    目的 探讨基层医院急救转运模式及方法,提高本地区危重患儿的抢救成功率,降低危重患儿死亡率及致残率.方法对丰顺县人民医院近3年来转运的危重患儿128例进行回顾性分析.结果全部危重病患儿均安全转运至上级医院相应专科病房,在转运患儿的原发病以新生儿疾病、重症肺炎和各种感染为主,无1例在途中发生意外或死亡.结论加强转运前、转运途中质量控制,充分估计病情变化,密切监测病情是安全转运的前提条件,快捷安全的转运,提高了本地区危重患儿的抢救成功率,降低危重患儿死亡率及致残率是非常有效的.%Objective To explore the transport mode and hospital emergency methods to improve the survival rate in critically ill children, reducing mortality and morbidity in critically ill children. Methods Totally 128 cases from the past three years of transport critically ill children were analyzed retrospectively. Results All children were safety in critically ill patients transported to the appropriate specialist hospital ward higher, the disease neonatal illness, severe pneumonia and various infections primarily were the primary disease in transport children, no case of accident or death on the way. Conclusions Strengthening the transit quality control, estimates of changes in condition adequately, close monitoring of the disease is a premise for safe transport, fast and safety transport can improve the survival rate of critically ill children in the region, reducing mortality in critically ill children and disability.

  10. Suicide, Canadian law, and Exit International's "peaceful pill".

    Science.gov (United States)

    Ogden, Russel D

    2010-11-01

    Australia's Exit International ("Exit") is probably the most visible and controversial right-to-die organization in the world. Founded by Dr. Philip Nitschke, Exit is known for do-it-yourself ("DIY") suicide workshops and a book banned in Australia: The Peaceful Pill Handbook. In 2009, Exit held its first workshop in Canada. Due to legal concerns, the Vancouver Public Library reneged on a commitment to give Exit a venue, so the workshop proceeded in the sanctuary of a church hall. This article summarizes the history of suicide law in Canada and gives an overview of the emerging DIY movement. A case report describes how a Canadian woman studied Exit's literature and learned how to import veterinary pentobarbital. In accordance with Exit's information, she ended her life. Ethical and legal implications for researching DIY suicide are discussed and it is argued that prohibition contributes to an undesirable situation of uncontrolled and unregulated suicide. Whether they are prohibited, permitted, or tolerated, suicide and assisted suicide are controversial. Their legal treatment in Canada is conflicting because suicide is not a crime but it is a serious offense to assist, encourage, or counsel someone to suicide. Individuals can lawfully take their lives, but they must act independently. This legal situation has given rise to a do-it-yourself ("DIY") right-to-die movement dedicated to technologies and information to enhance the possibilities for planned and humane suicide, while limiting the legal exposure of sympathetic third parties (Martin, 2010; Ogden 2001). My aim is to summarize the legal history of suicide in Canada and discuss the emerging social movement for DIY suicide and assistance in suicide. Exit International ("Exit"), based in Australia, is a leading organization in this movement. I present a case report that describes how a Canadian woman ended her life using DIY techniques learned from Exit. Some ethical and legal implications for researching DIY

  11. Open Access Funds: A Canadian Library Survey

    Directory of Open Access Journals (Sweden)

    Leila Fernandez

    2011-07-01

    Full Text Available A survey of Canadian research libraries was conducted to determine the extent of funding support for open access publications in these institutions. Results indicate that there is substantial support for open access publishing, and a diversity of approaches is being used to fund open access resources. The reasons for funding support along with policy and promotional issues are explored. The broader implications of funding open access are discussed in the context of a changing scholarly publishing landscape. This paper will be especially relevant to Canadian academic libraries that are exploring options for funding open access publications.

  12. Statistics in action a Canadian outlook

    CERN Document Server

    Lawless, Jerald F

    2014-01-01

    Commissioned by the Statistical Society of Canada (SSC), Statistics in Action: A Canadian Outlook helps both general readers and users of statistics better appreciate the scope and importance of statistics. It presents the ways in which statistics is used while highlighting key contributions that Canadian statisticians are making to science, technology, business, government, and other areas. The book emphasizes the role and impact of computing in statistical modeling and analysis, including the issues involved with the huge amounts of data being generated by automated processes.The first two c

  13. Women in the Canadian Economy: A Teaching Unit.

    Science.gov (United States)

    Post, Sylvia; Staunton, Ted, Ed.

    One of a series of teaching units designed to introduce secondary school students to the Canadian economy, this handbook contains activities on the economic status and roles of Canadian women. The first of 4 sections presents a profile of male and female occupations. Section 2 contains statistics on females in the Canadian labor force. Section 3,…

  14. A Course in Canadian Film for U.S. Students

    Science.gov (United States)

    Gutenko, Gregory

    2010-01-01

    Canadian Film will be a new course in the Communications Studies department at the University of Missouri at Kansas City particularly designed for non-Canadian Midwestern US students. It will not only introduce students to the richness and significance of Canadian film as both art and entertainment (which is virtually unrecognized around here),…

  15. The flow of radionuclides through the Canadian archipelago

    International Nuclear Information System (INIS)

    The transport of contaminants to the Canadian Arctic by air and in water and their concentration through the marine food web has lead to enhanced levels of contaminants in several foods of Canadian northern inhabitants. Artificial radionuclides in the marine water can be used to determine water circulation and to trace contaminant transport through the Canadian Archipelago

  16. A Demographic and Career Profile of Canadian Research University Librarians

    Science.gov (United States)

    Fox, David

    2007-01-01

    This paper provides an up-to-date career and demographic profile of Canadian research university librarians by comparing newly derived data from the 8Rs Study: The "Future of Human Resources in Canadian Libraries", with corresponding information from the author's 2006 survey: "The Scholarship of Canadian Research University Librarians", and other…

  17. Emergency in pediatric and adolescent psychiatry. Note taking for the primary health assistance. Urgencias en psiquiatría infantil y adolescente. Apuntes para el nivel primario de atención.

    Directory of Open Access Journals (Sweden)

    Zenaida María Sáez

    2003-05-01

    Full Text Available The psyquiatric emergences in children and adolescents are usually manifested as alterations of the feelings, behavior or in the school efficiency and its origin is found in the physical tensions, contradictions in the breeding, marital conflicts, bad interpersonal relationships, negligence, loss of the significant model at home, etc. It is important to address that there is no direct relationship between the causal factor and the onset of the symptoms. This largely depends on variables such as temperament, levels of development, nature and duration of the stress, past experience and family capacity/ability of the family to get adapted to new situations.

    Parents frequently come to visit General Comprehensive doctor because they are worried about their children´s behaviors, i.e.; if they are normal or require certain intervention.

    In the current review we make reference to the psychosocial issues that may bring about psychopathological manifestations which need a timely intervention. Otherwise, there is a risk for the physical integrity of the kid, adolescent or another people which may result into a remarkable complications and suffering for the patients or their relatives. We are going to make reference to the abuse of some substances, adoption, nervous anorexia, suicide attempt, infant abuse, fire provocation and mourning reaction.

    We are making emphasis on the clinical assessment of the risk factors which contribute to the appearance of these issues and the management in the primary level of assistance to prevent further complications.

    Las urgencias psiquiátricas en el niño y el adolescente se manifiestan usualmente como alteraciones de los sentimientos, de la conducta o del rendimiento escolar y tienen su origen en tensiones físicas, contradicciones en la crianza, conflictos maritales, malos tratos, negligencia, pérdida de figuras significativas, etc. Es importante señalar que no existe una relación directa entre

  18. Relationship between optimum preoperative fasting time and intervals between eating and trauma in pediatric patients undergoing emergency orthopedic surgery%急诊骨科患儿术前禁食的适宜时间与进食-创伤间期的关系

    Institute of Scientific and Technical Information of China (English)

    孙可; 金梅; 杨庆国

    2013-01-01

    目的 通过超声测量胃窦部横截面积(CSA),探讨急诊骨科患儿术前禁食的适宜时间与进食-创伤间期的关系.方法 择期骨科手术患儿50例,年龄2~7岁,ASA分级Ⅰ或Ⅱ级,体重10 ~ 25 kg,采用随机数字表法,将其分为2组(n=25):禁食6h组(CA组)和禁食8h组(CB组);急诊骨科手术患儿75例,年龄2~7岁,ASA分级Ⅰ或Ⅱ级,体重10~ 25 kg,根据进食-创伤间期分3组:进食-创伤间期≤1h组(TA组,n=22)、进食-创伤间期>1h且≤4h(TB组,n=26),进食-创伤间期>4h(TC组,n=27).CA组于距末次进食6 h(T1)时、CB组于距末次进食8 h(T2)时测量CSA,TA、TB、TC组于T1、T2时测量CSA.结果 CA组与CB组CSA比较差异无统计学意义(P>0.05).与CA组比较,TA组和TB组CSA增大(P<0.05),TC组差异无统计学意义(P>0.05);与CB组比较,TA组CSA增大(P<0.05),TB组和TC组差异无统计学意义(P>0.05);与TA组比较,TC组T1时、TB组和TC组T2时CSA减小(P<0.05),TB组T1时差异无统计学意义(P>0.05);与TB组比较,L时TC组CSA减小(P<0.05),T2时差异无统计学意义(P>0.05);与T1时比较,T2时TB组CSA减小(P<0.05),TA组和TC组差异无统计学意义(P>0.05).结论 对于急诊骨科患儿,进食-创伤间期1~4h之间建议术前禁食时间达到8h;进食-创伤间期<1h时,即使禁食8h仍不能达到禁食目的,应做好应对返流误吸的措施;进食-创伤间期>4h时者可适当缩短术前禁食时间至6h.%Objective To evaluate the relationship between the optimum preoperative fasting time and in tervals between eating and trauma in pediatric patients undergoing emergency orthopedic surgery by measuring the gastric antral cross-sectional area (CSA) using ultrasound.Methods Fifty ASA physical status Ⅰ or Ⅱ pediatric patients,aged 2-7 yr,weighing 10-25 kg,undergoing elective orthopedic surgery,were randomly divided into 2 groups (n =25 each) using a random number table:6-h fast group (group CA) and 8-h fast group

  19. Nuclear emergency preparedness in Canada

    International Nuclear Information System (INIS)

    The preparedness of utilities and government agencies at various levels for dealing with nuclear emergencies occurring at nuclear reactors in Canada is reviewed and assessed. The review is centered on power reactors, but selected research reactors are included also. Emergency planning in the U.S.A., Germany and France, and international recommendations on emergency planning are reviewed to provide background and a basis for comparison. The findings are that Canadians are generally well protected by existing nuclear emergency plans at the electric utility and provincial levels but there are improvements that can be made, mainly at the federal level and in federal-provincial coordination. Ten issues of importance are identified: commitment to nuclear emergency planning by the federal government; division of federal and provincial roles and responsibilities; auditing of nuclear emergency preparedness of all levels of government and of electric utilities; the availability of technical guidance appropriate to Canada; protective action levels for public health and safety; communication with the public; planning and response for the later phases of a nuclear emergency; off-site exercises and training; coordination of international assistance; and emergency planning for research reactors. (L.L.) 79 refs., 2 tabs

  20. Kerala Pioneering Pediatric Surgery in India

    Directory of Open Access Journals (Sweden)

    TP Joseph

    2014-04-01

    Full Text Available Pediatric surgeons of Kerala are very proud to have led the development of superspeciality in any branch of medicine in Kerala and also superspeciality of Pediatric surgery in whole of India. Late Prof. Raman Nair returned in 1954 after training under Dr. Everett Koop in US. Same year, in his far-sighted vision for future development of the speciality, he moved to SATH, Medical College, Trivandrum and started Pediatric surgery as a speciality attached to Paediatrics department; this was the beginning of Pediatric surgery in India. He opted for Pediatric surgery as a full time job and did not do any general surgery work in adults. He was the first full time Pediatric surgeon of India; during the next few years, 2 surgeons, one in Calcutta, Prof. UC Chakraboty and Prof. D Anjaneyulu in Hyderabad started working as full time Pediatric surgeons. In Mumbai, Delhi and Chennai, Pediatric surgery developed much later and then all over the country.

  1. What Is a Pediatric Critical Care Specialist?

    Science.gov (United States)

    ... in a pediatric intensive care unit (PICU). Pediatric critical care specialists coordinate the care of these children which is provided by a team of doctors, nurses, and other health care specialists. They use the ...

  2. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan;

    2013-01-01

    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping...

  3. Practical pediatric abdominal CT

    International Nuclear Information System (INIS)

    This course is designed to help the radiologist in a hospital setting successfully approach abdominal CT in the infant and child. Emphasis is placed on techniques necessary for a high-quality examination of the upper abdomen, as applied to common pediatric problems such as trauma, tumor, and infection. Material is presented on technical considerations, including patient sedation, preparation, and potential pitfalls and helpful hints for imaging. An emphasis is placed on dynamic scanning with table incrementation. The section on trauma focuses on an approach to imaging the abdomen in the injured child, typical injuries, patterns of injury in the upper abdomen, and why CT is the best imaging modality for blunt upper abdominal trauma. The discussion of tumor imaging reviews the appearance of typical childhood neoplasia including Wilms tumor, neuroblastoma, non-Hodgkin and Burkitt lymphoma, and disseminated solid tumors such as rhabdomyosarcoma. The authors emphasize what to look for and where, both on initial and on later (for recurrences) examinations. The discussion of infection addresses detection of abscesses and occult infections in children, as well as imaging of abscesses prior to intervention

  4. Pediatric cranial computed tomography

    International Nuclear Information System (INIS)

    The introduction of CT in the investigation of intercranial pathology has revolutionized the approach to clinical neurological and neurosurgical practice. This book applies the advances of cranial CT to the pediatric patient. The test is divided into two sections. The first portion describes the practical methodology, anatomy and normal and abnormal CT scan appearance, including high or low density lesions, cystic lesions and ventricular or subarachnoid space dilation. The characteristic scans for various neurological diseases are presented and discussed. The author has given special attention to the CT diagnosis of congenital malformations and cerebral neoplasms. Partial Contents: Normal Computed Tomographic Anatomy/ High Density Lesions/Low Density Lesions/Cystic Lesions; Supratentorial/Cystic Lesions; Infratentorial/Increased Head Circumference/Increased Ventricular Size/Small Ventricular Size/Cranial Lesions/Spinal Lesions/CT Cisternography/Part II CT in Neonates/Congenital Craniocerebral Malformations/Hydrocephalus/Craniosynostosis/Head Trauma/Cerebrovascular Lesions/Intracranial Lesions/Seizure Disorders/Intracranial and Other Chronic Neurological Disorders

  5. Common pediatric epilepsy syndromes.

    Science.gov (United States)

    Park, Jun T; Shahid, Asim M; Jammoul, Adham

    2015-02-01

    Benign rolandic epilepsy (BRE), childhood idiopathic occipital epilepsy (CIOE), childhood absence epilepsy (CAE), and juvenile myoclonic epilepsy (JME) are some of the common epilepsy syndromes in the pediatric age group. Among the four, BRE is the most commonly encountered. BRE remits by age 16 years with many children requiring no treatment. Seizures in CAE also remit at the rate of approximately 80%; whereas, JME is considered a lifelong condition even with the use of antiepileptic drugs (AEDs). Neonates and infants may also present with seizures that are self-limited with no associated psychomotor disturbances. Benign familial neonatal convulsions caused by a channelopathy, and inherited in an autosomal dominant manner, have a favorable outcome with spontaneous resolution. Benign idiopathic neonatal seizures, also referred to as "fifth-day fits," are an example of another epilepsy syndrome in infants that carries a good prognosis. BRE, CIOE, benign familial neonatal convulsions, benign idiopathic neonatal seizures, and benign myoclonic epilepsy in infancy are characterized as "benign" idiopathic age-related epilepsies as they have favorable implications, no structural brain abnormality, are sensitive to AEDs, have a high remission rate, and have no associated psychomotor disturbances. However, sometimes selected patients may have associated comorbidities such as cognitive and language delay for which the term "benign" may not be appropriate.

  6. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing ...

  7. Bedside emergency cardiac ultrasound in children

    Directory of Open Access Journals (Sweden)

    Doniger Stephanie

    2010-01-01

    Full Text Available Bedside emergency ultrasound has rapidly developed over the past several years and has now become part of the standard of care for several applications. While it has only recently been applied to critically ill pediatric patients, several of the well-established adult indications may be applied to pediatric patients. One of the most important and life-saving applications is bedside echocardiography. While bedside emergency ultrasonography does not serve to replace formal comprehensive studies, it serves as an extension of the physical examination. It is especially useful as a rapid and effective tool in the diagnosis of pericardial effusions, tamponade and in distinguishing potentially reversible causes of pulseless electrical activity from asystole. Most recently, left ventricular function and inferior vena cava measurements have proven helpful in the assessment of undifferentiated hypotension and shock in adults and children. Future research remains to be carried out in determining the efficacy of bedside ultrasonography in pediatric-specific pathology such as congenital heart disease. This article serves as a comprehensive review of the adult literature and a review of the recent applications in the pediatric emergency department. It also highlights the techniques of bedside ultrasonography with examples of normal and pathologic images.

  8. Human security and Canadian foreign policy: the new face of Canadian internationalism

    OpenAIRE

    DeJong, Melissa Joy

    2011-01-01

    In the late 1990s, human security was promoted as a new idea to guide the formation of Canadian foreign policy in the post-Cold War era. However, a review of the ideas which have influenced foreign policymaking in Canada since the end of the Second World War demonstrates that human security is rooted in internationalism, the dominant Canadian foreign policy tendency. Internationalism prescribes that cooperation, multilateralism, responsibility, international law and a consideration of the v...

  9. Bidi and Hookah Use Among Canadian Youth: Findings From the 2010 Canadian Youth Smoking Survey

    OpenAIRE

    Czoli, Christine D; Leatherdale, Scott T; Rynard, Vicki

    2013-01-01

    Introduction Although cigarette use among Canadian youth has decreased significantly in recent years, alternative forms of tobacco use are becoming increasingly popular. Surveillance of youth tobacco use can help inform prevention programs by monitoring trends in risk behaviors. We examined the prevalence of bidi and hookah use and factors associated with their use among Canadian youth by using data from the 2010–2011 Youth Smoking Survey (YSS). Methods We analyzed YSS data from 28,416 studen...

  10. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Groen, Aard J.; Sijde, van der Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies an

  11. 2009 Pediatric Academic Societies Annual Meeting

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Pediatric experts from Children's National Medical Center are being featured in 85 presentations, workshops, and posters at the 2009 Pediatric Academic Societies Annual Meeting-the largest meeting for pediatric clinical research in the country, May 2-5, Baltimore, Maryland.

  12. Forecasting Canadian nuclear power station construction costs

    International Nuclear Information System (INIS)

    Because of the huge volume of capital required to construct a modern electric power generating station, investment decisions have to be made with as complete an understanding of the consequences of the decision as possible. This understanding must be provided by the evaluation of future situations. A key consideration in an evaluation is the financial component. This paper attempts to use an econometric method to forecast the construction costs escalation of a standard Canadian nuclear generating station (NGS). A brief review of the history of Canadian nuclear electric power is provided. The major components of the construction costs of a Canadian NGS are studied and summarized. A database is built and indexes are prepared. Based on these indexes, an econometric forecasting model is constructed using an apparently new econometric methodology of forecasting modelling. Forecasts for a period of 40 years are generated and applications (such as alternative scenario forecasts and range forecasts) to uncertainty assessment and/or decision-making are demonstrated. The indexes, the model, and the forecasts and their applications, to the best of the author's knowledge, are the first for Canadian NGS constructions. (author)

  13. Asian and Pacific Migration: The Canadian Experience.

    Science.gov (United States)

    Samuel, T. John

    1994-01-01

    Examines the characteristics of landed immigrants (permanent settlers) from Asia, and explores their settlement, adaptation, and integration experience in Canada. It suggests that access to Canadian land does not always translate into equal opportunity in the economy and society, but notes that Canada may be more successful at assimilating Asian…

  14. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

    Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada

  15. A Canadian View of Monitoring Activities

    Science.gov (United States)

    Inhaber, Herbert

    1975-01-01

    A Canadian scientist discusses his country's environmental monitoring programs (by parameter and medium), points out their strengths and weaknesses, and indicates some possible directions for future efforts in the field of environmental monitoring at both the national and international level. (BT)

  16. Who Are the Players in Canadian Curriculum?

    Science.gov (United States)

    Milburn, Geoffrey

    1987-01-01

    Labels range of persons advocating different theoretical positions of Canadian curriculum as "players." Describes players as "managers,""predictors,""transformers,""sleuths,""analysts." Values varied viewpoints for attention to language regarding curriculum, critical review of ideas/concepts, examination of current policies, awareness of history…

  17. Canadian Art Partnership Program in Finland

    Science.gov (United States)

    Ketovuori, Mikko

    2011-01-01

    This article is about a multidisciplinary R&D project in which a Canadian Learning Through The Arts (LTTA) program was imported to Finland in 2003-2004. Cultural differences in arts education in Finland and Canada are discussed. While Finland has a national school curriculum with all the arts included. Canada relies more on partnerships to ensure…

  18. In the Field: The Canadian Ecology Centre.

    Science.gov (United States)

    Magee, Clare

    2000-01-01

    The Canadian Ecology Centre (Ontario) offers year-round residential and day programs in outdoor and environmental education for secondary students, field placement and internship opportunities for college students, and ecotourism programs, while providing employment and tax revenues to the local community. Dubbed consensus environmentalism, the…

  19. Canadian Indigenous Arts Exhibited in China

    Institute of Scientific and Technical Information of China (English)

    YangCheng

    2004-01-01

    A beautiful collection of Canadian Inuit wall hangings, titled “Culture on Cloth,” was exhibited at the Capital Library in Beijing from October 12 to 22, 2004. The exhibition was composed of 19 works by women artists from Baker Lake, Nunavut, Canada.

  20. Canadian Adult Education: Still a Movement

    Science.gov (United States)

    Nesbit, Tom

    2011-01-01

    Writing recently in this journal, two of Canada's veteran adult educators contemplated the "death" of the Canadian adult education movement. I disagree and argue that adult education in Canada is as vital an activity as ever and one that still fully justifies being called a movement. Specifically, Selman and Selman (2009) list five trends that…

  1. Revisiting the Canadian English vowel space

    Science.gov (United States)

    Hagiwara, Robert

    2005-04-01

    In order to fill a need for experimental-acoustic baseline measurements of Canadian English vowels, a database is currently being constructed in Winnipeg, Manitoba. The database derives from multiple repetitions of fifteen English vowels (eleven standard monophthongs, syllabic /r/ and three standard diphthongs) in /hVd/ and /hVt/ contexts, as spoken by multiple speakers. Frequencies of the first four formants are taken from three timepoints in every vowel token (25, 50, and 75% of vowel duration). Preliminary results (from five men and five women) confirm some features characteristic of Canadian English, but call others into question. For instance the merger of low back vowels appears to be complete for these speakers, but the result is a lower-mid and probably rounded vowel rather than the low back unround vowel often described. With these data Canadian Raising can be quantified as an average 200 Hz or 1.5 Bark downward shift in the frequency of F1 before voiceless /t/. Analysis of the database will lead to a more accurate picture of the Canadian English vowel system, as well as provide a practical and up-to-date point of reference for further phonetic and sociophonetic comparisons.

  2. Computer Language Settings and Canadian Spellings

    Science.gov (United States)

    Shuttleworth, Roger

    2011-01-01

    The language settings used on personal computers interact with the spell-checker in Microsoft Word, which directly affects the flagging of spellings that are deemed incorrect. This study examined the language settings of personal computers owned by a group of Canadian university students. Of 21 computers examined, only eight had their Windows…

  3. Family Business Training: A Canadian Perspective

    Science.gov (United States)

    Ibrahim, A. B.; Soufani, K.; Lam, Jose

    2003-01-01

    Family firms play an important role in the working of the Canadian economy; despite their importance to the economic activities and job creation it is observed that family businesses have lower survival rates than non-family firms, some argue that this can possibly be attributed (amongst other factors) to the lack of training. Most of the training…

  4. An Overview of Canadian Education. Fourth Edition.

    Science.gov (United States)

    Gayfer, Margaret

    An overview of Canadian education is provided in this book. Chapter 1 presents basic facts and figures on the educational system's general structure and diversity and the role of the federal government. The second chapter describes provincial/territorial structure, specifically: the role of the departments of education and school board, financing,…

  5. Canadian Ethnohistory: A Source for Social Studies?

    Science.gov (United States)

    Wickwire, Wendy

    1998-01-01

    Presents an overview of ethnohistory, a relatively new area of historical investigation that draws on anthropology, geography, and linguistics, as well as history, to document the pasts of predominantly indigenous peoples. Encourages social studies teachers to take notice of a major body of work being produced by Canadian ethnohistorians. (DSK)

  6. International surgery: definition, principles and Canadian practice.

    Science.gov (United States)

    Lett, Ronald

    2003-10-01

    This article is dedicated to the Canadian international surgeon, Norman Bethune (1890-1939). International surgery is defined as a humanitarian branch of medicine concerned with the treatment of bodily injuries or disorders by incision or manipulations, emphasizing cooperation and understanding among nations and involving education, research, development and advocacy. In this article I review the colonial past, the dark ages following the Declaration of Alma-Ata, the progress made and the present challenges in international surgery. I present a definition of international surgery that recognizes the current era of surgical humanitarianism, validates a global understanding of surgical issues and promotes cooperation among nations. Included are the principles of international surgery: education, research, infrastructure development and advocacy. International surgical projects are classified according to type (clinical, relief, developmental) and integration strategy (vertical or horizontal). Also reviewed are the Canadian practice of international surgery by nongovernmental, professional and academic organizations and the requirements of international and Canadian funding agencies, the development concepts basic to all projects, including results-based management and the cross-cutting themes of gender equity, environmental protection and human safety. I recommend formalizing international surgery into a discipline as a means of promoting surgical care in low-income countries. If international surgery is to be sustained in Canada, infrastructure and support from Canadian surgeons is particularly important. An understanding of the history, definition and classification of international surgery should promote surgical care in low-income countries.

  7. Canadian suicide mortality rates: first-generation immigrants versus Canadian-born.

    Science.gov (United States)

    Strachan, J; Johansen, H; Nair, C; Nargundkar, M

    1990-01-01

    This article examines suicide mortality rates and trends in Canada for first-generation immigrants and the Canadian-born population. Data are analyzed by age, sex and country of birth. Since 1950, suicide rates worldwide for both men and women have been increasing. In North America and most of Europe, suicide has been one of the major causes of death for many years. In Canada, suicide rates are also rising. However, this increase is due entirely to a rise in the rate for men; the rate for women has remained relatively stable. Several differences are apparent between the rates for the Canadian-born population and those for first-generation immigrants. For example, three times as many Canadian-born men as women commit suicide. For first-generation immigrants, the ratio is two to one. Suicide mortality rates for the Canadian-born are higher than those for first-generation immigrants in every age group except for the 65 and over groups. Canadian born males have higher ASMR than first generation immigrant males. The rates for women show that first-generation immigrant women have higher suicide mortality rates than their Canadian-born counterparts, and that the highest rate for all women is for immigrants born in Asia.

  8. National study of continuity clinic satisfaction in pediatric fellowship training

    Directory of Open Access Journals (Sweden)

    Gangat M

    2013-09-01

    Full Text Available Mariam Gangat,1 Genna W Klein,1 Hillel W Cohen,2 Rubina A Heptulla1 1Division of Pediatric Endocrinology and Diabetes, The Children's Hospital at Montefiore, 2Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA Background: A national online survey was conducted to evaluate pediatric subspecialty fellow satisfaction regarding continuity clinic experience. Methods: An anonymous online survey (SurveyMonkey™ was developed to evaluate demographics of the program, clinic organization, and patient and preceptor characteristics, and to compare fellow satisfaction when fellows were the primary providers with faculty supervision versus attending-run clinics assisted by fellows or a combination of the two models. Pediatric subspecialty fellows in a 3-year Accreditation Council for Graduate Medical Education accredited program in the United States (excluding emergency medicine, neonatology, and critical care were invited to participate. Results: There were 644 respondents and nearly half (54% of these had fellow-run clinics. Eighty-six percent of fellows responded that they would prefer to have their own continuity clinics. Higher satisfaction ratings on maintaining continuity of care, being perceived as the primary provider, and feeling that they had greater autonomy in patient management were associated with being part of a fellow-run clinic experience (all P < 0.001. Additionally, fellow-run clinics were associated with a feeling of increased involvement in designing a treatment plan based on their differential diagnosis (P < 0.001. There were no significant associations with patient or preceptor characteristics. Conclusion: Fellow-run continuity clinics provide fellows with a greater sense of satisfaction and independence in management plans. Keywords: resident education/training, workforce, pediatric, patient-provider relationship, pediatric outpatient clinic

  9. Treatment Options for Pediatric Psoriasis.

    Science.gov (United States)

    Madiraca, Dora; Šitum, Mirna; Prkačin, Ivana; Ožanić Bulić, Suzana

    2016-08-01

    Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of the pediatric population. Pediatric psoriasis, presenting similar to adult psoriasis, significantly reduces patient quality of life, often requiring an individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease severity respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are the next line of treatment to be considered. There is limited data available on the use and long-term safety of biologics in the pediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis who are intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those treatments are contraindicated. PMID:27663917

  10. Predictors of Outcome of Convulsive Status Epilepticus Among an Egyptian Pediatric Tertiary Hospital.

    Science.gov (United States)

    Halawa, Eman F; Draz, Iman; Ahmed, Dalia; Shaheen, Hala A

    2015-11-01

    Convulsive status epilepticus is a common neurologic emergency in pediatrics. We aimed to study the etiology, clinical features, and prognostic factors among pediatric patients with convulsive status epilepticus. Seventy patients were included in this cohort study from pediatric emergency department of the specialized Children Hospital of Cairo University. The outcome was evaluated using the Glasgow Outcome Score. Acute symptomatic etiology was the most common cause of convulsive status epilepticus. Refractory convulsive status epilepticus was observed more significantly in cases caused by acute symptomatic etiologies. The outcome was mortality in 26 (37.1%) patients, severe disability in 15 (21.4%), moderate disability in 17 (24.3%), and good recovery in 12 (17.1%) patients. The significant predictor of mortality was lower modified Glasgow Coma Scale score on admission, whereas lower modified Glasgow Coma Scale score on admission and refractory convulsive status epilepticus were the significant predictors for disability and mortality.

  11. MicroRNAs and Recent Insights into Pediatric Ovarian Cancers

    Directory of Open Access Journals (Sweden)

    Jessica Anne Crawford

    2013-04-01

    Full Text Available Ovarian cancer is the most common pediatric gynecologic malignancy. When diag-nosed in children, ovarian cancers present unique challenges that differ dramatically from those faced by adults. Here, we review the spectrum of ovarian cancers found in young women and girls and discuss the biology of these diseases. A number of advances have re-cently shed significant new understanding on the potential causes of ovarian cancer in this unique population. Particular emphasis is placed on understanding how altered expression of non-coding RNA transcripts known as microRNAs play a key role in the etiology of ovarian germ cell and sex cord-stromal tumors. Emerging transgenic models for these diseases are also reviewed. Lastly, future challenges and opportunities for understanding pediatric ovarian cancers, delineating clinically useful biomarkers and developing targeted therapies are discussed.

  12. Gaps in pediatric clinician communication and opportunities for improvement.

    Science.gov (United States)

    Woods, Donna M; Holl, Jane L; Angst, Denise B; Echiverri, Susan C; Johnson, Daniel; Soglin, David F; Srinivasan, Gopal; Amsden, Laura B; Barnathan, Julia; Hason, Teri; Lamkin, Leonard; Weiss, Kevin B

    2008-01-01

    Teamwork and good communication are central to the provision of high-quality care. A standardized focus-group protocol was used. Analysis assessed emergent themes of patient safety-related effective and problematic clinician communication. Sixty-three focus groups were conducted with clinicians from five Chicago Pediatric Patient Safety Consortium hospitals. Effective and problematic clinician-to-clinician communication themes were described in all focus groups and at each participating hospital. Problematic communication contexts included the communication process for orders, consultations, acuity assessment, management of surgical and medical patients, and the discharge process. Organizational policies and systems leading to patient safety risk included a lack of clear responsibilities and expectations for clinicians and for clinical communication, as well as a lack of a clear chain of responsibility for communication when hierarchical communication barriers affected safe patient care. Results of this investigation highlighted gaps in pediatric clinician communication and opportunities for improvement. PMID:18831476

  13. Diffusion-weighted imaging in pediatric body magnetic resonance imaging.

    Science.gov (United States)

    Chavhan, Govind B; Caro-Dominguez, Pablo

    2016-05-01

    Diffusion-weighted MRI is being increasingly used in pediatric body imaging. Its role is still emerging. It is used for detection of tumors and abscesses, differentiation of benign and malignant tumors, and detection of inflamed bowel segments in inflammatory bowel disease in children. It holds great promise in the assessment of therapy response in body tumors, with apparent diffusion coefficient (ADC) value as a potential biomarker. Significant overlap of ADC values of benign and malignant processes and less reproducibility of ADC measurements are hampering its widespread use in clinical practice. With standardization of the technique, diffusion-weighted imaging (DWI) is likely to be used more frequently in clinical practice. We discuss the principles and technique of DWI, selection of b value, qualitative and quantitative assessment, and current status of DWI in evaluation of disease processes in the pediatric body. PMID:27229502

  14. Pediatric health, medicine, and therapeutics

    Directory of Open Access Journals (Sweden)

    Claire E Wainwright

    2011-03-01

    Full Text Available Claire E Wainwright1,21Royal Children’s Hospital, Brisbane and Queensland, Queensland, Australia; 2Queensland Children’s Medical Research Institute, The University of Queensland, Brisbane, AustraliaThe idea of children as small adults with health care needs that can be managed by extrapolation from adult studies has now largely been abandoned. We now recognize that adult health and disease are closely linked to childhood factors and the critical and ethical importance of clinical research in pediatrics is increasingly being recognized.  While funding and output from pediatric clinical research continues to lag behind health research in adults, particularly in the area of therapeutics, the last decade has thankfully seen a dramatic increase in the number of pediatric studies and particularly randomized controlled clinical trials (RCTs. Since the 1997 Food and Drug Administration (FDA Modernization Act in the United States (US and the subsequent changes in drug registration regulatory systems in the US and Europe, there has been a huge increase in the number of pediatric studies sponsored by pharmaceutical companies. In the United Kingdom, the Medicine for Children’s Research Network was established in 2005 to address the lack of clinical studies in pediatrics. Over the first five years they reported an exciting increase in the number of high quality clinical studies and on their website they have a current portfolio of over 200 pediatric studies, half of which are RCTs and half are sponsored by pharmaceutical companies. Other countries particularly across Europe are also establishing similar programs. 

  15. The Canadian Natural Health Products (NHP regulations: industry perceptions and compliance factors

    Directory of Open Access Journals (Sweden)

    Boon Heather

    2006-05-01

    Full Text Available Abstract Background The use of natural health products, such as vitamins, minerals, and herbs, by Canadians has been increasing with time. As a result of consumer concern about the quality of these products, the Canadian Department of Health created the Natural Health Products (NHP Regulations. The new Canadian regulations raise questions about whether and how the NHP industry will be able to comply and what impact they will have on market structure. The objectives of this study were to explore who in the interview sample is complying with Canada's new NHP Regulations (i.e., submitted product licensing applications on time; and explore the factors that affect regulatory compliance. Methods Twenty key informant interviews were conducted with employees of the NHP industry. The structured interviews focused on the level of satisfaction with the Regulations and perceptions of compliance and non-compliance. Interviews were tape recorded and then transcribed verbatim. Data were independently coded, using qualitative content analysis. Team meetings were held after every three to four interviews to discuss emerging themes. Results The major finding of this study is that most (17 out of 20 companies interviewed were beginning to comply with the new regulatory regime. The factors that contribute to likelihood of regulatory compliance were: perceptions and knowledge of the regulations and business size. Conclusion The Canadian case can be instructive for other countries seeking to implement regulatory standards for natural health products. An unintended consequence of the Canadian NHP regulations may be the exit of smaller firms, leading to industry consolidation.

  16. An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

    Directory of Open Access Journals (Sweden)

    Snyder Jeremy

    2011-05-01

    Full Text Available Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients

  17. An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

    Science.gov (United States)

    2011-01-01

    Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad

  18. Pediatric transverse myelitis.

    Science.gov (United States)

    Absoud, Michael; Greenberg, Benjamin M; Lim, Ming; Lotze, Tim; Thomas, Terrence; Deiva, Kumaran

    2016-08-30

    Pediatric acute transverse myelitis (ATM) is an immune-mediated CNS disorder and contributes to 20% of children experiencing a first acquired demyelinating syndrome (ADS). ATM must be differentiated from other presentations of myelopathy and may be the first presentation of relapsing ADS such as neuromyelitis optica (NMO) or multiple sclerosis (MS). The tenets of the diagnostic criteria for ATM established by the Transverse Myelitis Consortium Working Group can generally be applied in children; however, a clear sensory level may not be evident in some. MRI lesions are often centrally located with high T2 signal intensity involving gray and neighboring white matter. Longitudinally extensive ATM occurs in the majority. Asymptomatic lesions on brain MRI are seen in more than one-third and predict MS or NMO. The role of antibodies such as myelin oligodendrocyte glycoprotein in monophasic and relapsing ATM and their significance in therapeutic approaches remain unclear. ATM is a potentially devastating condition with variable outcome and presents significant cumulative demands on health and social care resources. Children generally have a better outcome than adults, with one-half making a complete recovery by 2 years. There is need for standardization of clinical assessment and investigation protocols to enable international collaborative studies to delineate prognostic factors for disability and relapse. There are no robust controlled trials in children or adults to inform optimal treatment of ATM, with one study currently open to recruitment. This review provides an overview of current knowledge of clinical features, investigative workup, pathogenesis, and management of ATM and suggests future directions. PMID:27572861

  19. Pediatric Cardiology Boot Camp: Description and Evaluation of a Novel Intensive Training Program for Pediatric Cardiology Trainees.

    Science.gov (United States)

    Ceresnak, Scott R; Axelrod, David M; Motonaga, Kara S; Johnson, Emily R; Krawczeski, Catherine D

    2016-06-01

    The transition from residency to subspecialty fellowship in a procedurally driven field such as pediatric cardiology is challenging for trainees. We describe and assess the educational value of a pediatric cardiology "boot camp" educational tool designed to help prepare trainees for cardiology fellowship. A two-day intensive training program was provided for pediatric cardiology fellows in July 2015 at a large fellowship training program. Hands-on experiences and simulations were provided in: anatomy, auscultation, echocardiography, catheterization, cardiovascular intensive care (CVICU), electrophysiology (EP), heart failure, and cardiac surgery. Knowledge-based exams as well as surveys were completed by each participant pre-training and post-training. Pre- and post-exam results were compared via paired t tests, and survey results were compared via Wilcoxon rank sum. A total of eight participants were included. After boot camp, there was a significant improvement between pre- and post-exam scores (PRE 54 ± 9 % vs. POST 85 ± 8 %; p ≤ 0.001). On pre-training survey, the most common concerns about starting fellowship included: CVICU emergencies, technical aspects of the catheterization/EP labs, using temporary and permanent pacemakers/implantable cardiac defibrillators (ICDs), and ECG interpretation. Comparing pre- and post-surveys, there was a statistically significant improvement in the participants comfort level in 33 of 36 (92 %) areas of assessment. All participants (8/8, 100 %) strongly agreed that the boot camp was a valuable learning experience and helped to alleviate anxieties about the start of fellowship. A pediatric cardiology boot camp experience at the start of cardiology fellowship can provide a strong foundation and serve as an educational springboard for pediatric cardiology fellows. PMID:26961569

  20. Psychological complications of pediatric obesity.

    Science.gov (United States)

    Vander Wal, Jillon S; Mitchell, Elisha R

    2011-12-01

    Psychological complications associated with pediatric obesity include low self-esteem, depression, body dissatisfaction, loss-of-control eating, unhealthy and extreme weight control behaviors, impaired social relationships, obesity stigma, and decreased health-related quality of life. Bioecological models offer a framework for understanding the interaction between pediatric obesity and psychological complications and illustrate system-level approaches for prevention and intervention. As the medical setting is often the first point of contact for families, pediatricians are instrumental in the identification and referral of children with psychological complications. Motivational interviewing, patient talking points, brief screening measures, and referral resources are important tools in this process. PMID:22093858

  1. Advances in Pediatric Gastrostomy Placement.

    Science.gov (United States)

    McSweeney, Maireade E; Smithers, C Jason

    2016-01-01

    Placement of gastrostomy tubes in infants and children has become increasingly commonplace. A historical emphasis on use of open gastrostomy has been replaced by less invasive methods of placement, including percutaneous endoscopic gastrostomy and laparoscopically assisted gastrostomy procedures. Various complications, ranging from minor to the more severe, have been reported with all methods of placement. Many pediatric patients who undergo gastrostomy tube placement will require long-term enteral therapy. Given the prolonged time pediatric patients may remain enterally dependent, further quality improvement and education initiatives are needed to improve long-term care and outcomes of these patients.

  2. Psychoneuroimmunology and the pediatric surgeon.

    Science.gov (United States)

    Tagge, Edward P; Natali, Elizabeth Lee; Lima, Evan; Leek, Dustin; Neece, Cameron L; Randall, Kiti Freier

    2013-08-01

    The mind-body connection is receiving increasing scrutiny in a large number of clinical settings, although research has lagged in the pediatric specialties. Psychoneuroimmunology (PNI) is a novel interdisciplinary scientific field that examines the relationship of the mind to the patient's neurologic, endocrine, and immune systems by examining critical parameters such as the effects of mental stress on wound healing and infection rates. Techniques that modify a patient's emotional and mental responses to illness and surgery have positive effects on their physiology resulting in improved recoveries and higher patient satisfaction rates. In the appropriate clinical settings, an awareness of PNI can enhance outcomes for pediatric surgical patients.

  3. Setting up the Pediatric Endoscopy Unit.

    Science.gov (United States)

    Lerner, Diana G; Pall, Harpreet

    2016-01-01

    As pediatric gastrointestinal endoscopy continues to develop and evolve, pediatric gastroenterologists are more frequently called on to develop and direct a pediatric endoscopy unit. Lack of published literature and focused training in fellowship can render decision making about design, capacity, operation, equipment purchasing, and staffing challenging. To help guide management decisions, we distributed a short survey to 18 pediatric gastroenterology centers throughout the United States and Canada. This article provides practical guidance by summarizing available expert opinions on the topic of setting up a pediatric endoscopy unit. PMID:26616893

  4. Nuclear Medicine in Pediatric and Adolescent Tumors.

    Science.gov (United States)

    Kiratli, Pınar Özgen; Tuncel, Murat; Bar-Sever, Zvi

    2016-07-01

    patients for peptide receptor radionuclide therapy with somatostatin analogues. C-11 hydroxyephedrine PET/CT is a specific PET tracer for NB, but the C-11 label that requires an on-site cyclotron production and the high physiologic uptake in the liver and kidneys limit its use. I-124 MIBG is useful for I-131 MIBG pretherapeutic dosimetry planning. Its use for diagnostic imaging as well as the use of F-18 labeled MIBG analogues is currently experimental. PET/MR imaging is emerging and is likely to become an important tool in the evaluation. It provides metabolic and superior morphological data in one imaging session, expediting the diagnosis and lowering the radiation exposure. Radioactive iodines not only detect residual tissue and metastatic disease but also are used in the treatment of differentiated thyroid cancer. However, these are not well documented in pediatric age group like adult patients. Use of radioactivity in pediatric population is very important and strictly controlled because of the possibility of secondary malignities; therefore, management of oncological cases requires detailed literature knowledge. This article aims to review the literature on the use of radionuclide imaging and therapy in pediatric population with thyroid cancer, sarcomas, lymphoma, and NB. PMID:27237441

  5. Health behaviour changes after diagnosis of chronic illness among Canadians aged 50 or older.

    Science.gov (United States)

    Newson, Jason T; Huguet, Nathalie; Ramage-Morin, Pamela L; McCarthy, Michael J; Bernier, Julie; Kaplan, Mark S; McFarland, Bentson H

    2012-12-01

    Changes in health behaviours (smoking, physical activity, alcohol consumption, and fruit and vegetable consumption) after diagnosis of chronic health conditions (heart disease, cancer, stroke, respiratory disease, and diabetes) were examined among Canadians aged 50 or older. Results from 12 years of longitudinal data from the Canadian National Population Health Survey indicated relatively modest changes in behaviour. Although significant decreases in smoking were observed among all groups except those with respiratory disease, at least 75% of smokers did not quit. No significant changes emerged in the percentage meeting physical activity recommendations, except those with diabetes, or in excessive alcohol consumption, except those with diabetes and respiratory disease. The percentage reporting the recommended minimum fruit and vegetable intake did not increase significantly among any group.

  6. Dragon slayers: Canadian wild well tamers among the best in world

    International Nuclear Information System (INIS)

    The development of oil well fire fighting techniques, and some of the more famous fires in the Alberta oil patch such as the Atlantic 3 blowout at Leduc Alberta in 1955 and the Lodgepole fire in 1982, are described, leading up to a discussion of the outstanding work done by Canadian oilfield fire fighters in Kuwait. During the Gulf War in 1991 the retreating Iraqi forces blew up 732 oil wells, sparking the largest oilfield emergency in history. Fire fighters from the Drayton Valley, Alberta, firm of 'Safety Boss' snuffed out 180 wells in 200 days, establishing Canadian oil well fire fighters as among the best in the world. Since then, the company was called upon to assist in extinguishing fires at the Tupras Refinery following the earthquake in Turkey in the summer of 1999, and at the Hub Oil Ltd. fire in southeast Calgary, just a week prior to the earthquake in Turkey. 2 photos

  7. Recognizing victims of human trafficking in the pediatric emergency department.

    Science.gov (United States)

    Becker, Heather J; Bechtel, Kirsten

    2015-02-01

    Human trafficking is a form of modern-day slavery that is rapidly expanding in the United States and throughout the world. It is a crime under both the United States and international law. The child and adult victims of human trafficking are denied their basic human rights and subjected to unspeakable physical and emotional harm. Traffickers exert complete control over their victims and are proficient at hiding their condition from authorities. Healthcare practitioners may be the only professionals who come into contact with victims if they present for medical care. This article will describe human trafficking and its potential victims, as well as guide medical management and access to services that will ensure their safety and restore their freedom. PMID:25651385

  8. Methylisothiazolinone: an emergent allergen in common pediatric skin care products.

    Science.gov (United States)

    Schlichte, Megan J; Katta, Rajani

    2014-01-01

    Recalcitrant dermatitis, such as that of the hands, face, or genitals, may be due to allergic contact dermatitis (ACD) from ingredients in seemingly innocuous personal care products. Rising rates of allergy have been noted due to the preservative methylisothiazolinone (MI). This preservative is commonly found in skin and hair care products, especially wipes. This study evaluated the use of MI in products specifically marketed for babies and children and examined the associated marketing terms of such products. Ingredients of skin care products specifically marketed for babies and children were surveyed at two major retailers. Of 152 products surveyed, 30 products contained MI. Categories of products surveyed included facial or body wipes, antibacterial hand wipes, hair products, soaps, bubble baths, moisturizers, and sunscreens. Facial or body wipes and hair products were the categories with the greatest number of MI-containing products. MI-containing products were manufactured by a number of popular brands. Of note, products marketed as "gentle," "sensitive," "organic," or "hypoallergenic" often contained MI, thus emphasizing the importance of consumer scrutiny of product choices. These findings reinforce the importance of educating parents and providing consumer decision-making advice regarding common skin care products, in order to help prevent ACD in children. PMID:25342949

  9. Methylisothiazolinone: An Emergent Allergen in Common Pediatric Skin Care Products

    Directory of Open Access Journals (Sweden)

    Megan J. Schlichte

    2014-01-01

    Full Text Available Recalcitrant dermatitis, such as that of the hands, face, or genitals, may be due to allergic contact dermatitis (ACD from ingredients in seemingly innocuous personal care products. Rising rates of allergy have been noted due to the preservative methylisothiazolinone (MI. This preservative is commonly found in skin and hair care products, especially wipes. This study evaluated the use of MI in products specifically marketed for babies and children and examined the associated marketing terms of such products. Ingredients of skin care products specifically marketed for babies and children were surveyed at two major retailers. Of 152 products surveyed, 30 products contained MI. Categories of products surveyed included facial or body wipes, antibacterial hand wipes, hair products, soaps, bubble baths, moisturizers, and sunscreens. Facial or body wipes and hair products were the categories with the greatest number of MI-containing products. MI-containing products were manufactured by a number of popular brands. Of note, products marketed as “gentle,” “sensitive,” “organic,” or “hypoallergenic” often contained MI, thus emphasizing the importance of consumer scrutiny of product choices. These findings reinforce the importance of educating parents and providing consumer decision-making advice regarding common skin care products, in order to help prevent ACD in children.

  10. Recognizing victims of human trafficking in the pediatric emergency department.

    Science.gov (United States)

    Becker, Heather J; Bechtel, Kirsten

    2015-02-01

    Human trafficking is a form of modern-day slavery that is rapidly expanding in the United States and throughout the world. It is a crime under both the United States and international law. The child and adult victims of human trafficking are denied their basic human rights and subjected to unspeakable physical and emotional harm. Traffickers exert complete control over their victims and are proficient at hiding their condition from authorities. Healthcare practitioners may be the only professionals who come into contact with victims if they present for medical care. This article will describe human trafficking and its potential victims, as well as guide medical management and access to services that will ensure their safety and restore their freedom.

  11. Emergency treatment options for pediatric traumatic brain injury

    OpenAIRE

    Exo, J; Smith, C.; Smith, R.; Bell, MJ

    2009-01-01

    Traumatic brain injury is a leading killer of children and is a major public health problem around the world. Using general principles of neurocritical care, various treatment strategies have been developed to attempt to restore homeostasis to the brain and allow brain healing, including mechanical factors, cerebrospinal fluid diversion, hyperventilation, hyperosmolar therapies, barbiturates and hypothermia. Careful application of these therapies, normally in a step-wise fashion as intracrani...

  12. Biomarker Correlates of Survival in Pediatric Patients with Ebola Virus Disease

    Centers for Disease Control (CDC) Podcasts

    2014-08-19

    Dr. Mike Miller reads an abridged version of the article, Biomarker Correlates of Survival in Pediatric Patients with Ebola Virus Disease.  Created: 8/19/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/19/2014.

  13. Evaluation by thermography of pediatric orthopaedic injuries; Evaluacion mediante termografia de lesions traumatologicas pediatricas

    Energy Technology Data Exchange (ETDEWEB)

    Morillo, M.; Cibrian, R.; Codoner, P.; Ballester, E.; Gonzalez-Pena, R.; Dalmases, F.; Romero, C.; Nebot, P.; Salvador, R.

    2013-07-01

    In this paper we have used thermography as a diagnostic of child trauma injury technique, seeking to turn it into an alternative to x-rays in this field. The objectives have focused on the preparation of an optimal protocol of imaging in a Pediatric Emergency Department and obtain variable quantifier of pathology. (Author)

  14. Psychiatric adverse effects of pediatric corticosteroid use.

    Science.gov (United States)

    Drozdowicz, Linda B; Bostwick, J Michael

    2014-06-01

    Corticosteroids, highly effective drugs for myriad disease states, have considerable neuropsychiatric adverse effects that can manifest in cognitive disorders, behavioral changes, and frank psychiatric disease. Recent reviews have summarized these effects in adults, but a comprehensive review on corticosteroid effects in children has not been published since 2005. Here, we systematically review articles published since then that, we find, naturally divide into 3 main areas: (1) chronic effects of acute prenatal and neonatal exposure associated with prematurity and congenital conditions; (2) immediate behavioral effects of acute exposure via oncological protocols; and (3) acute behavioral effects of sporadic use in children and adolescents with other conditions. PsycInfo, MEDLINE, Embase, and Scopus were queried to identify articles reporting psychiatric adverse effects of corticosteroids in pediatric patients. Search terms included corticosteroids, adrenal cortex hormones, steroid psychosis, substance-induced psychoses, glucocorticoids, dexamethasone, hydrocortisone, prednisone, adverse effects, mood disorders, mental disorders, psychosis, psychotic, psychoses, side effect, chemically induced, emotions, affective symptoms, toxicity, behavior, behavioral symptoms, infant, child, adolescent, pediatric, paediatric, neonatal, children, teen, and teenager. Following guidelines for systematic reviews from the Potsdam Consultation on Meta-Analysis, we have found it difficult to draw specific conclusions that are more than general impressions owing to the quality of the available studies. We find a mixed picture with neonates exposed to dexamethasone, with some articles reporting eventual deficits in neuropsychiatric functioning and others reporting no effect. In pediatric patients with acute lymphoblastic leukemia, corticosteroid use appears to correlate with negative psychiatric and behavioral effects. In children treated with corticosteroids for noncancer conditions

  15. Pediatric glaucoma: current perspectives

    Directory of Open Access Journals (Sweden)

    Marchini G

    2014-05-01

    Full Text Available Giorgio Marchini, Marco Toscani, Francesca Chemello Eye Clinic, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy Abstract: “Childhood glaucoma” is a heterogeneous group of severe pediatric conditions often associated with significant visual loss and characterized by elevated intraocular pressure (IOP and optic-disk cupping. Successful IOP control is crucial but challenging and most often achieved surgically, with medical therapy playing a supportive role. There are many classifications of childhood glaucoma, but they can simply be divided into primary, in which a developmental abnormality of the anterior chamber angle only exists, and secondary, in which aqueous outflow is reduced due to independent mechanisms that secondarily impair the function of the filtration angle. The worldwide prevalence of childhood blindness ranges from 0.03% in high-income countries to 0.12% in undeveloped countries. The majority of cases do not have an identified genetic mutation and, where the mutation is known, the genes often account for only a small proportion of cases. Several pathogenetic mechanisms are known to contribute to the development of childhood glaucoma. Whatever the cause, it results in a reduced aqueous outflow at the level of the trabecular meshwork. Age of onset and magnitude of the elevated IOP largely determine the clinical manifestation the high variability of clinical manifestations. Glaucoma from any cause in a neonate and infant is characterized by the classic triad of epiphora, photophobia, and blepharospasm, and could be associated with eye enlargement (buphthalmos and Haab striae. The eye examination, usually performed under general anesthesia, includes: tonometry, anterior-segment examination, gonioscopy, corneal diameter and axial length measurement, dilated fundoscopy with optic-nerve-head evaluation. Medical therapy, considering the high frequency of side effects, is generally used as

  16. Theory of planned behaviour can help understand processes underlying the use of two emergency medicine diagnostic imaging rules

    OpenAIRE

    Perez, Richard; Brehaut, Jamie C; Taljaard, Monica; Stiell, Ian G.; Clement, Catherine M; Grimshaw, Jeremy

    2014-01-01

    Background Clinical decision rules (CDRs) can be an effective tool for knowledge translation in emergency medicine, but their implementation is often a challenge. This study examined whether the Theory of Planned Behaviour (TPB) could help explain the inconsistent results between the successful Canadian C-Spine Rule (CCR) implementation study and unsuccessful Canadian CT Head Rule (CCHR) implementation study. Both rules are aimed at improving the accuracy and efficiency of emergency departmen...

  17. [Cerebrolysin in pediatric neurology practice].

    Science.gov (United States)

    Petrukhin, A S; Pylaeva, O A

    2014-01-01

    Мany aspects of сerebrolysin treatment in a wide range of nervous system disorders in children are described. High efficacy and well tolerated therapy are revealed. These findings expand the perspectives of using сerebrolysin in pediatric neurology. PMID:24637827

  18. Assessing Competence in Pediatric Cardiology

    Science.gov (United States)

    Johnson, Apul E.; And Others

    1976-01-01

    In response to the need to assure physician competence, a rating scale was developed at the University of Minnesota Medical School for use in evaluating clinical competence in pediatric cardiology. It was tested on first- and second-year specialists. Development and testing procedures are described. (JT)

  19. Diagnostic Criteria for Pediatric MS

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-06-01

    Full Text Available Investigators at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago review the diagnostic criteria for pediatric multiple sclerosis, the differential diagnosis, the 2010 McDonald criteria, and Callen criteria.

  20. Dexmedetomidine in the pediatric population

    DEFF Research Database (Denmark)

    Plambech, Morten; Afshari, A

    2015-01-01

    Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solutio...