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Sample records for paediatric investigators collaborative

  1. Collaboration between paediatric surgery and other medical specialties in Nigeria

    Directory of Open Access Journals (Sweden)

    Philemon E Okoro

    2012-01-01

    Full Text Available Background: The quality of service and success of patient care and research in most fields of medicine depend on effective collaboration between different specialties. Paediatric surgery is a relatively young specialty in Nigeria and such collaborations are desirable. This survey assesses the nature and extent of collaboration between paediatric surgery and other specialties in Nigeria. Materials and Methods: This is a questionnaire survey carried out in November 2008 among paediatric surgeons and their trainees practising in Nigeria. Questionnaires were distributed and retrieved either by hand or e-mailing. The responses were then collated and analysed using the SPSS 17.0. Results: Forty-seven respondents were included in the survey. Forty-five (95.7% respondents thought that there was inadequate collaboration and that there was a need for an increased collaboration between paediatric surgery and other specialties. Anaesthesia, paediatrics and radiology are among the specialties where collaborations were most required but not adequately received. Collaboration had been required from these specialties in areas of patient care, training and research. Reasons for inadequate collaboration included the paucity of avenues for inter-specialty communication and exchange of ideas 33 (70.3%, lack of awareness of the need for collaboration 32 (68.1%, tendency to apportion blames for bad outcome 13 (27.7%, and mutual suspicion 8 (17%. Conclusion: There is presently inadequate collaboration between paediatric surgery and other specialties in Nigeria. There is a need for more inter-specialty support, communication, and exchange of ideas in order to achieve desirable outcomes.

  2. Oral medicines for children in the European paediatric investigation plans

    NARCIS (Netherlands)

    van Riet-Nales, Diana A; Römkens, Erwin G A W; Saint-Raymond, Agnes; Kozarewicz, Piotr; Schobben, Alfred F A M; Egberts, Toine C G; Rademaker, Carin M A

    2014-01-01

    INTRODUCTION: Pharmaceutical industry is no longer allowed to develop new medicines for use in adults only, as the 2007 Paediatric Regulation requires children to be considered also. The plans for such paediatric development called Paediatric Investigation Plans (PIPs) are subject to agreement by

  3. The Investigation of Proptosis in Paediatric Practice

    Directory of Open Access Journals (Sweden)

    Ms Sayantani Ghosh

    2009-08-01

    Full Text Available A retrospective review of 65 cases of paediatric proptosispresenting to a rural teaching hospital in India, from February2006 to June 2008. There were 17 cases with orbital cellulitisand 15 with retinoblastoma. We report the history, clinicalexamination, radiological findings and diagnosis. Most caseshad a characteristic history and pathognomonic eye signs.Computer Tomography (CT correlated with histopathology inmost cases. CT is widely available, even within a remotesetting, and is a convenient investigation. Thus, a detailedhistory, clinical examination and CT scan were the mostfruitful approach to the diagnosis of childhood proptosis inthis series.

  4. A review of salient elements defining team collaboration in paediatric rehabilitation

    NARCIS (Netherlands)

    Nijhuis, B. J. G.; Reinders-Messelink, H. A.; de Blecourt, A. C. E.; Olijve, W. G.; Groothoff, J. W.; Nakken, H.; Postema, K.; Postuma, K.

    Objective: To explicate the complex process of team collaboration and identify salient elements of team collaboration in paediatric rehabilitation. Data sources: After an initial search to define key features of team collaboration a systematic search on team collaboration and the key features was

  5. Paediatric musculoskeletal matters (pmm)--collaborative development of an online evidence based interactive learning tool and information resource for education in paediatric musculoskeletal medicine.

    Science.gov (United States)

    Smith, Nicola; Rapley, Tim; Jandial, Sharmila; English, Christine; Davies, Barbara; Wyllie, Ruth; Foster, Helen E

    2016-01-05

    We describe the collaborative development of an evidence based, free online resource namely 'paediatric musculoskeletal matters' (pmm). This resource was developed with the aim of reaching a wide range of health professionals to increase awareness, knowledge and skills within paediatric musculoskeletal medicine, thereby facilitating early diagnosis and referral to specialist care. Engagement with stakeholder groups (primary care, paediatrics, musculoskeletal specialties and medical students) informed the essential 'core' learning outcomes to derive content of pmm. Representatives from stakeholder groups, social science and web development experts transformed the learning outcomes into a suitable framework. Target audience representatives reviewed the framework and their opinion was gathered using an online survey (n = 74) and focus groups (n = 2). Experts in paediatric musculoskeletal medicine peer reviewed the content and design. User preferences informed design with mobile, tablet and web compatible versions to facilitate access, various media and formats to engage users and the content presented in module format (i.e. Clinical assessment, Investigations and management, Limping child, Joint pain by site, Swollen joint(s) and Resources). We propose that our collaborative and evidence-based approach has ensured that pmm is user-friendly, with readily accessible, suitable content, and will help to improve access to paediatric musculoskeletal medicine education. The content is evidence-based with the design and functionality of pmm to facilitate optimal and 'real life' access to information. pmm is targeted at medical students and the primary care environment although messages are transferable to all health care professionals involved in the care of children and young people.

  6. Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery.

    Science.gov (United States)

    Ó Mír, M; O'Sullivan, C

    2018-02-01

    One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.

  7. Pre-operative haematological investigations in paediatric orofacial ...

    African Journals Online (AJOL)

    Pre-operative haematological investigations in paediatric orofacial cleft repair: Any relevance to management outcome? ... Aim and Objectives: To determine the value of routine pre-operative haematologic investigations in children undergoing orofacial cleft repair. Background: Although routine pre-operative laboratory ...

  8. Oral medicines for children in the European paediatric investigation plans.

    Directory of Open Access Journals (Sweden)

    Diana A van Riet-Nales

    Full Text Available INTRODUCTION: Pharmaceutical industry is no longer allowed to develop new medicines for use in adults only, as the 2007 Paediatric Regulation requires children to be considered also. The plans for such paediatric development called Paediatric Investigation Plans (PIPs are subject to agreement by the European Medicines Agency (EMA and its Paediatric Committee (PDCO. The aim of this study was to evaluate the key characteristics of oral paediatric medicines in the PIPs and the changes implemented as a result of the EMA/PDCO review. METHODS: All PIPs agreed by 31 December 2011 were identified through a proprietary EMA-database. PIPs were included if they contained an agreed proposal to develop an oral medicine for children 0 to 11 years. Information on the therapeutic area (EMA classification system; target age range (as defined by industry and pharmaceutical characteristics (active substance, dosage form(s as listed in the PIP, strength of each dosage form, excipients in each strength of each dosage form was extracted from the EMA website or the EMA/PDCO assessment reports. RESULTS: A hundred and fifty PIPs were included corresponding to 16 therapeutic areas and 220 oral dosage forms in 431 strengths/compositions. Eighty-two PIPs (37% included tablets, 44 (20% liquids and 35 (16% dosage forms with a specific composition/strength that were stored as a solid but swallowed as a liquid e.g. dispersible tablets. The EMA/PDCO review resulted in an increase of 13 (207 to 220 oral paediatric dosage forms and 44 (387 to 431 dosage forms with a specific composition/strength. For many PIPs, the target age range was widened and the excipient composition and usability aspects modified. CONCLUSION: The EMA/PDCO review realized an increase in the number of requirements for the development of oral dosage forms and a larger increase in the number of dosage forms with a specific composition/strength, both targeting younger children. Changes to their pharmaceutical

  9. Competences for enhancing interprofessional collaboration in a paediatrics setting: Enabling and hindering factors.

    Science.gov (United States)

    Solevåg, Anne Lee; Karlgren, Klas

    2016-01-01

    In 2011 an interprofessional educational programme called "Pediatric systematic assessment and communication for preventing emergencies" designed to increase clinical staff's competence in treating sick children was introduced in one paediatrics department in Norway. To elicit an in-depth understanding of the perceptions of clinical staff about the programme and enact adjustments according to identified enabling and hindering factors for learning, nurses and paediatricians were invited to participate in focus group interviews. The interviews were analysed by content analysis. Enabling factors for learning included improved interprofessional collaboration and positive feedback on performance. Hindering factors included perceptions that the programme was redundant and the fact that collaborating departments, such as the surgical departments, were not familiar with the programme. Peer learning, more interprofessional learning activities, and the fostering of a learning organization were suggestions for sustained learning. Based on the results of the study we have now included collaborating departments in the programme.

  10. An Investigation of Collaborative Leadership

    Science.gov (United States)

    2013-01-01

    has made it difficult to focus on value added collaborative endeavors. Problem Statement Several articles and books have described the theory of...Model carmenwiki.osu.edu/display/libraries/Definition+of+Collaboration Dixon, P. (1999). Nietzsche and Jung: Sailing a deeper night. New York: P. Lang

  11. Remote Collaborative 3D Printing - Process Investigation

    Science.gov (United States)

    2016-04-01

    COLLABORATIVE 3D PRINTING - PROCESS INVESTIGATION Cody M. Reese, PE CAD MODEL PRINT MODEL PRINT PREVIEW PRINTED PART AERIAL VIRTUAL This...REMOTE COLLABORATIVE 3D PRINTING - PROCESS INVESTIGATION 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Cody M. Reese...release; distribution is unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Remote Collaborative 3D Printing project is a collaboration between

  12. Towards integrated paediatric services in the Netherlands : A survey of views and policies on collaboration in the care for children with cerebral palsy

    NARCIS (Netherlands)

    Nijhuis, B. J. G.; Reinders-Messelink, H. A.; de Blécourt, A. C. E.; Olijve, W. G.; Haga, N.; Groothoff, J. W.; Nakken, H.; Postema, K.

    Aim Worldwide, family- centred and co- ordinated care are seen as the two most desirable and effective methods of paediatric care delivery. This study outlines current views on how team collaboration comprising professionals in paediatric rehabilitation and special education and the parents of

  13. Paediatric Interventional Uroradiology

    International Nuclear Information System (INIS)

    Barnacle, Alex M.; Wilkinson, A. Graham; Roebuck, Derek J.

    2011-01-01

    Paediatric interventional uroradiology lies at the intersection of the disciplines of paediatric interventional radiology and paediatric endourology. Interdisciplinary collaboration has led to the development of new techniques and refinement of procedures adopted from adult practice. This article reviews the major procedures used in paediatric interventional uroradiology, with emphasis on nephrostomy, percutaneous nephrolithotomy, balloon-burst pyeloplasty, and antegrade ureteric stenting.

  14. Improved results in paediatric diabetes care using a quality registry in an improvement collaborative: a case study in Sweden.

    Directory of Open Access Journals (Sweden)

    Anette Peterson

    Full Text Available Several studies show that good metabolic control is important for children and adolescents with type 1 diabetes. In Sweden, there are large differences in mean haemoglobin A1c (HbA1c in different hospitals and difficulties implementing national guidelines in everyday practice. This study shows how the participation in an improvement collaborative could facilitate improvements in the quality of care by paediatric diabetes teams. The Swedish paediatric diabetes quality registry, SWEDIABKIDS was used as a tool and resource for feedback and outcome measures.Twelve teams at paediatric diabetes centres, caring for 30% (2302/7660 of patients in Sweden, participated in an 18-month quality improvement program. Each team defined treatment targets, areas needing improvement, and action plans. The main outcome was the centre patients' mean HbA1c levels, but other clinical variables and change concepts were also studied. Data from the previous six months were compared with the first six months after starting the program, and the long-term follow up after another eleven months.All centres reduced mean HbA1c during the second and third periods compared with the first. The mean reduction for all was 3·7 mmol/mol (p<0.001, compared with non-participating centres who improved their mean HbA1c with 1·7 mmol/mol during the same period. Many of the participating centres reduced the frequency of severe hypoglycaemia and/or ketoacidosis, and five centres reached their goal of ensuring that all patients had some sort of physical activity at least once weekly. Change concepts were, for example, improved guidelines, appointment planning, informing the patients, improving teamwork and active use of the registry, and health promotion activities.By involving paediatric diabetes teams in a quality improvement collaborative together with access to a quality register, the quality of paediatric diabetes care can improve, thereby contributing to a reduced risk of late

  15. Team collaboration in Dutch paediatric rehabilitation. Cooperation between parents, rehabilitation professionals and special education professionals in the care for children with cerebral palsy

    NARCIS (Netherlands)

    Nijhuis, Bianca Gertruda Johanna

    2007-01-01

    This thesis describes the collaborative processes in Dutch paediatric teams engaged in the care for children with cerebral palsy (CP). The three main stakeholder groups in these teams are the parents and the professionals in child rehabilitation and special education. Although the need for close

  16. Paediatric urological investigations - dose comparison between urology-related and CT irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Page, Mark; Florescu, Cosmin [Southern Health, Diagnostic Imaging, Melbourne (Australia); Johnstone, Lilian [Monash Children' s Hospital, Department of Paediatrics, Melbourne (Australia); Habteslassie, Daniel [Monash University, Department of Medicine, Melbourne (Australia); Ditchfield, Michael [Southern Health, Diagnostic Imaging, Melbourne (Australia); Monash Children' s Hospital, Diagnostic Imaging, Melbourne (Australia); Monash University, Department of Medicine, Melbourne (Australia)

    2013-07-15

    Urological investigation in children frequently involves high radiation doses; however, the issue of radiation for these investigations receives little attention compared with CT. To compare the radiation dose from paediatric urological investigations with CT, which is commonly regarded as the more major source of radiation exposure. We conducted a retrospective audit in a tertiary paediatric centre of the number and radiation dose of CT scans, micturating cystourethrography exams and urological nuclear medicine scans from 2006 to 2011. This was compared with radiation doses in the literature and an audit of the frequency of these studies in Australia. The tertiary centre audit demonstrated that the ratio of the frequency of urological to CT examinations was 0.8:1 in children younger than 17 years. The ratio of the radiation dose of urological to CT examinations was 0.7:1. The ratio in children younger than 5 years was 1.9:1. In Australia the frequency of urological procedures compared with CT was 0.4:1 in children younger than 17 years and 3.1:1 in those younger than 5 years. The ratio of radiation-related publications was 1:9 favouring CT. The incidence and radiation dose of paediatric urological studies is comparable to those of CT. Nevertheless the radiation dose of urological procedures receives considerably less attention in the literature. (orig.)

  17. Paediatric multidetector CT optimisation training: a survey of common scanning procedures and the resultant dose reduction associated with paediatric MDCT investigations in Australia

    International Nuclear Information System (INIS)

    Wallace, Anthony; Sibelle, Kimberly; Stanley, Martin; Budd, Ray; Goergen, Stacey; Heggie, John

    2008-01-01

    The growing recognition of the increased risk of stochastic injury to paediatric patients from multidetector CT (MDCT) investigations prompted a survey sponsored by Royal Australian and New Zealand College of Radiology (RANZCR), Austin Health and Monash University to initiate a national paediatric dosimetry review for some of the most common investigations undertaken in MDCT paediatric practice. The survey forms included a data sheet requiring acquisition protocol parameters and a phantom graphic sheet requiring the marking of the inferior and superior acquisition margins. Survey forms were supplied for each of 13 common MDCT acquisitions to be tested. Response data was input into CT-Expo Version 1.5.1., a CT dosimetry calculation engine, to determine dose length product (DLP (mGy.cm)) and effective dose (ED (mSv)). Initial survey data was collected, calculated, blinded and collated into various presentations that were given at a MDCT optimisation seminar in November, 2006. All sites were re-surveyed in May 2007 and doses calculated. Initial survey data showed a range of dose efficiencies spread across the surveyed sites. A measure of the initial spread of DLP values per procedure ranged from a minimum of less than 2 for a head-trauma acquisition (372 - 520 mGy.cm) to 14 for a chest-trauma acquisition (28 - 388 mGy.cm). Results of the 2nd survey strongly indicate that the application of optimisation training to paediatric MDCT scanning can produce significant dose savings by the application of simple dose saving strategies. Many protocols demonstrated dose reductions of greater than 50% with significant reductions in both the maximum and minimum values of calculated DLP and ED. The development of a survey-training-resurvey model of MDCT optimisation has proven to be a successful strategy for paediatric MDCT dose reduction in Australia. (author)

  18. Contemporary Australian dose area product levels in the fluoroscopic investigation of paediatric congenital heart disease

    International Nuclear Information System (INIS)

    Jones, T.; Brennan, P.C.; Mello-Thoms, C.; Ryan, E.

    2017-01-01

    This study examines radiation dose levels delivered to children from birth to 15 y of age in the investigation of congenital heart disease (CHD) at a major Sydney children's hospital. The aims are to compare values with those derived from similar studies, to provide a template for more consistent dose reporting, to establish local and national diagnostic reference levels and to contribute to the worldwide paediatric dosimetry database. A retrospective review of 1007 paediatric procedural records was undertaken. The cohort consisted of 795 patients over a period from January 2007 to December 2012 who have undergone cardiac catheterisation for the investigation of CHD. The age range included was from the day of birth to 15 y. Archived dose area product (DAP) and fluoroscopy time (FT) readings were retrieved and analysed. The mean, median, 25. and 75. percentile DAP levels were calculated for six specific age groupings. The 75. percentile DAP values for the specific age categories were as follows: 0-30 d-1.9 Gy cm 2 , 1-12 months-2.9 Gy cm 2 , 1-3 y-5.3 Gy cm 2 , 3-5 y-6.2 Gy cm 2 , 5-10 y-7.5 Gy cm 2 and 10-15 y-17.3 Gy cm 2 . These levels were found to be lower than the values reported in comparable overseas studies. Individual year-specific levels were determined, and it is proposed that these are more useful than the common grouping method. The age-specific 75. percentile DAP levels outlined in this study can be used as baseline local diagnostic reference levels. The needs for the standardisation of DAP reporting and for a greater range of age-specific diagnostic reference levels have been highlighted. For the first time, Australian dose values for paediatric cardiac catheterisation are presented. (authors)

  19. Epidemiological investigation of Candida species causing bloodstream infection in paediatric small bowel transplant recipients.

    Science.gov (United States)

    Suhr, Mallory J; Gomes-Neto, João Carlos; Banjara, Nabaraj; Florescu, Diana F; Mercer, David F; Iwen, Peter C; Hallen-Adams, Heather E

    2017-06-01

    Small bowel transplantation (SBT) can be a life-saving medical procedure. However, these recipients experience high risk of bloodstream infections caused by Candida. This research aims to characterise the SBT recipient gut microbiota over time following transplantation and investigate the epidemiology of candidaemia in seven paediatric patients. Candida species from the recipients' ileum and bloodstream were identified by internal transcribed spacer sequence and distinguished to strain by multilocus sequence typing and randomly amplified polymorphic DNA. Antifungal susceptibility of bloodstream isolates was determined against nine antifungals. Twenty-two ileostomy samples harboured at least one Candida species. Fungaemia were caused by Candida parapsilosis, Candida albicans, Candida glabrata, Candida orthopsilosis and Candida pelliculosa. All but three bloodstream isolates showed susceptibility to all the antifungals tested. One C. glabrata isolate showed multidrug resistance to itraconazole, amphotericin B and posaconazole and intermediate resistance to caspofungin. Results are congruent with both endogenous (C. albicans, C. glabrata) and exogenous (C. parapsilosis) infections; results also suggest two patients were infected by the same strain of C. parapsilosis. Continuing to work towards a better understanding of sources of infection-particularly the exogenous sources-would lead to targeted prevention strategies. © 2017 Blackwell Verlag GmbH.

  20. Quality and clinical supply considerations of Paediatric Investigation Plans for IV preparations-A case study with the FP7 CloSed project.

    Science.gov (United States)

    Hanning, Sara M; Orlu Gul, Mine; Winslade, Jackie; Baarslag, Manuel A; Neubert, Antje; Tuleu, Catherine

    2016-09-25

    A Paediatric Investigation Plan (PIP) is a development plan that aims to ensure that sufficient data are obtained through studies in paediatrics to support the generation of marketing authorisation of medicines for children. This paper highlights some practical considerations and challenges with respect to PIP submissions and paediatric clinical trials during the pharmaceutical development phase, using the FP7-funded Clonidine for Sedation of Paediatric Patients in the Intensive Care Unit (CloSed) project as a case study. Examples discussed include challenges and considerations regarding formulation development, blinding and randomisation, product labelling and shipment and clinical trial requirements versus requirements for marketing authorisation. A significant quantity of information is required for PIP submissions and it is hoped that future applicants may benefit from an insight into some critical considerations and challenges faced in the CloSed project. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC study of aseptic meningitis

    Directory of Open Access Journals (Sweden)

    Robinson Joan L

    2006-04-01

    Full Text Available Abstract Background The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results There were 233 cases of proven enteroviral (EV meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children Conclusion The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants

  2. Investigating the Effects of Peer to Peer Prompts on Collaborative Argumentation, Consensus and Perceived Efficacy in Collaborative Learning

    Science.gov (United States)

    Harney, Owen M.; Hogan, Michael J.; Quinn, Sarah

    2017-01-01

    In a society which is calling for more productive modes of collaboration to address increasingly complex scientific and social issues, greater involvement of students in dialogue, and increased emphasis on collaborative discourse and argumentation, become essential modes of engagement and learning. This paper investigates the effects of…

  3. Architecture for an advanced biomedical collaboration domain for the European paediatric cancer research community (ABCD-4-E).

    Science.gov (United States)

    Nitzlnader, Michael; Falgenhauer, Markus; Gossy, Christian; Schreier, Günter

    2015-01-01

    Today, progress in biomedical research often depends on large, interdisciplinary research projects and tailored information and communication technology (ICT) support. In the context of the European Network for Cancer Research in Children and Adolescents (ENCCA) project the exchange of data between data source (Source Domain) and data consumer (Consumer Domain) systems in a distributed computing environment needs to be facilitated. This work presents the requirements and the corresponding solution architecture of the Advanced Biomedical Collaboration Domain for Europe (ABCD-4-E). The proposed concept utilises public as well as private cloud systems, the Integrating the Healthcare Enterprise (IHE) framework and web-based applications to provide the core capabilities in accordance with privacy and security needs. The utility of crucial parts of the concept was evaluated by prototypic implementation. A discussion of the design indicates that the requirements of ENCCA are fully met. A whole system demonstration is currently being prepared to verify that ABCD-4-E has the potential to evolve into a domain-bridging collaboration platform in the future.

  4. Investigating collaborative learning success with physiological coupling indices based on electrodermal activity

    NARCIS (Netherlands)

    Pijeira-díaz, Hector; Drachsler, Hendrik; Järvelä, Sanna; Kirschner, Paul A.

    2017-01-01

    Collaborative learning is considered a critical 21st century skill. Much is known about its contribution to learning, but still investigating a process of collaboration remains a challenge. This paper approaches the investigation on collaborative learning from a psychophysiological perspective. An

  5. Collaboration

    Science.gov (United States)

    King, Michelle L.

    2010-01-01

    This article explores collaboration between library media educators and regular classroom teachers. The article focuses on the context of the issue, positions on the issue, the impact of collaboration, and how to implement effective collaboration into the school system. Various books and professional journals are used to support conclusions…

  6. A Net Centric Collaborative Support System Concept: A Preliminary Investigation

    National Research Council Canada - National Science Library

    Eggleston, Robert

    2004-01-01

    ... layer added to the information technology (IT) infrastructure. Design requirements for this layer of the collaborative interface are derived from principles of Cognitive Systems Engineering and characteristics of human expertise...

  7. Investigating the experiences in a school-based occupational therapy program to inform community-based paediatric occupational therapy practice.

    Science.gov (United States)

    Rens, Lezahn; Joosten, Annette

    2014-06-01

    A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.

  8. Inequality in outcomes for adolescents living with perinatally acquired HIV in sub-Saharan Africa: a Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Cohort Collaboration analysis.

    Science.gov (United States)

    2018-02-01

    Eighty percent of adolescents living with perinatally and behaviourally acquired HIV live in sub-Saharan Africa (SSA), a continent with marked economic inequality. As part of our global project describing adolescents living with perinatally acquired HIV (APH), we aimed to assess whether inequality in outcomes exists by country income group (CIG) for APH within SSA. Through the CIPHER cohort collaboration, individual retrospective data from 7 networks and 25 countries in SSA were included. APH were included if they entered care at age 10 years. World Bank CIG classification for median year of first visit was used. Cumulative incidence of mortality, transfer-out and loss-to-follow-up was calculated by competing risks analysis. Mortality was compared across CIG by Cox proportional hazards models. A total of 30,296 APH were included; 50.9% were female and 75.7% were resident in low-income countries (LIC). Median [interquartile range (IQR)] age at antiretroviral therapy (ART) start was 8.1 [6.3; 9.5], 7.8 [6.2; 9.3] and 7.3 [5.2; 8.9] years in LIC, lower-middle income countries (LMIC) and upper-middle income countries (UMIC) respectively. Median age at last follow-up was 12.1 [10.9; 13.8] years, with no difference between CIG. Cumulative incidence (95% CI) for mortality between age 10 and 15 years was lowest in UMIC (1.1% (0.8; 1.4)) compared to LIC (3.5% (3.1; 3.8)) and LMIC (3.9% (2.7; 5.4)). Loss-to-follow-up was highest in UMIC (14.0% (12.9; 15.3)) compared to LIC (13.1% (12.4; 13.8)) and LMIC (8.3% (6.3; 10.6)). Adjusted mortality hazard ratios (95% CI) for APH in LIC and LMIC in reference to UMIC were 2.50 (1.85; 3.37) and 2.96 (1.90; 4.61) respectively, with little difference when restricted only to APH who ever received ART. In adjusted analyses mortality was similar for male and female APH. Results highlight probable inequality in mortality according to CIG in SSA even when ART was received. These findings highlight that without attention towards SDG 10 (to

  9. Investigation of effects of a new integrin inhibitor and of its association with radiotherapy on paediatric glioma cell lines; etude des effets d'un nouvel inhibiteur d'integrines et de son association avec la radiotherapie sur des lignees de gliomes pediatriques

    Energy Technology Data Exchange (ETDEWEB)

    Le Tinier, F.; Meignan, S.; Leblond, P.; Dewitte, A.; Wattez, N.; Lartigau, E.; Lansiaux, A. [Centre Oscar-Lambret, Lille (France)

    2011-10-15

    The authors report the investigation of the effects of Cilengitide (an integrin inhibitor) alone or in association with ionizing radiation on paediatric glioma cell lines. Five grade-II to IV paediatric glioma cell lines and one high grade adult glioma cell line have been studied. It appears that Cilengitide has a direct effect on paediatric glioma cells, notably before irradiation. Short communication

  10. PAEDIATRIC SURGERY

    African Journals Online (AJOL)

    in increased mortality in developing nations.6,7 However, it has been shown ... Background: The time from birth to the first paediatric surgical consultation of neonates with gastroschisis is a predictor ... of Helsinki and its later amendments. Informed consent was obtained from the parents of the infants included in the study.

  11. Advance Care Planning in palliative care: a qualitative investigation into the perspective of Paediatric Intensive Care Unit staff.

    Science.gov (United States)

    Mitchell, Sarah; Dale, Jeremy

    2015-04-01

    The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. To explore the experiences of senior medical and nursing staff regarding the challenges associated with Advance Care Planning in relation to children and young people with life-limiting illnesses in the Paediatric Intensive Care Unit environment and opportunities for improvement. Qualitative one-to-one, semi-structured interviews were conducted with Paediatric Intensive Care Unit consultants and senior nurses, to gain rich, contextual data. Thematic content analysis was carried out. UK tertiary referral centre Paediatric Intensive Care Unit. Eight Paediatric Intensive Care Unit consultants and six senior nurses participated. Four main themes emerged: recognition of an illness as 'life-limiting'; Advance Care Planning as a multi-disciplinary, structured process; the value of Advance Care Planning and adverse consequences of inadequate Advance Care Planning. Potential benefits of Advance Care Planning include providing the opportunity to make decisions regarding end-of-life care in a timely fashion and in partnership with patients, where possible, and their families. Barriers to the process include the recognition of the life-limiting nature of an illness and gaining consensus of medical opinion. Organisational improvements towards earlier recognition of life-limiting illness and subsequent Advance Care Planning were recommended, including education and training, as well as the need for wider societal debate. Advance Care Planning for children and young people with life-limiting conditions has the potential to improve care for patients and their families, providing the opportunity to make decisions based on clear information at an appropriate time, and avoid potentially harmful intensive clinical interventions at the end of life. © The Author(s) 2015.

  12. Using Wikis to Investigate Communication, Collaboration and Engagement in Capstone Engineering Design Projects

    Science.gov (United States)

    Berthoud, L.; Gliddon, J.

    2018-01-01

    In today's global Aerospace industry, virtual workspaces are commonly used for collaboration between geographically distributed multidisciplinary teams. This study investigated the use of wikis to look at communication, collaboration and engagement in 'Capstone' team design projects at the end of an engineering degree. Wikis were set up for teams…

  13. Investigating Science Collaboratively: A Case Study of Group Learning

    Science.gov (United States)

    Zinicola, Debra A.

    2009-01-01

    Discussions of one urban middle school group of students who were investigating scientific phenomena were analyzed; this study was conducted to discern if and how peer interaction contributes to learning. Through a social constructivist lens, case study methodology, we examined conceptual change among group members. Data about science talk was…

  14. Successful private-public funding of paediatric medicines research: lessons from the EU programme to fund research into off-patent medicines.

    Science.gov (United States)

    Ruggieri, L; Giannuzzi, V; Baiardi, P; Bonifazi, F; Davies, E H; Giaquinto, C; Bonifazi, D; Felisi, M; Chiron, C; Pressler, R; Rabe, H; Whitaker, M J; Neubert, A; Jacqz-Aigrain, E; Eichler, I; Turner, M A; Ceci, A

    2015-04-01

    The European Paediatric Regulation mandated the European Commission to fund research on off-patent medicines with demonstrated therapeutic interest for children. Responding to this mandate, five FP7 project calls were launched and 20 projects were granted. This paper aims to detail the funded projects and their preliminary results. Publicly available sources have been consulted and a descriptive analysis has been performed. Twenty Research Consortia including 246 partners in 29 European and non-European countries were created (involving 129 universities or public-funded research organisations, 51 private companies with 40 SMEs, 7 patient associations). The funded projects investigate 24 medicines, covering 10 therapeutic areas in all paediatric age groups. In response to the Paediatric Regulation and to apply for a Paediatric Use Marketing Authorisation, 15 Paediatric Investigation Plans have been granted by the EMA-Paediatric Committee, including 71 studies of whom 29 paediatric clinical trials, leading to a total of 7,300 children to be recruited in more than 380 investigational centres. Notwithstanding the EU contribution for each study is lower than similar publicly funded projects, and also considering the complexity of paediatric research, these projects are performing high-quality research and are progressing towards the increase of new paediatric medicines on the market. Private-public partnerships have been effectively implemented, providing a good example for future collaborative actions. Since these projects cover a limited number of off-patent drugs and many unmet therapeutic needs in paediatrics remain, it is crucial foreseeing new similar initiatives in forthcoming European funding programmes.

  15. Expectations and satisfaction of academic investigators in nonclinical collaboration with the pharmaceutical industry.

    Science.gov (United States)

    Amiri, Marjan; Michel, Martin C

    2015-06-01

    In light of a growing role of research collaborations between academia and the pharmaceutical industry, we have explored expectations and experience of academic investigators with preclinical collaborations. Researchers from Western Europe, North America, and Japan with preclinical publications in the obstructed airways or diabetes fields were invited to anonymously participate in a web-based survey. A total of 134 investigators (28 % of invitees) participated in the two sequentially performed surveys with similar responses in both therapeutic areas. A secondary but prespecified subgroup analysis was based on region of residence, gender, and career level of the investigator. Across all groups, responders considered freedom to publish, obtaining funding and obtaining compounds to be the most important objectives of nonclinical collaborations with the pharmaceutical industry, whereas cultivating professional relationships, getting external scientific input, direct relationship to disease treatment, and involvement with drug development were less important. Among eight attributes of the primary contact person in the company, trustworthiness ranked highest, followed by a collaborative spirit and transparent information sharing; supportiveness, scientific qualification, accessibility, and timeliness of responses ranked lower, and friendliness, lowest. Related to their most recent collaboration, investigators also expressed the highest level of satisfaction with the trustworthiness attribute. On the other hand, the process of reaching a contract was often considered too long and difficult, for which both university and company legal departments were reported as culprits. We conclude that academic researchers are generally satisfied with their preclinical collaboration with the pharmaceutical industry but look for improved contracting procedures.

  16. Achieving social-ecological fit through bottom-up collaborative governance: an empirical investigation

    Directory of Open Access Journals (Sweden)

    Angela M. Guerrero

    2015-12-01

    Full Text Available Significant benefits can arise from collaborative forms of governance that foster self-organization and flexibility. Likewise, governance systems that fit with the extent and complexity of the system under management are considered essential to our ability to solve environmental problems. However, from an empirical perspective the fundamental question of whether self-organized (bottom-up collaborative forms of governance are able to accomplish adequate fit is unresolved. We used new theory and methodological approaches underpinned by interdisciplinary network analysis to address this gap by investigating three governance challenges that relate to the problem of fit: shared management of ecological resources, management of interconnected ecological resources, and cross-scale management. We first identified a set of social-ecological network configurations that represent the hypothesized ways in which collaborative arrangements can contribute to addressing these challenges. Using social and ecological data from a large-scale biodiversity conservation initiative in Australia, we empirically determined how well the observed patterns of stakeholder interactions reflect these network configurations. We found that stakeholders collaborate to manage individual parcels of native vegetation, but not for the management of interconnected parcels. In addition, our data show that the collaborative arrangements enable management across different scales (local, regional, supraregional. Our study provides empirical support for the ability of collaborative forms of governance to address the problem of fit, but also suggests that in some cases the establishment of bottom-up collaborative arrangements would likely benefit from specific guidance to facilitate the establishment of collaborations that better align with the ways ecological resources are interconnected across the landscape. In our case study region, this would improve the capacity of stakeholders to

  17. Atlas of Bone Scintigraphy in the Developing Paediatric Skeleton: The Normal Skeleton, Variants and Pitfalls

    International Nuclear Information System (INIS)

    2011-01-01

    Since the introduction of 99m technetium polyphosphate in 1972 by Dr. M. Subramanian, bone scintigraphy has become an integral part of the evaluation of paediatric musculoskeletal disorders. Using the current high resolution gamma cameras and 99m technetium-methylene diphosphonate ( 99m Tc-MDP) or 99m Tc 2,3-dicarboxypropane-1,1-diphosphonate ( 99m Tc-DPD), the quality of images available for interpretation is high. From the very earliest days, there has been a certain confusion over normal bone physiology, as depicted by the bone scintigram in paediatric patients. This has resulted in a number of difficulties in detecting subtle abnormalities, especially near the dynamically changing scintigraphic presentation of the physes (growth zones). Examples of abnormalities that might be confused with normal bone activity are osteomyelitis, bucket handle fractures of the long bones, as well as neuroblastoma and leukaemic metastases. The aim of this publication is to provide structured information about the maturation and normal appearance of the skeleton from infancy to adulthood. As such, it reflects the current status of bone scintigraphy. It is hoped that this work will contribute to an enhanced understanding of the dynamic process of naturally occurring metabolic bone changes, which will, in turn, improve the quality of reporting of paediatric bone scans. As the majority of paediatric bone scintigrams are interpreted by non-paediatric nuclear physicians, the availability of this reference atlas should improve the care of children. This atlas is intended to address the needs of nuclear medicine physicians, both residents and specialists. It is intended to serve as an illustrative reference to those not having sufficient exposure to paediatric bone scan investigations, to enable them to maintain adequate competency in this particular application. Experts in paediatric nuclear medicine are often consulted for their opinion on bone scans obtained in their respective

  18. Paediatric autoimmune encephalopathies: clinical features, laboratory investigations and outcomes in patients with or without antibodies to known central nervous system autoantigens

    Science.gov (United States)

    Hacohen, Yael; Wright, Sukhvir; Waters, Patrick; Agrawal, Shakti; Carr, Lucinda; Cross, Helen; De Sousa, Carlos; DeVile, Catherine; Fallon, Penny; Gupta, Rajat; Hedderly, Tammy; Hughes, Elaine; Kerr, Tim; Lascelles, Karine; Lin, Jean-Pierre; Philip, Sunny; Pohl, Keith; Prabahkar, Prab; Smith, Martin; Williams, Ruth; Clarke, Antonia; Hemingway, Cheryl; Wassmer, Evangeline; Vincent, Angela; Lim, Ming J

    2013-01-01

    Objective To report the clinical and investigative features of children with a clinical diagnosis of probable autoimmune encephalopathy, both with and without antibodies to central nervous system antigens. Method Patients with encephalopathy plus one or more of neuropsychiatric symptoms, seizures, movement disorder or cognitive dysfunction, were identified from 111 paediatric serum samples referred from five tertiary paediatric neurology centres to Oxford for antibody testing in 2007–2010. A blinded clinical review panel identified 48 patients with a diagnosis of probable autoimmune encephalitis whose features are described. All samples were tested/retested for antibodies to N-methyl-D-aspartate receptor (NMDAR), VGKC-complex, LGI1, CASPR2 and contactin-2, GlyR, D1R, D2R, AMPAR, GABA(B)R and glutamic acid decarboxylase. Results Seizures (83%), behavioural change (63%), confusion (50%), movement disorder (38%) and hallucinations (25%) were common. 52% required intensive care support for seizure control or profound encephalopathy. An acute infective organism (15%) or abnormal cerebrospinal fluid (32%), EEG (70%) or MRI (37%) abnormalities were found. One 14-year-old girl had an ovarian teratoma. Serum antibodies were detected in 21/48 (44%) patients: NMDAR 13/48 (27%), VGKC-complex 7/48(15%) and GlyR 1/48(2%). Antibody negative patients shared similar clinical features to those who had specific antibodies detected. 18/34 patients (52%) who received immunotherapy made a complete recovery compared to 4/14 (28%) who were not treated; reductions in modified Rankin Scale for children scores were more common following immunotherapies. Antibody status did not appear to influence the treatment effect. Conclusions Our study outlines the common clinical and paraclinical features of children and adolescents with probable autoimmune encephalopathies. These patients, irrespective of positivity for the known antibody targets, appeared to benefit from immunotherapies and further

  19. Transfusion therapy in paediatric trauma patients

    DEFF Research Database (Denmark)

    Nystrup, Kristin Brønnum; Stensballe, Jakob; Bøttger, Morten

    2015-01-01

    Haemorrhage is a leading cause of death in paediatric trauma patients. Predefined massive transfusion protocols (MTP) have the potential to significantly reduce mortality by treating haemorrhagic shock and coagulopathy, in adhering to the principles of haemostatic resuscitation with rapid...... in paediatric trauma patients is challenging, and the optimal blood product ratio that will increase survival in massively bleeding paediatric trauma patients has yet to be determined. To date, only a few small descriptive studies and case reports have investigated the use of predefined MTP in paediatric trauma...... patients.MTP with increased FFP or PLT to RBC ratios combined with viscoelastic haemostatic assay (VHA) guided haemostatic resuscitation have not yet been tested in paediatric populations but based on results from adult trauma patients, this therapeutic approach seems promising.Considering the high...

  20. Investigating the Effects of Prompts on Argumentation Style, Consensus and Perceived Efficacy in Collaborative Learning

    Science.gov (United States)

    Harney, Owen M.; Hogan, Michael J.; Broome, Benjamin; Hall, Tony; Ryan, Cormac

    2015-01-01

    This paper investigates the effects of task-level versus process-level prompts on levels of perceived and objective consensus, perceived efficacy, and argumentation style in the context of a computer-supported collaborative learning session using Interactive Management (IM), a computer facilitated thought and action mapping methodology. Four…

  1. Interventional Radiology in Paediatrics.

    Science.gov (United States)

    Chippington, Samantha J; Goodwin, Susie J

    2015-01-01

    As in adult practice, there is a growing role for paediatric interventional radiology expertise in the management of paediatric pathologies. This review is targeted for clinicians who may refer their patients to paediatric interventional radiology services, or who are responsible for patients who are undergoing paediatric interventional radiology procedures. The article includes a brief overview of the indications for intervention, techniques involved and the commonest complications. Although some of the procedures described are most commonly performed in a tertiary paediatric centre, many are performed in most Children's hospitals.

  2. Framework of collaboration investigation on neutron effect on superconducting magnet materials

    International Nuclear Information System (INIS)

    Nishimura, Arata; Takeuchi, Takao; Nishijima, Shigehiro; Izumi, Yoshinobu; Takakura, Kosuke; Ochiai, Kentaro; Henmi, Tsutomu; Nishijima, Gen; Watanabe, Kazuo; Sato, Isamu; Kurisita, Hiroaki; Narui, Minoru; Shikama, Tatsuo

    2009-01-01

    A fusion reactor will generate D-T neutron and the kinetic energy of the neutron will be converted to the thermal energy and electrical energy. The neutron has huge energy and will be able to penetrate a shielding blanket and stream out of ports for neutral beam injections. The penetrated and streamed out neutrons will reach superconducting magnets and make some damages on the magnet system. To investigate the neutron irradiation effects on the superconducting magnet materials, a collaborative network must be organized and the irradiation researches must be performed. This report will describe the framework of the collaboration investigation which has been established among neutronics, superconducting magnet and fusion system. After showing the collaboration scheme, some new results on 14 MeV neutron irradiation effect are presented. Then, a three years new project which was adopted as one of 'Nuclear basic infrastructure strategy study initiatives' by MEXT will be introduced as an example of collaborative program among superconducting materials, fission reactor and high magnetic field technology. (author)

  3. Investigating the cost-effectiveness of videotelephone based support for newly diagnosed paediatric oncology patients and their families: design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Theodoros Deborah

    2007-03-01

    Full Text Available Abstract Background Providing ongoing family centred support is an integral part of childhood cancer care. For families living in regional and remote areas, opportunities to receive specialist support are limited by the availability of health care professionals and accessibility, which is often reduced due to distance, time, cost and transport. The primary aim of this work is to investigate the cost-effectiveness of videotelephony to support regional and remote families returning home for the first time with a child newly diagnosed with cancer Methods/design We will recruit 162 paediatric oncology patients and their families to a single centre randomised controlled trial. Patients from regional and remote areas, classified by Accessibility/Remoteness Index of Australia (ARIA+ greater than 0.2, will be randomised to a videotelephone support intervention or a usual support control group. Metropolitan families (ARIA+ ≤ 0.2 will be recruited as an additional usual support control group. Families allocated to the videotelephone support intervention will have access to usual support plus education, communication, counselling and monitoring with specialist multidisciplinary team members via a videotelephone service for a 12-week period following first discharge home. Families in the usual support control group will receive standard care i.e., specialist multidisciplinary team members provide support either face-to-face during inpatient stays, outpatient clinic visits or home visits, or via telephone for families who live far away from the hospital. The primary outcome measure is parental health related quality of life as measured using the Medical Outcome Survey (MOS Short Form SF-12 measured at baseline, 4 weeks, 8 weeks and 12 weeks. The secondary outcome measures are: parental informational and emotional support; parental perceived stress, parent reported patient quality of life and parent reported sibling quality of life, parental satisfaction

  4. A paediatric cardiopulmonary resuscitation training project in Honduras.

    Science.gov (United States)

    Urbano, Javier; Matamoros, Martha M; López-Herce, Jesús; Carrillo, Angel P; Ordóñez, Flora; Moral, Ramón; Mencía, Santiago

    2010-04-01

    It is possible that the exportation of North American and European models has hindered the creation of a structured cardiopulmonary resuscitation (CPR) training programme in developing countries. The objective of this paper is to describe the design and present the results of a European paediatric and neonatal CPR training programme adapted to Honduras. A paediatric CPR training project was set up in Honduras with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The programme was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. During the first phase, 24 Honduran doctors from paediatric intensive care, paediatric emergency and anaesthesiology departments attended the paediatric CPR course and 16 of them the course for preparation as instructors. The Honduran Paediatric and Neonatal CPR Group was formed. In the second phase, workshops were given by Honduran instructors and four of them attended a CPR course in Spain as trainee instructors. In the third phase, a CPR course was given in Honduras by the Honduran instructors, supervised by the Spanish team. In the final phase of independent teaching, eight courses were given, providing 177 students with training in CPR. The training of independent paediatric CPR groups with the collaboration and scientific assessment of an expert group could be a suitable model on which to base paediatric CPR training in Latin American developing countries. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  5. [Early clinical trials in paediatric oncology in Spain: a nationwide perspective].

    Science.gov (United States)

    Bautista, Francisco; Gallego, Soledad; Cañete, Adela; Mora, Jaume; Díaz de Heredia, Cristina; Cruz, Ofelia; Fernández, José María; Rives, Susana; Berlanga, Pablo; Hladun, Raquel; Juan Ribelles, Antonio; Madero, Luis; Ramírez, Manuel; Fernández Delgado, Rafael; Pérez-Martínez, Antonio; Mata, Cristina; Llort, Anna; Martín Broto, Javier; Cela, María Elena; Ramírez, Gema; Sábado, Constantino; Acha, Tomás; Astigarraga, Itziar; Sastre, Ana; Muñoz, Ascensión; Guibelalde, Mercedes; Moreno, Lucas

    2017-09-01

    Cancer is the leading cause of death between the first year of life and adolescence, and some types of diseases are still a major challenge in terms of cure. There is, therefore, a major need for new drugs. Recent findings in cancer biology open the door to the development of targeted therapies against individual molecular changes, as well as immunotherapy. Promising results in adult anti-cancer drug development have not yet been translated into paediatric clinical practice. A report is presented on the activity in early paediatric oncology trials (phase I-II) in Spain. All members of the Spanish Society of Paediatric Haematology Oncology (SEHOP) were contacted in order to identify early clinical trials in paediatric cancer opened between 2005 and 2015. A total of 30 trials had been opened in this period: 21 (70%) in solid tumours, and 9 (30%) in malignant haemopathies. A total of 212 patients have been enrolled. The majority was industry sponsored (53%). Since 2010, four centres have joined the international consortium of Innovative Therapies for Children with Cancer (ITCC), which has as its aim to develop novel therapies for paediatric tumours. A significant number of new studies have opened since 2010, improving the treatment opportunities for our children. Results of recently closed trials show the contribution of Spanish investigators, the introduction of molecularly targeted agents, and their benefits. The activity in clinical trials has increased in the years analysed. The SEHOP is committed to develop and participate in collaborative academic trials, in order to help in the advancement and optimisation of existing therapies in paediatric cancer. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Paediatrics: messages from Munich

    Directory of Open Access Journals (Sweden)

    Fabio Midulla

    2015-05-01

    Full Text Available The aim of this article is to describe paediatric highlights from the 2014 European Respiratory Society (ERS International Congress in Munich, Germany. Abstracts from the seven groups of the ERS Paediatric Assembly (Respiratory Physiology and Sleep, Asthma and Allergy, Cystic Fibrosis, Respiratory Infection and Immunology, Neonatology and Paediatric Intensive Care, Respiratory Epidemiology, and Bronchology are presented in the context of the current literature.

  7. A Webometric Investigation of Visibility and Collaboration of Iranian Nanotechnology Websites

    Directory of Open Access Journals (Sweden)

    Faramarz Sohili

    2007-07-01

    Full Text Available The present investigation intends to review the extent of visibility, impact and collaboration of Iranian nanotechnology websites using webometric method of link analysis. The sample consists of all websites dealing with nanotechnology in Iran. Findings showed that these sites have low visibility, web impact factor and page count. Iranian Nanotechnology Initiative, Nano Ideas and Iranian Nanotechnology Association had the highest number of inlinks and therefore highest visibility, while Nanotechnology Department Website had the lowest visibility. Findings also indicated that Amir Kabir Technical University Nanotechnology Committee website, Iran Nanotechnology initiative and Nano Ideas websites had the highest web impact factor, while Kashan University Institute for Nano Science and Technology had the lowest web impact factor. It was further established that Iranian Nanotech websites collaborate within two clusters. A Multi-dimensional scale was used.

  8. Investigating the Relationship between Learning Style Preferences and Teaching Collaboration Skills and Technology

    DEFF Research Database (Denmark)

    Kim, Seung L.; Sonnenwald, Diane H.

    2002-01-01

    This paper reports on an exploratory study that investigates the relationship between participants' learning style preferences and their perceptions of a professional workshop on collaboration and technology to support collaboration. The Learning Preference Scale-Students (LPSS) (Owens & Barnes...... style, and Group 2 showed a strong preference for competitive and cooperative learning styles. Group 1 rated the workshop more positively than Group 2. However, Group 2 reported a larger increase in self-efficacy compared to those in Group 1 (18.9% vs. 6.0%). Both groups provided different suggestions...... regarding the content of the workshop. Group 1 suggested adding more discussions and group exercises, whereas Group 2 suggested adding explicit theory or rules to govern behavior. These findings indicate that learning styles should be considered as a potential variable that influences learning outcomes...

  9. Migrant women living with HIV in Europe: are they facing inequalities in the prevention of mother-to-child-transmission of HIV?: The European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) study group in EuroCoord.

    Science.gov (United States)

    Favarato, G; Bailey, H; Burns, F; Prieto, L; Soriano-Arandes, A; Thorne, C

    2018-02-01

    In pregnancy early interventions are recommended for prevention of mother-to-child-transmission (PMTCT) of HIV. We examined whether pregnant women who live with HIV in Europe and are migrants encounter barriers in accessing HIV testing and care. Four cohorts within the European Pregnancy and Paediatric HIV Cohort Collaboration provided data for pooled analysis of 11 795 pregnant women who delivered in 2002-12 across ten European countries. We defined a migrant as a woman delivering in a country different from her country of birth and grouped the countries into seven world regions. We compared three suboptimal PMTCT interventions (HIV diagnosis in late pregnancy in women undiagnosed at conception, late anti-retroviral therapy (ART) start in women diagnosed but untreated at conception and detectable viral load (VL) at delivery in women on antenatal ART) in native and migrant women using multivariable logistic regression models. Data included 9421 (79.9%) migrant women, mainly from sub-Saharan Africa (SSA); 4134 migrant women were diagnosed in the current pregnancy, often (48.6%) presenting with CD4 count <350 cells/µl. Being a migrant was associated with HIV diagnosis in late pregnancy [OR for SSA vs. native women, 2.12 (95% CI 1.67, 2.69)] but not with late ART start if diagnosed but not on ART at conception, or with detectable VL at delivery once on ART. Migrant women were more likely to be diagnosed in late pregnancy but once on ART virological response was good. Good access to antenatal care enables the implementation of PMTCT protocols and optimises both maternal and children health outcomes generally. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. 2016 American College of Rheumatology/European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Juvenile Dermatomyositis An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative

    NARCIS (Netherlands)

    Rider, Lisa G.; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M.; Huber, Adam M.; Cimaz, Rolando; Cuttica, Rubén J.; de Oliveira, Sheila Knupp; Lindsley, Carol B.; Pilkington, Clarissa A.; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Dressler, Frank; Magalhaes, Claudia Saad; Constantin, Tamás; Davidson, Joyce E.; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A.; Miller, Frederick W.; Vencovsky, Jiri; Ruperto, Nicolino; Hansen, Paul; Apaz, Maria; Bowyer, Suzanne; Curran, Megan; Davidson, Joyce; Griffin, Thomas; Huber, Adam H.; Jones, Olcay; Kim, Susan; Lang, Bianca; Lindsley, Carol; Lovell, Daniel; Saad Magalhaes, Claudia; Pachman, Lauren M.; Pilkington, Clarissa; Ponyi, Andrea; Quartier, Pierre; Ramanan, Athimalaipet V.; Reed, Ann; Rennebohm, Robert

    2017-01-01

    Objective. To develop response criteria for juvenile dermatomyositis (DM). Methods. We analyzed the performance of 312 definitions that used core set measures from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Paediatric Rheumatology International Trials

  11. 2016 American College of Rheumatology/European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Juvenile Dermatomyositis : An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative

    NARCIS (Netherlands)

    Rider, Lisa G.; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M.; Huber, Adam M.; Cimaz, Rolando; Cuttica, Rubén J.; De Oliveira, Sheila Knupp; Lindsley, Carol B.; Pilkington, Clarissa A.; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Dressler, Frank; Magalhaes, Claudia Saad; Constantin, Tamás; Davidson, Joyce E.; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A.; Miller, Frederick W.; Vencovsky, Jiri; Ruperto, Nicolino; Rider, Lisa G.; Ruperto, Nicolino; Miller, Frederick W.; Aggarwal, Rohit; Erman, Brian; Bayat, Nastaran; Pistorio, Angela; Huber, Adam M.; Feldman, Brian M.; Hansen, Paul; Rockette, Howard; Lachenbruch, Peter A.; Ruperto, Nicolino; Rider, Lisa G.; Apaz, Maria T; Bowyer, Suzanne; Cimaz, Rolando; Constantin, Tamás; Curran, Megan; Davidson, Joyce E.; Feldman, Brian M.; Griffin, Thomas; Huber, Adam H.; Jones, Olcay; Kim, Susan; Lang, Bianca; Lindsley, Carol; Lovell, Daniel J.; Saad Magalhaes, Claudia; Pachman, Lauren M.; Pilkington, Clarissa; Ponyi, Andrea; Punaro, Marilynn; Quartier, Pierre; Ramanan, Athimalaipet V; Ravelli, Angelo; Reed, Ann M.; Rennebohm, Robert; Sherry, David D.; Silva, Clovis A.; Stringer, Elizabeth; van Royen-Kerkhof, Annet; Wallace, Carol; Miller, Frederick W.; Oddis, Chester V.; Reed, Ann M.; Rider, Lisa G.; Ruperto, Nicolino; Apaz, Maria T; Avcin, Tadej; Becker, Mara; Beresford, Michael W.; Cimaz, Rolando; Constantin, Tamás; Curran, Megan; Cuttica, Ruben; Davidson, Joyce E.; Dressler, Frank; Dvergsten, Jeffrey; Feitosa de Oliveira, Sheila Knupp; Feldman, Brian M.; Leme Ferriani, Virginia Paes; Flato, Berit; Gerloni, Valeria; Griffin, Thomas; Henrickson, Michael; Hinze, Claas; Hoeltzel, Mark; Huber, Adam M.; Ibarra, Maria; Ilowite, Norman T; Imundo, Lisa; Jones, Olcay; Kim, Susan; Kingsbury, Daniel; Lang, Bianca; Lindsley, Carol; Lovell, Daniel J.; Martini, Alberto; Saad Magalhaes, Claudia; Magnusson, Bo; Maguiness, Sheilagh; Maillard, Susan; Mathiesen, Pernille; McCann, Liza J.; Nielsen, Susan; Pachman, Lauren M.; Passo, Murray; Pilkington, Clarissa; Punaro, Marilynn; Quartier, Pierre; Rabinovich, Egla; Ramanan, Athimalaipet V; Ravelli, Angelo; Reed, Ann M.; Rennebohm, Robert; Rider, Lisa G.; Rivas-Chacon, Rafael; Byun Robinson, Angela; Rouster-Stevens, Kelly; Russo, Ricardo; Rutkowska-Sak, Lidia; Sallum, Adriana; Sanner, Helga; Schmeling, Heinrike; Selcen, Duygu; Shaham, Bracha; Sherry, David D.; Silva, Clovis A.; Spencer, Charles H.; Sundel, Robert; Tardieu, Marc; Thatayatikom, Akaluck; van der Net, Janjaap; van Royen-Kerkhof, Annet; Wahezi, Dawn; Wallace, Carol; Zulian, Francesco; analysis, Conjoint; Cimaz, Rolando; Constantin, Tamás; Cuttica, Ruben; Davidson, Joyce E.; Dressler, Frank; Knupp Feitosa de Oliveira, Sheila; Feldman, Brian M.; Griffin, Thomas; Henrickson, Michael; Huber, Adam M.; Imundo, Lisa; Lang, Bianca; Lindsley, Carol; Saad Magalhaes, Claudia; Magnusson, Bo; Maillard, Susan; Pachman, Lauren M.; Passo, Murray; Pilkington, Clarissa; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rider, Lisa G.; Rouster-Stevens, Kelly; Russo, Ricardo; Shaham, Bracha; Sundel, Robert; van der Net, Janjaap; van Royen-Kerkhof, Annet; Cimaz, Rolando; Cuttica, Rubén J.; Knupp Feitosa de Oliveira, Sheila; Feldman, Brian M.; Huber, Adam M.; Lindsley, Carol B.; Pilkington, Clarissa; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Amato, Anthony A; Chinoy, Hector; Cooper, Robert G.; Dastmalchi, Maryam; de Visser, Marianne; Fiorentino, David; Isenberg, David; Katz, James; Mammen, Andrew; Oddis, Chester V.; Ytterberg, Steven R.

    2017-01-01

    Objective: To develop response criteria for juvenile dermatomyositis (DM). Methods: We analyzed the performance of 312 definitions that used core set measures from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Paediatric Rheumatology International Trials

  12. It takes two to tango : Investigating the antecedents and consequences of effective collaboration between designers and managers in innovation projects

    NARCIS (Netherlands)

    Tabeau, K.E.

    2016-01-01

    Designers are increasingly playing a strategic role in innovation projects. They can do this, amongst others, by more effectively collaborating with the managers of these projects. This thesis investigates the antecedents and consequences of effective collaboration between designers and managers in

  13. Paediatric cardiopulmonary resuscitation training program in Latin-America: the RIBEPCI experience.

    Science.gov (United States)

    López-Herce, Jesús; Matamoros, Martha M; Moya, Luis; Almonte, Enma; Coronel, Diana; Urbano, Javier; Carrillo, Ángel; Del Castillo, Jimena; Mencía, Santiago; Moral, Ramón; Ordoñez, Flora; Sánchez, Carlos; Lagos, Lina; Johnson, María; Mendoza, Ovidio; Rodriguez, Sandra

    2017-09-12

    To describe the design and to present the results of a paediatric and neonatal cardiopulmonary resuscitation (CPR) training program adapted to Latin-America. A paediatric CPR coordinated training project was set up in several Latin-American countries with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The program was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. Instructors from each country participated in the development of the next group in the following country. Paediatric Basic Life Support (BLS), Paediatric Intermediate (ILS) and Paediatric Advanced (ALS) courses were organized in each country adapted to local characteristics. Five Paediatric Resuscitation groups were created sequentially in Honduras (2), Guatemala, Dominican Republican and Mexico. During 5 years, 6 instructors courses (94 students), 64 Paediatric BLS Courses (1409 students), 29 Paediatrics ILS courses (626 students) and 89 Paediatric ALS courses (1804 students) were given. At the end of the program all five groups are autonomous and organize their own instructor courses. Training of autonomous Paediatric CPR groups with the collaboration and scientific assessment of an expert group is a good model program to develop Paediatric CPR training in low- and middle income countries. Participation of groups of different countries in the educational activities is an important method to establish a cooperation network.

  14. Paediatric radiopharmaceutical administration

    DEFF Research Database (Denmark)

    Lassmann, Michael; Treves, S Ted; Borgwardt, Lise

    2014-01-01

    In 2008 the EANM published their paediatric dosage card. In 2011 the North American consensus guidelines recommended a set of administered activities for paediatric nuclear medicine. During the EANM congress in 2012 a working group of the EANM and the SNMMI met to study the possibility of harmoni...

  15. Manifestations of metacognitive activity during the collaborative planning of chemistry practical investigations

    Science.gov (United States)

    Mathabathe, Kgadi Clarrie; Potgieter, Marietjie

    2017-07-01

    This paper elaborates a process followed to characterise manifestations of cognitive regulation during the collaborative planning of chemistry practical investigations. Metacognitive activity was defined as the demonstration of planning, monitoring, control and evaluation of cognitive activities by students while carrying out the chemistry task. Inherent in collaborative learning is the social aspect of metacognition, which in this study was evidenced in social cognitive regulation (notably of intra- and interpersonal metacognitive regulations) as groups of students went about planning their practical investigations. Discussions of two of the learning groups (n = 4; n = 3) as they planned the extended practical investigation were recorded, transcribed and analysed for indicators of any inherent metacognitive activity. The process of characterising the manifestations of metacognition resulted in the development of a coding system which specifies not only the regulatory strategies at play but the type of regulation (self or other), the area of regulation (cognition, task performance or behaviour) as well as the depth of regulatory contributions (high or low). The fine-grained coding system allowed for a finer theoretical elucidation of the social nature of metacognition. The implications of this study for metacognition and chemistry education research are highlighted.

  16. Safety in paediatric imaging

    International Nuclear Information System (INIS)

    Carter, D.; Filice, I.; Murray, D.; Thomas, K.

    2006-01-01

    Those of us working in a dedicated paediatric environment are aware of the important safety issues with regard to paediatrics. Our goal when working with paediatric patients, the goal is to obtain the best quality images while keeping patients safe and their distress to a minimum. This article will discuss some of the issues regarding paediatric safety in a diagnostic imaging department, including radiation doses and the risk to paediatric patients, reducing medication errors, safe sedation practice and environmental safety. Also discussed are some conditions requiring special consideration to maintain patient safety such as epiglottitis and suspected child abuse. Promotion of a patient/family-centered care system will create an environment of trust where parents or guardians will know that their children are being well cared for in a safe, effective environment. (author)

  17. A Collaborative Epidemiological Investigation into the Criminal Fake Artesunate Trade in South East Asia

    Science.gov (United States)

    Newton, Paul N; Fernández, Facundo M; Plançon, Aline; Mildenhall, Dallas C; Green, Michael D; Ziyong, Li; Christophel, Eva Maria; Phanouvong, Souly; Howells, Stephen; McIntosh, Eric; Laurin, Paul; Blum, Nancy; Hampton, Christina Y; Faure, Kevin; Nyadong, Leonard; Soong, C. W. Ray; Santoso, Budiono; Zhiguang, Wang; Newton, John; Palmer, Kevin

    2008-01-01

    Background Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered. Methods and Findings With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL) and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75), Cambodia (48), Lao PDR (115), Myanmar (Burma) (137) and the Thai/Myanmar border (16), were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9%) on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to ∼ 50 mg per genuine tablet). Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine (‘ecstasy'). Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures. Conclusions An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation

  18. A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia.

    Directory of Open Access Journals (Sweden)

    Paul N Newton

    2008-02-01

    Full Text Available Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered.With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75, Cambodia (48, Lao PDR (115, Myanmar (Burma (137 and the Thai/Myanmar border (16, were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9% on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to approximately 50 mg per genuine tablet. Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine ('ecstasy'. Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People's Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures.An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation. International cross

  19. The paediatric acute scrotum: are we still managing correctly?

    African Journals Online (AJOL)

    Objective The objective of this study was to investigate current investigation and management practice in a general district hospital in the UK of the paediatric acute scrotum. Summary background Diagnosis and management of the paediatric acute scrotum remains an elusive and often challenging area of urology.

  20. A qualitative investigation of the role of paediatric rehabilitation professionals in rural South Africa: Rehabilitation professionals’ perspectives

    Directory of Open Access Journals (Sweden)

    Desmond Mathye

    2016-02-01

    Full Text Available Purpose: To investigate the role that rehabilitation professionals play in the rehabilitation of children with disabilities in the rural and under-resourced community of Giyani in South Africa. Method: A qualitative, exploratory and descriptive approach was used. Semi-structured face-to-face interviews were used to collect data from a convenient sample of eight rehabilitation professionals. Data were transcribed verbatim by two trained students and verified by the main researcher. An inductive approach to qualitative data analysis was used. In vivo and open coding were used to generate codes. Results: Analysis of data resulted in 21 codes, 9 subcategories, 5 categories and 1 theme. The role of rehabilitation professionals was described in terms of the five categories which are to examine newborn babies and children at risk, support caregivers of children with disabilities, impart skills training for caregivers of children with disabilities, rehabilitate children with disabilities and conduct follow-ups in communities where the children with disabilities reside. Conclusion: The role that rehabilitation professionals play in the rural and under-resourced community of Giyani in South Africa is similar to the role played in high-income countries. The role that rehabilitation professionals play is not only focused on the child but also on the family.

  1. Paediatric chronic liver diseases: how to investigate and follow up? Role of imaging in the diagnosis of fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Pariente, Daniele; Franchi-Abella, Stephanie [University Paris XI, Pediatric Radiology Department, Bicetre Hospital, Assistance Publique Hopitaux de Paris, Le Kremlin Bicetre (France)

    2010-06-15

    Chronic liver diseases are rare in children, but encompass a wide spectrum of disorders that may all be complicated by liver fibrosis and therefore by portal hypertension. They may be classified according to the level of portal flow obstruction: prehepatic, intrahepatic or suprahepatic. Most of them, except presinusoidal diseases, may progress to cirrhosis that carries additional risks of impaired liver function and development of hepatocellular carcinoma. Imaging plays an important role in guiding the diagnosis and biopsy and for follow-up during treatment. US, with high-frequency transducers and Doppler, is the first modality of choice, directs the rest of the investigations and guides interventional radiology. MDCT has made great progress and has replaced angiography for diagnostic purposes. MRI is indicated for parenchyma and nodule characterization and for biliary tract evaluation. To avoid liver biopsy, several elasticity imaging techniques have been developed and have to be evaluated for accuracy and convenience in children. The role of each modality with main imaging findings is described in extrahepatic portal vein obstruction, hepatoportal sclerosis, congenital hepatic fibrosis, cirrhosis and Budd-Chiari syndrome. (orig.)

  2. Peer teaching in paediatrics - medical students as learners and teachers on a paediatric course.

    Science.gov (United States)

    Schauseil-Zipf, Ulrike; Karay, Yassin; Ehrlich, Roland; Knoop, Kai; Michalk, Dietrich

    2010-01-01

    Peer assisted learning is known as an effective educational strategy in medical teaching. We established a peer assisted teaching program by student tutors with a focus on clinical competencies for students during their practical training on paediatric wards. It was the purpose of this study to investigate the effects of a clinical skills training by tutors, residents and consultants on students evaluations of the teaching quality and the effects of a peer teaching program on self assessed clinical competencies by the students. Medical student peers in their 6(th) year were trained by an intensive instruction program for teaching clinical skills by paediatric consultants, doctors and psychologists. 109 students in their 5(th) year (study group) participated in a peer assisted teaching program for training clinical skills in paediatrics. The skills training by student peer teachers were supervised by paediatric doctors. 45 students (control group) participated in a conventional paediatric skills training by paediatric doctors and consultants. Students from both groups, which were consecutively investigated, completed a questionnaire with an evaluation of the satisfaction with their practical training and a self assessment of their practical competencies. The paediatric skills training with student peer teachers received significantly better ratings than the conventional skills training by paediatric doctors concerning both the quality of the practical training and the support by the teaching medical staff. Self assessed learning success in practical skills was higher rated in the peer teaching program than in the conventional training. The peer assisted teaching program of paediatric skills training was rated higher by the students regarding their satisfaction with the teaching quality and their self assessment of the acquired skills. Clinical skills training by student peer teachers have to be supervised by paediatric doctors. Paediatric doctors seem to be more

  3. Let’s Improv It: The Embodied Investigation of Social Collaboration

    Directory of Open Access Journals (Sweden)

    Klara Łucznik

    2017-11-01

    Full Text Available How do we share embodied knowledge? How do we understand the world through our bodies? How can we effectively interpret and communicate somatic experiences to a wider audience? These questions emerged during a collaborative research project Let’s Improv It (August 2016, Plymouth University, which set out to explore how kinaesthetic empathy and multisensory perception help us to understand our own actions, intentions and emotions, as well as those of others. We additionally questioned the role and perception of physical and emotional touch within embodied knowledge. After a five-day practice-led investigation, a 20-minute improvised somatic movement score was developed with the aim of providing a novel experience of touch and movement. The authors collectively delivered the score and reflected on the outcomes of this experience over the course of a year (2016–2017. In this paper, we explore how our research project expanded the boundaries of the conventional concepts of knowledge and cognition. We see such participatory sessions, in which movement and embodied experience freely unfold in time and space, as a ‘laboratory’ in which we examine the underlying mechanisms of collaboration. We reflect on how such an experience can be seen as a creative process, or as an emergent, collaborative artwork. The participants are both the creators and, simultaneously, the audience of our improvised experience. The experience provided a non-judgmental context for physical engagement and observation, which is an outcome that will be introduced alongside participants’ feedback. Overall, the project revealed that shared embodied knowledge is highly appreciated, particularly among those without previous experience with embodied enquiry or movement research.

  4. Paediatric Malignancies | Joseph | African Journal of Paediatric ...

    African Journals Online (AJOL)

    malignancies. Other common malignancies included sarcomas 10(14.71%), neurofibromatosis 9(13.24%), nephroblastoma 8(11.77%), acute lymphoblastic leukaemia 5(7.35%) and retinoblastoma 4(5.88%). The less common paediatric malignancies were melanoma, invasive lobular breast carcinoma and squamous cell ...

  5. Investigating Technical and Pedagogical Usability Issues of Collaborative Learning with Wikis

    Science.gov (United States)

    Hadjerrouit, Said

    2012-01-01

    Wikis have been recently promoted as tools that foster collaborative learning. However, there has been little research devoted to the criteria that are suitable to address issues pertinent to collaborative learning. This paper proposes a set of criteria to explore technical and pedagogical usability issues of collaborative learning with wikis. The…

  6. Paediatric Anxiety Disorders

    Directory of Open Access Journals (Sweden)

    Beena Johnson

    2017-07-01

    Full Text Available Anxiety disorders are highly prevalent among children and are associated with serious morbidity. Lifetime prevalence of paediatric anxiety disorders is about fifteen percent. Social phobia, generalized anxiety disorder and separation anxiety disorder are included in the triad of paediatric anxiety disorders. Specific phobia, obsessive compulsive disorder and post-traumatic stress disorder are also commonly seen in children. Overprotection by parents, parental death or separation, female sex, low educational status, family history of anxiety disorder, financial stress in family and adverse childhood experiences are risk factors for the development of anxiety disorders. If not diagnosed and managed at the earliest, paediatric anxiety disorders can cause life threatening problems in the future. Hence early and scientific management of anxiety disorders is essential. Cognitive behavioural therapy is the effective evidence based treatment for paediatric anxiety disorders.

  7. Paediatric talus fracture.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria

    2012-01-01

    Paediatric talus fractures are rare injuries resulting from axial loading of the talus against the anterior tibia with the foot in dorsiflexion. Skeletally immature bone is less brittle, with higher elastic resistance than adult bone, thus the paediatric talus can sustain higher forces before fractures occur. However, displaced paediatric talus fractures and those associated with high-energy trauma have been associated with complications including avascular necrosis, arthrosis, delayed union, neurapraxia and the need for revision surgery. The authors present the rare case of a talar neck fracture in a skeletally immature young girl, initially missed on radiological review. However, clinical suspicion on the part of the emergency physician, repeat examination and further radiographic imaging revealed this rare paediatric injury.

  8. Paediatric interventional radiology

    African Journals Online (AJOL)

    2016-06-29

    Jun 29, 2016 ... Non-operative management is the standard of care in children with blunt solid ... treatment of choice in children with extensive deep venous ... thrombosis. An IVC .... children, a paediatric nurse comfortable with administering.

  9. Challenges in paediatric neurosurgery

    Directory of Open Access Journals (Sweden)

    Pragati Ganjoo

    2017-01-01

    Full Text Available Improvements in technique, knowledge and expertise have brought about rapid advances in the fields of paediatric neurosurgery and anaesthesia, and many procedures limited earlier to adults are now being increasingly attempted in neonates and small children, with good outcomes. This article highlights the challenges faced by the operating team while handling some of the technically complex procedures like awake craniotomy, interventional neuroradiology, minimally invasive neurosurgery, procedures in intraoperative magnetic resonance imaging suites, and neonatal emergencies in the paediatric population.

  10. Malnutrition in paediatric oncology patients

    African Journals Online (AJOL)

    Nutritional status of paediatric cancer patients at diagnosis ... Professor and Executive Head, Department of Paediatrics and Child Health, Stellenbosch University and Tygerberg Hospital, .... can lead to decreased oral intake, weight loss.

  11. Genodermatoses in paediatric age group

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    1996-01-01

    Full Text Available Pattern of genodermatoses in paediatric age group was studied. The relative incidence of genodermatoses in paediatric dermatology out patient department was 0.62%. The commonest genodermatoses observed was ichthyosis.

  12. Drugs for the paediatric heart

    African Journals Online (AJOL)

    Head, Paediatric Cardiology Service of the Western Cape, Department of Paediatrics and Child Health, ... His interests also include the care of complex patients ... The pharmacy only has enalapril available – can you substitute this drug for the ...

  13. African Journal of Paediatric Surgery

    African Journals Online (AJOL)

    The African Journal of Paediatric Surgery aims to promote research, post- graduate training and further education among Paediatric surgeons, Paediatric Surgical Trainees and paramedical personnel in the surgery of newborn infants and children particularly in Africa and other tropical regions of the world.AJPS welcomes ...

  14. African Journal of Paediatric Nephrology

    African Journals Online (AJOL)

    African Journal of Paediatric Nephrology is the official Journal of the African Paediatric Nephrology Association (AFPNA). The journal is dedicated to increasing awareness and knowledge of Paediatric nephrology in Africa and beyond. We publish research articles on renal diseases in children, on fluid and electrolyte ...

  15. Paediatric interventional radiology

    International Nuclear Information System (INIS)

    McLaren, Clare

    2014-01-01

    Paediatric interventional radiology (PIR) is a rapidly-growing subspecialty, which offers a wide range of procedures applicable to almost all areas of hospital paediatrics. There are many important differences between paediatric and adult practice in interventional radiology, including disease processes and treatment goals, anatomical considerations, periprocedural patient management, radiation exposure optimisation and legal aspects. The use of retrievable or absorbable interventional devices such as stents will probably become more widespread in PIR practice. Recent advances in the technology of imaging equipment have been accompanied by an increase in the complexity of the work done by the radiographer. These developments present challenges and opportunities related to training and maintenance of skills, staffing arrangements, and the potential for advanced practice. It is likely that specialisation in PIR will become a more common role for radiographers in the future

  16. Investigating ultra high-enthalpy geothermal systems: a collaborative initiative to promote scientific opportunities

    Science.gov (United States)

    Elders, W. A.; Nielson, D.; Schiffman, P.; Schriener, A., Jr.

    2014-12-01

    Scientists, engineers, and policy makers gathered at a workshop in the San Bernardino Mountains of southern California in October 2013 to discuss the science and technology involved in developing high-enthalpy geothermal fields. A typical high-enthalpy geothermal well between 2000 and 3000 m deep produces a mixture of hot water and steam at 200-300 °C that can be used to generate about 5-10 MWe of electric power. The theme of the workshop was to explore the feasibility and economic potential of increasing the power output of geothermal wells by an order of magnitude by drilling deeper to reach much higher pressures and temperatures. Development of higher enthalpy geothermal systems for power production has obvious advantages; specifically higher temperatures yield higher power outputs per well so that fewer wells are needed, leading to smaller environmental footprints for a given size of power plant. Plans for resource assessment and drilling in such higher enthalpy areas are already underway in Iceland, New Zealand, and Japan. There is considerable potential for similar developments in other countries that already have a large production of electricity from geothermal steam, such as Mexico, the Philippines, Indonesia, Italy, and the USA. However drilling deeper involves technical and economic challenges. One approach to mitigating the cost issue is to form a consortium of industry, government and academia to share the costs and broaden the scope of investigation. An excellent example of such collaboration is the Iceland Deep Drilling Project (IDDP), which is investigating the economic feasibility of producing electricity from supercritical geothermal reservoirs, and this approach could serve as model for future developments elsewhere. A planning committee was formed to explore creating a similar initiative in the USA.

  17. Investigating JEEM empirically: a story of co-authorship and collaboration

    OpenAIRE

    Schymura, Michael; Löschel, Andreas

    2012-01-01

    We examine the incidence and extent of co-authorship and intellectual collaboration in the leading journal of environmental and resource economics: the Journal of Environmental Economics and Management. Previous studies of general economic journals have offered empirical evidence for the fact that intellectual collaboration is most prevalent in the field of environmental and resource economics. However, no previous study has examined this finding more carefully. This is a gap in the literatur...

  18. Dismantling the Co-creation Unicorn : Investigating the "How" in Inter-firm Collaboration

    OpenAIRE

    Skog, Daniel

    2012-01-01

    In order to face the challenges derived from an increasingly disruptive technologicalenvironment, firms often engage in collaborative arrangements with other firms. While it isargued that inter-firm networks can serve as a way to catalyze innovation, to manage risksinvolved in R&D and to enable the creation of new value through co-creation, the causes andreasons for inter-firm collaboration are well-known. However, little effort has been focused atcritically examining the challenges that ...

  19. Paediatric cardiac intensive care unit: current setting and organization in 2010.

    Science.gov (United States)

    Fraisse, Alain; Le Bel, Stéphane; Mas, Bertrand; Macrae, Duncan

    2010-10-01

    Over recent decades, specialized paediatric cardiac intensive care has emerged as a central component in the management of critically ill, neonatal, paediatric and adult patients with congenital and acquired heart disease. The majority of high-volume centres (dealing with over 300 surgical cases per year) have dedicated paediatric cardiac intensive care units, with the smallest programmes more likely to care for paediatric cardiac patients in mixed paediatric or adult intensive care units. Specialized nursing staff are also a crucial presence at the patient's bedside for quality of care. A paediatric cardiac intensive care programme should have patients (preoperative and postoperative) grouped together geographically, and should provide proximity to the operating theatre, catheterization laboratory and radiology department, as well as to the regular ward. Age-appropriate medical equipment must be provided. An optimal strategy for running a paediatric cardiac intensive care programme should include: multidisciplinary collaboration and involvement with paediatric cardiology, anaesthesia, cardiac surgery and many other subspecialties; a risk-stratification strategy for quantifying perioperative risk; a personalized patient approach; and anticipatory care. Finally, progressive withdrawal from heavy paediatric cardiac intensive care management should be institutionalized. Although the countries of the European Union do not share any common legislation on the structure and organization of paediatric intensive care or paediatric cardiac intensive care, any paediatric cardiac surgery programme in France that is agreed by the French Health Ministry must perform at least '150 major procedures per year in children' and must provide a 'specialized paediatric intensive care unit'. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  20. Paediatric airway management: basic aspects

    DEFF Research Database (Denmark)

    Holm-Knudsen, R J; Rasmussen, L S

    2009-01-01

    Paediatric airway management is a great challenge, especially for anaesthesiologists working in departments with a low number of paediatric surgical procedures. The paediatric airway is substantially different from the adult airway and obstruction leads to rapid desaturation in infants and small...... children. This paper aims at providing the non-paediatric anaesthesiologist with a set of safe and simple principles for basic paediatric airway management. In contrast to adults, most children with difficult airways are recognised before induction of anaesthesia but problems may arise in all children...

  1. An Investigation into the Effectiveness of Collaboration between Greek Secondary EFL Teachers and Specialist Providers for Dyslexia Issues

    Science.gov (United States)

    Rontou, Maria

    2013-01-01

    This paper investigates the collaboration of Greek secondary school teachers of English as a Foreign Language (EFL) with psychologists and advisers for dyslexia issues. Data were collected through audio recorded observations and interviews with head teachers and teachers. Taking a Vygotskian approach to learning, activity theory is applied to…

  2. Playing in "Trelis Weyr": Investigating Collaborative Practices in a "Dragons of Pern" Role-Play-Game Forum

    Science.gov (United States)

    Alley, Kathleen M.

    2013-01-01

    This descriptive case study examined adolescents' and emerging adults' literate and social practices within the context of a role-play-game (RPG) forum, investigating the ways participants read and collaboratively composed within this space. As a researcher, I was interested in how this space functioned and how the interactions between…

  3. Information-computational platform for collaborative multidisciplinary investigations of regional climatic changes and their impacts

    Science.gov (United States)

    Gordov, Evgeny; Lykosov, Vasily; Krupchatnikov, Vladimir; Okladnikov, Igor; Titov, Alexander; Shulgina, Tamara

    2013-04-01

    Analysis of growing volume of related to climate change data from sensors and model outputs requires collaborative multidisciplinary efforts of researchers. To do it timely and in reliable way one needs in modern information-computational infrastructure supporting integrated studies in the field of environmental sciences. Recently developed experimental software and hardware platform Climate (http://climate.scert.ru/) provides required environment for regional climate change related investigations. The platform combines modern web 2.0 approach, GIS-functionality and capabilities to run climate and meteorological models, process large geophysical datasets and support relevant analysis. It also supports joint software development by distributed research groups, and organization of thematic education for students and post-graduate students. In particular, platform software developed includes dedicated modules for numerical processing of regional and global modeling results for consequent analysis and visualization. Also run of integrated into the platform WRF and «Planet Simulator» models, modeling results data preprocessing and visualization is provided. All functions of the platform are accessible by a user through a web-portal using common graphical web-browser in the form of an interactive graphical user interface which provides, particularly, capabilities of selection of geographical region of interest (pan and zoom), data layers manipulation (order, enable/disable, features extraction) and visualization of results. Platform developed provides users with capabilities of heterogeneous geophysical data analysis, including high-resolution data, and discovering of tendencies in climatic and ecosystem changes in the framework of different multidisciplinary researches. Using it even unskilled user without specific knowledge can perform reliable computational processing and visualization of large meteorological, climatic and satellite monitoring datasets through

  4. Sustaining Broader Impacts through Researcher-Teacher Collaboration (A Model Based on Award Abstract #1334935: Collaborative Research: Investigating the Ecological Importance of Iron Storage in Diatoms.)

    Science.gov (United States)

    Sutton, M.; Marchetti, A.

    2016-02-01

    Broader impacts have become a vital component of scientific research projects. A variety of outreach avenues are available to assist scientists in reaching larger audiences, however, the translation of cutting-edge scientific content and concepts can be challenging. Collaborating with educators is a viable option to assist researchers in fulfilling NSF's broader impact requirements. A broader impacts model based on collaborations between a teacher and 28 researchers from 14 institutions will demonstrate successful science outreach and engagement through interactions between teachers, researchers, students, and general audiences. Communication styles (i.e., blogs, social media) and outreach data incorporated by researchers and the teacher will be shared to illustrate the magnitude of the broader impacts achieved with this partnership. Inquiry-based investigations and activities developed to translate the science into the classroom will also be demonstrated, including the use of real scientific data collected during the research cruise. "Finding Microbe Needles in a Haystack of Oceans" provides an understanding of how remote sensing technology is used to locate specific ocean environments (e.g. High Nutrient Low Chlorophyll - HNLC) that support diverse microbial food webs. A board game ("Diatom Adventures©") designed to explore the physiology of microbial organisms and microscopic food webs will also be demonstrated. The tentative nature of science requires a constant vigil to stay abreast of the latest hypotheses and discoveries. Researcher/Teacher collaborations allow each professional to focus on his/her strengths while meeting broader impact requirements. These partnerships encourage lifelong learning as educators observe and work with scientists first-hand and then follow appropriate scope, sequence, and pedagogy to assist various audiences in understanding the innovative technologies being used to explore new scientific frontiers.

  5. Investigating Factors That Influence Students' Management of Study Environment in Online Collaborative Groupwork

    Science.gov (United States)

    Du, Jianxia; Xu, Jianzhong; Fan, Xitao

    2015-01-01

    The present study examines empirical models of students' management of the learning environment in the context of online collaborative groupwork. Such environment management is an important component of students' overall self-regulated learning strategy for effective learning. Student- and group-level predictors for study environment management in…

  6. Paediatric horse-related trauma.

    Science.gov (United States)

    Theodore, Jane E; Theodore, Sigrid G; Stockton, Kellie A; Kimble, Roy M

    2017-06-01

    This retrospective cohort study reported on the epidemiology of horse-related injuries for patients presenting to the only tertiary paediatric trauma hospital in Queensland. The secondary outcome was to examine the use of helmets and adult supervision. Traumatic brain injury (TBI) was examined in relation to helmet use. Morbidity and mortality were also recorded. Included were all patients presenting with any horse-related trauma to the Royal Children's Hospital in Brisbane from January 2008 to August 2014. Data were retrospectively collected on patient demographics, hospital length of stay (LOS), mechanism of injury (MOI), safety precautions taken, diagnoses and surgical procedures performed. Included in the analysis were 187 incidents involving 171 patients. Most patients were aged 12-14 years (36.9%) and female (84.5%). The most common MOI were falls while riding horses (97.1%). Mild TBI (24.6%) and upper limb fractures (20.9%) were common injuries sustained. Patients who wore helmets had significantly reduced hospital LOS and severity of TBI when compared with those who did not wear helmets (P horses, in addition to being a compulsory requirement whilst horse riding. Prompts in documentation may assist doctors to record the use of safety attire and adult supervision. This will allow future studies to further investigate these factors in relation to clinical outcomes. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  7. Parental knowledge of paediatric vaccination

    Directory of Open Access Journals (Sweden)

    Borràs Eva

    2009-05-01

    Full Text Available Abstract Background Although routine vaccination is a major tool in the primary prevention of some infectious diseases, there is some reluctance in a proportion of the population. Negative parental perceptions of vaccination are an important barrier to paediatric vaccination. The aim of this study was to investigate parental knowledge of paediatric vaccines and vaccination in Catalonia. Methods A retrospective, cross-sectional study was carried out in children aged Results An association was observed between greater vaccination coverage of the 4:4:4:3:1 schedule (defined as: 4 DTPa/w doses, 4 Hib doses, 4 OPV doses, 3 MenC doses and 1 MMR dose and maternal age >30 years (OR: 2.30; 95% CI: 1.20–4.43 and with a knowledge of vaccination score greater than the mean (OR: 0.45; 95% CI: 0.28–0.72. The score increased with maternal educational level and in parents of vaccinated children. A total of 20.47% of parents stated that vaccines could have undesirable consequences for their children. Of these, 23.26% had no specific information and 17.83% stated that vaccines can cause adverse reactions and the same percentage stated that vaccines cause allergies and asthma. Conclusion Higher vaccination coverage is associated with older maternal age and greater knowledge of vaccination. Vaccination coverage could be raised by improving information on vaccines and vaccination.

  8. Ethical dimensions of paediatric nursing: A rapid evidence assessment.

    Science.gov (United States)

    Bagnasco, Annamaria; Cadorin, Lucia; Barisone, Michela; Bressan, Valentina; Iemmi, Marina; Prandi, Marzia; Timmins, Fiona; Watson, Roger; Sasso, Loredana

    2018-02-01

    Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, 'What are the most common ethical dimensions and competences related to paediatric nursing?' A rapid evidence assessment. According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses' perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.

  9. Paediatric conscious sedation: views and experience of specialists in paediatric dentistry.

    Science.gov (United States)

    Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L

    2009-09-26

    The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.

  10. An investigation of the efficacy of collaborative virtual reality systems for moderated remote usability testing.

    Science.gov (United States)

    Chalil Madathil, Kapil; Greenstein, Joel S

    2017-11-01

    Collaborative virtual reality-based systems have integrated high fidelity voice-based communication, immersive audio and screen-sharing tools into virtual environments. Such three-dimensional collaborative virtual environments can mirror the collaboration among usability test participants and facilitators when they are physically collocated, potentially enabling moderated usability tests to be conducted effectively when the facilitator and participant are located in different places. We developed a virtual collaborative three-dimensional remote moderated usability testing laboratory and employed it in a controlled study to evaluate the effectiveness of moderated usability testing in a collaborative virtual reality-based environment with two other moderated usability testing methods: the traditional lab approach and Cisco WebEx, a web-based conferencing and screen sharing approach. Using a mixed methods experimental design, 36 test participants and 12 test facilitators were asked to complete representative tasks on a simulated online shopping website. The dependent variables included the time taken to complete the tasks; the usability defects identified and their severity; and the subjective ratings on the workload index, presence and satisfaction questionnaires. Remote moderated usability testing methodology using a collaborative virtual reality system performed similarly in terms of the total number of defects identified, the number of high severity defects identified and the time taken to complete the tasks with the other two methodologies. The overall workload experienced by the test participants and facilitators was the least with the traditional lab condition. No significant differences were identified for the workload experienced with the virtual reality and the WebEx conditions. However, test participants experienced greater involvement and a more immersive experience in the virtual environment than in the WebEx condition. The ratings for the virtual

  11. Collaborative Economy

    DEFF Research Database (Denmark)

    collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... and similar phenomena are among these collective innovations in tourism that are shaking the very bedrock of an industrial system that has been traditionally sustained along commercial value chains. To date there has been very little investigation of these trends, which have been inspired by, amongst other...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...

  12. Science diplomacy: Investigating the perspective of scholars on politics-science collaboration in international affairs.

    Science.gov (United States)

    Fähnrich, Birte

    2017-08-01

    Science diplomacy is a widely practiced area of international affairs, but academic research is rather sparse. The role of academia within this field of politics-science interaction has hardly been considered. This article analyzes this scholarly perspective: Based on a literature review, a case study of a German science diplomacy program is used to explore objectives, benefits, and constraints of science diplomacy for participating scholars. While political approaches suggest an ideal world where both sides profit from the collaboration, the findings of the case study point to another conclusion which shows that the interaction of scholars and officials in science diplomacy is far more complex. Thus, the contribution is regarded as both a useful starting point for further research and for a critical reflection of academics and politicians in science diplomacy practice to gauge what can be expected from the collaboration and what cannot.

  13. Prosthetics in Paediatric Dentistry

    Directory of Open Access Journals (Sweden)

    Vulićević Zoran

    2017-07-01

    Full Text Available Premature loss of teeth in children may lead to both functional and esthetic problems. Missing teeth in both anterior and posterior regions may cause malfunctions in mastication and proper pronunciation. If the missing teeth are not replaced, further complications may occur, including adjacent tooth migration, loss of alveolar bone, and irregular occlusion. Considering the sensitive nature of children, loss of teeth may cause the development of insecurities and low self esteem problems. Due to dynamic nature of growth in children and adolescents, prosthetic appliances must not hinder development of orofacial system, and must meet adequate esthetic and functional standards. Dental prosthetic appliances in paediatrics must be planned with respect to the special conditions that led to tooth loss or damage. Multi-disciplinary approach is needed, under constant supervision of paediatric dentist and orthodontist, as well as regular checkups with clinical and radiographical examinations.

  14. Paediatric treadmill friction injuries.

    Science.gov (United States)

    Jeremijenko, Luke; Mott, Jonathan; Wallis, Belinda; Kimble, Roy

    2009-05-01

    The aim of this study was to report on the severity and incidence of children injured by treadmills and to promote the implementation of safety standards. This retrospective review of children with treadmill friction injuries was conducted in a single tertiary-level burns centre in Australia between January 1997 and June 2007. The study revealed 37 children who sustained paediatric treadmill friction injuries. This was a presentation of 1% of all burns. Thirty-three (90%) of the injuries occurred in the last 3.5 years (January 2004 to June 2007). The modal age was 3.2 years. Thirty-three (90%) injuries were either full thickness or deep partial friction burns. Eleven (30%) required split thickness skin grafts. Of those who became entrapped, 100% required skin grafting. This study found that paediatric treadmill friction injuries are severe and increasing in incidence. Australian standards should be developed, implemented and mandated to reduce this preventable and severe injury.

  15. Investigating the interplay between fundamentals of national research systems: performance, investments and international collaborations

    OpenAIRE

    Cimini, Giulio; Zaccaria, Andrea; Gabrielli, Andrea

    2015-01-01

    We discuss, at the macro-level of nations, the contribution of research funding and rate of international collaboration to research performance, with important implications for the science of science policy. In particular, we cross-correlate suitable measures of these quantities with a scientometric-based assessment of scientific success, studying both the average performance of nations and their temporal dynamics in the space defined by these variables during the last decade. We find signifi...

  16. Investigating the effect of collaborative care on depression, anxiety, and stress of patients after coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Parastoo Rezapour

    2016-02-01

    Full Text Available Background: Coronary artery disease and its associated treatment interventions such as angioplasty can lead to emotional problems, including depression, anxiety, and stress, in patients and might have adverse effects on the recovery process. This study aimed to evaluate the effect of collaborative care model on depression, anxiety, and stress in patients after coronary angioplasty. Methods: This clinical trial was conducted on 50 patients undergoing coronary angioplasty, who were referred to intensive care unit and surgical ward of one of the hospitals of Isfahan, Iran, in 2015. Samples were selected through randomized convenience sampling and were divided into intervention and control group (n=25 for each group. Collaborative care model, consisting of four stages of motivation, preparation, engagement, and evaluation, was implemented for the intervention group through five 45-60 minute sessions and a three-month telephone follow-up. Data was collected using depression, anxiety, and stress scale (DASS-42 before and one month after the intervention from both groups. Data were analyzed using descriptive statistics, Chi-square, as well as independent and paired t-tests in SPSS, version 18. Results: In this study, mean score of depression was significantly decreased in the intervention group after the implementation of collaborative model (from 31.6±3.7 to 6.3±5.03 (P<0.001, and mean anxiety and stress scores were reduced from 32.6±3.04 and 32.2±3.3 to 6.2±4.1 and 8.5±4.8, respectively (P<0.001. In this regard, a significant difference was observed between the intervention and control groups (P<0.001. Conclusion: Implementation of collaborative care could be associated with lower depression, anxiety, and stress in patients after coronary angioplasty. Therefore, its application is recommended as an effective method for such patients.

  17. Gearbox Reliability Collaborative Investigation of High-Speed-Shaft Bearing Loads

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Jonathan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Guo, Yi [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-06-01

    The loads and contact stresses in the bearings of the high speed shaft section of the Gearbox Reliability Collaborative gearbox are examined in this paper. The loads were measured though strain gauges installed on the bearing outer races during dynamometer testing of the gearbox. Loads and stresses were also predicted with a simple analytical model and higher-fidelity commercial models. The experimental data compared favorably to each model, and bearing stresses were below thresholds for contact fatigue and axial cracking.

  18. Investigation of osteosarcoma genomics and its impact on targeted therapy: an international collaboration to conquer human osteosarcoma

    OpenAIRE

    Yang, Ji-Long

    2014-01-01

    Osteosarcoma is a genetically unstable malignancy that most frequently occurs in children and young adults. The lack of progress in managing this devastating disease in the clinic has prompted international researchers to collaborate to profile key genomic alterations that define osteosarcoma. A team of researchers and clinicians from China, Finland, and the United States investigated human osteosarcoma by integrating transcriptome sequencing (RNA-seq), high-density genome-wide array comparat...

  19. Litigation in paediatrics

    LENUS (Irish Health Repository)

    Murphu, JFA

    2011-03-01

    on the issue. This is understandable. Most individuals are healthy during their childhood and have less need of and less interaction with medical services when compared with adults. However, Paediatric litigation does happen and furthermore it is likely to increase in parallel with other specialties. Carroll and Buddenbaum1 have described the pattern of Paediatric litigation in the US. The annual incidence of malpractice claims has been quoted to be as high as 6.6 claims per 100 Paediatricians per year. Almost 30% of Paediatricians have been sued with many being sued on more than one occasion. Of these cases 36% were settled out of court, 33% were dropped by the plaintiff with the remainder going before the judiciary. The authors point out that in the US medical malpractice is a hotly debated issue. Litigation has a questionable impact on health care quality, cost, and access to services. The AMA believes that rising premiums are resulting in the curtailment of medical care particularly in states with high medico-legal rates. The Physician Insurers Association of America (PIAA) is a trade organisation which insures 60% of all private practicing physicians and surgeons has been a useful source of data. In the 20 year period 1985-2005 among a total of 214,226 claims there were 6363 (2.9%) Paediatric claims which ranked it 10th among the 28 specialties covered. The claims arose in equal numbers from the hospital and Paediatrician’s office settings. Common reasons for Paediatric litigation were errors in diagnosis (32%), incorrect performance of a medical or surgical procedure (13%), failure to monitor or manage a case effectively (10%) and medication error (5%). The top five medico-legal conditions were meningitis, routine infant or child checks, newborn respiratory problems, appendicitis and brain-damaged infants as a co-defendant with Obstetrics. Good quality information about litigation is important because the discussion among doctors is frequently confused by

  20. An investigation of red blood cell concentrate quality during storage in paediatric-sized polyvinylchloride bags plasticized with alternatives to di-2-ethylhexyl phthalate (DEHP).

    Science.gov (United States)

    Serrano, K; Levin, E; Chen, D; Hansen, A; Turner, T R; Kurach, J; Reidel, A; Boecker, W F; Acker, J P; Devine, D V

    2016-04-01

    Di-2-ethylhexyl phthalate (DEHP) is a blood bag plasticizer. It is also a toxin, raising concerns for vulnerable populations, for example, neonates and infants. Here, the in vitro quality of red cell concentrates (RCC) stored in paediatric bags formulated with alternative plasticizers to DEHP was compared. RCC were pooled and split into polyvinylchloride (PVC)/DEHP, PVC/1,2-cyclohexanedicarboxylic acid diisononyl ester (DINCH) or PVC/butyryl trihexyl citrate (BTHC) bags. Quality was assessed on storage days 5, 21, 35 and 43. Metabolism differed among the bags: pCO2 levels were lowest and pO2 were highest in BTHC bags. Glucose consumption and lactate production suggested higher metabolic rates in BTHC bags. ATP levels were best maintained in DINCH bags (day 43 mean level: 2·86 ± 0·29 μmol/g Hb). RCC in BTHC bags had the greatest potassium release (54·6 ± 3·0 mm on day 43). From day 21, haemolysis was higher in BTHC bags (P bags showed more microparticle formation than RCC in DEHP or DINCH bags. The results suggest that the BTHC formulation used was detrimental to RBC quality. DINCH bags could be a viable alternative to DEHP: they outperformed DEHP bags energetically, with better maintenance of ATP levels. © 2015 International Society of Blood Transfusion.

  1. Renal imaging in paediatrics

    International Nuclear Information System (INIS)

    Porn, U.; Hahn, K.; Fischer, S.

    2003-01-01

    The most frequent renal diseases in paediatrics include urinary tract infections, hydronephrosis, kidney anomalies and reflux. The main reason for performing DMSA scintigraphy in paediatrics is the detection of cortical abnormalities related to urinary tract infection. Because the amount of tracer retained in the tubular cells is associated with the distribution of functioning renal parenchyma in the kidney, it is possible, to evaluate the split renal function. In comparison to ultrasound and intravenous urography the sensitivity in the detection of acute as well as chronic inflammatory changes is very high, however less specific. An indication for a renography in neonates and children is beside an estimation of the total renal function and the calculation of the split renal function, the assessment of renal drainage in patients with unclear dilatation of the collecting system in ultrasound. The analysis of the time activity curve provides, especially for follow-up studies, a reproducible method to assess the urinary outflow. The diuretic scintigraphy allows the detection of urinary obstruction. Subsequently it is possible to image the micturition phase to detect vesico-ureteric reflux (indirect MCU) after drainage of tracer from the renal pelvis. An reflux in the ureters or the pelvicalyceal system is visible on the scintigraphic images and can be confirmed by time activity curves. A more invasive technique is the direct isotope cystography with bladder catheterization. The present paper should give an overview about the role of nuclear medicine in paediatric urology. (orig.) [de

  2. Collaboration and E-collaboration

    DEFF Research Database (Denmark)

    Razmerita, Liana; Kirchner, Kathrin

    2015-01-01

    Understanding student’s perception of collaboration and how collaboration is supported by ICT is important for its efficient use in the classroom. This article aims to investigate how students perceive collaboration and how they use new technologies in collaborative group work. Furthermore......, it tries to measure the impact of technology on students’ satisfaction with collaboration outcomes. In particular, the study aims to address the following research questions: Which demographic information (e.g. gender and place of origin) is significant for collaboration and ecollaboration? and Which...... are the perceived factors that influence the students’ group performance? The findings of this study emphasize that there are gender and cultural differences with respect to the perception of e-collaboration. Furthermore, the article summarizes in a model the most significant factors influencing group performance....

  3. Student use of a Learning Management System for group projects: A case study investigating interaction, collaboration, and knowledge construction

    Science.gov (United States)

    Lonn, Steven D.

    Web-based Learning Management Systems (LMS) allow instructors and students to share instructional materials, make class announcements, submit and return course assignments, and communicate with each other online. Previous LMS-related research has focused on how these systems deliver and manage instructional content with little concern for how students' constructivist learning can be encouraged and facilitated. This study investigated how students use LMS to interact, collaborate, and construct knowledge within the context of a group project but without mediation by the instructor. The setting for this case study was students' use in one upper-level biology course of the local LMS within the context of a course-related group project, a mock National Institutes of Health grant proposal. Twenty-one groups (82 students) voluntarily elected to use the LMS, representing two-thirds of all students in the course. Students' peer-to-peer messages within the LMS, event logs, online surveys, focus group interviews, and instructor interviews were used in order to answer the study's overarching research question. The results indicate that students successfully used the LMS to interact and, to a significant extent, collaborate, but there was very little evidence of knowledge construction using the LMS technology. It is possible that the ease and availability of face-to-face meetings as well as problems and limitations with the technology were factors that influenced whether students' online basic interaction could be further distinguished as collaboration or knowledge construction. Despite these limitations, students found several tools and functions of the LMS useful for their online peer interaction and completion of their course project. Additionally, LMS designers and implementers are urged to consider previous literature on computer-supported collaborative learning environments in order to better facilitate independent group projects within these systems. Further research is

  4. Hidden Costs in Paediatric Psychiatry Consultation Liaison Services

    LENUS (Irish Health Repository)

    Kehoe, C

    2018-03-01

    It is recognised that children attending paediatric services have an increased rate of mental health (MH) problems1. Hospital based Mental Health services, interchangeably termed Psychiatric Consultation Liaison Services (PCLS), or Psychological Medicine, exist in the large hospitals, and collaborate with their paediatric colleagues, offering assessment and intervention as required. However, PCLS may also have a role in providing Emergency MH assessments for young people presenting to the Emergency Department (ED), a role independent of their paediatric colleagues. In some cases, these children will need to be admitted to an acute paediatric bed for the management of their mental health illness or psychological distress, awaiting transfer to a child psychiatry specialised bed, or discharge to community services. The profile and costs of these cases are inadequately captured by both HSE CAMHS Annual Reporting System3,4 and the Healthcare Pricing Office (HIPE)2 as they often inadequately record MH referrals. This study explores the costs associated with a cohort of patients presenting to a large paediatric hospital ED, and managed by PCLS, in a one-year period.

  5. An Investigation into the Role of Mobile Technology in Collaborative Disease Management for Persons Living with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    S. Sultan

    2015-05-01

    Full Text Available Diabetes and other chronic non-communicable diseases represent a leading threat to health care and human development. The authors discusses how mobile technology can achieve collaborative disease management (CDM within a population living with Type 2 diabetes. We introduces a framework for CDM using mobile technologies. While it can be applied to the management of any disease, we describe a specific instance for diabetes peer-support. In this paper, we validate the framework through the development and testing of a Mobile Health initiative called Mobile Diabetes Self-Management Support (DSMS. It allows persons living with diabetes to learn from each others’ experiences through a virtual support group. The paper presents two user studies conducted. The first study captured the participants’ initial perceptions of the application in a controlled environment and the second study investigated system usage and collaboration when the application was used in their personal settings.

  6. EAP viewpoint on unpublished data from paediatric clinical trials.

    Science.gov (United States)

    Schrier, L; Illy, K; Valiulis, A; Wyder, C; Stiris, T

    2018-02-01

    European children and paediatricians rely heavily on the fair, complete and timely publication of data obtained from paediatric randomised controlled trials (RCTs). Selective publication and reporting of paediatric RCTs is common practice. Industry-sponsored trials are more likely to remain unpublished, and take longer to get published compared with trials sponsored by others. However, also academic sponsors contribute to inefficiencies in publishing clinical data. Publication bias violates the ethical obligation that investigators have towards study participants, leads to considerable inefficiencies in research and a waste of financial and human resources, and has the potential to distort evidence for treatment approaches. The European Academy of Paediatrics (EAP) therefore actively supports initiatives that increase the public dissemination of paediatric clinical trial data. The EAP will raise awareness about the guidelines for Good Publication Practice among European paediatricians and subspecialty societies.

  7. Investigating the role of socially mediated metacognition during collaborative troubleshooting of electric circuits

    Science.gov (United States)

    Van De Bogart, Kevin L.; Dounas-Frazer, Dimitri R.; Lewandowski, H. J.; Stetzer, MacKenzie R.

    2017-12-01

    Developing students' ability to troubleshoot is an important learning outcome for many undergraduate physics lab courses, especially electronics courses. In other work, metacognition has been identified as an important feature of troubleshooting. However, that work has focused primarily on individual students' metacognitive processes or troubleshooting abilities. In contrast, electronics courses often require students to work in pairs, and hence students' in-class experiences likely have significant social dimensions that are not well understood. In this work, we use an existing framework for socially mediated metacognition to analyze audiovisual data from think-aloud activities in which eight pairs of students from two institutions attempted to diagnose and repair a malfunctioning electric circuit. In doing so, we provide insight into some of the social metacognitive dynamics that arise during collaborative troubleshooting. We find that students engaged in socially mediated metacognition at multiple key transitions during the troubleshooting process. Reciprocated metacognitive dialogue arose when students were collectively strategizing about which measurements to perform, or reaching a shared understanding of the circuit's behavior. Our research demonstrates the value of the framework of socially mediated metacognition in providing insight into the nature of collaborative student troubleshooting in the context of electronics. As such, this framework may be a useful resource for future efforts to examine and support the development of student troubleshooting skills in other upper-division laboratory courses.

  8. Investigating the role of socially mediated metacognition during collaborative troubleshooting of electric circuits

    Directory of Open Access Journals (Sweden)

    Kevin L. Van De Bogart

    2017-09-01

    Full Text Available Developing students’ ability to troubleshoot is an important learning outcome for many undergraduate physics lab courses, especially electronics courses. In other work, metacognition has been identified as an important feature of troubleshooting. However, that work has focused primarily on individual students’ metacognitive processes or troubleshooting abilities. In contrast, electronics courses often require students to work in pairs, and hence students’ in-class experiences likely have significant social dimensions that are not well understood. In this work, we use an existing framework for socially mediated metacognition to analyze audiovisual data from think-aloud activities in which eight pairs of students from two institutions attempted to diagnose and repair a malfunctioning electric circuit. In doing so, we provide insight into some of the social metacognitive dynamics that arise during collaborative troubleshooting. We find that students engaged in socially mediated metacognition at multiple key transitions during the troubleshooting process. Reciprocated metacognitive dialogue arose when students were collectively strategizing about which measurements to perform, or reaching a shared understanding of the circuit’s behavior. Our research demonstrates the value of the framework of socially mediated metacognition in providing insight into the nature of collaborative student troubleshooting in the context of electronics. As such, this framework may be a useful resource for future efforts to examine and support the development of student troubleshooting skills in other upper-division laboratory courses.

  9. Immobilisation in Australian paediatric medical imaging: A pilot study

    International Nuclear Information System (INIS)

    Noonan, S.; Spuur, K.; Nielsen, S.

    2017-01-01

    Aims: The primary aim of this study is to document the use of paediatric immobilisation techniques in medical imaging. Secondary aims are to investigate differences between current practice of paediatric and non-paediatric facilities and radiographer gender and to investigate immobilisation protocols. Methods: A SurveyMonkey link was distributed through the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) newsletter. Radiographer members of ASMIRT were invited to participate. Frequency percentage analysis was undertaken; as the 'frequency of immobilisation' response was on a Likert scale and the ages categorical, a Fisher's exact test could determine dependency. Results: The use of paediatric immobilisation techniques was determined to be related to age. The most commonly used technique in general X-ray was “other people”; in computed tomography, Velcro, verbal reminders and distraction techniques; and in magnetic resonance imaging, sedation and Velcro. A comparison of immobilisation techniques demonstrated that Velcro use in X-ray was dependent on facility (p = 0.017) with paediatric facilities using it up to 17 years. Immobilisation frequency was dependent in 13–17 years (p = 0.035) with paediatric facilities rarely immobilising and non-paediatric facilities never. No dependencies resulted upon comparing genders. Immobilisation frequency was not dependent between protocols or current practice. Conclusion: The use of paediatric immobilisation technique is related to age with “other people”, sedation, Velcro, verbal reminders and distraction techniques being regularly used. The dependency of Velcro use and immobilisation frequency in 13–17 years is for unknown reasons and further investigation is required. A larger study should be carried out to validate these findings. - Highlights: • Document the use of paediatric immobilisation techniques in medical imaging. • Investigate differences in practice between

  10. Metastatic paediatric colorectal carcinoma.

    LENUS (Irish Health Repository)

    Woods, R

    2012-03-01

    A 16-year-old girl presented to our unit with crampy abdominal pain, change in bowel habit, a subjective impression of weight loss and a single episode of haematochezia. She was found to have a rectosigmoid adenocarcinoma and proceeded to laparoscopic anterior resection, whereupon peritoneal metastases were discovered. She received chemotherapy and is alive and well ten month later with no radiological evidence of disease. Colorectal carcinoma is rare in the paediatric population but is increasing in incidence. Early diagnosis is critical to enable optimal outcomes.

  11. Paediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Da Costa, H [Bhabha Atomic Research Centre, Bombay (India). Radiation Medicine Centre

    1978-05-01

    The use of radiopharmaceutical agents for the diagnosis of diseases frequently encountered in the paediatric age group is outlined. The agents suitable for scanning of brain, thyroid, kidney, liver and spleen are mentioned and their efficacy in diagnosis of pathological conditions based on practical experience is reported. Bromide partition test for diagnosis of intracranial tuberculosis and /sup 131/I uptake test for thyroid study are also described. Dose of the agent is smaller than that in the case of adults and depends upon the child's body weight.

  12. Phase I results of a phase I/II study of weekly nab-paclitaxel in paediatric patients with recurrent/refractory solid tumours: A collaboration with innovative therapies for children with cancer.

    Science.gov (United States)

    Moreno, Lucas; Casanova, Michela; Chisholm, Julia C; Berlanga, Pablo; Chastagner, Pascal B; Baruchel, Sylvain; Amoroso, Loredana; Melcón, Soledad Gallego; Gerber, Nicolas U; Bisogno, Gianni; Fagioli, Franca; Geoerger, Birgit; Glade Bender, Julia L; Aerts, Isabelle; Bergeron, Christophe; Hingorani, Pooja; Elias, Ileana; Simcock, Mathew; Ferrara, Stefano; Le Bruchec, Yvan; Slepetis, Ruta; Chen, Nianhang; Vassal, Gilles

    2018-06-21

    nab-Paclitaxel has demonstrated efficacy in adults with solid tumours and preclinical activity in paediatric solid tumour models. Results from phase I of a phase I/II study in paediatric patients with recurrent/refractory solid tumours treated with nab-paclitaxel are reported. Patients with recurrent/refractory extracranial solid tumours received nab-paclitaxel on days 1, 8 and 15 every 4 weeks at 120, 150, 180, 210, 240, or 270 mg/m 2 (rolling-6 dose-escalation) to establish the maximum tolerated dose (MTD) and recommended phase II dose (RP2D). Sixty-four patients were treated. Dose-limiting toxicities were grade 3 dizziness at 120 mg/m 2 and grade 4 neutropenia >7 days at 270 mg/m 2 . The most frequent grade 3/4 adverse events were haematologic, including neutropenia (36%), leukopenia (36%) and lymphopenia (25%). Although the MTD was not reached, 270 mg/m 2 was declared non-tolerable due to grade 3/4 toxicities during cycles 1-2 (neutropenia, n = 5/7; skin toxicity, n = 2/7; peripheral neuropathy, n = 1/7). Of 58 efficacy-evaluable patients, complete response occurred in one patient (2%; Ewing sarcoma) and partial responses in four patients (7%; rhabdomyosarcoma, Ewing sarcoma, renal tumour with pulmonary metastases [high-grade, malignant] and sarcoma not otherwise specified); all responses occurred at ≥210 mg/m 2 . Thirteen patients (22%) had stable disease (5 lasting ≥16 weeks) per RECIST. nab-Paclitaxel 240 mg/m 2 qw3/4 (nearly double the adult recommended monotherapy dose for this schedule in metastatic breast cancer) was selected as the RP2D based on the tolerability profile, pharmacokinetics and antitumour activity. Phase II is currently enrolling patients with recurrent/refractory neuroblastoma, rhabdomyosarcoma and Ewing sarcoma. CLINICALTRIALS.GOV: NCT01962103. 2013-000144-26. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Learning science through talk: A case study of middle school students engaged in collaborative group investigation

    Science.gov (United States)

    Zinicola, Debra Ann

    Reformers call for change in how science is taught in schools by shifting the focus towards conceptual understanding for all students. Constructivist learning is being promoted through the dissemination of National and State Science Standards that recommend group learning practices in science classrooms. This study examined the science learning and interactions, using case study methodology, of one collaborative group of 4 students in an urban middle school. Data on science talk and social interaction were collected over 9 weeks through 12 science problem solving sessions. To determine student learning through peer interaction, varied group structures were implemented, and students reflected on the group learning experience. Data included: field notes, cognitive and reflective journals, audiotapes and videotapes of student talk, and audiotapes of group interviews. Journal data were analyzed quantitatively and all other data was transcribed into The Ethnograph database for qualitative analysis. The data record was organized into social and cognitive domains and coded with respect to interaction patterns to show how group members experienced the social construction of science concepts. The most significant finding was that all students learned as a result of 12 talk sessions as evidenced by pre- and post-conceptual change scores. Interactions that promoted learning involved students connecting their thoughts, rephrasing, and challenging ideas. The role structure was only used by students about 15% of the time, but it started the talk with a science focus, created awareness of scientific methods, and created an awareness of equitable member participation. Students offered more spontaneous, explanatory talk when the role structure was relaxed, but did not engage in as much scientific writing. They said the role structure was important for helping them know what to do in the talk but they no longer needed it after a time. Gender bias, status, and early adolescent

  14. Paediatric nuclear medicine imaging.

    Science.gov (United States)

    Biassoni, Lorenzo; Easty, Marina

    2017-09-01

    Nuclear medicine imaging explores tissue viability and function by using radiotracers that are taken up at cellular level with different mechanism. This imaging technique can also be used to assess blood flow and transit through tubular organs. Nuclear medicine imaging has been used in paediatrics for decades and this field is continuously evolving. The data presented comes from clinical experience and some milestone papers on the subject. Nuclear medicine imaging is well-established in paediatric nephro-urology in the context of urinary tract infection, ante-natally diagnosed hydronephrosis and other congenital renal anomalies. Also, in paediatric oncology, I-123-meta-iodobenzyl-guanidine has a key role in the management of children with neuroblastic tumours. Bone scintigraphy is still highly valuable to localize the source of symptoms in children and adolescents with bone pain when other imaging techniques have failed. Thyroid scintigraphy in neonates with congenital hypothyroidism is the most accurate imaging technique to confirm the presence of ectopic functioning thyroid tissue. Radionuclide transit studies of the gastro-intestinal tract are potentially useful in suspected gastroparesis or small bowel or colonic dysmotility. However, until now a standardized protocol and a validated normal range have not been agreed, and more work is necessary. Research is ongoing on whether magnetic resonance imaging (MRI), with its great advantage of great anatomical detail and no ionizing radiations, can replace nuclear medicine imaging in some clinical context. On the other hand, access to MRI is often difficult in many district general hospitals and general anaesthesia is frequently required, thus adding to the complexity of the examination. Patients with bone pain and no cause for it demonstrated on MRI can benefit from bone scintigraphy with single photon emission tomography and low-dose computed tomography. This technique can identify areas of mechanical stress at

  15. Designing quality of care--contributions from parents: Parents' experiences of care processes in paediatric care and their contribution to improvements of the care process in collaboration with healthcare professionals.

    Science.gov (United States)

    Gustavsson, Susanne; Gremyr, Ida; Kenne Sarenmalm, Elisabeth

    2016-03-01

    The aim of this article was to explore whether current quality dimensions for health care services are sufficient to capture how parents perceive and contribute to quality of health care. New quality improvement initiatives that actively involve patients must be examined with a critical view on established quality dimensions to ensure that these measures support patient involvement. This paper used a qualitative and descriptive design. This paper is based on interviews with parents participating in two experience-based co-design projects in a Swedish hospital that included qualitative content analysis of data from 12 parent interviews in paediatric care. Health care professionals often overemphasize their own significance for value creation in care processes and underappreciate parents' ability to influence and contribute to better quality. However, quality is not based solely on how professionals accomplish their task, but is co-created by health care professionals and parents. Consequently, assessment of quality outcomes also must include parents' ability and context. This paper questions current models of quality dimensions in health care, and suggests additional sub-dimensions, such as family quality and involvement quality. This paper underscores the importance of involving parents in health care improvements with health care professionals to capture as many dimensions of quality as possible. © 2015 John Wiley & Sons Ltd.

  16. An Investigative Laboratory Course in Human Physiology Using Computer Technology and Collaborative Writing

    Science.gov (United States)

    FitzPatrick, Kathleen A.

    2004-01-01

    Active investigative student-directed experiences in laboratory science are being encouraged by national science organizations. A growing body of evidence from classroom assessment supports their effectiveness. This study describes four years of implementation and assessment of an investigative laboratory course in human physiology for 65…

  17. Collaboration of chemistry instructional games and group investigation (Gi) model to improve learning outcome in high school students

    Science.gov (United States)

    Puspita, Ita; Sugiyarto, Kristian H.; Ikhsan, Jaslin

    2017-05-01

    The aims of this research are to: (1) develop chemistry instructional games on reaction rate matter; and (2) reveal the collaboration of chemistry instructional games and group investigation model to improvement learning outcome in high school student. This study is research and development (R&D). The procedure of developing product was adapted from Borg & Gall that modified into three principal steps: product planning, product developing, and product evaluating. The product planning step consist of field study, literature study, and manufacturing product. Product developing was developed product using Adobe Flash Professional CS 6 program. The last, product evaluating was performed by year XI of high school students, uses experimental methods nonequivalent control-group design by control class and experiment class. The results of this research show that: (1) a software of chemistry instructional games successfully developed using Adobe Flash Professional CS 6 and can be run on Android device; and (2) the test results of students showed that the collaboration of instructional games and group investigation model able to improvement learning outcome of hight school student.

  18. The development of paediatric neuroradiology

    International Nuclear Information System (INIS)

    Harwood-Nash, D.C.

    1978-01-01

    The development of paediatric neuroradiology is a specific persuasion within neuroradiology and has increased in scope and significance throughout the last ten years. The emergence of computed tomography has altered the indications for types of neuroradiological procedures in infants and children. The sophistication, accuracy, and safety of standard neuroradiological procedures have been increased by the accuracy and safety of computed tomography, particularly in the premature infant. There is a growing need for education and instruction in paediatric neuroradiological techniques and paediatric neuroradiological diseases within the neuroradiological fraternity as a whole. (orig.) [de

  19. 2016 American College of Rheumatology/European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Juvenile Dermatomyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative.

    Science.gov (United States)

    Rider, Lisa G; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M; Huber, Adam M; Cimaz, Rolando; Cuttica, Rubén J; de Oliveira, Sheila Knupp; Lindsley, Carol B; Pilkington, Clarissa A; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Dressler, Frank; Saad Magalhaes, Claudia; Constantin, Tamás; Davidson, Joyce E; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A; Miller, Frederick W; Vencovsky, Jiri; Ruperto, Nicolino

    2017-05-01

    To develop response criteria for juvenile dermatomyositis (DM). We analysed the performance of 312 definitions that used core set measures from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Paediatric Rheumatology International Trials Organisation (PRINTO) and were derived from natural history data and a conjoint analysis survey. They were further validated using data from the PRINTO trial of prednisone alone compared to prednisone with methotrexate or cyclosporine and the Rituximab in Myositis (RIM) trial. At a consensus conference, experts considered 14 top candidate criteria based on their performance characteristics and clinical face validity, using nominal group technique. Consensus was reached for a conjoint analysis-based continuous model with a total improvement score of 0-100, using absolute per cent change in core set measures of minimal (≥30), moderate (≥45), and major (≥70) improvement. The same criteria were chosen for adult DM/polymyositis, with differing thresholds for improvement. The sensitivity and specificity were 89% and 91-98% for minimal improvement, 92-94% and 94-99% for moderate improvement, and 91-98% and 85-86% for major improvement, respectively, in juvenile DM patient cohorts using the IMACS and PRINTO core set measures. These criteria were validated in the PRINTO trial for differentiating between treatment arms for minimal and moderate improvement (p=0.009-0.057) and in the RIM trial for significantly differentiating the physician's rating for improvement (p<0.006). The response criteria for juvenile DM consisted of a conjoint analysis-based model using a continuous improvement score based on absolute per cent change in core set measures, with thresholds for minimal, moderate, and major improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. An international point source outbreak of typhoid fever: a European collaborative investigation*

    Science.gov (United States)

    Stanwell-Smith, R. E.; Ward, L. R.

    1986-01-01

    A point source outbreak of Salmonella typhi, degraded Vi-strain 22, affecting 32 British visitors to Kos, Greece, in 1983 was attributed by a case—control study to the consumption of a salad at one hotel. This represents the first major outbreak of typhoid fever in which a salad has been identified as the vehicle. The source of the infection was probably a carrier in the hotel staff. The investigation demonstrates the importance of national surveillance, international cooperation, and epidemiological methods in the investigation and control of major outbreaks of infection. PMID:3488842

  1. Cuffed endotracheal tubes in paediatrics

    African Journals Online (AJOL)

    cuffed endotracheal tubes (CETTs) in children who are younger than eight years old. Most paediatric ... the smallest functional part of the infant airway, because the ... During the 2003 severe acute respiratory syndrome (SARS) outbreak in ...

  2. Extrapolation in the development of paediatric medicines: examples from approvals for biological treatments for paediatric chronic immune-mediated inflammatory diseases.

    Science.gov (United States)

    Stefanska, Anna M; Distlerová, Dorota; Musaus, Joachim; Olski, Thorsten M; Dunder, Kristina; Salmonson, Tomas; Mentzer, Dirk; Müller-Berghaus, Jan; Hemmings, Robert; Veselý, Richard

    2017-10-01

    The European Union (EU) Paediatric Regulation requires that all new medicinal products applying for a marketing authorisation (MA) in the EU provide a paediatric investigation plan (PIP) covering a clinical and non-clinical trial programme relating to the use in the paediatric population, unless a waiver applies. Conducting trials in children is challenging on many levels, including ethical and practical issues, which may affect the availability of the clinical evidence. In scientifically justified cases, extrapolation of data from other populations can be an option to gather evidence supporting the benefit-risk assessment of the medicinal product for paediatric use. The European Medicines Agency (EMA) is working on providing a framework for extrapolation that is scientifically valid, reliable and adequate to support MA of medicines for children. It is expected that the extrapolation framework together with therapeutic area guidelines and individual case studies will support future PIPs. Extrapolation has already been employed in several paediatric development programmes including biological treatment for immune-mediated diseases. This article reviews extrapolation strategies from MA applications for products for the treatment of juvenile idiopathic arthritis, paediatric psoriasis and paediatric inflammatory bowel disease. It also provides a summary of extrapolation advice expressed in relevant EMA guidelines and initiatives supporting the use of alternative approaches in paediatric medicine development. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Patient exposure in paediatric radiology

    International Nuclear Information System (INIS)

    Iacob, O.; Diaconescu, C.; Isac, R.

    2002-01-01

    Because of their longer life expectancy, the risk of late manifestations of detrimental radiation effects is greater in children than in adults and, consequently, paediatric radiology gives ground for more concern regarding radiation protection than radiology of adults. The purpose of our study was to assess, in terms of effective dose, the magnitude of paediatric patient exposure during conventional X-ray examinations, selected for their high frequency or their relatively high doses delivered to patient

  4. Investigating the Influence of Special On–Off Attacks on Challenge-Based Collaborative Intrusion Detection Networks

    Directory of Open Access Journals (Sweden)

    Wenjuan Li

    2018-01-01

    Full Text Available Intrusions are becoming more complicated with the recent development of adversarial techniques. To boost the detection accuracy of a separate intrusion detector, the collaborative intrusion detection network (CIDN has thus been developed by allowing intrusion detection system (IDS nodes to exchange data with each other. Insider attacks are a great threat for such types of collaborative networks, where an attacker has the authorized access within the network. In literature, a challenge-based trust mechanism is effective at identifying malicious nodes by sending challenges. However, such mechanisms are heavily dependent on two assumptions, which would cause CIDNs to be vulnerable to advanced insider attacks in practice. In this work, we investigate the influence of advanced on–off attacks on challenge-based CIDNs, which can respond truthfully to one IDS node but behave maliciously to another IDS node. To evaluate the attack performance, we have conducted two experiments under a simulated and a real CIDN environment. The obtained results demonstrate that our designed attack is able to compromise the robustness of challenge-based CIDNs in practice; that is, some malicious nodes can behave untruthfully without a timely detection.

  5. Shared decision-making in the paediatric field: a literature review and concept analysis.

    Science.gov (United States)

    Park, Eun Sook; Cho, In Young

    2017-09-13

    The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

  6. Investigating 6th graders' use of a tablet-based app supporting synchronous use of multiple tools designed to promote collaborative knowledge building in science

    Science.gov (United States)

    Sherwood, Carrie-Anne

    At this pivotal moment in time, when the proliferation of mobile technologies in our daily lives is influencing the relatively fast integration of these technologies into classrooms, there is little known about the process of student learning, and the role of collaboration, with app-based learning environments on mobile devices. To address this gap, this dissertation, comprised of three manuscripts, investigated three pairs of sixth grade students' synchronous collaborative use of a tablet-based science app called WeInvestigate . The first paper illustrated the methodological decisions necessary to conduct the study of student synchronous and face-to-face collaboration and knowledge building within the complex WeInvestigate and classroom learning environments. The second paper provided the theory of collaboration that guided the design of supports in WeInvestigate, and described its subsequent development. The third paper detailed the interactions between pairs of students as they engaged collaboratively in model construction and explanation tasks using WeInvestigate, hypothesizing connections between these interactions and the designed supports for collaboration. Together, these manuscripts provide encouraging evidence regarding the potential of teaching and learning with WeInvestigate. Findings demonstrated that the students in this study learned science through WeInvestigate , and were supported by the app - particularly the collabrification - to engage in collaborative modeling of phenomena. The findings also highlight the potential of the multiple methods used in this study to understand students' face-to-face and technology-based interactions within the "messy" context of an app-based learning environment and a traditional K-12 classroom. However, as the third manuscript most clearly illustrates, there are still a number of modifications to be made to the WeInvestigate technology before it can be optimally used in classrooms to support students' collaborative

  7. The influence of the European paediatric regulation on marketing authorisation of orphan drugs for children.

    Science.gov (United States)

    Kreeftmeijer-Vegter, Annemarie Rosan; de Boer, Anthonius; van der Vlugt-Meijer, Roselinda H; de Vries, Peter J

    2014-08-05

    Drug development for rare diseases is challenging, especially when these orphan drugs (OD) are intended for children. In 2007 the EU Paediatric Drug Regulation was enacted to improve the development of high quality and ethically researched medicines for children through the establishment of Paediatric Investigation Plans (PIPs). The effect of the EU Paediatric Drug Regulation on the marketing authorisation (MA) of drugs for children with rare diseases was studied. Data on all designated orphan drugs, their indication, MA, PIPs and indication group (adult or child) were obtained from the European Medicines Agency (EMA). The outcome and duration of the process from orphan drug designation (ODD) to MA, was compared, per indication, by age group. The effect of the Paediatric Drug Regulation, implemented in 2007, on the application process was assessed with survival analysis. Eighty-one orphan drugs obtained MA since 2000 and half are authorised for (a subgroup of) children; another 34 are currently undergoing further investigations in children through agreed PIPs. The Paediatric Drug Regulation did not significantly increase the number of ODDs with potential paediatric indications (58% before vs 64% after 2007 of ODDs, p = 0.1) and did not lead to more MAs for ODs with paediatric indications (60% vs 43%, p = 0.22). ODs authorised after 2007 had a longer time to MA than those authorised before 2007 (Hazard ratio (95% CI) 2.80 (1.84-4.28), p < 0.001); potential paediatric use did not influence the time to MA (Hazard ratio (95% CI) 1.14 (0.77-1.70), p = 0.52). The EU Paediatric Drug Regulation had a minor impact on development and availability of ODs for children, was associated with a longer time to MA, but ensured the further paediatric development of drugs still off-label to children. The impact of the Paediatric Drug Regulation on research quantity and quality in children through PIPs is not yet clear.

  8. Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

    Directory of Open Access Journals (Sweden)

    Kamps Willem A

    2007-11-01

    Full Text Available Abstract Background Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. Methods Communication preferences were examined by means of online focus groups. Seven patients (aged 8–17, 11 parents, and 18 survivors (aged 8–17 at diagnosis participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. Results Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. Conclusion Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents.

  9. Paediatric acute care: Highlights from the Paediatric Acute Care-Advanced Paediatric Life Support Conference, Gold Coast, 2017.

    Science.gov (United States)

    Teo, Stephen Ss; Rao, Arjun; Acworth, Jason

    2018-04-25

    The Paediatric Acute Care Conference is an annual conference organised by APLS Australia to advance paediatric acute care topics for clinicians in pre-hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The Conference 2017 was held at Surfers Paradise, Queensland. We provide a summary of some of the presentations. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  10. Use of the Delphi process in paediatric cataract management.

    Science.gov (United States)

    Serafino, Massimiliano; Trivedi, Rupal H; Levin, Alex V; Wilson, M Edward; Nucci, Paolo; Lambert, Scott R; Nischal, Ken K; Plager, David A; Bremond-Gignac, Dominique; Kekunnaya, Ramesh; Nishina, Sachiko; Tehrani, Nasrin N; Ventura, Marcelo C

    2016-05-01

    To identify areas of consensus and disagreement in the management of paediatric cataract using a modified Delphi approach among individuals recognised for publishing in this field. A modified Delphi method. International paediatric cataract experts with a publishing record in paediatric cataract management. The process consisted of three rounds of anonymous electronic questionnaires followed by a face-to-face meeting, followed by a fourth anonymous electronic questionnaire. The executive committee created questions to be used for the electronic questionnaires. Questions were designed to have unit-based, multiple choice or true-false answers. The questionnaire included issues related to the preoperative, intraoperative and postoperative management of paediatric cataract. Consensus based on 85% of panellists being in agreement for electronic questionnaires or 80% for the face-to-face meeting, and near consensus based on 70%. Sixteen of 22 invited paediatric cataract surgeons agreed to participate. We arrived at consensus or near consensus for 85/108 (78.7%) questions and non-consensus for the remaining 23 (21.3%) questions. Those questions where consensus was not reached highlight areas of either poor evidence or contradicting evidence, and may help investigators identify possible research questions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Nigerian Journal of Paediatrics: Editorial Policies

    African Journals Online (AJOL)

    Dr. Austine I Omoigberale FWACP (Paed) Professor of Paediatrics, Neonatology & Infectious diseases. Dept of Child Health University of Benin Teaching Hospital Benin City Nigeria isigboge@gmail.com +2348030750641. Dr. Felix Akinbami FWACP (Paed) Professor of Paediatrics & Gastroenterology Dept of Paediatrics

  12. Anaesthesia for paediatric patients: Minimising the risk

    African Journals Online (AJOL)

    to paediatric patients need to be offset against the need for optimal utilisation of national ... Risk stratification of paediatric patients for specific procedures in ... support colleagues in smaller district hospitals by means of telephonic advice, the ... techniques that can minimise risk in the paediatric surgical population. S Afr Med ...

  13. Paediatric and adult malignant glioma

    DEFF Research Database (Denmark)

    Jones, Chris; Perryman, Lara; Hargrave, Darren

    2012-01-01

    Gliomas in children differ from their adult counterparts by their distribution of histological grade, site of presentation and rate of malignant transformation. Although rare in the paediatric population, patients with high-grade gliomas have, for the most part, a comparably dismal clinical outcome...... to older patients with morphologically similar lesions. Molecular profiling data have begun to reveal the major genetic alterations underpinning these malignant tumours in children. Indeed, the accumulation of large datasets on adult high-grade glioma has revealed key biological differences between...... the adult and paediatric disease. Furthermore, subclassifications within the childhood age group can be made depending on age at diagnosis and tumour site. However, challenges remain on how to reconcile clinical data from adult patients to tailor novel treatment strategies specifically for paediatric...

  14. The impact of immunological and biomolecular investigations on the outcome of children with acute lymphoblastic leukemia - experience of IIIrd Paediatric Clinic Timisoara

    Directory of Open Access Journals (Sweden)

    Jinca Cristian

    2018-01-01

    Full Text Available Introduction. The unsatisfactory results of the survival in patients with acute lymphoblastic leukemia (ALL until 2000 in our center have led us to improve the approach of diagnosis and therapy. Since 2003 in all patients the following have been performed: flow cytometry, conventional genetic diagnosis, FISH (fluorescent in situ hybridization, and molecular biology. Objectives. Our aims were to identify solutions to increase patients’ survival. Patients and method. It is a single-center, retrospective study of 136 patients with ALL treated at 3rd Pediatric Clinic of Timisoara, over a period of 10 years (2003-2012, where survival was assessed. Results. Morphologically, 86% of the patients were L1 type, 13% L2 type and 1% L3 type. Flow citometry revealed that 68% were ALL with B precursors, and 19% with T immunophenotype. Acute leukemia with mixed phenotype (biphenotypic was identified in 2.3% of patients and 10.7% of the forms were acute leukemia with myeloid markers. In 27.7% of patients, mutations were detected by the RT-PCR method, the most commonly identified was TEL-AML1 (ETV6- RUNX1 accounting for 12.7% of the cases. Relapse-free survival at 5 years for the entire group was 59%, and for the group treated between 2008 and 2012 it was 72%. Conclusion. Our analysis confirms the decisive value of laboratory investigations for the prognosis and improvement of supportive therapy.

  15. Effective doses in paediatric radiology

    International Nuclear Information System (INIS)

    Iacob, Olga; Diaconescu, Cornelia; Roca, Antoaneta

    2001-01-01

    Because of their longer life expectancy, the risk of late manifestations of detrimental radiation effects is greater in children than in adults and, consequently, paediatric radiology gives ground for more concern regarding radiation protection than radiology of adults. The purpose of our study is to assess in terms of effective doses the magnitude of paediatric patient exposure during conventional X-ray examinations, selected for their high frequency or their relatively high doses to the patient. Effective doses have been derived from measurements of dose-area product (DAP) carried out on over 900 patients undergoing X-ray examinations, in five paediatric units. The conversion coefficients for estimating effective doses are those calculated by the NRPB using Monte-Carlo technique on a series of 5 mathematical phantoms representing 0, 1, 5, 10 and 15 year old children. The annual frequency of X-ray examinations necessary for collective dose calculation are those reported in our last national study on medical exposure, conducted in 1995. The annual effective doses from all medical examinations for the average paediatric patient are as follows: 1.05 mSv for 0 year old, 0.98 mSv for 1 year old, 0.53 mSv for 5 year old, 0.65 mSv for 10 year old and 0.70 mSv for 15 year old. The resulting annual collective effective dose was evaluated at 625 man Sv with the largest contribution of pelvis and hip examinations (34%). The annual collective effective associated with paediatric radiology in Romania represent 5% of the annual value resulting from all diagnostic radiology. Examination of the chest is by far the most frequent procedure for children, accounting for about 60 per cent of all annually performed X-ray conventional examinations. Knowledge of real level of patient dose is an essential component of quality assurance programs in paediatric radiology. (authors)

  16. The BRACELET Study: surveys of mortality in UK neonatal and paediatric intensive care trials

    Directory of Open Access Journals (Sweden)

    Platt Martin

    2010-05-01

    Full Text Available Abstract Background The subject of death and bereavement in the context of randomised controlled trials in neonatal or paediatric intensive care is under-researched. The objectives of this phase of the Bereavement and RAndomised ControlLEd Trials (BRACELET Study were to determine trial activity in UK neonatal and paediatric intensive care (2002-06; numbers of deaths before hospital discharge; and variation in mortality across intensive care units and trials and to determine whether bereavement support policies were available within trials. These are essential prerequisites to considering the implications of future policies and practice subsequent to bereavement following a child's enrolment in a trial. Methods The units survey involved neonatal units providing level 2 or 3 care, and paediatric units providing level II care or above; the trials survey involved trials where allocation was randomized and interventions were delivered to intensive care patients, or to parents but designed to affect patient outcomes. Results Information was available from 191/220 (87% neonatal units (149 level 2 or 3 care; and 28/32 (88% paediatric units. 90/177 (51% eligible responding units participated in one or more trial (76 neonatal, 14 paediatric and 54 neonatal units and 6 paediatric units witnessed at least one death. 50 trials were identified (36 neonatal, 14 paediatric. 3,137 babies were enrolled in neonatal trials, 210 children in paediatric trials. Deaths ranged 0-278 (median [IQR interquartile range] 2 [1, 14.5] per neonatal trial, 0-4 (median [IQR] 1 [0, 2.5] per paediatric trial. 534 (16% participants died post-enrolment: 522 (17% in neonatal trials, 12 (6% in paediatric trials. Trial participants ranged 1-236 (median [IQR] 21.5 [8, 39.8] per neonatal unit, 1-53 (median [IQR] 11.5 [2.3, 33.8] per paediatric unit. Deaths ranged 0-37 (median [IQR] 3.5 [0.3, 8.8] per neonatal unit, 0-7 (median [IQR] 0.5 [0, 1.8] per paediatric unit. Three trials had a

  17. Singapore Paediatric Resuscitation Guidelines 2016.

    Science.gov (United States)

    Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

    2017-07-01

    We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

  18. The role of anaesthetists in paediatric intensive care units

    African Journals Online (AJOL)

    Adele

    to various surgical and critical care disciplines, the usefulness of a paediatric intensive care unit (PICU) rotation was investigated. A brief overview of the experiences of anaesthetic registrars at a. South African teaching hospital rotating through a PICU is pre- sented, as well as the potential advantages for both trainees and.

  19. Students' clinical learning in an emerging dental school: an investigation in international collaboration between Michigan and Ghana.

    Science.gov (United States)

    Peters, Mathilde C; Adu-Ababio, Francis; Jarrett-Ananaba, Nejay P; Johnson, Lynn A

    2013-12-01

    The dearth of dental faculty members is a widely known problem that is exacerbated in countries that are attempting to begin dental education programs. This collaboration between Kwame Nkrumah University of Science and Technology and the University of Michigan investigated if dental students who have just started their clinical dental education can learn the knowledge and skills required for identifying and restoring cavitated caries lesions through compact course delivery. There were three instructional blocks: 1) didactic seminar; 2) seminar, simulated hands-on skills instruction, and clinical observation/assisting with treatment of schoolchildren; and 3) seminar, simulated skills training, and application to schoolchildren. Each dental student completed a questionnaire measuring knowledge and perceptions of knowledge, experience, and confidence at five points in time. The dental students' knowledge increased significantly as well as their perceived knowledge, experience, and confidence (p<0.0001). In general, the students showed proficiency in delivering simple treatments. The project showed that an integrated compact course delivery model may assist emerging dental schools to cope with the challenging shortage of resident faculty members.

  20. Confidence amongst Multidisciplinary Professionals in Managing Paediatric Rheumatic Disease in Australia

    Directory of Open Access Journals (Sweden)

    Samuel Cassidy

    2018-01-01

    Full Text Available Objective. Interprofessional collaboration is a crucial component of care for children with rheumatic disease. Interprofessional care, when delivered appropriately, prevents disability and improves long-term prognosis in this vulnerable group. Methods. The aim of this survey was to explore allied health professionals’ and nurses’ confidence in treating paediatric rheumatology patients. Results. Overall, 117 participants were recruited, 77.9% of participants reported being “not confident at all,” “not confident,” or “neutral” in treating children with rheumatic diseases (RD despite 65.1% of participants reporting having treated >1 paediatric rheumatology case in the past month. Furthermore, 67.2% of participants felt their undergraduate education in paediatric rheumatology was inadequate. “Journals” or “texts books” were used by 49.3% of participants as their primary source of continuing professional development (CPD and 39.3% of participants indicated that they did not undertake any CPD related to paediatric rheumatology. Small group and online education were perceived to be potentially of “great benefit” for CPD. Conclusion. This paper highlights allied health professionals’ and nurses’ perceived inadequacy of their undergraduate education in paediatric RD and their low confidence in recognising and treating RD. Undergraduate and postgraduate education opportunities focusing on interprofessional collaboration should be developed to address this workforce deficiency.

  1. Collaborative Design

    Science.gov (United States)

    Broderick, Debora

    2014-01-01

    This practitioner research study investigates the power of multimodal texts within a real-world context and argues that a participatory culture focused on literary arts offers marginalized high school students opportunities for collaborative design and authoring. Additionally, this article invites educators to rethink the at-risk label. This…

  2. Autoimmune paediatric liver disease.

    Science.gov (United States)

    Mieli-Vergani, Giorgina; Vergani, Diego

    2008-06-07

    Liver disorders with a likely autoimmune pathogenesis in childhood include autoimmune hepatitis (AIH), autoimmune sclerosing cholangitis (ASC), and de novo AIH after liver transplantation. AIH is divided into two subtypes according to seropositivity for smooth muscle and/or antinuclear antibody (SMA/ANA, type 1) or liver kidney microsomal antibody (LKM1, type 2). There is a female predominance in both. LKM1 positive patients tend to present more acutely, at a younger age, and commonly have partial IgA deficiency, while duration of symptoms before diagnosis, clinical signs, family history of autoimmunity, presence of associated autoimmune disorders, response to treatment, and long-term prognosis are similar in both groups. The most common type of paediatric sclerosing cholangitis is ASC. The clinical, biochemical, immunological, and histological presentation of ASC is often indistinguishable from that of AIH type 1. In both, there are high IgG, non-organ specific autoantibodies, and interface hepatitis. Diagnosis is made by cholangiography. Children with ASC respond to immunosuppression satisfactorily and similarly to AIH in respect to remission and relapse rates, times to normalization of biochemical parameters, and decreased inflammatory activity on follow up liver biopsies. However, the cholangiopathy can progress. There may be evolution from AIH to ASC over the years, despite treatment. De novo AIH after liver transplantation affects patients not transplanted for autoimmune disorders and is strikingly reminiscent of classical AIH, including elevated titres of serum antibodies, hypergammaglobulinaemia, and histological findings of interface hepatitis, bridging fibrosis, and collapse. Like classical AIH, it responds to treatment with prednisolone and azathioprine. De novo AIH post liver transplantation may derive from interference by calcineurin inhibitors with the intrathymic physiological mechanisms of T-cell maturation and selection. Whether this condition is a

  3. The neurophysiology of paediatric movement disorders.

    Science.gov (United States)

    McClelland, Verity M

    2017-12-01

    To demonstrate how neurophysiological tools have advanced our understanding of the pathophysiology of paediatric movement disorders, and of neuroplasticity in the developing brain. Delineation of corticospinal tract connectivity using transcranial magnetic stimulation (TMS) is being investigated as a potential biomarker for response to therapy. TMS measures of cortical excitability and neuroplasticity are also being used to investigate the effects of therapy, demonstrating neuroplastic changes that relate to functional improvements. Analyses of evoked potentials and event-related changes in the electroencephalogaphy spectral activity provide growing evidence for the important role of aberrant sensory processing in the pathophysiology of many different movement disorders. Neurophysiological findings demonstrate that children with clinically similar phenotypes may have differing underlying pathophysiology, which in turn may explain differential response to therapy. Neurophysiological parameters can act as biomarkers, providing a means to stratify individuals, and are well suited to provide biofeedback. They therefore have enormous potential to facilitate improvements to therapy. Although currently a small field, the role of neurophysiology in paediatric movement disorders is poised to expand, both fuelled by and contributing to the rapidly growing fields of neuro-rehabilitation and neuromodulation and the move towards a more individualized therapeutic approach.

  4. What Evidence Underlies Clinical Practice in Paediatric Surgery? A Systematic Review Assessing Choice of Study Design.

    Directory of Open Access Journals (Sweden)

    Benjamin Allin

    Full Text Available Identify every paediatric surgical article published in 1998 and every paediatric surgical article published in 2013, and determine which study designs were used and whether they were appropriate for robustly assessing interventions in surgical conditions.A systematic review was conducted according to a pre-specified protocol (CRD42014007629, using EMBASE and Medline. Non-English language studies were excluded. Studies were included if meeting population criteria and either condition or intervention criteria.Children under the age of 18, or adults who underwent intervention for a condition managed by paediatric surgeons when they were under 18 years of age.One managed by general paediatric surgeons.Used for treatment of a condition managed by general paediatric surgeons.Studies were classified according to whether the IDEAL collaboration recommended their design for assessing surgical interventions or not. Change in proportions between 1998 and 2013 was calculated.1581 paediatric surgical articles were published in 1998, and 3453 in 2013. The most commonly used design, accounting for 45% of studies in 1998 and 46.8% in 2013, was the retrospective case series. Only 1.8% of studies were RCTs in 1998, and 1.9% in 2013. Overall, in 1998, 9.8% of studies used a recommended design. In 2013, 11.9% used a recommended design (proportion increase 2.3%, 95% confidence interval 0.5% increase to 4% increase, p = 0.017.A low proportion of published paediatric surgical manuscripts utilise a design that is recommended for assessing surgical interventions. RCTs represent fewer than 1 in 50 studies. In 2013, 88.1% of studies used a less robust design, suggesting the need for a new way of approaching paediatric surgical research.

  5. Firm handling; the information exchange interaction by parents in paediatric care – An observational study

    Directory of Open Access Journals (Sweden)

    Carina Berterö

    2011-01-01

    Full Text Available Background: Information exchange is fundamental in the paediatric care encounter. Health care professionals need further background knowledge to encounter the parents/guardians from their perspective in their minors’ paediatric care. The parents’/guardians’ ability to manage the situation is dependent on their receiving optimal information, which is why it is important to study how information is exchanged.Aim: The aim of this study was to identify, describe and conceptualize how parents/guardians resolved their main concern ininformation exchange with health care professionals in paediatric care situations involving their minors.Methodology: Glaser’s grounded theory method was used and all data were analysed using constant comparative analysis. The observational study took place at three paediatric outpatient units at a university hospital and 24 parents/guardians participated. Data sources were field notes from 37 observations of paediatric care situations and five adherent excerpts from the minors’ medical records. Grounded theory is a method of conceptualising behaviour, which is why an observational study of parents’/guardians’ information exchange and social interaction in the context of nursing care is relevant as research design.Results: Firm handling was revealed as the way the parents/guardians resolved their main concerns when they were exchanging information about their minors’ paediatric care. Firm handling is built on five inter-related categories: representative advocating, collaborating, aim sharing, supportive resourcing and minor bypassing.Conclusions: This knowledge suggests possible ways for health care professionals to design paediatric care that supports, facilitates, strengthens and improves the parents’/guardians’ firm handling. The key issue is to find ways to support parents/guardians and minors so they can participate in health care encounters according to their preferences. Firm handling gives an

  6. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.

    2010-01-01

    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of

  7. Paediatric diarrhoea rehydration therapy revisited

    African Journals Online (AJOL)

    Alive. 1539. 2035. Patients and methods. At the end of 1985, one of four paediatric inpatient wards ... handbooks, but thereafter a protocol was evolved in which emphasis was ... In the absence of an adequate short-stay facility, this ward had to ...

  8. Methodologies to assess paediatric adiposity.

    LENUS (Irish Health Repository)

    Horan, M

    2014-05-04

    Childhood obesity is associated with increased risk of adult obesity, cardiovascular disease, diabetes and cancer. Appropriate techniques for assessment of childhood adiposity are required to identify children at risk. The aim of this review was to examine core clinical measurements and more technical tools to assess paediatric adiposity.

  9. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    -organisational continuous improvement of their performance, relative to that of other EMEs. Developing a collaborative improvement relationship between companies is a protracted and complex process and, according to some surveys, the failure rate is as low as one to three. This failure rate is affected by a whole range...... of factors. The research presented in this thesis was aimed at identifying these factors and investigating their interplay and influence on the progress and success of the development of the collaborative improvement. This thesis presents our findings regarding the factors found, their interplay...

  10. pattern of long bone fractures in a paediatric population at kenyatta

    African Journals Online (AJOL)

    attributed to increased sporting activity, which cause up to 39% of the ... severity and location at time of injury in the paediatric age group. Design: This .... investigator. Data management and analysis: Collected data was ..... children and youth.

  11. Improvement of Learning Process and Learning Outcomes in Physics Learning by Using Collaborative Learning Model of Group Investigation at High School (Grade X, SMAN 14 Jakarta)

    Science.gov (United States)

    Astra, I. Made; Wahyuni, Citra; Nasbey, Hadi

    2015-01-01

    The aim of this research is to improve the quality of physics learning through application of collaborative learning of group investigation at grade X MIPA 2 SMAN 14 Jakarta. The method used in this research is classroom action research. This research consisted of three cycles was conducted from April to May in 2014. Each cycle consists of…

  12. Comparing Ethical and Epistemic Standards for Investigative Journalists and Equity-Oriented Collaborative Community-Based Researchers: Why Working for a University Matters

    Science.gov (United States)

    Newman, Anne; Glass, Ronald David

    2014-01-01

    Criticisms of IRBs are proliferating. In response, we compare the ethical and epistemic standards of two closely related forms of inquiry, investigative journalism and equity-oriented collaborative community-based research (EOCCBR). We argue that a university affiliation justifies formal ethical review of research and suggest how institutionalized…

  13. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  14. Paediatric Crohn's disease: a radiological review

    International Nuclear Information System (INIS)

    Ali, S.I.; Carty, H.M.L.

    2000-01-01

    Paediatric Crohn's disease can be a serious and complex condition which is not always easy to diagnose if it presents in an atypical manner. Although the pathological processes are the same in adults and children, the clinical presentation and disease distribution can be different in children. The impact of the disease can also be much more significant in a growing and developing child than in an adult. Numerous investigations are available to establish the diagnosis, define the complications and to demonstrate the extra-intestinal manifestations. Close co-operation is required between the clinician and radiologist when investigating a child suspected of having Crohn's disease or its symptoms to minimise the radiation dose and the psychological and physical trauma. We review the clinical and radiological aspects of Crohn's disease and discuss the imaging modalities available in diagnosing Crohn's disease and its complications and suggest an investigation pathway as used in our institution. (orig.)

  15. Prevalence of malnutrition, obesity and nutritional risk of Australian paediatric inpatients: a national one-day snapshot.

    Science.gov (United States)

    White, Melinda; Dennis, Nicole; Ramsey, Rebecca; Barwick, Katie; Graham, Christie; Kane, Sarah; Kepreotes, Helen; Queit, Leah; Sweeney, Annabel; Winderlich, Jacinta; Wong See, Denise; Littlewood, Robyn

    2015-03-01

    Low prevalence rates of malnutrition at 2.5% to 4% have previously been reported in two tertiary paediatric Australian hospitals. The current study is the first to measure the prevalence of malnutrition, obesity and nutritional risk of paediatric inpatients in multiple hospitals throughout Australia. Malnutrition, obesity and nutritional risk prevalence were investigated in 832 and 570 paediatric inpatients, respectively, in eight tertiary paediatric hospitals and eight regional hospitals across Australia on a single day. Malnutrition and obesity prevalence was determined using z-scores and body mass index (BMI) percentiles. High nutritional risk was determined as a Paediatric Yorkhill Malnutrition Score of 2 or more. The prevalence rates of malnourished, wasted, stunted, overweight and obese paediatric patients were 15%, 13.8%, 11.9%, 8.8% and 9.9%, respectively. Patients who identified as Aboriginal and Torres Strait Islander were more likely to have lower height-for-age z-scores (P malnutrition and nutritional risk of Australian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  16. Collaboration 'Engineerability'

    NARCIS (Netherlands)

    Kolfschoten, Gwendolyn L.; de Vreede, Gert-Jan; Briggs, Robert O.; Sol, Henk G.

    Collaboration Engineering is an approach to create sustained collaboration support by designing collaborative work practices for high-value recurring tasks, and transferring those designs to practitioners to execute for themselves without ongoing support from collaboration professionals. A key

  17. MR imaging of paediatric uterovaginal anomalies

    International Nuclear Information System (INIS)

    Lang, I.M.; Babyn, P.; Oliver, G.D.

    1999-01-01

    Background. Transabdominal ultrasound (US) has not proved completely reliable in Muellerian duct anomalies. One study has shown it useful in obstructed uterovaginal anomalies. We are unaware of a study that has used endovaginal ultrasound in children to investigate uterovaginal anomalies. Magnetic resonance imaging (MRI) is now gaining wide acceptance in imaging congenital abnormalities of the genital tract. Objective. To identify the problems and potential pitfalls of using MRI to evaluate the female genital tract in paediatric patients. Materials and methods. A retrospective review of the MRI scans of 19 patients, aged 3 months to 19 years (mean 14 years), with uterovaginal anomalies. Results. The uterovaginal anomalies were categorised into three groups: (1) congenital absence of the Muellerian ducts, or the Mayer-Rokitansky-Kuster-Hauser syndrome (n = 7), (2) disorders of vertical fusion (n = 2) and (3) disorders of lateral fusion (n = 10). Conclusions. MRI is a reliable method for evaluating paediatric uterovaginal anomalies, but should be analysed in conjunction with other imaging modalities (US and genitography). Previous surgery makes interpretation more difficult and, if possible, MRI should be carried out prior to any surgery. An accurate MRI examination can be extremely helpful prior to surgery and it is important for the radiologist to have knowledge of how these complex anomalies are managed and what pitfalls to avoid. (orig.)

  18. Drug development: EU paediatric legislation, the European Medicines Agency and its Paediatric Committee--adolescents' melanoma as a paradigm.

    Science.gov (United States)

    Rose, Klaus; Senn, Stephen

    2014-01-01

    The European Medicines Agency (EMA) website lists all diseases that officially exist in adults only. The class waiver for juvenile melanoma was revoked in 2008 referring to US SEER statistics. This statistical justification is misleading. Melanoma in adolescents is much rarer than claimed by EMA/Paediatric Committee; < 1 ∕ 4 of adolescents with melanoma need systemic treatment; separate efficacy studies are neither medically justified nor feasible. The scarce adolescent patients should be allowed to participate in adult trials. To force companies to investigate them separately turns them into paediatric hostages, to adapt the term therapeutic orphans coined in 1968 by Shirkey. There are now five melanoma Paediatric Investigation Plans (PIPs). Probably none of the PIP-triggered clinical studies will ever be completed; we propose to call them ghost studies. An oncology research network considering a reasonable trial in melanoma, including adolescents, will compete for recruitment with the PIP-triggered trials designed by regulatory tunnel vision and sponsored by companies under EMA-imposed pressure. EMA/Paediatric Committee's territorial enthusiasm ("our patients") damages oncology research. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Investigating the effectiveness and cost-effectiveness of FITNET-NHS (Fatigue In Teenagers on the interNET in the NHS) compared to Activity Management to treat paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME): protocol for a randomised controlled trial.

    Science.gov (United States)

    Baos, Sarah; Brigden, Amberly; Anderson, Emma; Hollingworth, William; Price, Simon; Mills, Nicola; Beasant, Lucy; Gaunt, Daisy; Garfield, Kirsty; Metcalfe, Chris; Parslow, Roxanne; Downing, Harriet; Kessler, David; Macleod, John; Stallard, Paul; Knoop, Hans; Van de Putte, Elise; Nijhof, Sanne; Bleijenberg, Gijs; Crawley, Esther

    2018-02-22

    Paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and disabling condition. The National Institute for Health and Clinical Excellence (NICE) recommends Cognitive Behavioural Therapy (CBT) as a treatment option for paediatric CFS/ME because there is good evidence that it is effective. Despite this, most young people in the UK are unable to access local specialist CBT for CFS/ME. A randomised controlled trial (RCT) showed FITNET was effective in the Netherlands but we do not know if it is effective in the National Health Service (NHS) or if it is cost-effective. This trial will investigate whether FITNET-NHS is clinically effective and cost-effective in the NHS. Seven hundred and thirty-four paediatric patients (aged 11-17 years) with CFS/ ME will be randomised (1:1) to receive either FITNET-NHS (online CBT) or Activity Management (delivered via video call). The internal pilot study will use integrated qualitative methods to examine the feasibility of recruitment and the acceptability of treatment. The full trial will assess whether FITNET-NHS is clinically effective and cost-effective. The primary outcome is disability at 6 months, measured using the SF-36-PFS (Physical Function Scale) questionnaire. Cost-effectiveness is measured via cost-utility analysis from an NHS perspective. Secondary subgroup analysis will investigate the effectiveness of FITNET-NHS in those with co-morbid mood disorders. If FITNET-NHS is found to be feasible and acceptable (internal pilot) and effective and cost-effective (full trial), its provision by the NHS has the potential to deliver substantial health gains for the large number of young people suffering from CFS/ME but unable to access treatment because there is no local specialist service. This trial will provide further evidence evaluating the delivery of online CBT to young people with chronic conditions. ISRCTN registry, registration number: ISRCTN18020851 . Registered on 4 August 2016.

  20. The Internet and the paediatric surgeon.

    Science.gov (United States)

    Srinivas, M; Inumpudi, A; Mitra, D K

    1998-12-01

    The Internet, which has truly united the world, is an extensive network of inter-linked computers storing immense bytes of information that can be accessed by anyone, transcending all barriers. The paediatric surgery Internet consists of exponentially growing material that deals with information specifically for paediatric surgeons and patients of the paediatric age group. We reviewed the methods available to take advantage of this network to enable busy paediatric surgeons to accrue the benefits easily and efficiently rather than be lost in the information ocean by surfing individually. By getting connected to the Internet, the paediatric surgeon gains enormous information that can be useful for patient care. The Internet has revolutionised scientific publications by virtue of its fast and accurate transmission of manuscripts. Paediatric surgeons can send manuscripts by this channel and also access journals, obviating the inherent lag period of communication by post.

  1. A paediatric and perinatal HIV/AIDS leadership initiative in Kingston, Jamaica.

    Science.gov (United States)

    Christie, C D C

    2004-10-01

    In Jamaica 1-2% of pregnant women are HIV-positive; 876 HIV-positive pregnant women will deliver and at least 283 newly infected HIV-infected infants will be born in 2003; HIV/AIDS is the leading cause of death in children aged one to four years. We describe a collaborative "Town and Gown" programme to address the paediatric and perinatal HIV epidemic in Kingston. A team of academic and government healthcare personnel, comprising paediatricians, obstetricians, public health practitioners, nurses, microbiologists, data management and information technology personnel collaborated to address this public health emergency. A five-point plan was implemented This comprised leadership and training of a core group of paediatric/perinatal HIVprofessionals to serve Greater Kingston and St Catherine and be a model for the rest of Jamaica. Mother-to-child transmission of HIV/AIDS is prevented by counselling and HIV-testing women in the antenatal clinics, giving azidothymidine (AZT) to HIV pregnant women beginning at 28 weeks gestation, throughout labour and to the HIV-exposed infants for the first six weeks of life. A unified parallel programme for identifying the HIV-infected infant and delivering paediatric HIV care at the major paediatric centres was implemented In three years, over 30,000 pregnant women are being tested for HIV; 600 HIV-exposed babies are being identified and about 140 paediatric HIV infections will be prevented The team is building research capacity which emphasizes a strong outcomes-based research agenda and implementation of clinical trials. We are collaborating, locally, regionally and internationally. Collaboratively, the mission of reducing mother-to-child transmission of HIV/AIDS and improving the quality of life for those already living and affected by HIV/AIDS can be achieved.

  2. Variation in radiographic protocols in paediatric interventional cardiology

    International Nuclear Information System (INIS)

    McFadden, S L; Hughes, C M; Winder, R J

    2013-01-01

    The aim of this work is to determine current radiographic protocols in paediatric interventional cardiology (IC) in the UK and Ireland. To do this we investigated which imaging parameters/protocols are commonly used in IC in different hospitals, to identify if a standard technique is used and illustrate any variation in practice. A questionnaire was sent to all hospitals in the UK and Ireland which perform paediatric IC to obtain information on techniques used in each clinical department and on the range of clinical examinations performed. Ethical and research governance approval was sought from the Office for Research Ethics Committees Northern Ireland and the individual trusts. A response rate of 79% was achieved, and a wide variation in technique was found between hospitals. The main differences in technique involved variations in the use of an anti-scatter grid and the use of additional filtration to the radiation beam, frame rates for digital acquisition and pre-programmed projections/paediatric specific programming in the equipment. We conclude that there is no standard protocol for carrying out paediatric IC in the UK or Ireland. Each hospital carries out the IC procedure according to its own local protocols resulting in a wide variation in radiation dose. (paper)

  3. Variation in radiographic protocols in paediatric interventional cardiology.

    Science.gov (United States)

    McFadden, S L; Hughes, C M; Winder, R J

    2013-06-01

    The aim of this work is to determine current radiographic protocols in paediatric interventional cardiology (IC) in the UK and Ireland. To do this we investigated which imaging parameters/protocols are commonly used in IC in different hospitals, to identify if a standard technique is used and illustrate any variation in practice. A questionnaire was sent to all hospitals in the UK and Ireland which perform paediatric IC to obtain information on techniques used in each clinical department and on the range of clinical examinations performed. Ethical and research governance approval was sought from the Office for Research Ethics Committees Northern Ireland and the individual trusts. A response rate of 79% was achieved, and a wide variation in technique was found between hospitals. The main differences in technique involved variations in the use of an anti-scatter grid and the use of additional filtration to the radiation beam, frame rates for digital acquisition and pre-programmed projections/paediatric specific programming in the equipment. We conclude that there is no standard protocol for carrying out paediatric IC in the UK or Ireland. Each hospital carries out the IC procedure according to its own local protocols resulting in a wide variation in radiation dose.

  4. Consultant paediatric outreach clinics--a practical step in integration.

    Science.gov (United States)

    Spencer, N J

    1993-04-01

    Ten years' experience of paediatric outreach clinics is reviewed and evaluated. The advantages and disadvantages of paediatric outreach and its possible place in the new era of contracting and more developed community paediatric services are discussed. It is concluded that paediatric outreach increases parental and professional choice and access to paediatric consultant services, increases service flexibility, reduces unnecessary hospital visits, and enables more rational and relevant clinical decision making. Outreach is particularly relevant in areas of deprivation where paediatric needs are greatest.

  5. Investigating the influence of special on-off attacks on challenge-based collaborative intrusion detection networks

    DEFF Research Database (Denmark)

    Li, Wenjuan; Meng, Weizhi; Kwok, Lam For

    2018-01-01

    to exchange data with each other. Insider attacks are a great threat for such types of collaborative networks, where an attacker has the authorized access within the network. In literature, a challenge-based trust mechanism is effective at identifying malicious nodes by sending challenges. However...

  6. Virtual Teams and E-Collaboration Technology: A Case Study Investigating the Dynamics of Virtual Team Communication

    Science.gov (United States)

    Mattison, Theresa

    2011-01-01

    The purpose of this study was to determine to what extent the use of e-collaboration tools when used as a primary channel of communication affected virtual team members' trust and motivation, in a spatially dispersed environment. Structured interviews were conducted with 18 project managers, who were responsible for leading virtual projects…

  7. What's new in paediatric dentistry?

    Science.gov (United States)

    Vitale, M. C.

    2016-03-01

    Since the early 80's, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner. In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a "micro-invasive" dentistry and a "clean" surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.

  8. Hypnosis in paediatric respiratory medicine.

    Science.gov (United States)

    McBride, Joshua J; Vlieger, Arine M; Anbar, Ran D

    2014-03-01

    Hypnotherapy is an often misunderstood yet effective therapy. It has been reported to be useful within the field of paediatric respiratory medicine as both a primary and an adjunctive therapy. This article gives a brief overview of how hypnotherapy is performed followed by a review of its applications in paediatric patients with asthma, cystic fibrosis, dyspnea, habit cough, vocal cord dysfunction, and those requiring non-invasive positive pressure ventilation. As the available literature is comprised mostly of case series, retrospective studies, and only a single small randomized study, the field would be strengthened by additional randomized, controlled trials in order to better establish the effectiveness of hypnosis as a treatment, and to identify the processes leading to hypnosis-induced physiologic changes. As examples of the utility of hypnosis and how it can be taught to children with respiratory disease, the article includes videos that demonstrate its use for patients with cystic fibrosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Recent advances in paediatric gastroenterology.

    Science.gov (United States)

    Hansen, Richard; Russell, Richard K; Muhammed, Rafeeq

    2015-09-01

    Over the last few years, many changes have been introduced in the diagnosis and management of paediatric gastrointestinal problems. This review highlights the recent developments in Helicobacter pylori infection, eosinophilic oesophagitis, coeliac disease and inflammatory bowel disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. A focus on paediatric hypertension

    Directory of Open Access Journals (Sweden)

    Pier Paolo Bassareo

    2015-04-01

    Full Text Available Hypertension can begin early in childhood, as occasional increases in blood pressure or abnormal blood pressure responses to physical or emotional stress. High blood pressure in juvenile age is defined as a blood pressure repeatedly above the 95th percentile of specific nomograms. Its worldwide prevalence ranges from 1% to about 10%. The purpose of this paper is to perform an overview about characteristics, diagnosis, risk factors, therapy, and prognosis of paediatric hypertension.

  11. The Allergic Rhinitis Clinical Investigator Collaborative (AR-CIC): verification of nasal allergen challenge procedures in a study utilizing an investigational immunotherapy for cat allergy.

    Science.gov (United States)

    Neighbour, Helen; Soliman, Mena; Steacy, Lisa M; Hickey, Pascal; Forbes, Beth; Larché, Mark; Ellis, Anne K

    2018-01-01

    The Allergic Rhinitis Clinical Investigator Collaborative (AR-CIC) is a network of experienced Allergic Rhinitis (AR) researchers developing better research tools based on the nasal allergen challenge (NAC). A key objective of such is the ability to detect efficacy in a small population. AR-CIC sought to test its NAC protocol as a secondary objective in two small mechanistic research trials of a novel form of immunotherapy [Cat Peptide Antigen Desensitisation (Cat-PAD)] for which efficacy had previously been demonstrated. The primary objective (not presented here) was to identify potential biomarkers of efficacy for peptide immunotherapy, and this provided an ideal opportunity to corroborate the NAC protocol. We aim to clinically validate the AR-CIC NAC methodology in a pooled analysis of secondary endpoints measured in two open label mechanistic studies of cat allergic participants treated with Cat-PAD. Cat allergic AR sufferers with ongoing cat exposure were included. Participants had to demonstrate a total nasal symptom score (TNSS) of at least 8 (max 12) and/or achieve a reduction in peak nasal inspiratory flow (PNIF) of ≥ 50% during a screening titrated NAC. Eligible participants then underwent a baseline NAC visit with the allergen dose that produced a positive challenge at screening, followed by four monthly injections of 6 nmol Cat-PAD. A follow up NAC visit documented changes in nasal response 1 month following the completion of treatment. Nineteen subjects completed the study protocol in the two studies combined. Four injections of Cat-PAD resulted in a significant reduction in TNSS responses generated via NAC following allergen challenge (15 min p  < 0.05, 30 min p  < 0.05, 1 h p  < 0.01, 2 h p  < 0.05). There was modest correlation between symptom scores and PNIF measurements. This study supports the validity of the AR-CIC's optimised NAC protocol for conducting research of the potential efficacy of novel therapeutics in multi

  12. Paediatric dentistry- novel evolvement

    Directory of Open Access Journals (Sweden)

    Saleha Shah, B.D.S, MClinDent Paediatric Dentistry (UK

    2018-01-01

    Full Text Available Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry including other traditional fields of dentistry. The skills apply to the ever-changing stages of dental, physical, and psychosocial development for treating conditions and diseases distinctive to growing individuals. Hence with the changing scope of practice it is imperative that the clinician stays updated with the current evidence based trends in practice, collaborates with other disciplines and Imparts quality oral health care tailored to the specific needs of every child.

  13. Impact of the mother-nurse partnership programme on mother and infant outcomes in paediatric cardiac intensive care unit.

    Science.gov (United States)

    Uhm, Ju-Yeon; Kim, Hee Soon

    2018-04-04

    To identify the effects of a mother-nurse partnership programme based on the core components of information sharing, negotiation and participation in care. Specifically, we examined the programme's effects on parental satisfaction, parental self-efficacy, perceived partnership and anxiety, as well as infants' time to reach full oral feeding and length of postoperative hospital stay, following cardiac surgery on infants at a paediatric intensive care unit with a restrictive visiting policy. Quasi-experimental study. An analysis of covariance was used to investigate between-group differences while ensuring homogeneity. A paediatric cardiac ICU. Parental satisfaction, parental self-efficacy, perceived partnership and anxiety. Data from 37 and 36 mothers in the control and experimental groups respectively, were analysed. Compared with controls, experimental group mothers reported significantly higher parental satisfaction (F = 39.29, p partnership (F = 62.30, p < .001) and lower anxiety (F = 12.93, p < .001), upon transfer to the ward. Infant outcomes did not differ between the groups. This programme appears to facilitate collaboration between nurses and mothers and positively influences mothers' emotional and cognitive outcomes following infants' cardiac surgery. Copyright © 2018. Published by Elsevier Ltd.

  14. The prevalence of pressure ulcers in the paediatric population.

    Science.gov (United States)

    Habiballah, Laila; Tubaishat, Ahmad

    2016-05-01

    A paucity of research related to the problem of pressure ulcers in paediatrics is found, with a variety of reported prevalence rates. To record the prevalence, location and categories of PU in the inpatient paediatric wards, and to identify the characteristics of pressure ulcer patients. A descriptive point prevalence study. All paediatric inpatient wards in two hospitals in Jordan. One of which is a university-affiliated hospital and the other a paediatric public hospital. Isolation, burn and emergency units, outpatients' clinics and psychiatric wards were excluded. One sixty six paediatric patients aged from one day up to 18 years from both hospitals. Patients who met the inclusion criteria were included and examined for the existence of pressure ulcers on one day in each hospital by the primary investigator. The European Pressure Ulcer Advisory Panel classification system was used to categorise each identified ulcer. The characteristics of ulcers were collected as well. Sixteen ulcers were identified in 11 patients, giving a prevalence rate of 6.6%.When Category I ulcers were excluded, the prevalence rate dropped to 2.4%. All except one of the PU patients were being treated in critical care units (n = 10, 90.9%), and most of the ulcers were category one (n = 7, 63.6%) and caused by devices (n = 7, 63.6). The face was the most frequently reported location of PUs (n = 6, 54.5%), followed by the occiput (n = 2, 18.2%). Most PU patients were male (n = 6, 54.5%), and less than 12 months old (n = 8, 72.7%). PU patients had experienced longer hospital stays than patients free from PU (U = 499.0, p = 0.02). Jordanian paediatric patients do have pressure ulcers, with a prevalence rate congruent with previously reported international rates. Most of the ulcers found were caused by devices used in critical care units. This should encourage nurses to pay extra attention to their paediatric patients when they are connected to medical devices. Copyright

  15. Theorizing benefits and constraints in collaborative environmental governance: a transdisciplinary social-ecological network approach for empirical investigations

    Directory of Open Access Journals (Sweden)

    Örjan Bodin

    2016-03-01

    Full Text Available When environmental processes cut across socioeconomic boundaries, traditional top-down government approaches struggle to effectively manage and conserve ecosystems. In such cases, governance arrangements that foster multiactor collaboration are needed. The effectiveness of such arrangements, however, depends on how well any ecological interdependencies across governed ecosystems are aligned with patterns of collaboration. This inherent interdisciplinary and complex problem has impeded progress in developing a better understanding of how to govern ecosystems for conservation in an increasingly interconnected world. We argue for the development of empirically informed theories, which are not only able to transcend disciplinary boundaries, but are also explicit in taking these complex social-ecological interdependences into account. We show how this emerging research frontier can be significantly improved by incorporating recent advances in stochastic modeling of multilevel social networks. An empirical case study from an agricultural landscape in Madagascar is reanalyzed to demonstrate these improvements.

  16. [Transition - how adolescents with cystic fibrosis their parents experience the change from paediatric to adult care].

    Science.gov (United States)

    Becher, Christine; Regamey, Nicolas; Spichiger, Elisabeth

    2014-12-01

    Cystic Fibrosis is the most common autosomal-recessive hereditary disease among white Europeans. The average survival of CF patients has increased to above 40 years and transition from paediatric to adult care has therefore become a significant issue. With this study, experiences of adolescents with CF and their parents with the transition from the paediatric to the adult care were explored. At a Swiss university CF centre, six adolescents and their mothers were recruited. Twelve narrative interviews were conducted on how the phase of transition was experienced. The transcribed interviews were analysed according to the method of hermeneutic phenomenology. Positive and negative experiences with long term routine care in the paediatric service, general themes of adolescence and the quality of the relationship with paediatric doctors influenced the families' experience during transition significantly. For mothers, insensitive information on the CF diagnosis might have influenced the transition experience. The adolescents welcomed an individualized and age appropriate care. Continuity in care, the announcement of, and involvement in the planning of the transfer were of great importance. The families particularly appreciated the timed adaptations of the transfer to individual needs. Flexibility and a strong collaboration between paediatric and adult CF teams are most relevant in the care of families.

  17. Collaborative Learning in the Cloud

    DEFF Research Database (Denmark)

    Kirchner, Kathrin; Razmerita, Liana

    2015-01-01

    This present study aims to investigate how students perceive collaboration and identifies associated technologies used to collaborate. In particular we aim to address the following research questions: What are the factors that impact satisfaction with collaboration? How do these factors differ in...... in different collaborative settings? Based on data from 75 students from Denmark and Germany, the article identifies collaborative practices and factors that impact positively and negatively satisfaction with collaboration....

  18. New hazards in paediatric poisoning presentations.

    LENUS (Irish Health Repository)

    Moore, C

    2015-02-01

    Accidental ingestion is an important preventable cause of childhood morbidity. All accidental ingestion presentations (n = 478) to a tertiary paediatric ED from January 2010 to December 2011 were analysed. These results were compared with a similar study in the same institution ten years previously in 2001 and showed that while accidental ingestions constituted a higher proportion of presentations (0.5% in this study v 0.45% in 2001), fewer had investigations performed (21% v 35%) and fewer were admitted (7% v 20%). Accidental ingestions account for 0.5% of presentations and are an important focus of home safety information for parents and guardians. Paracetamol (n = 67, 14%) and liquid detergent capsules (n = 44, 9.2%) were the two most common substances implicated in these presentations, and have the potential to cause severe morbidity and mortality.

  19. Paediatric Early Warning Score - A multi-center randomized controlled intervention study

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Aagaard, Hanne; Olesen, Hanne Vebert

    Paediatric Early Warning System on evolving critical illness and intervention in hospitalised children; a regional multicentre study on implementation of a Paediatric Early Warning System Background: Critical illness in the patient and death can potentially be predicted and prevented. Deterioration...... is critically ill are related to the child’s symptoms of serious illness often being uncharacteristic. Children can seem relatively unaffected until a short time before circulatory insufficiency and cardiac arrest. Thus, there is a need for developing and investigating if an Paediatric Early Warning System...... of the intervention and evaluation. The study involves all paediatric departments and some acute departments in Central Denmark Region. The project both includes quantitative studies and a qualitative evaluation study. The studies will have different designs: • Registry study - exploring and describing life...

  20. The relevance of the Goudge inquiry to the practice of child protection/forensic paediatrics.

    Science.gov (United States)

    Skellern, Catherine; Donald, Terence

    2014-10-01

    In 2008 Ontario, Canada the Goudge Inquiry arose following increasing concerns about practices surrounding forensic pathology and the investigation of paediatric deaths. Some of the considerations and recommendations have relevance to child protection/forensic paediatricians, particularly in relation to their responsibilities in opinion formulation and as expert witnesses. By examining the Inquiry recommendations, this paper applies them in relation to child protection/forensic paediatrics by discussing forensic medicine and its legal context, how interpretation of published reports and data should be used in opinion formulation; issues of 'diagnosis' versus 'opinion'; issues specific to child protection paediatrics; quality control; aspects of report writing and terminological considerations. It concludes with an adaptation of key recommendations directly from those of Goudge, applied to the context of paediatric forensic medicine undertaken in child protection assessments. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte

    2018-01-01

    with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. DISCUSSION: We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered......BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We...... records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15...

  2. Paediatric sunburn: the experience of an Australian paediatric burns unit.

    Science.gov (United States)

    Mah, Latifa; Di Giovine, Paul; Quinn, Linda; Sparnon, Anthony

    2013-08-01

    The number of hospital presentations and admissions for treatment of sunburn remains significant, despite efforts to educate the public regarding sun protection. Current literature chiefly examines public health campaigns and sun protection behaviours and attitudes. There are very few articles that explore paediatric sunburn requiring hospital presentation. This study was therefore undertaken to provide a snapshot of this issue and to identify patterns and causative factors in the development of severe sunburn requiring hospital presentation. Data were collected for retrospective analysis from case records of patients who presented with sunburn and were registered on the Burns Service database at the Women's and Children's Hospital in South Australia. This study includes patients who presented during the period of October 2006 to March 2011. There were 81 cases identified over the period of 2006-2011 from the Burns database that had sufficient information for the purpose of this study. Factors such as outdoor activity and water sports were predictably apparent, with patients being burned on days with extremely high ultraviolet ratings. Key patterns that emerged were location of sunburn and sun protection use, which were gender and age specific. Larger-scale studies are warranted to further delineate the contributing factors and to identify the specific populations of children at risk of sunburn. Future educational programmes can therefore target these subgroups and behaviours for effective prevention of sunburn. Tailored campaigns that address these factors may be of greater impact in reducing hospital presentations and admissions of significant sunburn. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  3. Anaesthetic considerations for paediatric laparoscopy | Lasersohn ...

    African Journals Online (AJOL)

    Children, infants and neonates represent an anaesthetic challenge because of age-specific anatomical and physiological issues. Apart from paediatric-specific anaesthetic considerations, the paediatric anaesthetist must understand the implications of laparoscopic surgery, and prevent and react appropriately to changes ...

  4. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten

    2014-01-01

    INTRODUCTION: Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare...

  5. Anaesthesia for Ambulatory Paediatric Surgery: Common ...

    African Journals Online (AJOL)

    BACKGROUND: Ambulatory surgical care accounts for over 70% of elective procedures in Northern America. Ambulatory paediatric surgical practice is not widespread in Nigeria. This report examined clinical indicators for quality care in paediatric ambulatory surgery using common outcomes after day case procedures as ...

  6. Appendicitis in paediatric age group: Correlation between ...

    African Journals Online (AJOL)

    Introduction: Clinical diagnosis of appendicitis can be challenging, particularly in the paediatric age group. There is an increased risk of perforation in paediatrics; therefore, a need for sensitive and specific diagnostic tool is mandatory. Aim: The aim of this study is to evaluate the role of preoperative inflammatory markers in ...

  7. Congenital malformations in paediatric and neurosurgical practices ...

    African Journals Online (AJOL)

    Congenital malformations in paediatric and neurosurgical practices: problems and pattern (A preliminary report) ... Open Access DOWNLOAD FULL TEXT ... over a 5-year period (1998 to 2002) with congenital anomalies to the Paediatric Surgery and Neurosurgery units of the University Teaching Hospital, Ilorin, Nigeria.

  8. The paediatric ophthalmic examination

    African Journals Online (AJOL)

    vision improves with the pinhole, then it is most probably a refractive error and can be corrected with glasses. If the vision does not improve the child should be investigated for a cause. Pupil examination in bright light and dim light, looking for anisocoria or a poorly reactive pupil is vital. Watching a child reading a page with.

  9. Conventional imaging in paediatric uroradiology

    International Nuclear Information System (INIS)

    Riccabona, M.; Lindbichler, F.; Sinzig, M.

    2002-01-01

    Objective: To briefly describe basic conventional imaging in paediatric uroradiology. Method: The state of the art performance of standard imaging techniques (intravenous urography (IVU), voiding cystourethrography (VCU), and ultrasound (US)) is described, with emphasis on technical aspects, indications, and patient preparation such as adequate hydration. Only basic applications as used in routine clinical work are included. Result and conclusion: Conventional imaging methods are irreplaceable. They cover the majority of daily clinical routine queries, with consecutive indication of more sophisticated modalities in those patients who need additional imaging for establishing the final diagnosis or outlining therapeutic options

  10. Conventional imaging in paediatric uroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, M. E-mail: michael.riccabona@kfunigraz.ac.at; Lindbichler, F.; Sinzig, M

    2002-08-01

    Objective: To briefly describe basic conventional imaging in paediatric uroradiology. Method: The state of the art performance of standard imaging techniques (intravenous urography (IVU), voiding cystourethrography (VCU), and ultrasound (US)) is described, with emphasis on technical aspects, indications, and patient preparation such as adequate hydration. Only basic applications as used in routine clinical work are included. Result and conclusion: Conventional imaging methods are irreplaceable. They cover the majority of daily clinical routine queries, with consecutive indication of more sophisticated modalities in those patients who need additional imaging for establishing the final diagnosis or outlining therapeutic options.

  11. PREVENTIVE PAEDIATRICS — NEW CHALLENGES

    Directory of Open Access Journals (Sweden)

    A. A. Baranov

    2012-01-01

    Full Text Available The article takes up priority directions of preventive paediatrics concerning health formation of rising generation, organization of health care for children, decrease of morbidity, disability and mortality rate. The authors mention the importance of vaccination in control of the most common infections, base the necessity of complex rehabilitation health care system organization for disable children and need of wide spreading of developed and used in practical Russian health care types and methods of prophylaxis of rare (orphan diseases. The ways of prophylaxis, maintenance, strengthening and recovery of children’s health are suggested in this article.

  12. Canadian Paediatric Neurology Workforce Survey and Consensus Statement.

    Science.gov (United States)

    Doja, Asif; Orr, Serena L; McMillan, Hugh J; Kirton, Adam; Brna, Paula; Esser, Michael; Tang-Wai, Richard; Major, Philippe; Poulin, Chantal; Prasad, Narayan; Selby, Kathryn; Weiss, Shelly K; Yeh, E Ann; Callen, David Ja

    2016-05-01

    Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.

  13. Interpretation of Chemical Pathology Test Results in Paediatrics ...

    African Journals Online (AJOL)

    At any time we interprete paediatric chemical pathology test results we must take into consideration a number of factors, which are related with and restricted to paediatric patients. Such factors include the paediatric patient's age that may change from prematurity to above 18 years, and the paediatric patient's body weight ...

  14. [News in paediatrics].

    Science.gov (United States)

    Depallens, Sarah; Lutz, Nicolas; Carlomagno, Raffaella; Meyrat, Blaise; Barazzoni, Mirjam Schuler; Tchameni, Yves Yamgoue; Pascual, Andres; Scerba, François; Superti-Furga, Andrea

    2016-01-13

    Every pediatrician will be confronted with newborns oryoung infants with skin lesions in proximity of the vertebral column. It is important not to miss a spinal dysraphism because of the risk of meningeal infection or of the possible presence of a tethered cord. A practical algorithm is presented. Non-accidental injury in young infants and toddlers is not rare but difficult to detect. Bruises and fractures are highly suspicious for non-accidental injury and should trigger specific investigations. Emergency departments and hospitals are switching from hypotonic to isotonic solutions as maintenance infusions of children. They reduce the risk of hyponatremia without increasing that of hypernatremia, and they should be used preferentially in the majority of pediatric clinical settings.

  15. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  16. The educational challenge of Paediatric Virology: An interview with Professor of Neonatology Anne Greenough.

    Science.gov (United States)

    Mammas, Ioannis N; Spandidos, Demetrios A

    2017-10-01

    According to Professor Anne Greenough, Professor of Neonatology and Clinical Respiratory Physiology at the King's College London (London, UK), Paediatric Virology is indeed a rapidly increasing educational challenge. Professor Greenough, who in 1992 wrote her book on congenital, perinatal and neonatal infections, believes that during the past 3 decades, paediatric health professionals are becoming increasingly involved in specialised care and follow-up of paediatric patients with viral diseases, who require advanced medical care and innovative technological services. Moreover, she highlights the expected role of new vaccines and antiviral agents that are currently under investigation, as well as the impact of emerging viral diseases that require novel prevention strategies and therapeutic protocols. However, she notes that the number of Paediatric Virologists in any one country is likely to be small; hence, a separate paediatric subspecialty needs to be considered carefully. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor Greenough will give her plenary lecture on the impact of viral infections on the long term outcomes of prematurely born infants.

  17. The paediatric Bohler's angle and crucial angle of Gissane: a case series

    Directory of Open Access Journals (Sweden)

    Crawford Haemish A

    2011-01-01

    Full Text Available Abstract Background Bohler's angle and the crucial angle of Gissane can be used to assess calcaneal fractures. While the normal adult values of these angles are widely known, the normal paediatric values have not yet been established. Our aim is to investigate Bohler's angle and the crucial angle of Gissane in a paediatric population and establish normal paediatric reference values. Method We measured Bohler's angle and the crucial angle of Gissane using normal plain ankle radiographs of 763 patients from birth to 14 years of age completed over a five year period from July 2003 to June 2008. Results In our paediatric study group, the mean Bohler's angle was 35.2 degrees and the mean crucial angle of Gissane was 111.3 degrees. In an adult comparison group, the mean Bohler's angle was 39.2 degrees and the mean crucial angle of Gissane was 113.8 degrees. The differences in Bohler's angle and the crucial angle of Gissane between these two groups were statistically significant. Conclusion We have presented the normal values of Bohler's angle and the crucial angle of Gissane in a paediatric population. These values may provide a useful comparison to assist with the management of the paediatric calcaneal fracture.

  18. Discrepancy in reporting among specialist registrars and the role of a paediatric neuroradiologist in reporting paediatric CT head examinations

    International Nuclear Information System (INIS)

    Nagaraja, S.; Ullah, Q.; Lee, K.J.; Bickle, I.; Hon, L.Q.; Griffiths, P.D.; Raghavan, A.; Flynn, P.; Connolly, D.J.A.

    2009-01-01

    Aim: To evaluate the discrepancy rate among specialist registrars (SPR) to assess whether seniority had a bearing on the discrepancy rate. To investigate which were the commonly missed abnormalities and the consequences for teaching purposes. To investigate the role of a specialist consultant neuroradiologist in reporting paediatric head computed tomography examinations. Materials and methods: The study was carried out over a 9-month period at the regional paediatric hospital during which time 270 CT head examinations were reported. Reporting in the department is carried out by one of the five general paediatric radiologists (GR) and also a specialist paediatric neuroradiologist (NR). The NR was considered the reference standard, who corroborated in areas of discrepancy with a second senior NR for this study. Of the 270 examinations, 260 were reported by the paediatric NR, 160 were reported by the SPR, GR, and NR, and 51 were reported by an SPR and the NR. In addition, four were reported by the GR and the NR, 45 by the NR only, seven by the GR only, and three cases were reported by the GR and an SPR. The discrepancy rates were calculated for GR versus NR, and SPR versus NR. All the discrepancies were re-evaluated by a second senior NR and confirmed in all cases. The reports of the SPR were further scrutinized. The trainees of training years 1-3 were considered junior and 4-5 were considered senior. Results: There was a discrepancy in 26/164 cases (15.9%) reported by the GR and NR. There was a discrepancy in 59/211 cases (28%) reported by an SPR and NR. The chi-squared test (two-sided) showed a significant difference (p = 0.005) between the two groups. There was a discrepancy in 36/118 cases (30.5%) reported by the junior SPR and NR. There was a discrepancy in 23/93 cases (24.7%) reported by a senior SPR and NR. The chi-squared test (two-sided) showed a non-significant difference (p = 0.353) between the two groups. Conclusion: The performance of the SPR was

  19. Quality control in the radiological examinations of paediatric patients

    International Nuclear Information System (INIS)

    Gaiba, W.; Rossi, A.; Vos, C.V.; Giacomelli, G.; Galletti, S.; Rimondi, E.

    1985-01-01

    With a view to minimising the dose absorbed by the paediatric patient during radiological investigations, the most usual X-ray examinations performed in paediatrics were checked in order to standardise and optimise the techniques used. The present study deals with the quality control of the X-ray beam used in radiological diagnosis of young patients, particularly considering that hips and pelvis pathologies can be widespread and that very often it is not possible to shield the patient's gonads during the examination. The electrical and geometrical parameters which minimise the absorbed dose but are compatible with obtaining valid diagnostic information are selected. An anthromorphic phantom reproducing bone and lung inhomogeneities was constructed to the average size of a 12-month-old baby. Inside the phantom TLD 4F 100 dosimeters were located in order to evaluate the absorbed doses. The technique which proved more convenient is indicated and suggested for routine work. (author)

  20. Radiation dose to the heart in paediatric interventional cardiology

    International Nuclear Information System (INIS)

    Keiller, D A; Martin, C J

    2015-01-01

    Recent ICRP publications have reviewed evidence for induction of heart disease. Studies suggest the threshold dose to the heart may be as low as 500 mGy. Doses to the heart from paediatric interventional procedures performed in Glasgow between April 2012 and July 2013 to correct congenital heart defects were investigated to assess the level of potential risk of cardiovascular disease. For common procedures, doses were found to be typically less than 50 mGy, with the highest dose in the period for which data are available estimated to be 330 mGy. These results suggest that any increased risk due to paediatric interventional cardiology is likely to be small, but cumulative doses over a number of years could reach the threshold for effects. (paper)

  1. Variation in radiation doses in paediatric cardiac catheterisation procedures

    International Nuclear Information System (INIS)

    Al-Haj, A. N.; Lobriguito, A. M.; Rafeh, W.

    2008-01-01

    Paediatric cardiac catheterisation involves diagnostic and therapeutic procedures that range from simple to complex and can subject paediatric patients to varying radiation doses. The study aims to determine the variation in entrance doses in patients in terms of dose-area product (DAP) values and to investigate the methods for optimising radiation protection. A total of 190 paediatric patients belonging to age groups 0, 1, 5 and 10 y who underwent diagnostic and six selected therapeutic procedures at King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia) were included in the study. Therapeutic procedures include coarctation (COA), patent ductus arteriosus (PDA), radiofrequency ablation, pulmonary, embolisation and septostomy. Fluoroscopy and cine radiography were used in all procedures. Patient demography (weight, age, gender and height), radiographic technique factors, fluoroscopy and cine time, frame rate, and DAP values were taken from patients records. Effective doses for each procedure were estimated from the DAP values. The mean DAP per procedure were analysed for correlation with patient equivalent cylindrical diameter, weight, fluoroscopy time and number of frames. Factors influencing the variation in doses were investigated. Initial results show that PDA occlusion has the highest mean DAP value of 23.21 Gy-cm 2 , while the diagnostic and septostomy procedures have the lowest value of 7.77 and 6.95 Gy-cm 2 , respectively. (authors)

  2. The social essentials of learning: an experimental investigation of collaborative problem solving and knowledge construction in mathematics classrooms in Australia and China

    Science.gov (United States)

    Chan, Man Ching Esther; Clarke, David; Cao, Yiming

    2018-03-01

    Interactive problem solving and learning are priorities in contemporary education, but these complex processes have proved difficult to research. This project addresses the question "How do we optimise social interaction for the promotion of learning in a mathematics classroom?" Employing the logic of multi-theoretic research design, this project uses the newly built Science of Learning Research Classroom (ARC-SR120300015) at The University of Melbourne and equivalent facilities in China to investigate classroom learning and social interactions, focusing on collaborative small group problem solving as a way to make the social aspects of learning visible. In Australia and China, intact classes of local year 7 students with their usual teacher will be brought into the research classroom facilities with built-in video cameras and audio recording equipment to participate in purposefully designed activities in mathematics. The students will undertake a sequence of tasks in the social units of individual, pair, small group (typically four students) and whole class. The conditions for student collaborative problem solving and learning will be manipulated so that student and teacher contributions to that learning process can be distinguished. Parallel and comparative analyses will identify culture-specific interactive patterns and provide the basis for hypotheses about the learning characteristics underlying collaborative problem solving performance documented in the research classrooms in each country. The ultimate goals of the project are to generate, develop and test more sophisticated hypotheses for the optimisation of social interaction in the mathematics classroom in the interest of improving learning and, particularly, student collaborative problem solving.

  3. Ophthalmological screening of a paediatric cochlear implant population: a retrospective analysis and 12-year follow-up.

    LENUS (Irish Health Repository)

    Falzon, K

    2010-06-01

    To determine the nature and prevalence of ophthalmological findings for a cohort of children in a paediatric cochlear implant program and to assist the clinician in devising an investigative plan for this population.

  4. Determinants of virological outcome and adverse events in African children treated with paediatric nevirapine fixed-dose-combination tablets

    NARCIS (Netherlands)

    Bienczak, A.; Denti, P.; Cook, A.; Wiesner, L.; Mulenga, V.; Kityo, C.; Kekitiinwa, A.; Gibb, D.M.; Burger, D.M.; Walker, A.S.; McIlleron, H.

    2017-01-01

    BACKGROUND: Nevirapine is the only nonnucleoside reverse transcriptase inhibitor currently available as a paediatric fixed-dose-combination tablet and is widely used in African children. Nonetheless, the number of investigations into pharmacokinetic determinants of virological suppression in African

  5. Collaborative Economy

    DEFF Research Database (Denmark)

    collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...... localities of tourism Greg Richards 11.Collaborative economy and destination marketing organizations: A systems approach Jonathan Day 12.Working within the Collaborative Tourist Economy: The complex crafting of work and meaning Jane Widtfeldt Meged and Mathilde Dissing Christensen PART - III Encounters...

  6. Development of a paediatric population-based model of the pharmacokinetics of rivaroxaban.

    Science.gov (United States)

    Willmann, Stefan; Becker, Corina; Burghaus, Rolf; Coboeken, Katrin; Edginton, Andrea; Lippert, Jörg; Siegmund, Hans-Ulrich; Thelen, Kirstin; Mück, Wolfgang

    2014-01-01

    Venous thromboembolism has been increasingly recognised as a clinical problem in the paediatric population. Guideline recommendations for antithrombotic therapy in paediatric patients are based mainly on extrapolation from adult clinical trial data, owing to the limited number of clinical trials in paediatric populations. The oral, direct Factor Xa inhibitor rivaroxaban has been approved in adult patients for several thromboembolic disorders, and its well-defined pharmacokinetic and pharmacodynamic characteristics and efficacy and safety profiles in adults warrant further investigation of this agent in the paediatric population. The objective of this study was to develop and qualify a physiologically based pharmacokinetic (PBPK) model for rivaroxaban doses of 10 and 20 mg in adults and to scale this model to the paediatric population (0-18 years) to inform the dosing regimen for a clinical study of rivaroxaban in paediatric patients. Experimental data sets from phase I studies supported the development and qualification of an adult PBPK model. This adult PBPK model was then scaled to the paediatric population by including anthropometric and physiological information, age-dependent clearance and age-dependent protein binding. The pharmacokinetic properties of rivaroxaban in virtual populations of children were simulated for two body weight-related dosing regimens equivalent to 10 and 20 mg once daily in adults. The quality of the model was judged by means of a visual predictive check. Subsequently, paediatric simulations of the area under the plasma concentration-time curve (AUC), maximum (peak) plasma drug concentration (C max) and concentration in plasma after 24 h (C 24h) were compared with the adult reference simulations. Simulations for AUC, C max and C 24h throughout the investigated age range largely overlapped with values obtained for the corresponding dose in the adult reference simulation for both body weight-related dosing regimens. However

  7. Distribution of branchial anomalies in a paediatric Asian population.

    Science.gov (United States)

    Teo, Neville Wei Yang; Ibrahim, Shahrul Izham; Tan, Kun Kiaang Henry

    2015-04-01

    The objective of the present study was to review the distribution and incidence of branchial anomalies in an Asian paediatric population and highlight the challenges involved in the diagnosis of branchial anomalies. This was a retrospective chart review of all paediatric patients who underwent surgery for branchial anomalies in a tertiary paediatric hospital from August 2007 to November 2012. The clinical notes were correlated with preoperative radiological investigations, intraoperative findings and histology results. Branchial anomalies were classified based on the results of the review. A total of 28 children underwent surgery for 30 branchial anomalies during the review period. Two children had bilateral branchial anomalies requiring excision. Of the 30 branchial anomalies, 7 (23.3%) were first branchial anomalies, 5 (16.7%) were second branchial anomalies, 3 (10.0%) were third branchial anomalies, and 4 (13.3%) were fourth branchial anomalies (one of the four patients with fourth branchial anomalies had bilateral branchial anomalies). In addition, seven children had 8 (26.7%) branchial anomalies that were thought to originate from the pyriform sinus; however, we were unable to determine if these anomalies were from the third or fourth branchial arches. There was inadequate information on the remaining 3 (10.0%) branchial anomalies for classification. The incidence of second branchial anomalies appears to be lower in our Asian paediatric population, while that of third and fourth branchial anomalies was higher. Knowledge of embryology and the related anatomy of the branchial apparatus is crucial in the identification of the type of branchial anomaly.

  8. Does fluoroscopy improve outcomes in paediatric forearm fracture reduction?

    International Nuclear Information System (INIS)

    Menachem, S.; Sharfman, Z.T.; Perets, I.; Arami, A.; Eyal, G.; Drexler, M.; Chechik, O.

    2016-01-01

    Aim: To compare the radiographic results of paediatric forearm fracture reduced with and without fluoroscopic enhancement to investigate whether fractures reduced under fluoroscopic guidance would have smaller residual deformities and lower rates of re-reduction and surgery. Materials and methods: A retrospective cohort analysis was conducted comparing paediatric patients with acute forearm fracture in two trauma centres. Demographics and radiographic data from paediatric forearm fractures treated in Trauma Centre A with the aid of a C-arm fluoroscopy were compared to those treated without fluoroscopy in Trauma Centre B. Re-reduction, late displacement, post-reduction deformity, and need for surgical intervention were compared between the two groups. Results: The cohort included 229 children (175 boys and 54 girls, mean age 9.41±3.2 years, range 1–16 years) with unilateral forearm fractures (83 manipulated with fluoroscopy and 146 without). Thirty-four (15%) children underwent re-reduction procedures in the emergency department. Fifty-three (23%) children had secondary displacement in the cast, of which 18 were operated on, 20 were re-manipulated, and the remaining 15 were kept in the cast with an acceptable deformity. Twenty-nine additional children underwent operation for reasons other than secondary displacement. There were no significant differences in re-reduction and surgery rates or in post-reduction deformities between the two groups. Conclusion: The use of fluoroscopy during reduction of forearm fractures in the paediatric population apparently does not have a significant effect on patient outcomes. Reductions performed without fluoroscopy were comparably accurate in correcting deformities in both coronal and sagittal planes. - Highlights: • Compared outcomes of pediatric forearm fracture reduction with and without fluoroscopy. • The use of fluoroscopy during reduction of forearm fractures in the pediatric population apparently does not have a

  9. Do geography and resources influence the need for colostomy in Hirschsprung's disease and anorectal malformations? A Canadian association of paediatric surgeons: association of paediatric surgeons of Nigeria survey.

    Science.gov (United States)

    Abdur-Rahman, Lukman O; Shawyer, Anna; Vizcarra, Rachel; Bailey, Karen; Cameron, Brian H

    2014-01-01

    This survey compared surgical management of Hirschsprung's disease (HD) and anorectal malformations (ARM) in high and low resource settings. An online survey was sent to 208 members of the Canadian Association of Paediatric Surgeons (CAPS) and the Association of Paediatric Surgeons of Nigeria (APSON). The response rate was 76.8% with 127 complete surveys (APSON 34, CAPS 97). Only 29.5% of APSON surgeons had frozen section available for diagnosis of HD. They were more likely to choose full thickness rectal biopsy (APSON 70.6% vs. CAPS 9.4%, P colostomy for HD (APSON 23.5% vs. CAPS 0%, P colostomy in females with vestibular fistula varied widely independent of geography. APSON surgeons were less likely to have enterostomal therapists and patient education resources. Local resources which vary by geographic location affect the management of HD and ARM including colostomy. Collaboration between CAPS and APSON members could address resource and educational needs to improve patient care.

  10. Radiation Protection in Paediatric Radiology

    International Nuclear Information System (INIS)

    2012-01-01

    Over the past decade and a half, special issues have arisen regarding the protection of children undergoing radiological examinations. These issues have come to the consciousness of a gradually widening group of concerned professionals and the public, largely because of the natural instinct to protect children from unnecessary harm. Some tissues in children are more sensitive to radiation and children have a long life expectancy, during which significant pathology can emerge. The instinct to protect children has received further impetus from the level of professional and public concern articulated in the wake of media responses to certain publications in the professional literature. Many institutions have highlighted the need to pay particular attention to the special problems of protecting paediatric patients. The International Commission on Radiological Protection has noted it and the IAEA's General Safety Requirements publication, Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards (BSS), requires it. This need has been endorsed implicitly in the advisory material on paediatric computed tomography scanning issued by bodies such as the US Food and Drug Administration and the National Cancer Institute in the United States of America, as well as by many initiatives taken by other national and regional radiological societies and professional bodies. A major part of patient exposure, in general, and paediatric exposure, in particular, now arises from practices that barely existed two decades ago. For practitioners and regulators, it is evident that this innovation has been driven both by the imaging industry and by an ever increasing array of new applications generated and validated in the clinical environment. Regulation, industrial standardization, safety procedures and advice on best practice lag (inevitably) behind industrial and clinical innovations. This Safety Report is designed to consolidate and provide timely advice on

  11. [Challenges in acute paediatric medicine].

    Science.gov (United States)

    Moll, Henriette A

    2016-01-01

    A big drop in the number of severe infections has resulted in less experience in recognising a seriously ill child. The challenge is finding a safe and effective balance between high-quality expertise and quickly accessible care, while avoiding over-diagnosis. There are a number of tools available to aid recognition of a seriously ill child and to avoid delay in diagnostic procedures and treatment: the use of a validated paediatric triage system, validated decision rules and guidelines, listening carefully to the parents ('my child's illness is different this time'), the clinical intuition of the experienced paediatrician and the provision of good 'safety net' advice to parents concerning the alarm signals and when they should contact a care provider. Experienced paediatricians should be at the forefront in the evaluation of the acutely ill child in order to teach their younger colleagues the importance of various alarm signals and the role played by clinical intuition.

  12. Radiation Effects in Paediatric radiography

    International Nuclear Information System (INIS)

    Mutwasi, O.

    2006-01-01

    Diagnostic imaging has evolved from single technique to a field which we have a choice from many modalities. Some without radiation. Radiation producing modalities include plain films (low dose), Fluoroscopy (mid range dose), Computed tomography (high dose). Radiography dose can significantly be influenced in plain radiography by varying speed of screens, cassette construction and type of radiography. E.g. digital or computed. In computed or digital radiography we are no longer able to tell h igh dose b y the quality of images. The final image is by great extend a product of post processing algorithms. It's for this reasons that the basic understanding of the sensitivity and specifying of various types of examinations and of specifically radiation effects is mandatory for a paediatric imager

  13. A clinical update on paediatric lupus

    African Journals Online (AJOL)

    Personal reference lists of the 3 authors were used in this update. ... with a paediatric specialist so that a tailored management plan can be made, depending ..... Cassidy JT, Petty RE, Laxer RM, Lindsley L.Textbook of Pediatric Rheumatology.

  14. The global burden of paediatric heart disease

    DEFF Research Database (Denmark)

    Musa, Ndidiamaka L; Hjortdal, Vibeke; Zheleva, Bistra

    2017-01-01

    An estimated 15 million children die or are crippled annually by treatable or preventable heart disease in low- and middle-income countries. Global efforts to reduce under-5 mortality have focused on reducing death from communicable diseases in low- and middle-income countries with little...... to no attention focusing on paediatric CHD and acquired heart disease. Lack of awareness of CHD and acquired heart disease, access to care, poor healthcare infrastructure, competing health priorities, and a critical shortage of specialists are important reasons why paediatric heart disease has not been addressed...... in low resourced settings. Non-governmental organisations have taken the lead to address these challenges. This review describes the global burden of paediatric heart disease and strategies to improve the quality of care for paediatric heart disease. These strategies would improve outcomes for children...

  15. Recent developments in neonatal and paediatric emergencies.

    Science.gov (United States)

    Turner, Nigel M

    2011-07-01

    The present article is intended as an update for anaesthesiologists on recent developments in life-threatening paediatric emergencies and paediatric resuscitation. It is assumed that the reader has at least a basic knowledge of the general principles of emergency medicine, such as the ABCDE-approach and the principle of 'treat first what kills first'; and also that the reader is familiar with the anatomical, physiological and psychological differences between adults and children. The article begins with a description of the background to paediatric emergencies followed by a description of a widely used systematic approach to the assessment of the seriously ill child. In the second half of the article, the principles of the initial treatment for acute, life-threatening problems in children and paediatric resuscitation are discussed with reference to the recent literature. The article ends with a discussion of the changes in latest guidelines for resuscitation of babies at birth.

  16. ORIGINAL ARTICLES HIV transmission during paediatric health ...

    African Journals Online (AJOL)

    prevalence in paediatric health care settings in Africa, risks for horizontal ... 29 West Governer Road, Hershey, Pennsylvania, USA. David Gisselquist, PhD ..... tolerance policy for HIV transmission through health care. February 2004, Vol.

  17. FORUM Paediatric living donor liver transplantation

    African Journals Online (AJOL)

    879 November 2012, Vol. 102, No. 11 SAMJ. REVIEW. Paediatric living donor liver transplantation ... been excellent after left lateral segmentectomy, with a usually quoted ... has led to the development of new surgical techniques to increase.

  18. Vedolizumab in Paediatric Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Ledder, Oren; Assa, Amit; Levine, Arie

    2017-01-01

    Background: Vedolizumab, an anti-integrin antibody, has proven to be effective in adults with inflammatory bowel disease [IBD], but the data in paediatrics are limited. We describe the short-term effectiveness and safety of vedolizumab in a European multi-centre paediatric IBD cohort. Method......: Retrospective review of children [aged 2-18 years] treated with vedolizumab from 19 centres affiliated with the Paediatric IBD Porto group of ESPGHAN. Primary outcome was Week 14 corticosteroid-free remission [CFR]. Results: In all, 64 children were included (32 [50%] male, mean age 14.5 ± 2.8 years...... minor drug-related adverse events. Only 3 of 16 children who underwent endoscopic evaluation had mucosal healing after treatment (19%). Conclusions: Vedolizumab was safe and effective in this cohort of paediatric refractory IBD. These data support previous findings of slow induction rate of vedolizumab...

  19. Job satisfaction and burnout among paediatric nurses.

    Science.gov (United States)

    Akman, Ozlem; Ozturk, Candan; Bektas, Murat; Ayar, Dijle; Armstrong, Merry A

    2016-10-01

    This study aims to determine factors of job satisfaction and burnout levels of paediatric nurses. A total of 165 nurses working in paediatric clinics completed the Minnesota job satisfaction scale and the Maslach burnout scale. Average scores of the emotional exhaustion and depersonalisation score were low, while personal accomplishment scores were high. A high level of job satisfaction, being married, increased age and a decreased number of assigned patients were significantly associated with a low level of burnout. Paediatric nurses experience burnout at significant levels. The most important variable that affected job satisfaction was income. The results of the study could guide development of strategies that might prevent or alleviate burnout of paediatric nurses. © 2016 John Wiley & Sons Ltd.

  20. Collaborative Economy

    DEFF Research Database (Denmark)

    that are emerging from them, and how governments are responding to these new challenges. In doing so, the book provides both theoretical and practical insights into the future of tourism in a world that is, paradoxically, becoming both increasingly collaborative and individualized. Table of Contents Preface 1.The...... collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...

  1. Working Collaboratively

    DEFF Research Database (Denmark)

    Holder, Anna; Lovett, George

    2009-01-01

    identified as a transformative global force of the last decade, most notably in knowledge and information publishing, communication and creation. This paper presents a structured conversation on changing understandings of collaboration, and the realities of collaborative methodology in architectural work...

  2. Challenges of safe medication practice in paediatric care--a nursing perspective.

    Science.gov (United States)

    Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph

    2013-05-01

    To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

  3. Paediatric cardiology programs in countries with limited resources: how to bridge the gap.

    Science.gov (United States)

    Sulafa, K M Ali

    2010-07-01

    Establishing paediatric cardiology service in a country with limited resources like Sudan is a challenging task. A paediatric cardiac team was formed then the services in different disciplines were gradually established. Echocardiography (echo) clinics were founded in tertiary and peripheral hospitals. Cardiac catheterization (cath) was established at the Sudan Heart Centre (SHC) in 2004 and over 400 procedures had been performed including interventional catheterization like pulmonary valve dilatation, patent ductus arteriosus and atrial septal defect device closure. Congenital heart surgery started in 2001, currently 200 cases are done each year including closed procedures as well as open heart procedures for patients weighing more than 8 kg. Cardiology-cardiac surgery as well as adult congenital heart disease meetings were held and contributed positively to the services. The cardiology-cardiac surgery scientific club meeting was founded as a forum for academic discussions. A fellowship program was established in 2004 and included seven candidates trained in paediatric cardiology and intensive care. Two training courses had been established: congenital heart disease echo and paediatric electrocardiogram interpretation. Links with regional and international cardiac centres had important roles in consolidating our program. Significant obstacles face our service due to the small number of trained personnel, high cost of procedures, the lack of regular supplies and lack of cardiac intensive care facilities for young infants. Bridging the huge gap needs extensive official as well as non-governmental efforts, training more staff, supporting families and collaboration with regional and international centres.

  4. Collaborations in Open Learning Environments

    NARCIS (Netherlands)

    Spoelstra, Howard

    2015-01-01

    This thesis researches automated services for professionals aiming at starting collaborative learning projects in open learning environments, such as MOOCs. It investigates the theoretical backgrounds of team formation for collaborative learning. Based on the outcomes, a model is developed

  5. ALARA and paediatric imaging in radiation therapy: A survey of Canadian paediatric imaging practice

    International Nuclear Information System (INIS)

    Rodgerson, Christine

    2014-01-01

    Purpose: There is little discussion in the literature regarding paediatric imaging dose reduction with respect to conventional imaging carried out in radiotherapy departments. This is in contrast to diagnostic radiography where dose optimization when imaging children is a very current topic. For this reason Canadian radiotherapy clinics were surveyed to look at paediatric imaging practice, knowledge and perspectives with respect to imaging dose reduction. Method: As this was an exploratory study, a questionnaire was developed and sent to radiation therapy clinics across Canada, via email, to assess knowledge of paediatric imaging and dose reduction initiatives. The questionnaire focus was CT simulation and treatment verification imaging of children. Results: Practice and knowledge of paediatric imaging varied across Canada. Forty percent of clinics reported using paediatric specific protocols for CT simulation and 20% of clinics reported using paediatric specific protocols for treatment verification imaging. There was variation in imaging practices among the clinics that reported treating the most children. The survey results show that while some measures are being taken to reduce paediatric imaging dose in radiation therapy, 46.7% of the respondents felt more could be done. Conclusion: The survey demonstrates interest in dose reduction in radiation therapy imaging as well as differences in current practice and knowledge across Canada. Paediatric imaging dose reduction would appear to be an area of practice that would benefit from more study and development of standards of practice

  6. A mixed methods evaluation of paediatric trainee preparedness to manage cardiopulmonary arrests.

    Science.gov (United States)

    Walsh, Órla; Lydon, Sinéad; O'Connor, Paul

    2017-12-01

    Paediatric cardiopulmonary arrest (CPA) survival rates are strongly linked to the training of the doctors responding to the event. This study sought to characterise the level of experience in managing CPAs among paediatric trainees and to investigate the nontechnical (NTS) required to effectively lead a paediatric CPA team. A mixed-methods research design was used. For the quantitative phase, a questionnaire was developed to assess training, confidence, and experiences related to CPA management. During the qualitative phase, 17 paediatric trainees participated in a series of critical incident technique (CIT) interviews to explore the NTS used during the management of paediatric CPAs. A total of 56 of 131 (37.1% response rate) trainees responded to the preparedness questionnaire. A total of 48.2% of respondents expressed low confidence in their skill as a team leader during the management of a CPA. The CIT interviews highlighted deficiencies in specific NTS (identifying options, prioritising, and identifying and utilising resources). Our results indicate that there is a desire for more training in CPA management among paediatric trainees, in particular as a team leader, which includes a focus on key NTS. What is Known • Levels of preparedness to be a paediatric cardiopulmonary arrests team member/leader are generally lower than desirable. • The importance of nontechnical skills to the effective performance of adult cardiopulmonary arrests teams has been identified. What is New • Levels of preparedness to be a cardiopulmonary arrests team member were higher than reported in US studies. • There is a need for greater training in cardiopulmonary arrest management which includes a focus on key nontechnical skills to include identifying options, prioritising, identifying and utilising resources.

  7. Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward.

    Science.gov (United States)

    Angelhoff, Charlotte; Edéll-Gustafsson, Ulla; Mörelius, Evalotte

    2018-02-01

    To describe sleep quality and mood in parents accommodated with their sick child in a family-centred paediatric ward. Secondary aims were to compare mothers' and fathers' sleep quality and mood in the paediatric ward and to compare the parents' sleep quality and mood between the paediatric ward and in a daily-life home setting after discharge. Frequent interruptions, ward noise and anxiety affect parents' sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents' ability to sustain attention and focus, and to care for their sick child. This was a prospective and descriptive study. Eighty-two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood. The parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood. Parents' sleep quality in family-centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated. The healthcare professionals should acknowledge parents' sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well-being in the family. © 2017 John Wiley & Sons Ltd.

  8. Program of scientific investigations and development of solid-oxide fuel cells (SOFC) in VNIITF. Proposals on scientific and technical collaboration and SOFC commercialization

    Energy Technology Data Exchange (ETDEWEB)

    Kleschev, Yu.N.; Chukharev, V.F.

    1996-04-01

    This paper describes proposals on scientific and technical collaborations pertaining to solid oxide fuel cell commercialization. Topics included for discussion are: materials research and manufacture; market estimation and cost; directions of collaboration; and project of proposals on joint enterprise creation.

  9. Collaborative research: Accomplishments & potential

    Science.gov (United States)

    Katsouyanni, Klea

    2008-01-01

    Although a substantial part of scientific research is collaborative and increasing globalization will probably lead to its increase, very few studies actually investigate the advantages, disadvantages, experiences and lessons learned from collaboration. In environmental epidemiology interdisciplinary collaboration is essential and the contrasting geographical patterns in exposure and disease make multi-location projects essential. This paper is based on a presentation given at the Annual Conference of the International Society for Environmental Epidemiology, Paris 2006, and is attempting to initiate a discussion on a framework for studying collaborative research. A review of the relevant literature showed that indeed collaborative research is rising, in some countries with impressive rates. However, there are substantial differences between countries in their outlook, need and respect for collaboration. In many situations collaborative publications receive more citations than those based on national authorship. The European Union is the most important host of collaborative research, mainly driven by the European Commission through the Framework Programmes. A critical assessment of the tools and trends of collaborative networks under FP6, showed that there was a need for a critical revision, which led to changes in FP7. In conclusion, it is useful to study the characteristics of collaborative research and set targets for the future. The added value for science and for the researchers involved may be assessed. The motivation for collaboration could be increased in the more developed countries. Particular ways to increase the efficiency and interaction in interdisciplinary and intercultural collaboration may be developed. We can work towards "the principles of collaborative research" in Environmental Epidemiology. PMID:18208596

  10. CMS Collaboration

    International Nuclear Information System (INIS)

    Faridah Mohammad Idris; Wan Ahmad Tajuddin Wan Abdullah; Zainol Abidin Ibrahim

    2013-01-01

    Full-text: CMS Collaboration is an international scientific collaboration located at European Organization for Nuclear Research (CERN), Switzerland, dedicated in carried out research on experimental particle physics. Consisting of 179 institutions from 41 countries from all around the word, CMS Collaboration host a general purpose detector for example the Compact Muon Solenoid (CMS) for members in CMS Collaboration to conduct experiment from the collision of two proton beams accelerated to a speed of 8 TeV in the LHC ring. In this paper, we described how the CMS detector is used by the scientist in CMS Collaboration to reconstruct the most basic building of matter. (author)

  11. Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU.

    Science.gov (United States)

    Ewald, Dominik A; Huss, Gottfried; Auras, Silke; Caceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

    2018-06-01

    Paediatric ambulatory healthcare systems in Europe are, because of historical reasons, diverse and show strikingly different outcomes. All across Europe, the benchmarking of structures, processes and outcomes could reveal opportunities for improving Paediatric Primary Care (PPC). The aim of this study was to develop a set of Quality Indicators (QIs) to assess and monitor PPC in Europe. In a three-step process, we used the available external evidence and European expert consensus in a modified RAND/UCLA Appropriateness Method (RAM) to develop an indicator set. (1) A broad literature and online research of published QI and guidelines yielded an inventory of 1516 QI. (2) A collaborative panel of paediatric senior experts from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) from 15 European countries participated in a first consensus process to reduce the initial indicator inventory by eliminating not PPC-focused indicators and duplicates. (3) In a second consensus process, the panel rated the QI regarding validity and feasibility. The final QI set "COSI-PPC-EU" consists of 42 indicators in five categories of PPC: (A) health promotion/prevention/screening (13 QI), (B) acute care (9 QI), (C) chronic care (8 QI), (D) practice management (3 QI) and (E) patient safety (9 QI). COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi

  12. Depression in paediatric chronic fatigue syndrome.

    Science.gov (United States)

    Bould, Helen; Collin, Simon M; Lewis, Glyn; Rimes, Katharine; Crawley, Esther

    2013-06-01

    To describe the prevalence of depression in children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and investigate the relationship between depression in CFS/ME and clinical symptoms such as fatigue, disability, pain and school attendance. Cross-sectional survey data using the Hospital Anxiety and Depression Scale (HADS) collected at assessment. Specialist paediatric CFS/ME service in the South West. Children aged 12-18 years with CFS/ME. Depression was defined as scoring >9 on the HADS depression scale. 542 subjects had complete data for the HADS and 29% (156/542) (95% CI 25% to 33%) had depression. In a univariable analysis, female sex, poorer school attendance, and higher levels of fatigue, disability, pain, and anxiety were associated with higher odds of depression. Age of child and duration of illness were not associated with depression. In a multivariable analysis, the factors most strongly associated with depression were disability, with higher scores on the physical function subscale of the 36 item Short Form (SF-36). Depression is commonly comorbid with CFS/ME, much more common than in the general population, and is associated with markers of disease severity. It is important to screen for, identify and treat depression in this population.

  13. [Promotion of breast feeding in paediatric outpatient settings].

    Science.gov (United States)

    Böse-O'Reilly, S; Wermuth, I; Hellmann, J; Siebert, U; Lob-Corzilius, T

    2008-03-01

    With some data and examples it can be shown that the competence and the knowledge of paediatric doctor's assistants and paediatric nurses can and should be improved. The training courses to become a "prevention assistant" have been very positively accepted by doctor's assistants and paediatric nurses, and it seems an appropriate method to reach these aims. Prevention and especially promotion of breast feeding is possible in paediatric outpatient settings. The immediate contact between infants, parents, paediatric doctor's assistants, paediatric nurses, and doctors offers a unique opportunity to promote the health of children, mainly due to the high acceptance of regular check-ups. So why not introduce the promotion of breast feeding in paediatric outpatient settings with specially trained doctor's assistants and paediatric nurses?

  14. Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development.

    Science.gov (United States)

    Vileito, A; Siebelink, M J; Verhagen, Aae

    2018-05-01

    Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Most countries use protocols for organ and tissue donation to ensure optimal care for the donor and family, but these mainly focus on adults. However, the donation process for children differs from adults in many ways. An overview of the literature was performed to identify protocols for the paediatric population. PubMed, Web of Science, EMBASE and the Internet were searched up to March 2016 for papers or other sources in English related to specific organ and tissue donation protocols for children and neonates. This comprised title, abstract and then full-text screening of relevant data. We included 12 papers and two electronic sources that were mainly from North America and Europe. Most discussed donations after cardiac death. The recurring themes included identifying potential donors, approaching parents, palliative care and collaboration with organ procurement organisations. Most papers called for paediatric donation policies to be standardised. Scientific publications in English on paediatric donation protocols are very scarce. No comprehensive paediatric donation protocol was found. We identified several recurring themes in the literature that could be used to develop such protocols. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  15. Population pharmacokinetics of tamsulosin hydrochloride in paediatric patients with neuropathic and non-neuropathic bladder

    Science.gov (United States)

    Tsuda, Yasuhiro; Tatami, Shinji; Yamamura, Norio; Tadayasu, Yusuke; Sarashina, Akiko; Liesenfeld, Karl-Heinz; Staab, Alexander; Schäfer, Hans-Günter; Ieiri, Ichiro; Higuchi, Shun

    2010-01-01

    AIMS The main objective of this study was to characterize the population pharmacokinetics of tamsulosin hydrochloride (HCl) in paediatric patients with neuropathic and non-neuropathic bladder. A secondary objective was to compare the pharmacokinetics in paediatric patients and adults. METHODS Tamsulosin HCl plasma concentrations in 1082 plasma samples from 189 paediatric patients (age range 2–16 years) were analyzed with NONMEM, applying a one compartment model with first-order absorption. Based on the principles of allometry, body weight was incorporated in the base model, along with fixed allometric exponents. Covariate analysis was performed by means of a stepwise forward inclusion and backward elimination procedure. Simulations based on the final model were used to compare the pharmacokinetics with those in adults. RESULTS Beside the priori-implemented body weight, only α1-acid glycoprotein had an effect on both apparent clearance and apparent volume of distribution. No other investigated covariates, including gender, age, race, patient population and concomitant therapy with anti-cholinergics, significantly affected the pharmacokinetics of tamsulosin HCl (P tamsulosin HCl in paediatric patients was established and it described the data well. There was no major difference in the pharmacokinetics of tamsulosin HCl between paediatric patients (age range 2–16 years) and adults when the effect of body weight was taken into consideration. PMID:20642551

  16. Silence in Intercultural Collaboration

    NARCIS (Netherlands)

    Verouden, Nick W.; Sanden, Van der Maarten C.A.; Aarts, Noelle

    2018-01-01

    China is widely recognized as a significant scientific partner for Western universities. Given that many Western universities are now operating in the Chinese context, this study investigates the everyday conversations in which international partnerships are collaboratively developed and

  17. Algorithm for optimisation of paediatric chest radiography

    International Nuclear Information System (INIS)

    Kostova-Lefterova, D.

    2016-01-01

    The purpose of this work is to assess the current practice and patient doses in paediatric chest radiography in a large university hospital. The X-ray unit is used in the paediatric department for respiratory diseases. Another purpose was to recommend and apply optimized protocols to reduce patient dose while maintaining diagnostic image quality for the x-ray images. The practice of two different radiographers was studied. The results were compared with the existing practice in paediatric chest radiography and the opportunities for optimization were identified in order to reduce patient doses. A methodology was developed for optimization of the x-ray examinations by grouping children in age groups or according to other appropriate indication and creating an algorithm for proper selection of the exposure parameters for each group. The algorithm for the optimisation of paediatric chest radiography reduced patient doses (PKA, organ dose, effective dose) between 1.5 and 6 times for the different age groups, the average glandular dose up to 10 times and the dose for the lung between 2 and 5 times. The resulting X-ray images were of good diagnostic quality. The subjectivity in the choice of exposure parameters was reduced and standardization has been achieved in the work of the radiographers. The role of the radiologist, the medical physicist and radiographer in the process of optimization was shown. It was proven the effect of teamwork in reducing patient doses at keeping adequate image quality. Key words: Chest Radiography. Paediatric Radiography. Optimization. Radiation Exposure. Radiation Protection

  18. Magnetic tomography within paediatric radiological diagnostics

    International Nuclear Information System (INIS)

    Smevik, Bjarne; Borthne, Arne

    2000-01-01

    Background: MRI is a promising imaging technique for diseases in most organ systems in children. Material and methods: this review discusses MRI on the basis of the literature and our own experience. Results: the value of MRI in paediatric neuroradiology is firmly established. In congenital heart defects and other reasons for cardiovascular imaging in children, the non-invasiveness of the method is appealing. MRI is already included in most international paediatric oncology protocols. Paediatric applications for MRI differ from those in adults as they focus on developmental and congenital abnormalities. Furthermore, some pathological conditions are unique to children. MRI is also a promising alternative to established methods for evaluation of the urinary tract. There are some specific problems with MRI in children. Immobilisation and sedation techniques include tight wrapping of the new-born with soft elastic bands, feeding immediately prior to the study and allowing one parent into the magnet with the child. Midazolam and oral chloral hydrate are usually used for sedation. Interpretation: MRI is of particular value in the paediatric age group as the method is capable of highly accurate imaging in a variety of congenital and paediatric diseases without the use of ionising radiation. Faster sequences and better resolution will further increase the use of MRI in children

  19. Collaborative experience

    DEFF Research Database (Denmark)

    Mortensen, Thomas Bøtker

    -Doerr, 1996) and has been shown to have a positive effect to the outcome of collaborative R&D (Sampson, 2005). Anand & Khanna (2000), furthermore, hypothesized that research joint ventures are more ambiguous than marketing joint ventures and even more the licensing and showed that the effect of collaborative......Literature review: Collaborative experience has been shown to have a positive effect on the collaborative outcome in general (Anand & Khanna, 2000; Kale, Dyer & Singh, 2002). Furthermore, it has been linked to the ability to exploit the network of the firm for learning (Powell, Koput and Smith...... experience was largest the higher the hypothesized ambiguity. Theoretically contribution: This research project aims at contributing to existing literature by arguing, that collaborative experience is a moderating variable which moderates the effects on collaborative outcome from the level of complexity...

  20. A collaborative quality improvement model and electronic community of practice to support sepsis management in emergency departments: investigating care harmonization for provincial knowledge translation.

    Science.gov (United States)

    Ho, Kendall; Marsden, Julian; Jarvis-Selinger, Sandra; Novak Lauscher, Helen; Kamal, Noreen; Stenstrom, Rob; Sweet, David; Goldman, Ran D; Innes, Grant

    2012-07-12

    Emergency medicine departments within several organizations are now advocating the adoption of early intervention guidelines for patients with the signs and symptoms of sepsis. This proposed research will lead to a comprehensive understanding of how diverse emergency department (ED) sites across British Columbia (BC), Canada, engage in a quality improvement collaborative to lead to improvements in time-based process measures and clinical outcomes for septic patients in EDs. To address the challenge of sepsis management, in 2007, the BC Ministry of Health began working with emergency health professionals, including health administrators, to establish a provincial ED collaborative: Evidence to Excellence (E2E). The E2E initiative employs the Institute for Healthcare Improvement (IHI) model and is supported by a Web-based community of practice (CoP) in emergency medicine. It aims to (1) support clinicians in accessing and applying evidence to clinical practice in emergency medicine, (2) support system change and clinical process improvement, and (3) develop resources and strategies to facilitate knowledge translation and process improvement. Improving sepsis management is one of the central foci of the E2E initiative. The primary purpose of our research is to investigate whether the application of sepsis management protocols leads to improved time-based process measures and clinical outcomes for patients presenting to EDs with sepsis. Also, we seek to investigate the implementation of sepsis protocols among different EDs. For example: (1) How can sepsis protocols be harmonized among different EDs? (2) What are health professionals' perspectives on interprofessional collaboration with various EDs? and (3) What are the factors affecting the level of success among EDs? Lastly, working in collaboration with the BC Ministry of Health as our policy-maker partner, the research will investigate how the demonstrated efficacy of this research can be applied on a provincial and

  1. The proposal of Paediatric Virology and its perspectives: An interview with Professor of Paediatrics Maria Theodoridou.

    Science.gov (United States)

    Mammas, Ioannis N; Spandidos, Demetrios A

    2017-10-01

    Professor Maria Theodoridou, Emeritus Professor of Paediatrics at the University of Athens, is one of the few paediatricians in Greece, who have experienced almost all the infectious diseases of the second half of the 20th century and their severe consequences, prior to the widespread adoption of immunisations. A milestone during her career was the establishment of a specialised National Reference Unit for the care of paediatric patients with acquired immune deficiency syndrome (AIDS) at the 'Aghia Sophia' Children's Hospital in Athens, Greece. According to Professor Theodoridou, training on the prevention, management and treatment of neonatal and paediatric viral infections represents a new educational challenge for both community as well as hospital-based paediatric health professionals. The debate of the potential strategically principal role of Paediatric Virology subspecialists in the primary, secondary and tertiary clinical practice is definitely necessary and needs further discussion and evaluation, she adds. She describes the difficulties that Greece, a country under a long-standing financial crisis, faces for the hospital-based management of paediatric viral infections and refers to the future advances, which are expected in the field of diagnosis and treatment of viral infections in neonates and children. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens on October 7th, 2017, Professor Theodoridou will focus on the immigration crisis and vaccination policy.

  2. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens Peter; B. Andersen, Claus

    2010-01-01

    It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  3. Clinical dehydration and glomerular filtration rate in acute paediatric gastroenteritis.

    Science.gov (United States)

    Milani, Gregorio P; Fossali, Emilio F; Perri, Alessandra; Vettori, Arianna; Grillo, Paolo; Agostoni, Carlo

    2013-08-01

    To evaluate changes in glomerular filtration rate in acute gastroenteritis. The correlation between two clinical diagnostic scales and glomerular filtration rate has been investigated in 113 children with acute gastroenteritis in a paediatric emergency setting. A significant reduction of GFR was found in 10% children less than, and 5% children higher than, 2 years of age with acute gastroenteritis. The differences observed as for risk of renal hypoperfusion suggests to consider the age of children as an important determinant to consider the dehydration status in acute gastroenteritis. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Investigando o processo de leitura por meio de ambientes colaborativos Investigating the Reading Process by Means of Collaborative Environment

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Neitzel

    2009-10-01

    Full Text Available Investigaciones brasileñas acerca de los factores determinantes para el éxito de programas de formación de lectores señalan la necesidad del empleo de la literatura como objeto estético para que el niño se aproxime al libro. Esta investigación se propuso estudiar las concepciones de los profesores acerca de la literatura a partir del punto de vista del lector infantil. Se utilizó el chat como mecanismo de recolección de datos, propuesto entre dos clases de la enseñanza fundamental, y entrevistas con las profesoras regentes. El análisis de los chats siguió la metodología de Franco (1997, evidenciando que los docentes no consideran al libro como un objeto estético que necesita ser disfrutado. Esta investigación señala tres ejes básicos para la conquista de un público lector: a recursos humanos calificados con claridad acerca de la concepción de literatura como fenómeno estético; b procedimientos metodológicos coherentes con esa concepción; c acervo bibliográfico ajustado a esa concepción. Brazilian research on the determining factors for the success of programs to teach reading indicates a need to view literature as an aesthetic object that will encourage children to appreciate books. This study proposes investigating teachers' concepts of literature, from the point of view of the children. Chat was used as a data collection mechanism, proposed between two groups of elementary school children and interviews with the teachers. The analysis of the chats followed the methodology of Franco (1997. This study indicates three key areas for winning a reading public: a qualified human resources, with a clear concept of literature as an aesthetic phenomenon; b methodological procedures that are coherent with this concept; c a bibliographical archive that is aligned with this concept.

  5. Diagnostic radiology in paediatric palliative care

    International Nuclear Information System (INIS)

    Patel, Preena; Koh, Michelle; Carr, Lucinda; McHugh, Kieran

    2014-01-01

    Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options. (orig.)

  6. Diagnostic radiology in paediatric palliative care

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Preena; Koh, Michelle; Carr, Lucinda; McHugh, Kieran [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)

    2014-01-15

    Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options. (orig.)

  7. Is paediatric trauma severity overestimated at triage?

    DEFF Research Database (Denmark)

    DO, H Q; Hesselfeldt, R; Steinmetz, J

    2014-01-01

    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational...... follow-up study that involves one level I TC and seven local hospitals. We included paediatric (trauma patients with a driving distance to the TC > 30 minutes. The primary end-point was the proportion of trauma patients arriving in the TC. RESULTS: We included 1934...... trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post-injury (P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score (ISS) 9 vs. 14, P 

  8. Development and implementation of a multi-centre information system for paediatric and infant critical care.

    Science.gov (United States)

    Maybloom, Bruce; Champion, Zahra

    2003-12-01

    With no UK collective information system, a need existed to establish an integrated information system for public and private sector hospitals providing paediatric and infant critical care services. A lack of information in the past made it difficult for those procuring, providing and monitoring services to make informed, evidence-based decisions using reliable integrated data. To develop and implement a collective multi-purpose information system for paediatric and infant critical care that was easily adaptable to any UK infant or paediatric critical care setting. Information outputs had to fulfil policy requirements and meet the needs of stakeholders. Two minimum datasets, corresponding data definitions, survey forms and a user database were developed through a process of consultation by utilising an information partnership. Design, content, development and implementation issues were identified, discussed and resolved through a co-ordinated collaborative process. Data collection was implemented in all London and Brighton National Health Service (NHS) general and cardio-thoracic paediatric intensive care (PIC) units, several private PIC units and one NHS tertiary referral neonatal unit (NNU) 24 months from project start. The development of universal integrated information systems for defined settings of care is achievable within reasonable timeframes; however, successful development and implementation requires working within an information partnership to maximise co-ordination, co-operation and collaboration. Those collecting and using data must be identified and involved in all aspects of development from project start. Financial and manpower resources must be well planned. Datasets should be as small as possible in order to make the collection of complete and valid data realistically achievable. When considering service-based information needs, considerable thought should be given to a multi-purpose; multi-use approach based on the most refined minimum dataset

  9. Virtual colonoscopy in paediatric patients

    International Nuclear Information System (INIS)

    Carrascosa, Patricia; Lopez, Elba Martin; Capunay, Carlos; Vallejos, Javier; Carrascosa, Jorge

    2010-01-01

    Objective: To determine the usefulness of perspective-filet view for polypoid lesions in paediatric patients in comparison with conventional virtual colonoscopy (VC) analysis and optical colonoscopy. Methods: Sixty-one patients (mean age 5 years old) with a previous episode of rectal bleeding were studied using a 16 slices CT scanner. All patients underwent a colonic preparation. Two acquisitions were done in supine and prone positions with slices of 2 mm thickness; increment 1 mm, 30-50 mA; 90-120 kV. In a workstation an experienced radiologist reviewed images twice. The first read was done using the conventional virtual colonoscopy technique with the evaluation of two-dimensional (2D), three-dimensional (3D) and endoscopical images. Later, in a second session, perspective-filet view was used. It shows a 360 deg. unrolled visualization of the inner colon. The presence, size and location of the lesions were determined. A record of the reading time was made. Results: At per patient evaluation the conventional virtual colonoscopy analysis obtained a sensitivity of 86% and a specificity of 98%. The perspective-filet view obtained a sensitivity of 91% and a specificity of 99%. In the evaluation on a per lesion basis the conventional analysis had a sensitivity of 81% and a specificity of 88%. Perspective-filet view, had a sensitivity of 82% and specificity of 90%. The average total reading time using conventional colonoscopy technique was 18 ± 3 min, versus 4 ± 1 min using the perspective-filet view. Conclusion: Virtual colon dissection with perspective-filet view is more time-efficient than conventional virtual colonoscopy evaluation with correct correlation in results.

  10. Paediatric Radiation Oncology. Chapter 21

    International Nuclear Information System (INIS)

    Anacak, Y.; Zaghloul, M.; Laskar, S.

    2017-01-01

    Although cancer is a typical disease of ageing adults, it can be seen at any age and cancer diagnosis in a child is not a rare situation. Every day around the world, many teenagers, young children and even infants are diagnosed with cancer. Cancer in children is an important health care problem, not only for the individual patient and medical staff, but also for families, teachers, friends and society as a whole. In every culture, children are considered innocent human beings and the diagnosis of such an ‘evil’ disease in a young child always induces feelings of unfairness and anguish. Most childhood cancers are curable; using the best treatment options, more than 80% of children with cancer may survive to adulthood. However, cure alone is not the ultimate goal for paediatric cancer treatment; late effects of treatment impact the quality of life of patients. Cure from cancer in a child means adding at least 50–60 years to his or her life, which is long enough to develop serious late effects of the treatment and the induction of secondary cancers. Thus, treatment should be tailored to minimize the exposure of healthy tissues to chemotherapy drugs and radiation. Cancer treatment can be a painful process, often involving surgery, radiotherapy and chemotherapy, and requiring very long treatment periods, which impair the motor and mental development of the child, and his or her educational activities and relations with society. Childhood cancer survivors sometimes have modest to severe sequelae of the disease itself and the treatment used, which may disrupt their development to a healthy adulthood. These cancer survivors should be fully integrated into society and be allowed to live productive lives even when lifelong rehabilitation is required to keep them active.

  11. Retinal detachment in paediatric patients

    International Nuclear Information System (INIS)

    Zafar, S. N.; Qureshi, N.; Azad, N.; Khan, A.

    2013-01-01

    Objective: To assess the causes of retinal detachment in children and the various operative procedures requiring vitreoretinal surgical intervention for the same. Study Design: Case series. Place and Duration of Study: Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2006 to May 2009. Methodology: A total of 281 eyes of 258 patients, (aged 0 - 18 years) who underwent vitreo-retinal surgical intervention for retinal detachment were included. Surgical log was searched for the type of retinal detachment and its causes. Frequencies of various interventions done in these patients viz. vitrectomy, scleral buckle, use of tamponading agents, laser photocoagulation and cryotherapy were noted. Results were described as descriptive statistics. Results: Myopia was the cause in 62 (22.1%) and trauma in 51 (18.1%) of the eyes. Total retinal detachment (RD) was treated in 94 (33.5%) eyes, sub total RD in 36 (12.8%), recurrent RD in 32 (11.4%), giant retinal tear in 28 (10%), tractional RD in 15 (5.3%) and exudative RD in 2 (0.7%). Prophylactic laser or cryotherapy was applied in 74 (26.3%) of the eyes. Pars plana vitrectomy (PPV) was carried out in 159 (56.6%) eyes while scleral buckle procedure was done in 129 (45.9%) eyes. Silicon oil was used in 149 (53%), perfluorocarbon liquid in 32 (11.4%) and gas tamponade in 20 (7.1%) eyes. Conclusion: The most common cause of retinal detachment in paediatric patients was myopia, followed by trauma. Total RD was more common as compared to the other types. The most common procedure adopted was pars plana vitrectomy followed by scleral buckle procedure. (author)

  12. Radiological protection of paediatric patients: An overview

    International Nuclear Information System (INIS)

    Ringertz, H.G.; Bremmer, S.

    2001-01-01

    Paediatric patients require special attention with respect to radiation protection, for various reasons. The difference between a 1 kg premature baby and a 100 kg teenager puts special demands on the radiographic techniques used, and the increased radiosensitivity of growing tissue and the patients' longer life expectancy put greater demands on the justification of the procedures to be carried out. The optimization procedure involves practical aspects such as immobilization, body build specific exposure parameters and body build specific anatomical knowledge. These and other aspects of paediatric radiological protection are discussed in this overview. (author)

  13. A disjointed effort: paediatric musculoskeletal examination.

    LENUS (Irish Health Repository)

    Gill, Irwin

    2012-07-01

    Musculoskeletal (MSK) symptoms are a frequent cause of emergency department attendance for children, and while most often indicative of benign or self-limiting disease, such symptoms can occasionally be the first presentation of serious illness such as leukaemia or juvenile idiopathic arthritis. MSK examination, however, is often not included as part of the routine paediatric examination. The authors aimed to evaluate how often and how thoroughly MSK examination was performed during admissions to the paediatric ward and to compare it with the examination of other symptoms in relation to the presenting complaint and eventual diagnosis.

  14. Collaborative Hierarchy.

    Science.gov (United States)

    Maris, Mariann

    The University of Wisconsin-Milwaukee writing program is collaborative, not divisionary, as some, such as Jeanne Gunner, have suggested. Three terms are useful in understanding the relationships and ethics governing operations at Wisconsin-Milwaukee: (1) authority and collaboration; (2) hierarchical difference; (3) professional respect.…

  15. Collaborative Prototyping

    DEFF Research Database (Denmark)

    Bogers, Marcel; Horst, Willem

    2014-01-01

    of the prototyping process, the actual prototype was used as a tool for communication or development, thus serving as a platform for the cross-fertilization of knowledge. In this way, collaborative prototyping leads to a better balance between functionality and usability; it translates usability problems into design......This paper presents an inductive study that shows how collaborative prototyping across functional, hierarchical, and organizational boundaries can improve the overall prototyping process. Our combined action research and case study approach provides new insights into how collaborative prototyping...... can provide a platform for prototype-driven problem solving in early new product development (NPD). Our findings have important implications for how to facilitate multistakeholder collaboration in prototyping and problem solving, and more generally for how to organize collaborative and open innovation...

  16. Young patients', parents', and survivors' communication preferences in paediatric oncology: using online focus groups.

    NARCIS (Netherlands)

    Zwaanswijk, M.; Tates, K.; Dulmen, S. van; Hoogerbrugge, M.; Kamps, W.A.; Bensing, J.M.

    2007-01-01

    BACKGROUND: Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated

  17. Reduced N400 Semantic Priming Effects in Adult Survivors of Paediatric and Adolescent Traumatic Brain Injury

    Science.gov (United States)

    Knuepffer, C.; Murdoch, B. E.; Lloyd, D.; Lewis, F. M.; Hinchliffe, F. J.

    2012-01-01

    The immediate and long-term neural correlates of linguistic processing deficits reported following paediatric and adolescent traumatic brain injury (TBI) are poorly understood. Therefore, the current research investigated event-related potentials (ERPs) elicited during a semantic picture-word priming experiment in two groups of highly functioning…

  18. Paediatric trauma and safety in the media: An audit of its coverage in ...

    African Journals Online (AJOL)

    Objectives. In view of the high rate of paediatric trauma in South Africa, we investigated how much attention – and of what nature – was given in printed media to these incidents, and to the broader subject of child safety. Methods. Over 4 months, every article in the Cape Argus and Weekend Argus that pertained to either: (i) ...

  19. The Effect of Functional Roles on Group Efficiency : Using Multilevel Modeling and Content Analysis to Investigate Computer-Supported Collaboration in Small Groups

    NARCIS (Netherlands)

    Strijbos, J.W.; Martens, R.L.; Jochems, W.M.G.; Broers, N.J.

    2004-01-01

    The usefulness of roles to support small group performance can often be read; however, their effect is rarely empirically assessed. This article reports the effects of functional roles on group performance, efficiency, and collaboration during computer-supported collaborative learning. A comparison

  20. A Compound LAMS-MOODLE Environment to Support Collaborative Project-Based Learning: A Case Study with the Group Investigation Method

    Science.gov (United States)

    Paschalis, Giorgos

    2017-01-01

    Collaborative project-based learning is well established as a component of several courses in higher education, since it seems to motivate students and make them active in the learning process. Collaborative Project-Based Learning methods are demanded so that tutors become able to intervene and guide the students in flexible ways: by encouraging…

  1. Plasma EBV microRNAs in paediatric renal transplant recipients.

    Science.gov (United States)

    Hassan, Jaythoon; Dean, Jonathan; De Gascun, Cillian F; Riordan, Michael; Sweeney, Clodagh; Connell, Jeff; Awan, Atif

    2018-06-01

    Epstein-Barr virus (EBV) was the first human virus identified to express microRNA (miRNA). To date, 44 mature miRNAs are encoded for within the EBV genome. EBV miRNAs have not been profiled in paediatric renal transplant recipients. In this study, we investigated circulating EBV miRNA profiles as novel biomarkers in paediatric renal transplant patients. Forty-two microRNAs encoded within 2 EBV open reading frames (BART and BHRF) were examined in renal transplant recipients who resolved EBV infection (REI) or maintained chronic high viral loads (CHL), and in non-transplant patients with acute infectious mononucleosis (IM). Plasma EBV-miR-BART2-5p was present in higher numbers of IM (7/8) and CHL (7/10) compared to REI (7/12) patients. A trend was observed between the numbers of plasma EBV miRNAs expressed and EBV viral load (p < 0.07). Several EBV-miRs including BART7-3p, 15, 9-3p, 11-3p, 1-3p and 3-3p were detected in IM and CHL patients only. The lytic EBV-miRs, BHRF1-2-3p and 1-1, indicating active viral replication, were detected in IM patients only. One CHL patient developed post-transplant lymphoproliferative disease (PTLD) after several years and analysis of 10 samples over a 30-month period showed an average 24-fold higher change in plasma EBV-miR-BART2-5p compared to the CHL group and 110-fold higher change compared to the REI group. Our results suggest that EBV-miR-BART2-5p, which targets the stress-induced immune ligand MICB to escape recognition and elimination by NK cells, may have a role in sustaining high EBV viral loads in CHL paediatric kidney transplant recipients.

  2. Designing collaborative policy innovation

    DEFF Research Database (Denmark)

    Agger, Annika; Sørensen, Eva

    2014-01-01

    Recent approaches to enhancing public innovation suffer from two shortcomings: They overemphasize competition as a driver of innovation and overlook the fact that public sector innovation involves policy innovation as well as service innovation. Drawing on governance research and innovation theory......, the chapter investigates the extent to which and how collaboration between politicians and relevant stakeholders can spur the formulation, implementation and diffusion of new innovative policies. A case study of a process of collaborative policy innovation in a Danish municipality shows that collaborative...... policy arenas do contribute to policy innovation but also that the degree to which they do so depends on the institutional design of these arenas....

  3. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

    Science.gov (United States)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

    2018-01-05

    Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

  4. Achieving good oral health in children: the importance of a current, relevant and unbiased evidence base in paediatric dentistry.

    Science.gov (United States)

    Clarkson, J E; Bonetti, D; Worthington, H

    2013-06-01

    The Cochrane Collaboration was founded in 1993 as an international, non-profit and independent organisation dedicated to making up-to-date, accurate and reliable information about healthcare readily available. This paper discusses how the Cochrane Oral Health Group reviews have contributed to the oral health evidence base used in the development of many international and U.K. dental guidance documents, particularly in the field of paediatric dentistry.

  5. Morbidity among Israeli paediatric travellers.

    Science.gov (United States)

    Rabinowicz, Shira; Schwartz, Eli

    2017-09-01

    International travel, particularly to developing countries, is becoming increasingly common among the Israeli population, including an increase in the number of travelling children. Since children are a distinct travellers' population, data about their post-travel morbidity are needed. A retrospective study which examined all children (0-19 years old) who presented to our centre after international travel from 1999 to 2015. About 314 children were seen. The mean age was 10 years (SD ± 5.8). Most of the patients (80.6%) were tourists, and the rest were expatriates. The main destinations visited were South-Asia (46.5%), Sub-Saharan Africa (33.4%), Latin-America (7%) and Europe (6.4%). Overall, the most common diagnoses were gastrointestinal (GI) (mainly chronic) disorders (30.6%), followed by febrile diseases (26.4%), among which 18.1% of patients were diagnosed with dengue fever and 12% with malaria. Dermatologic conditions accounted for 25.2%. Additional diagnoses were schistosomiasis (6.4%) and neuropsychiatric symptoms (2.2%). A substantial part, 10.8%, had eosinophilia, either symptomatic or asymptomatic. Travellers to Asia, compared to travellers to Africa, presented more commonly with GI illness (OR 2.02, 95% confidence interval 1.13-3.61), and dermatologic conditions (OR 1.94, 95% confidence interval 1.05-3.61). Morbidity was associated with a variety of transmission modes, such as food-borne illnesses (30.9%), bite and sting wounds (10.2%), mosquito-borne infections (8%), freshwater contact (6.7%) and tick-borne infections (2.2%). The main conditions seen in paediatric returning travellers were GI, febrile and dermatologic illnesses, some may be rare in their country of origin. Targeting care for the suspected pathogens based on updated knowledge of epidemiology and thorough travel history is essential. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  6. Patient dosimetry study of a paediatric CT examination

    International Nuclear Information System (INIS)

    Hranitzky, C.; Stadtmann, H.

    2011-01-01

    Dosimetry studies are of increasing interest in diagnostic high-dose applications such as computed tomography especially for examinations of children. A routine CT scan protocol for paediatric head and neck imaging was investigated at a new multi-detector CT scanner using LiF:Mg,Cu,P thermoluminescence dosemeters (TLDs) and a 0.125 cm 3 thimble ionization chamber. Calibrations of the detectors in terms of absorbed dose to water were carried out at the Dosimetry Laboratory Seibersdorf in standard radiation fields. The dosimetry method was validated in the spiral CT X-ray field by comparing TLD and ionization chamber measurement results in cylindrical PMMA phantoms. Absorbed dose results were within stated uncertainties. An anthropomorphic phantom representing a child of about 5 years was loaded with TLD chips at various organ and tissue positions in the head and neck region as well as at some critical organ locations. Organ dose values were calculated from TLD based average absorbed dose with about 5% total uncertainty, e.g. 22 mGy (eyes), 21 mGy (thyroid), 19 mGy (brain), 3.4 mGy (thymus), and 0.03 mGy (testes). For comparison purposes an effective dose of 1.9 mSv was estimated for the investigated paediatric CT examination based on ICRP-103 age-independent tissue-weighting factors.

  7. Paediatric Neurological Conditions Seen at the Physiotherapy ...

    African Journals Online (AJOL)

    Paediatric neurological conditions constitute a major cause of disability in childhood. However there seems to be an apparent dearth of published works on the patterns of neurological conditions seen in Nigerian physiotherapy clinics of rural locations. This study aimed at describing the spectrum of neurological conditions ...

  8. Ingested foreign bodies in the paediatric patient.

    LENUS (Irish Health Repository)

    O'Brien, G C

    2012-02-03

    BACKGROUND: Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention. AIMS: To establish clear guidelines for management of paediatric FB ingestion. METHODS: A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999. RESULTS: Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery. CONCLUSION: Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.

  9. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten

    2014-01-01

    : 66-100%) of paediatric MS subjects, 77% (CI: 46-95%) had an elevated IgG index and 85% (CI: 55-98%) had oligoclonal bands in the cerebrospinal fluid. MRI showed characteristic white matter lesions in all children (CI: 80-100%). CONCLUSION: MS symptoms at the first demyelinating event and diagnostic...

  10. Whole-body MRI in paediatric oncology

    NARCIS (Netherlands)

    Nievelstein, Rutger A J; Littooij, Annemieke S.

    Imaging plays a crucial role in the diagnosis and follow-up of paediatric malignancies. Until recently, computed tomography (CT) has been the imaging technique of choice in children with cancer, but nowadays there is an increasing interest in the use of functional imaging techniques like positron

  11. Gonad protection for the paediatric patient

    International Nuclear Information System (INIS)

    Gyll, C.

    1988-01-01

    A brief article gives examples of hip radiographs of paediatric patients showing misplacement of shields for gonad protection. Shields cut out of lead-PVC sheeting or the fenestration method of shielding are proposed as more successful methods of gonad shielding. (UK)

  12. What?s New in Paediatric Sepsis

    OpenAIRE

    Farrell, Deborah; Nadel, Simon

    2016-01-01

    Severe sepsis and septic shock remains a leading cause of mortality and morbidity in children. There is ongoing uncertainty regarding the optimal treatment pathways however the initial management of sepsis is crucial. This article is designed to be an informal and personal review of recent developments in paediatric sepsis over the past 3?years.

  13. Clinician's gaze behaviour in simulated paediatric emergencies.

    Science.gov (United States)

    McNaughten, Ben; Hart, Caroline; Gallagher, Stephen; Junk, Carol; Coulter, Patricia; Thompson, Andrew; Bourke, Thomas

    2018-03-07

    Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency. Clinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions. Paediatric intensive care unit (PICU) consultants performed best and focused longer on the chest and airway. Paediatric consultants and trainees spent longer looking at the defibrillator and algorithm (51 180 ms and 50 551 ms, respectively) than the PICU and paediatric emergency medicine consultants. This study is the first to describe differences in the gaze behaviour between experts and novices in a resuscitation. They mirror those described in aviation and surgery. Further research is needed to evaluate the potential use of eye tracking as an educational tool. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. A review of paediatric tuberculosis in Denmark

    DEFF Research Database (Denmark)

    Hatleberg, Camilla; Prahl, Julie B; Rasmussen, Jeppe Nørgaard

    2014-01-01

    Paediatric tuberculosis (TB) is a key indicator for recent transmission and presents a reservoir for the disease. We describe trends in epidemiology, microbiological characteristics and treatment outcome in Denmark between 2000 and 2009. Data was retrieved from the national TB surveillance system...

  15. Paediatric organophosphate poisoning - a rural hospital experience ...

    African Journals Online (AJOL)

    Objectives. To document the presentation and course of organophosphate poisoning (OPP) in children and to record the frequency of atropine toxicity during treatment. Design. A retrospective observational study was conducted of all recorded paediatric cases of OPP admitted to a regional hospital over a 5-year period from ...

  16. Collaborative Consumption

    DEFF Research Database (Denmark)

    Gjerdrum Pedersen, Esben Rahbek; Netter, Sarah

    2015-01-01

    Purpose – The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach – The analysis is based on a multiple-case study of Scandinavian fashion libraries – a new...... to the new phenomenon of fashion libraries and does not cover other types of collaborative consumption within the fashion industry (Swap-parties, etc.). Originality/value – The paper is one of the first attempts to examine new business models of collaborative consumption in general and the fashion library...... concept in particular. The study contributes to the discussions of whether and how fashion sharing and collaboration holds promise as a viable business model and as a means to promote sustainability....

  17. Collaborative Consumption

    DEFF Research Database (Denmark)

    Gjerdrum Pedersen, Esben Rahbek; Netter, Sarah

    Purpose: The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach: The analysis is based on a multiple-­‐‑case study of Scandinavian fashion libraries – a new...... to the new phenomenon of fashion libraries and does not cover other types of collaborative consumption within the fashion industry (Swap-­‐‑parties, etc.). Originality/value: The paper is one of the first attempts to examine new business models of collaborative consumption in general and the fashion library...... concept in particular. The study contributes to the discussions of whether and how fashion sharing and collaboration holds promise as a viable business model and as a means to promote sustainability....

  18. STUDY ON NONINFECTIOUS DERMATOSES IN PAEDIATRIC AGE

    Directory of Open Access Journals (Sweden)

    Ananthi Mahalingam

    2017-09-01

    Full Text Available BACKGROUND Paediatric dermatology is a unique subspecialty in that child is not a miniature adult. Paediatric dermatoses differ from that of the adults in clinical presentation, treatment and prognosis. Various studies from India have shown infections and infestations to be the most common paediatric dermatoses. This study was planned to determine the epidemiological pattern of common noninfectious dermatoses in our paediatric patients as no such data are available from this part of the country. A cross-sectional study was undertaken to study the prevalence of the noninfectious dermatoses in all the new paediatric patients attending the Skin Outpatient Department (OPD at Villupuram Medical College over a period of three years. MATERIALS AND METHODS A total number of 550 children in the age group ranging from newborn to 12 years with noninfectious dermatoses attending the OPD for the first time were enrolled in the study. RESULTS Physiological changes of skin was the most common dermatoses in the newborn age group, while eczema was the most common dermatoses in infants, preschool and school going children. In the infants, eczema was followed by pigmentary disorders, mongolian spots, vascular nevi, ichthyosis, epidermolysis bullosa, alopecia areata and papular urticaria in the order of prevalence. Among preschool going children, eczema was followed by papular urticaria, papulosquamous disorders, pigmentary disorders, hair disorders, nevi, drug reactions, keratinisation disorders, urticaria, etc. In the school going age group, eczema was followed by papulosquamous disorders, pigmentary disorders, papular urticaria, nutritional disorders, ichthyosis, nevi, miliaria, drug reaction, hair disorders, photodermatoses, urticaria, collagen vascular disease and vascular nevi in the order of prevalence. CONCLUSION Eczema, papulosquamous disorders, papular urticaria, pigmentary disorders seem to be the most common noninfectious dermatoses in children. However

  19. The delivery of general paediatric surgery in Ireland: a survey of higher surgical trainees.

    LENUS (Irish Health Repository)

    Boyle, E

    2012-12-01

    The delivery of general paediatric surgery is changing in Ireland. Fewer paediatric surgical procedures are being performed by newly appointed consultant general surgeons, resulting in increased referrals to the specialist paediatric surgeons of uncomplicated general paediatric surgical problems. We surveyed current higher surgical trainees about their views on provision of paediatric surgical services.

  20. The experience of transition in adolescents and young adults transferring from paediatric to adult care

    DEFF Research Database (Denmark)

    Fegran, Liv; Ludvigsen, Mette Spliid; Aagaard, Hanne

    Introduction: Despite research and implementation of transition models in the last decades, transfer from paediatric to adult care still poses great challenges. Predominantly studies on health care transition have been based on the perspective of experts or health care professionals. Aim...... of familiar surroundings and relationships combined with insecurity and a feeling of being unprepared for what was ahead. Four sub-themes illustrating these experiences were identified: facing changes of significant relationships, moving from familiar to unknown ward cultures, timing of transfer and achieving...... as competent collaborators in their own transfer is crucial, and may protect them from additional health problems in a vulnerable phase of their life....

  1. Summary of the 2015 International Paediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute.

    Science.gov (United States)

    Jacobs, Jeffrey P; Quintessenza, James A; Karl, Tom R; Asante-Korang, Alfred; Everett, Allen D; Collins, Susan B; Ramirez-Correa, Genaro A; Burns, Kristin M; Cohen, Mitchell; Colan, Steven D; Costello, John M; Daly, Kevin P; Franklin, Rodney C G; Fraser, Charles D; Hill, Kevin D; Huhta, James C; Kaushal, Sunjay; Law, Yuk M; Lipshultz, Steven E; Murphy, Anne M; Pasquali, Sara K; Payne, Mark R; Rossano, Joseph; Shirali, Girish; Ware, Stephanie M; Xu, Mingguo; Jacobs, Marshall L

    2015-08-01

    In the United States alone, ∼14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was held on February 4 and 5, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children's Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children's Hospital Andrews/Daicoff Cardiovascular Program, the International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary "think-tank". The purpose of this manuscript is to summarise the lessons from the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute, to describe the "state of the art" of the treatment of paediatric cardiac failure, and to discuss future directions for research in the domain of paediatric cardiac failure.

  2. Social media in paediatric heart disease: professional use and opportunities to improve cardiac care.

    Science.gov (United States)

    Schumacher, Kurt R; Lee, Joyce M; Pasquali, Sara K

    2015-12-01

    Social media is any type of communication utilising electronic technology that follows two guiding principles: free publishing or sharing of content and ideas and group collaboration and inter-connectedness. Over the last 10 years, social media technology has made tremendous inroads into all facets of communication. Modalities such as Facebook, YouTube, and Twitter are no longer viewed as new communication technologies. Owing to their tremendous usage, they are now common ways to conduct a dialogue with individuals and groups. Greater than 91% of teenagers and 89% of young adults routinely use social media. Further, 24% of teenagers reported being online "almost constantly". These forms of communication are readily used by individuals cared for in the field of paediatric cardiology; thus, they should carry significant interest for cardiology care providers; however, social media's influence on medicine extends beyond use by patients. It directly affects all medical providers, both users and non-users. Further, social media has the ability to improve care for patients with paediatric heart disease. This article details social media's current influence on paediatric cardiology, including considerations for professional use of social media and potential opportunities to improve cardiac care.

  3. Collaboration in scientific practice

    DEFF Research Database (Denmark)

    Wagenknecht, Susann

    2014-01-01

    This monograph investigates the collaborative creation of scientific knowledge in research groups. To do so, I combine philosophical analysis with a first-hand comparative case study of two research groups in experimental science. Qualitative data are gained through observation and interviews......, and I combine empirical insights with existing approaches to knowledge creation in philosophy of science and social epistemology. On the basis of my empirically-grounded analysis I make several conceptual contributions. I study scientific collaboration as the interaction of scientists within research...... to their publication. Specifically, I suggest epistemic difference and the porosity of social structure as two conceptual leitmotifs in the study of group collaboration. With epistemic difference, I emphasize the value of socio-cognitive heterogeneity in group collaboration. With porosity, I underline the fact...

  4. [From paediatric urological care to adult urology. Assessment of a transition consultation for adolescents].

    Science.gov (United States)

    Even, L; Mouttalib, S; Moscovici, J; Soulie, M; Rischmann, P; Game, X; Galinier, P; Bouali, O

    2017-10-01

    the definitive nature of his handicap and the need of medical follow-up throughout his life. Transition consultation makes easier the passage from paediatric care to adult urological care. It allows a smooth change of interlocutors, facilitates subsequent care and improves compliance to medical follow-up. It requires a good collaboration between paediatric and adult care units. Transition responds to an increasing request of adolescents, families, and medical teams, since care rupture during adolescence can have functional and psychological consequences. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Recommending Research Profiles for Multidisciplinary Academic Collaboration

    Science.gov (United States)

    Gunawardena, Sidath Deepal

    2013-01-01

    This research investigates how data on multidisciplinary collaborative experiences can be used to solve a novel problem: recommending research profiles of potential collaborators to academic researchers seeking to engage in multidisciplinary research collaboration. As the current domain theories of multidisciplinary collaboration are insufficient…

  6. Dosimetry in Diagnostic Radiology for Paediatric Patients

    International Nuclear Information System (INIS)

    2013-01-01

    Concern about the radiation dose to children from diagnostic radiology examinations has recently been popularly expressed, particularly as related to computed tomography (CT) procedures. This involves the observation that children can receive doses far in excess of those delivered to adults, in part due to the digital nature of the image receptors that may give no warning to the operator of the dose to the patient. Concern for CT examinations should be extended to the broad range of paediatric diagnostic radiological procedures responsible for radiation doses in children, especially as factors, such as increased radiosensitivity and the longer life expectancy of children, increase the associated radiation risk. In all cases, owing to the added paediatric radiological examination factor of patient size and its associated impact on equipment selection, clinical examination protocol and dosimetric audit, the determination of paediatric dose requires a distinct approach from adult dosimetry associated with diagnostic radiological examinations. In response to this, there is a need to inform health professionals about standardized methodologies used to determine paediatric dose for all major modalities such as general radiography, fluoroscopy and CT. Methodologies for standardizing the conduct of dose audits and their use for the derivation and application of diagnostic reference levels for patient populations, that vary in size, are also required. In addition, a review is needed of the current knowledge on risks specific to non-adults from radiation, and also an analysis of the management of factors contributing to dose from paediatric radiological examinations. In 2007, the IAEA published a code of practice, Dosimetry in Diagnostic Radiology: An International Code of Practice, as Technical Reports Series No. 457 (TRS 457). TRS 457 recommends procedures for dosimetric measurement and calibration for the attainment of standardized dosimetry, and addresses requirements

  7. Medication communication between nurses and doctors for paediatric acute care: An ethnographic study.

    Science.gov (United States)

    Borrott, Narelle; Kinney, Sharon; Newall, Fiona; Williams, Allison; Cranswick, Noel; Wong, Ian; Manias, Elizabeth

    2017-07-01

    To examine how communication between nurses and doctors occurred for managing medications in inpatient paediatric settings. Communication between health professionals influences medication incidents' occurrence and safe care. An ethnographic study was undertaken. Semi-structured interviews, observations and focus groups were conducted in three clinical areas of an Australian tertiary paediatric hospital. Data were transcribed verbatim and thematically analysed using the Medication Communication Model. The actual communication act revealed health professionals' commitment to effective medication management and the influence of professional identities on medication communication. Nurses and doctors were dedicated to providing safe, effective medication therapy for children, within their scope of practice and perceived role responsibilities. Most nurses and junior doctors used tentative language in their communication while senior doctors tended to use direct language. Irrespective of language style, nurses actively engaged with doctors to promote patients' needs. Yet, the medical hierarchical structure, staffing and attendant expectations influenced communication for medication management, causing frustration among nurses and doctors. Doctors' lack of verbal communication of documented changes to medication orders particularly troubled nurses. Nurses persisted in their efforts to acquire appropriate orders for safe medication administration to paediatric patients. Collaborative practice between nurses and doctors involved complex, symbiotic relationships. Their dedication to providing safe medication therapy to paediatric patients facilitated effective medication management. At times, shortcomings in interdisciplinary communication impacted on potential and actual medication incidents. Understanding of the complexities affecting medication communication between nurses and doctors helps to ensure interprofessional respect for each other's roles and inherent demands

  8. Collaborative Economy

    DEFF Research Database (Denmark)

    things, de-industrialization processes and post-capitalist forms of production and consumption, postmaterialism, the rise of the third sector and collaborative governance. Addressing that gap, this book explores the character, depth and breadth of these disruptions, the creative opportunities for tourism...... that are emerging from them, and how governments are responding to these new challenges. In doing so, the book provides both theoretical and practical insights into the future of tourism in a world that is, paradoxically, becoming both increasingly collaborative and individualized. Table of Contents Preface 1.The......This book employs an interdisciplinary, cross-sectoral lens to explore the collaborative dynamics that are currently disrupting, re-creating and transforming the production and consumption of tourism. House swapping, ridesharing, voluntourism, couchsurfing, dinner hosting, social enterprise...

  9. Ischemic stroke in paediatrics - narrative review of the literature and two cases.

    Science.gov (United States)

    Klucka, Jozef; Stourac, Petr; Stoudek, Roman; Toukalkova, Michaela; Harazim, Hana; Kosinova, Martina; Stouracova, Alena; Mrlian, Andrej; Suk, Petr; Malaska, Jan

    2017-03-01

    Stroke is a rare condition in childhood with an estimated incidence of between 1.3-13/100.000 patients. Clinical manifestation and risk factors for paediatric stroke are different from those of adults. The uncommon incidence, age-associated difference and plethora of clinical symptoms make the diagnosis of such strokes extremely difficult and often delayed. The history and clinical examination should point to diseases or predisposing factors. Neuroimaging (DWI MR) is the golden standard for diagnosis of paediatric stroke and other investigations can be considered according to the clinical condition. Despite advances in paediatric stroke research and clinical care, questions remain unanswered regarding acute treatment, secondary prevention and rehabilitation. The treatment recommendations are mainly extrapolated from studies on adult populations. In the review authors summarized the clinical characteristics and diagnostic steps for stroke in children/adolescents based on the most recent international guidelines and practical directions for recognising and managing the child/adolescent with stroke in paediatric emergency. In the two case reports, we describe the clinical course in both stroke patients.

  10. Paediatric head injuries in the Kwazulu-Natal Province of South Africa: a developing country perspective.

    Science.gov (United States)

    Okyere-Dede, Ebenezer K; Nkalakata, Munyaradzi C; Nkomo, Tshepo; Hadley, G P; Madiba, Thandinkosi E

    2013-01-01

    We investigated the causes, management and outcome of head injuries in paediatric patients admitted to the paediatric surgery unit at King Edward VIII Hospital over a 3-year period, from 1999 to 2001. There were 506 patients (331 male; M:F ratio 2:1) and the mean age was 71.99 +36.8 months (2 weeks to 180 months). The injuries were due to: motor vehicle crashes (324); falls (121); assault (30); inadvertent injury (23); and unknown (11). Forty-nine patients (9%) were admitted with a Glasgow Coma Scale ≤8. The most common intracranial pathology on computed tomography was: intracranial haematoma/haemorrhage (44); contusion (16); and brain oedema (10). Nineteen patients (3.4%) underwent neurosurgical intervention and the rest were managed conservatively. Eighteen died in hospital (3.6%). The mean hospital stay was 5 ± 12 days. Twenty-three patients (4.5%) were discharged with neurological sequelae. Few paediatric patients are admitted with severe head injury: the majority from blunt injury caused by motor vehicle crashes. Management mainly requires simple neurological observation in a general ward with a surprisingly good prognosis. Specific protocols for paediatric head injuries have been proposed based on these findings.

  11. Professional and organizational commitment in paediatric occupational therapists: the influence of practice setting.

    Science.gov (United States)

    Seruya, Francine M; Hinojosa, Jim

    2010-09-01

    The professional and organizational commitment of paediatric occupational therapists working in two distinct practice settings, schools and medically based settings, was investigated. A web-based survey program was used to administer a questionnaire to occupational therapists employed in New York, New Jersey and Connecticut. The study employed social identity theory as a guiding perspective in understanding therapists' professional and organizational commitment. One hundred and fifty-seven paediatric therapists responded to the Professional Commitment Questionnaire and the Organizational Commitment Questionnaire to gauge their commitment to both the profession and their employing organizations. Results indicated that paediatric therapists, regardless of employment setting, have high professional commitment. Paediatric occupational therapists employed in medically based settings indicated statistically significant higher organizational commitment than their school-based counterparts. For therapists that work in school settings, the presence of a professional cohort did not influence professional commitment scores. As the study employed a web-based survey methodology, only individuals who were members of associations and had access to a computer and the Internet were able to participate. Further study might include widening the participant pool as well as adding additional instruments to explore both professional and organizational commitment on a more national scale. Copyright 2010 John Wiley & Sons, Ltd.

  12. Can drawing be considered a projective measure for children's distress in paediatric dentistry?

    Science.gov (United States)

    Aminabadi, Naser Asl; Ghoreishizadeh, Arezoo; Ghoreishizadeh, Mohammadali; Oskouei, Sina Ghertasi

    2011-01-01

    Several tools have been developed for the measurement of emotional status of the child in paediatric dental clinics including nonverbal self-report techniques. Subjective methods like drawing and Child Drawing: Hospital (CD:H) score have recently been applied in hospitalized children. Studies, however, have not attempted to analyse children's drawings as an aid to investigate the subjective feelings of children in paediatric dental settings. To assess drawing as a measure for child's distress in paediatric dental settings. Fifty-four children, aged 4-11 years, participated in this study. After finishing the first therapeutic session, the child was instructed to draw a picture of a person in a dental clinic. The pictures were scored using CD:H score sheet and the findings were compared with SEM and Frankl scores. CD:H was correlated with both Frankl (correlation coefficient = -0.550) and SEM (correlation coefficient = +0.483) scales (P Drawing is a useful measure of children's emotional status in dental settings in a way that is easier, familiar and more enjoyable for the child patient. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

  13. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    The thesis data have been collected in the EU-sponsored project: Collaborative Improvement Tool for the Extended Manufacturing Enterprise, CO-IMPROVE. In this project four universities (Denmark, Ireland, Italy, and The Netherlands), two software vendors (Greece and Sweden) and three companies...... (Denmark, Italy and The Netherlands) each with three to five suppliers were involved. The CO-IMPROVE project and the thesis is based on “action research” and “action learning”. The main aim of the whole project is through actual involvement and actions make the researchers, companies and selected suppliers...... learn how to improve operations in (hopefully) a win-win like manner through collaboration....

  14. [Efficacy of treatment with I(131) in paediatric Graves disease].

    Science.gov (United States)

    Enes Romero, P; Martín-Frías, M; de Jesús, M; Caballero Loscos, C; Alonso Blanco, M; Barrio Castellanos, R

    2014-01-01

    Radioiodine is an important therapeutic option in young patients with Grave's disease (GD). In the United States it is a widespread therapy, but in Europe its use in paediatrics is still controversial. To report our experience in radioiodine therapy of paediatric GD patients and analyse its effectiveness and safety. We retrospectively studied our paediatric population (de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Magnetic resonance imaging protocols for paediatric neuroradiology

    International Nuclear Information System (INIS)

    Saunders, Dawn E.; Thompson, Clare; Gunny, Roxanne; Jones, Rod; Cox, Tim; Chong, Wui Khean

    2007-01-01

    Increasingly, radiologists are encouraged to have protocols for all imaging studies and to include imaging guidelines in care pathways set up by the referring clinicians. This is particularly advantageous in MRI where magnet time is limited and a radiologist's review of each patient's images often results in additional sequences and longer scanning times without the advantage of improvement in diagnostic ability. The difficulties of imaging small children and the challenges presented to the radiologist as the brain develops are discussed. We present our protocols for imaging the brain and spine of children based on 20 years experience of paediatric neurological MRI. The protocols are adapted to suit children under the age of 2 years, small body parts and paediatric clinical scenarios. (orig.)

  16. Improving Treatment Response for Paediatric Anxiety Disorders

    DEFF Research Database (Denmark)

    Ege, Sarah; Reinholdt-Dunne, Marie Louise

    2016-01-01

    Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying psychopat......Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying...... interpretational biases, evidence regarding the effects of CBT on attentional biases is mixed. Novel treatment methods including attention bias modification training, attention feedback awareness and control training, and mindfulness-based therapy may hold potential in targeting attentional biases, and thereby...

  17. Paediatric doses from diagnostic radiology in Victoria

    International Nuclear Information System (INIS)

    Boal, T.J.; Cardillo, I.; Einsiedel, P.F.

    1998-01-01

    This study examines doses to paediatric patients from diagnostic radiology. Measurements were made at 29 hospitals and private radiology practices in the state of Victoria. Entrance skin doses in air were measured for the exposure factors used by hospital radiology departments and private radiology practices for a standard size 1, 5, 10 and 15 year old child, for the following procedures: chest AP/PA, lat; abdomen AP; pelvis AP; lumbar spine AP, lat; and skull AP, lat. There was a large range of doses for each particular procedure and age group. Factors contributing to the range of doses were identified. Guidance levels for paediatric radiology based on the third quartile value of the skin entrance doses have been recommended and are compared with guidance levels. Copyright (1998) Australasian Physical and Engineering Sciences in Medicine

  18. Action, prevention and epidemiology of paediatric obesity

    DEFF Research Database (Denmark)

    Lissau, Inge

    2005-01-01

    prevention studies, all of which are performed outside Denmark. Thus, this paper is not a classical review but rather a highlight of some aspects that the author finds important. The latest Danish national figures show a marked increase in the prevalence of obesity, especially among young men-a sevenfold...... regarding a national action plan against obesity. CONCLUSION: This paper highlights some important aspects of the epidemiology, prevention and actions in the field of paediatric obesity with special focus on Denmark.......UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...

  19. Alternative diagnoses at paediatric appendicitis MRI

    International Nuclear Information System (INIS)

    Moore, M.M.; Kulaylat, A.N.; Brian, J.M.; Khaku, A.; Hulse, M.A.; Engbrecht, B.W.; Methratta, S.T.; Boal, D.K.B.

    2015-01-01

    As the utilization of MRI in the assessment for paediatric appendicitis increases in clinical practice, it is important to recognize alternative diagnoses as the cause of abdominal pain. The purpose of this review is to share our institution's experience using MRI in the evaluation of 510 paediatric patients presenting with suspected appendicitis over a 30 month interval (July 2011 to December 2013). An alternative diagnosis was documented in 98/510 (19.2%) patients; adnexal pathology (6.3%, n = 32), enteritis–colitis (6.3%, n = 32), and mesenteric adenitis (2.2%, n = 11) comprised the majority of cases. These common entities and other less frequent illustrative cases obtained during our overall institutional experience with MRI for suspected appendicitis are reviewed

  20. Hand decontamination practices in paediatric wards

    Directory of Open Access Journals (Sweden)

    S Jelly

    2003-09-01

    Full Text Available The purpose of this study was to determine and describe hand decontamination practices of health care professionals in the paediatric wards of an academic hospital in Johannesburg. The purpose was addressed within a survey design and through the use of descriptive and comparative methods. Data were collected through direct observation conducted with the use of a researcher-administered checklist. A sample of sixtysix health professionals was obtained through convenience sampling.

  1. Osteoporosis in paediatric patients with spina bifida

    OpenAIRE

    Marreiros, Humberto; Loff, Clara; Calado, Eulalia

    2012-01-01

    The prevalence andmorbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective: To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state...

  2. Recent advances in paediatric respiratory medicine.

    Science.gov (United States)

    Turnbull, Andrew; Balfour-Lynn, Ian M

    2016-02-01

    This review highlights important advances in paediatric respiratory medicine since 2014, excluding cystic fibrosis. It focuses mainly on the more common conditions, bronchopulmonary dysplasia, bronchiolitis and preschool wheezing, asthma, pneumonia and sleep, and highlights some of the rarer conditions such as primary ciliary dyskinesia and interstitial lung disease (ILD). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Paediatric cervical spine injury but NEXUS negative

    OpenAIRE

    Maxwell, Melanie J; Jardine, Andrew D

    2007-01-01

    Cervical spine injuries in paediatric patients following trauma are extremely rare. The National Emergency X‐Radiography Utilization Study (NEXUS) guidelines are a set of clinical criteria used to guide physicians in identifying trauma patients requiring cervical spine imaging. It is validated for use in children. A case of a child who did not fulfil the NEXUS criteria for imaging but was found to have a cervical spine fracture is reported.

  4. Paediatric Virology in the Hippocratic Corpus

    Science.gov (United States)

    Mammas, Ioannis N.; Spandidos, Demetrios A.

    2016-01-01

    Hippocrates (Island of Kos, 460 B.C.-Larissa, 370 B.C.) is the founder of the most famous Medical School of the classical antiquity. In acknowledgement of his pioneering contribution to the new scientific field of Paediatric Virology, this article provides a systematic analysis of the Hippocratic Corpus, with particular focus on viral infections predominating in neonates and children. A mumps epidemic, affecting the island of Thasos in the 5th century B.C., is described in detail. ‘Herpes’, a medical term derived from the ancient Greek word ‘ἕρπειν’, meaning ‘to creep’ or ‘crawl’, is used to describe the spreading of cutaneous lesions in both childhood and adulthood. Cases of children with exanthema ‘resembling mosquito bites’ are presented in reference to varicella or smallpox infection. A variety of upper and lower respiratory tract viral infections are described with impressive accuracy, including rhinitis, pharyngitis, tonsillitis, laryngitis, bronchiolitis and bronchitis. The ‘cough of Perinthos’ epidemic, an influenza-like outbreak in the 5th century B.C., is also recorded and several cases complicated with pneumonia or fatal outcomes are discussed. Hippocrates, moreover, describes conjunctivitis, otitis, lymphadenitis, meningoencephalitis, febrile convulsions, gastroenteritis, hepatitis, poliomyelitis and skin warts, along with proposed treatment directions. Almost 2,400 years later, Hippocrates' systematic approach and methodical innovations can inspire paediatric trainees and future Paediatric Virology subspecialists. PMID:27446241

  5. Ocular involvement in paediatric haemolytic uraemic syndrome.

    Science.gov (United States)

    Sturm, Veit; Menke, Marcel N; Landau, Klara; Laube, Guido F; Neuhaus, Thomas J

    2010-11-01

    The aim of this study was to estimate the frequency and severity of ocular involvement in paediatric patients with haemolytic uraemic syndrome (HUS). The study was designed as an institutional, retrospective, observational case series. Charts for all 87 paediatric patients with HUS treated at the University Children's Hospital Zurich between 1995 and 2007 were reviewed. Patients with ocular involvement were identified and clinical findings presented. Three of 69 examined patients with HUS showed ocular involvement. Ophthalmic findings in two children were consistent with bilateral Purtscher retinopathy, showing multiple haemorrhages, exudations and superficial retinal whitening. The third child presented with bilateral isolated central intraretinal haemorrhages as a milder form of ocular involvement. In one of the children with Purtscher retinopathy, laser photocoagulation was required for bilateral rubeosis irides and development of disc neovascularization. Longterm outcomes in the two severely affected children showed decreased visual acuity caused by partial atrophy of the optic nerves. In the milder case visual acuity was not impaired at any time. A minority of paediatric patients with HUS developed ocular involvement. Acute ocular findings varied in severity from isolated intraretinal haemorrhages to Purtscher-like retinopathy with retinal ischaemia. Longterm complications included the development of neovascularizations and consecutive optic nerve atrophy. Although ocular involvement in HUS seems to be rare, physicians should be aware of this complication because of its possible vision-endangering consequences. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

  6. [The latest in paediatric resuscitation recommendations].

    Science.gov (United States)

    López-Herce, Jesús; Rodríguez, Antonio; Carrillo, Angel; de Lucas, Nieves; Calvo, Custodio; Civantos, Eva; Suárez, Eva; Pons, Sara; Manrique, Ignacio

    2017-04-01

    Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation. This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  7. Shortening the decade-long gap between adult and paediatric drug formulations: a new framework based on the HIV experience in low- and middle-income countries.

    Science.gov (United States)

    Penazzato, Martina; Lewis, Linda; Watkins, Melynda; Prabhu, Vineet; Pascual, Fernando; Auton, Martin; Kreft, Wesley; Morin, Sébastien; Vicari, Marissa; Lee, Janice; Jamieson, David; Siberry, George K

    2018-02-01

    Despite the coordinated efforts by several stakeholders to speed up access to HIV treatment for children, development of optimal paediatric formulations still lags 8 to 10 years behind that of adults, due mainly to lack of market incentives and technical complexities in manufacturing. The small and fragmented paediatric market also hinders launch and uptake of new formulations. Moreover, the problems affecting HIV similarly affect other disease areas where development and introduction of optimal paediatric formulations is even slower. Therefore, accelerating processes for developing and commercializing optimal paediatric drug formulations for HIV and other disease areas is urgently needed. The Global Accelerator for Paediatric Formulations (GAP-f) is an innovative collaborative model that will accelerate availability of optimized treatment options for infectious diseases, such as HIV, tuberculosis and viral hepatitis, affecting children in low- and middle-income countries (LMICs). It builds on the HIV experience and existing efforts in paediatric drug development, formalizing collaboration between normative bodies, research networks, regulatory agencies, industry, supply and procurement organizations and funding bodies. Upstream, the GAP-f will coordinate technical support to companies to design and study optimal paediatric formulations, harmonize efforts with regulators and incentivize manufacturers to conduct formulation development. Downstream, the GAP-f will reinforce coordinated procurement and communication with suppliers. The GAP-f will be implemented in a three-stage process: (1) development of a strategic framework and promotion of key regulatory efficiencies; (2) testing of feasibility and results, building on the work of existing platforms such as the Paediatric HIV Treatment Initiative (PHTI) including innovative approaches to incentivize generic development and (3) launch as a fully functioning structure. GAP-f is a key partnership example enhancing

  8. Contested collaboration

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.

    1995-01-01

    . The model describes design phases, roles, themes, and intergroup communication networks as they evolve throughout the design process and characterizes design as a process of "contested collaboration". It is a first step towards a predictive design model that suggests strategies which may help participants...

  9. Timeline Collaboration

    DEFF Research Database (Denmark)

    Bohøj, Morten; Borchorst, Nikolaj Gandrup; Bouvin, Niels Olof

    2010-01-01

    This paper explores timelines as a web-based tool for collaboration between citizens and municipal caseworkers. The paper takes its outset in a case study of planning and control of parental leave; a process that may involve surprisingly many actors. As part of the case study, a web-based timeline...

  10. Collaborative Appropriation

    DEFF Research Database (Denmark)

    Muller, Michael; Neureiter, Katja; Verdezoto, Nervo

    2016-01-01

    Previous workshops and papers have examined how individual users adopt and adapt technologies to meet their own local needs, by “completing design through use.” However, there has been little systematic study of how groups of people engage collaboratively in these activities. This workshop opens ...

  11. Scotland's GP paediatric scholarship: an evaluation.

    Science.gov (United States)

    MacVicar, Ronald; Borland, Lyndsey; McHale, Sharon; Goh, Dayeel; Potter, Alex

    2018-05-01

    In a previous publication we described the implementation and early evaluation of general practice paediatric scholarships in Scotland. We suggested that it was too early to be able to determine whether this significant investment will produce a return for Scotland in terms of enhanced roles in providing, leading or developing children's services in primary care or at the primary care/secondary care interface. This paper presents the results of a survey of the impact of the scholarship for the first six cohorts of the scholarship (119 General Practitioners). The response rate was 76%. Of the 90 respondents, almost half (44) have developed roles or areas of special paediatric interest either within or out with the practice, or in three cases both within and out with the practice. A total of 37 (43%) of those that continue to work within general practice reported that they have developed areas of special interest of benefit to the practice. Qualitative analysis of free text questions suggested that scholars had benefited from their experience in terms of increased confidence in dealing with child health problems, developing links with secondary care colleagues, and personal gain with respect to role development. What is already known in this area: Changes in GP Training have been suggested in order to provide a workforce that can meet the needs of infants, children and young people. Studies have shown a positive impact of paediatric trainees and GP trainees learning together. Little attention has however been given to the potential to support trained GPs to develop their expertise in child health. What this work adds: Early evaluation of the Scottish Paediatric Scholarship suggested a high degree of satisfaction. This more robust evaluation suggests that almost half (44/90 respondents) have developed roles or areas of special paediatric interest either within or out with the practice, or in three cases both within and out with the practice. Suggestions for future

  12. The pattern of paediatric blast injury in Afghanistan.

    Science.gov (United States)

    Thompson, Daniel C; Crooks, R J; Clasper, J C; Lupu, A; Stapley, S A; Cloke, D J

    2017-10-21

    Between 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults. A retrospective analysis was undertaken of prospectively collected data derived from the UK Joint Theatre Trauma Registry of ambulant paediatric (aged 2-15 years) admissions with blast injuries at the Role 3 Field Hospital, Camp Bastion from June 2006 to March 2013. The data set included demographic information, injury profile and severity (New Injury Severity Score) and operative findings. The pattern of injuries were investigated by looking at trends in the number and severity of injuries sustained by each body region. During this period, 295 admissions were identified, 76% of whom were male, with an overall mortality rate of 18.5%. The most common blast mechanism was an IED (68%) causing 80% of fatalities. The lower extremities were the most commonly injured body region, accounting for 31% of total injuries and occurring in 62% of cases. 24.3% of children between 2 and 7 years suffered severe head or neck injuries compared with 19.8% of children aged between 8 and 15 years. 34% of head injuries were rated unsurvivable and accounted for 88% of fatalities. 77% of cases required an operation with a mean operating time of 125 min. The most common first operations were debridement of soft tissues (50%), laparotomy (16%) and lower limb amputation (11%). Although paediatric blast casualties represented a small percentage of the overall workload at Camp Bastion Role 3 Medical Facility, the pattern of injuries seen suggests that children are more likely to sustain severe head, face and neck injuries than adults. © Article author

  13. Is clinical performance adversely affected by wearing gloves during paediatric peripheral intravenous cannulation?

    Science.gov (United States)

    Zhang, Michael; Lee, Mark; Knott, Susan

    2014-10-01

    To investigate if wearing protective gloves during paediatric intravenous cannulation affects performance of the procedure. This was a prospective observational study. Peripheral intravenous cannulation (PIVC) performed within the Paediatric ED was observed and recorded over a 12 month period. Data were compared between those clinicians wearing gloves and those not wearing gloves during PIVC. One thousand and twenty paediatric cannulations were recorded during the observed period. The mean age of the children was 5.79 years. The overall success rate of cannulation was 86.18% and first attempt success rate 76.08%. Overall, gloves were used by 54.31% of clinicians to establish vascular access; glove use was lowest in the registrar group (41.11% compliance rate). The glove-wearing group had comparable overall success rate of 85.74% (475/554) to the no-gloves group of 86.70% (404/466). The difference was not statistically significant (P > 0.05). Higher incidence of significant blood spillage during the procedure was observed among clinicians wearing no gloves (16.74%) in comparison with their glove-wearing counterparts (9.03%, P glove-wearing group and no-gloves group (3.94% vs 3.76%, P > 0.05). The present study shows that the use of protective gloves was not associated with adverse outcomes of clinical performance during paediatric cannulation. The low compliance rate of gloves use is alarming, and many clinicians might be exposed to potential blood-borne infections. Clinicians should be encouraged and supported to use gloves for paediatric cannulation. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Sudden death in paediatrics as a traumatic experience for critical care nurses.

    Science.gov (United States)

    Lima, Lígia; Gonçalves, Sandra; Pinto, Cândida

    2018-01-01

    Research shows that nurses working in critical care units and in particular, paediatric units, are at risk of developing symptoms of secondary traumatic stress (STS). However, little attention has been given to this phenomenon when associated with situations of sudden death in paediatrics. This study aimed to examine the impact of sudden death in paediatrics on nurses working in paediatrics critical care units and to explore nurses' experiences of this event. This study used a mixed-methods design. The Impact of Event Scale - Revised was used for investigating the presence of STS symptoms. In addition, an interview was conducted with six nurses. Fifty-seven percent of nurses responded to the surveys and six nurses were interviewed. The results showed that the sudden death of children and adolescents is an event that elicits symptoms of STS in nurses. The quantitative assessment, revealed that 19·4% presented total scores indicating high impact. The participants interviewed described experiences of subjective distress, such as intrusive thoughts, avoidance and hyperarousal. Other factors were also reported as influencing the experience of the sudden death of a child/adolescent, namely, the child's age, the cause of death and the family's reaction to the loss. According to the participants, the emotional impact was also determined by parenthood, previous training and professional experience. Sudden death in paediatric critical care units is one of the most difficult situations in nursing practice and elicits STS symptoms, which may severely impact the physical and psychological health of nurses and ultimately affect the quality of the provided care. This study emphasizes the need for promoting better conditions for professional practice, namely, with regard to emotional support, as well as training programmes for skills development in the area of management of traumatic situations and of communication with clients. © 2017 British Association of Critical Care

  15. Investigating Face-to-Face Peer Interaction Patterns in a Collaborative Web Discovery Task: The Bene?ts of a Shared Display

    Science.gov (United States)

    Chung, C-W.; Lee, C-C.; Liu, C-C.

    2013-01-01

    Mobile computers are now increasingly applied to facilitate face-to-face collaborative learning. However, the factors affecting face-to-face peer interactions are complex as they involve rich communication media. In particular, non-verbal interactions are necessary to convey critical communication messages in face-to-face communication. Through…

  16. The International Collaboration for Autism Registry Epidemiology (iCARE): Multinational Registry-Based Investigations of Autism Risk Factors and Trends

    Science.gov (United States)

    Schendel, Diana E.; Bresnahan, Michaeline; Carter, Kim W.; Francis, Richard W.; Gissler, Mika; Grønborg, Therese K.; Gross, Raz; Gunnes, Nina; Hornig, Mady; Hultman, Christina M.; Langridge, Amanda; Lauritsen, Marlene B.; Leonard, Helen; Parner, Erik T.; Reichenberg, Abraham; Sandin, Sven; Sourander, Andre; Stoltenberg, Camilla; Suominen, Auli; Surén, Pål; Susser, Ezra

    2013-01-01

    The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in…

  17. Improving Engineering Student Team Collaborative Discussions by Moving Them Online: An Investigation of Synchronous Chat and Face-to-Face Team Conversations

    Science.gov (United States)

    Fowler, Robin Revette

    2014-01-01

    Collaborative learning, particularly in the context of team-based, project-based learning, is common in undergraduate engineering education and is associated with deeper learning and enhanced student motivation and retention. However, grouping students in teams for project-based learning sometimes has negative outcomes, which can include lowered…

  18. Survey on paediatric tumour boards in Europe: current situation and results from the ExPo-r-Net project.

    Science.gov (United States)

    Juan Ribelles, A; Berlanga, P; Schreier, G; Nitzlnader, M; Brunmair, B; Castel, V; Essiaf, S; Cañete, A; Ladenstein, R

    2018-01-08

    Under the ExPO-r-NeT project (European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment), we aimed to identify paediatric oncology tumour boards in Europe to investigate the kind of technologies and logistics that are in place in different countries and to explore current differences between regions. A 20-question survey regarding several features of tumor boards was designed. Data collected included infrastructure, organization, and clinical decision-making information from the centres. The survey was distributed to the National Paediatric Haematology and Oncology Societies that forwarded the survey to the sites. For comparative analysis, respondents were grouped into four geographical regions. The questionnaire was distributed amongst 30 countries. Response was obtained from 23 (77%) that altogether have 212 paediatric oncology treating centres. A total of 121 institutions answered (57%). Ninety-one percent of the centres hold multidisciplinary boards; however, international second consultations are performed in 36% and only 15% participate on virtual tumor boards. Videoconferencing facilities and standard operational procedures (SOPs) are available in 49 and 43% of the centres, respectively. There were statistically significant differences between European regions concerning meeting infrastructure and organization/logistics: specific room, projecting equipment, access to medical records, videoconferencing facilities, and existence of SOPs. Paediatric tumor boards are a common feature in Europe. To reduce inequalities and have equal access to healthcare, a virtual network is needed. Important differences on the functioning and access to technology between regions in Europe have been observed and need to be addressed.

  19. Work stress, occupational burnout and depression levels: a clinical study of paediatric intensive care unit nurses in Taiwan.

    Science.gov (United States)

    Lin, Tzu-Ching; Lin, Huey-Shyan; Cheng, Su-Fen; Wu, Li-Min; Ou-Yang, Mei-Chen

    2016-04-01

    This study aimed to examine the relationship between work stress and depression; and investigate the mediating effect of occupational burnout among nurses in paediatric intensive care units. The relationships among work stress, occupational burnout and depression level have been explored, neither regarding occupational burnout as the mediating role that causes work stress to induce depression nor considering the paediatric intensive care unit context. A cross-sectional correlational design was conducted. One hundred and forty-four female paediatric intensive care unit nurses from seven teaching hospitals in southern Taiwan were recruited as the participants. Data were collected by structured questionnaires including individual demographics, the Nurse Stress Checklist, the Occupational Burnout Inventory and the Taiwan Depression Questionnaire. The results indicated that after controlling for individual demographic variables, the correlations of work stress with occupational burnout, as well as work stress and occupational burnout with depression level were all positive. Furthermore, occupational burnout may exert a partial mediating effect on the relationship between work stress and depression level. This study provides information about work stress, occupational burnout and depression level, and their correlations, as well as the mediating role of occupational burnout among paediatric intensive care unit nurses. It suggests government departments and hospital administrators when formulating interventions to prevent work stress and occupational burnout. These interventions can subsequently prevent episodes of depression in paediatric intensive care unit nurses, thereby providing patients with a safe and high-quality nursing environment. © 2016 John Wiley & Sons Ltd.

  20. The impact of legislation on drug substances used off-label in paediatric wards--a nationwide study.

    Science.gov (United States)

    Haslund-Krog, Sissel; Mathiasen, René; Christensen, Hanne Rolighed; Holst, Helle

    2014-04-01

    This nationwide study is aimed at describing to what extent the European Paediatric Regulation has met therapeutic needs in children. Data for each drug substance in defined daily doses (DDD) were extracted from the national Danish data base. We evaluated if drug substances were used off-label and whether they had a paediatric investigation plan (PIP). This study did not include drug prescriptions for individual paediatric patients; thus, it was not possible to make use of all off-label categories previously used. Additionally, paediatric standard assortments (SA) were compared to the European survey on paediatric medicinal products. Thirteen percent of the 100 most used drug substances were determined as being used off-label, four of which had a PIP and one had a full waiver. Only one of the three drug substances used off-label most often, accounting for 85 % of such use, had a PIP. Neonates were included in one-third of PIPs and adolescents in 15. Nineteen out of 21 PIPs had a waiver and 14 PIPs were deferred. In line with the European survey, carbapenems, corticosteroids and proton pump inhibitors were frequent found in SAs. PIPs only cover a small proportion of the drugs found to be used off-label in this study. Despite waivers granted, drug substances were used nonetheless. Unmet regulatory needs are still considerable in some therapeutic areas in neonates as well as in children.

  1. Care dependency of hospitalized children: testing the Care Dependency Scale for Paediatrics in a cross-cultural comparison.

    Science.gov (United States)

    Tork, Hanan; Dassen, Theo; Lohrmann, Christa

    2009-02-01

    This paper is a report of a study to examine the psychometric properties of the Care Dependency Scale for Paediatrics in Germany and Egypt and to compare the care dependency of school-age children in both countries. Cross-cultural differences in care dependency of older adults have been documented in the literature, but little is known about the differences and similarities with regard to children's care dependency in different cultures. A convenience sample of 258 school-aged children from Germany and Egypt participated in the study in 2005. The reliability of the Care Dependency Scale for Paediatrics was assessed in terms of internal consistency and interrater reliability. Factor analysis (principal component analysis) was employed to verify the construct validity. A Visual Analogue Scale was used to investigate the criterion-related validity. Good internal consistency was detected both for the Arabic and German versions. Factor analysis revealed one factor for both versions. A Pearson's correlation between the Care Dependency Scale for Paediatrics and Visual Analogue Scale was statistically significant for both versions indicating criterion-related validity. Statistically significant differences between the participants were detected regarding the mean sum score on the Care Dependency Scale for Paediatrics. The Care Dependency Scale for Paediatrics is a reliable and valid tool for assessing the care dependency of children and is recommended for assessing the care dependency of children from different ethnic origins. Differences in care dependency between German and Egyptian children were detected, which might be due to cultural differences.

  2. Radiological patterns of pulmonary tuberculosis in the paediatric age group

    International Nuclear Information System (INIS)

    Lamont, A.C.; Cremin, B.J.; Pelteret, R.M.; Cape Town Univ.

    1986-01-01

    The radiological patterns of culture-proven pulmonary tuberculosis in 154 children under the age of 14 years were studied. Good quality radiographs were an essential requirement to the study, and in cases where lymphadenopathy was in doubt, tomograms or high kV magnification films were obtained. The radiographical terms used were defined and the results of film review were analysed to show the prevalent patterns. These are summarized at the end of the article. It is felt that awareness of the radiographic patterns in paediatric pulmonary tuberculosis will be of value of those working in communities where tuberculosis is unusual or rare, in immigrant communities, and also for the investigation of children who are inadvertently exposed to the disease. (orig.)

  3. Pseudomonas aeruginosa diversity in distinct paediatric patient groups

    DEFF Research Database (Denmark)

    Tramper-Stranders, G.A.; Ent, C.K. van der; Wolfs, T.F.

    2008-01-01

    the other groups. A group of clonal isolates was observed among patients from the CF-chronic and CF-1 groups. These or different clonal isolates were not encountered among the three other patient groups. No characteristic resistance pattern could be identified among isolates from the distinct patient groups......Pseudomonas aeruginosa is a pathogen that often infects patients who are either immunocompromised or have local defects in host defences. It is known that cystic fibrosis (CF) patients are sometimes infected with certain clonal isolates. It is not clear whether these clonal isolates also infect non......-CF patients and whether clonality of isolates occurs in other patient groups. The aim of this study was to investigate P. aeruginosa diversity and the occurrence of clones within five distinct paediatric patient groups susceptible to P. aeruginosa infection. P. aeruginosa isolates were cultured from 157...

  4. The effect of adaptive statistical iterative reconstruction on the assessment of diagnostic image quality and visualisation of anatomical structures in paediatric cerebral CT examinations

    International Nuclear Information System (INIS)

    Larsson, Joel; Baath, Magnus; Thilander-Klang, Anne; Ledenius, Kerstin

    2016-01-01

    The purpose of this study was to investigate the effect of adaptive statistical iterative reconstruction (ASiR) on the visualisation of anatomical structures and diagnostic image quality in paediatric cerebral computed tomography (CT) examinations. Forty paediatric patients undergoing routine cerebral CT were included in the study. The raw data from CT scans were reconstructed into stacks of 5 mm thick axial images at various levels of ASiR. Three paediatric radiologists rated six questions related to the visualisation of anatomical structures and one question on diagnostic image quality, in a blinded randomised visual grading study. The evaluated anatomical structures demonstrated enhanced visibility with increasing level of ASiR, apart from the cerebrospinal fluid space around the brain. In this study, 60 % ASiR was found to be the optimal level of ASiR for paediatric cerebral CT examinations. This shows that the commonly used 30 % ASiR may not always be the optimal level. (authors)

  5. Collaborative Consumption

    OpenAIRE

    Rahbek Gjerdrum Pedersen, Esben; Netter, Sarah

    2013-01-01

    Purpose: The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach: The analysis is based on a multiple-­‐‑case study of Scandinavian fashion libraries – a new, clothes-­‐‑sharing concept that has emerged as a fashion niche within the last decade. Findings: It is concluded that fashion libraries offers interesting perspectives, e.g. by allow...

  6. Collaborative sketching

    DEFF Research Database (Denmark)

    Johansson, Martin Wetterstrand

    2006-01-01

    Sketching is a most central activity with in most design projects. But what happens if we adopt the ideas of collaborative design and invite participants that are not trained to sketch in to the design process, how can they participate in this central activity? This paper offers an introduction to...... the design material has been used to co- author possible futures within the scope of design sessions....

  7. HIV infection, tuberculosis and workload in a general paediatric ward

    African Journals Online (AJOL)

    South African Journal of Child Health ... To describe the impact of HIV infection and tuberculosis on the workload of a general paediatric ward at Red Cross War Memorial Children's Hospital in 2007. Methods. Prospective descriptive surveillance of the patient composition of a general paediatric ward over a 1-year period.

  8. Caring for paediatric patient as to broaden radiography spectrum

    International Nuclear Information System (INIS)

    Atiti, J.S.M.

    2006-01-01

    The paediatric patient is a special group of patients in the hospital set up. thus their special needs contribute to about 75% of quality imaging services offered. Age, Psychological aspects, parents participation, departmental atmosphere and environmental make them special. this presentation aims at installing into Imaging Technologies a sense of Responsibility for purpose of improving the resultant quality of Imaging services offered to paediatrics

  9. The practice of paediatric cardiology in Nigeria: A Review | Chinawa ...

    African Journals Online (AJOL)

    Background: The practice of Paediatric cardiology in Nigeria is at its early phase and it is being choked in an environment overwhelmed with economic, ethnic and political issues. Paediatric cardiology covers a broad area of medicine. This includes diagnosis, medical treatment, interventional cardiology, prenatal diagnosis ...

  10. Use of Zoledronic Acid in Paediatric Craniofacial Fibrous Dysplasia

    Directory of Open Access Journals (Sweden)

    Chiara Di Pede

    2016-01-01

    Full Text Available We describe a case of a paediatric patient affected by mandibular fibrous dysplasia (FD with severe and chronic pain who was successfully treated with zoledronic acid (ZOL: a third-generation bisphosphonate. Further research is needed to assess its safety and efficacy as a treatment option for FD in the paediatric population.

  11. The undergraduate paediatric surgery curriculum in Nigeria – how ...

    African Journals Online (AJOL)

    This study aimed to: (i) identify main objectives of paediatric surgery at he undergraduate level; (ii) establish students' knowledge with regard to these objectives; (iii) evaluate the input of both specialists and non-specialists to these objectives; and (iv) examine the status of undergraduate paediatric surgery instruction in our ...

  12. A review of paediatric anaesthetic-related mortality, serious adverse ...

    African Journals Online (AJOL)

    Keywords: mortality, outcomes, paediatric anaesthesia, perioperative, risks. Introduction ... informed decisions on patient care.2,17,18 ... use of a case mix and institutional audit with a small sample size.2,27,28, ..... Anesthesia safety: model or myth? .... Thomas J. Paediatric anaesthesia: a risky business?: guest editorial. S.

  13. Pattern of Paediatric Trauma in North Western Nigeria | Mungadi ...

    African Journals Online (AJOL)

    Socio-economic emancipation, intra-city traffic considerations, abrogation of child labour and provision of adequate water supply should reduce these accidents. Trauma prevention and care programme in developing countries should always address paediatric injuries. KEY Words: Paediatric, Trauma, North Western, ...

  14. Impact of the learning environment on career intentions of paediatric ...

    African Journals Online (AJOL)

    training on career intentions, specifically in terms of paediatrics, in a ... SA paediatric interns work in an environment with a high ... already challenging learning environment (LE) for interns. ... doctors during internship may influence career trajectories in a direction that is discordant with .... Cronbach's alpha for the teaching,.

  15. Weight-band dosing tables: simplifying paediatric art | Nuttall ...

    African Journals Online (AJOL)

    One of the obstacles to scaling up paediatric antiretroviral therapy (ART) coverage in resource-limited settings is the relative complexity of paediatric dosing. There is a need to simplify ART in order to facilitate treatment initiation and ongoing management of infants and children by health care providers, as well as to support ...

  16. Exciting times: Towards a totally minimally invasive paediatric urology service

    OpenAIRE

    Lazarus, John

    2011-01-01

    Following on from the first paediatric laparoscopic nephrectomy in 1992, the growth of minimally invasive ablative and reconstructive procedures in paediatric urology has been dramatic. This article reviews the literature related to laparoscopic dismembered pyeloplasty, optimising posterior urethral valve ablation and intravesical laparoscopic ureteric reimplantation.

  17. An audit of paediatric intussusception radiological reduction at the ...

    African Journals Online (AJOL)

    Methods. This retrospective analytic cohort study assessed data from the records of all paediatric patients with the diagnosis of idiopathic intussusception discharged from the Department of Paediatric Surgery between 1 January 2003 and 30 September 2011. Results. Thirty-five children with intussusception were identified.

  18. Future career intentions of higher specialist trainees in general Paediatrics.

    Science.gov (United States)

    Butler, Grainne; Breatnach, Colm; Harty, Sinead; Gavin, Patrick; O'Donnell, Colm; O'Grady, Michael J

    2018-03-27

    A survey of paediatric higher specialist trainees was carried out in 2002 assessing career intentions and perception of training. Fourteen years later, with increased numbers of trainees and a national model of care and a tertiary paediatric hospital on the horizon, we re-evaluated the career intentions of the current trainee workforce. To assess the career intentions of the current paediatric higher specialist trainees. A 28-item questionnaire was developed based on a previously validated instrument and distributed online using the Royal College of Physicians of Ireland trainee database. We distributed the questionnaire to 118 eligible trainees and received responses from 92 (78%). Seventy-nine (86%) respondents desire a consultant post in Ireland. Seventy-five (82%) indicated that their preferred consultant post location was in a tertiary paediatric centre. Sixty-two trainees (67%) intend to become subspecialists with 25 (27%) planning a career in general paediatrics. This contrasts with the 2002 survey when 76% wished to work in urban centres and 61% of trainees planned a career in general paediatrics. There appears to be a mismatch between the career goals of the future paediatric consultant workforce and the requirements for staffing paediatric units nationally. This has the potential to complicate the proposed expansion of general paediatricians in regional centres and result in a significant proportion of current trainees failing to secure a post in their desired location.

  19. The paediatric surgeon and his working conditions in Francophone ...

    African Journals Online (AJOL)

    Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA) and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1st May to 30th October 2008. The African Society of paediatric ...

  20. Monitoring of rotavirus infection in a paediatric hospital by RNA ...

    African Journals Online (AJOL)

    During the spring of 1987 and the autumn of 1988, stool specimens were collected from infants and young children in the paediatric unit at H. F. Verwoerd Hospital, Pretoria, and examined for the presence of rotaviruses to assess the potential for hospital-acquired infection in the paediatric wards. Stool samples were also ...

  1. SAMJ Monitoring of rotavirus infection in a paediatric hospital by ...

    African Journals Online (AJOL)

    During the spring of 1987 and the autumn of 1988, stool specimens were collected from infants and young children in the paediatric unit at H. F. Verwoerd Hospital, Pretoria, and examined for the presence of rotaviruses to assess the potential for hospital-acquired infection in the paediatric wards. Stool samples were also ...

  2. Paediatric fever management: continuing education for clinical nurses.

    Science.gov (United States)

    Walsh, Anne M; Edwards, Helen E; Courtney, Mary D; Wilson, Jenny E; Monaghan, Sarah J

    2006-01-01

    This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. Fifty-one nurses from medical wards in an Australian metropolitan paediatric hospital completed a self-report descriptive survey. Knowledge of fever management was mediocre (Mean 12.4, SD 2.18 on 20 items). Nurses practicing at a higher level and those with between one and four years paediatric or current experience were more knowledgeable than novices or more experienced nurses. Negative beliefs that would impact nursing practice were identified. Interestingly, beliefs about fever, antipyretic use in fever management and febrile seizures were similar; they were not influenced by nurses' knowledge, experience, education or level of practice. Paediatric nurses are not expert fever managers. Knowledge deficits and negative attitudes influence their practice irrespective of additional paediatric education, paediatric or current experience or level of practice. Continuing education is therefore needed for all paediatric nurses to ensure the latest clear evidence available in the literature for best practice in fever management is applied.

  3. A practical approach to anaesthesia for paediatric liver transplantation

    African Journals Online (AJOL)

    A practical approach to anaesthesia for paediatric liver transplantation. Jenny Thomas, M McCulloch, W Spearman, T Butt, A Numanoglu ... In more recent years, the use of reduced size and living related organs has increased the donor pool for infants and children. Paediatric liver transplantation in South Africa, up until the ...

  4. A comparison of paediatric dentists' and general dental practitioners' care patterns in paediatric dental care

    NARCIS (Netherlands)

    Schorer-Jensma, M.A.; Veerkamp, J.S.J.

    2010-01-01

    AIM: The aim of this study was to compare the care patterns of paediatric dentists and general dentists in the dental treatment of children in the Netherlands. STUDY DESIGN AND METHODS: A case control study was completed based on the financial records of one of the largest Dutch health insurance

  5. Paediatric neuro-imaging: Diagnosis

    Directory of Open Access Journals (Sweden)

    S.K. Misser

    2013-06-01

    Full Text Available We congratulate Professor Savvas Andronikou of the Department of Radiology, University of Pretoria, for his spot-on diagnosis, for which he receives the award of R1 000 from the RSSA. Dr Misser elaborates below on the images and findings. Please refer to page 45 of the March 2013 issue of the SAJR for the investigative images.

  6. Pancreaticoduodenectomy in children: optimising outcome of uncommon paediatric procedures.

    LENUS (Irish Health Repository)

    Yeap, B H

    2012-02-01

    Contemporary surgical practice is increasingly dominated by subspecialisation in response to improved outcome from high volume centres, though uncertainties persist for uncommon paediatric procedures. Three paediatric pancreaticoduodenectomies performed at Our Lady\\'s Children\\'s Hospital, Dublin, over a period of 9 years were evaluated to substantiate their continuing performance by paediatric rather than adult pancreatic surgeons. With ages ranging from 18 months to 8 years old, the mean operating time was 263 minutes, while the average hospital stay was 12 days. There was no perioperative mortality, although complication rate was 100%. Re-operation was required in 33%. The long term outcome of this small paediatric cohort was comparable to adult series despite the low patient accrual, underscoring the advantages of a multidisciplinary approach afforded by tertiary paediatric institutions for intricate yet infrequent operations in children.

  7. The value of postmortem computed tomography in paediatric natural cause of death : a Dutch observational study

    OpenAIRE

    Van Rijn, Rick R.; Beek, Erik J.; van de Putte, Elise M.; Teeuw, Arianne H.; Nikkels, Peter G.J.; Duijst, Wilma L.J.M.; Nievelstein, Rutger Jan A.

    2017-01-01

    Background Postmortem CT is a relatively new field of interest within paediatric radiology. This paper focusses on its value in cases of unexpected natural death. Objective We report on an observational Dutch study regarding the value of postmortem CT in children with an assumed natural unexpected death because postmortem CT is part of the Dutch NODO (additional investigations of cause of death) procedure. Materials and methods We included consecutive children who fulfilled criteria for the N...

  8. Learning to diagnose using patient video case in paediatrics: perceptive and cognitive processes

    OpenAIRE

    Balslev, Thomas

    2012-01-01

    Thomas Balslev, a paediatric neurologist and educational researcher, defended his thesis on 24 November 2011. The thesis included five published papers, and investigated learning with authentic, brief patient video cases. With analysis of a video case in a small group, learning processes and sharing of knowledge was intensely stimulated. Small group discussion and subsequent listening to an expert’s think-aloud were particularly effective approaches to enhance diagnostic accuracy among non-ex...

  9. Peer Teaching in der Pädiatrie - Evaluation eines studentischen Tutoriats im Blockpraktikum Kinderheilkunde [Peer Teaching in Paediatrics - Medical Students as Learners and Teachers on a Paediatric Course

    Directory of Open Access Journals (Sweden)

    Karay, Yassin

    2010-11-01

    Full Text Available [english] Background: Peer assisted learning is known as an effective educational strategy in medical teaching. We established a peer assisted teaching program by student tutors with a focus on clinical competencies for students during their practical training on paediatric wards. It was the purpose of this study to investigate the effects of a clinical skills training by tutors, residents and consultants on students evaluations of the teaching quality and the effects of a peer teaching program on self assessed clinical competencies by the students.Methods: Medical student peers in their 6 year were trained by an intensive instruction program for teaching clinical skills by paediatric consultants, doctors and psychologists. 109 students in their 5 year (study group participated in a peer assisted teaching program for training clinical skills in paediatrics. The skills training by student peer teachers were supervised by paediatric doctors. 45 students (control group participated in a conventional paediatric skills training by paediatric doctors and consultants. Students from both groups, which were consecutively investigated, completed a questionnaire with an evaluation of the satisfaction with their practical training and a self assessment of their practical competencies. Results: The paediatric skills training with student peer teachers received significantly better ratings than the conventional skills training by paediatric doctors concerning both the quality of the practical training and the support by the teaching medical staff. Self assessed learning success in practical skills was higher rated in the peer teaching program than in the conventional training. Conclusions: The peer assisted teaching program of paediatric skills training was rated higher by the students regarding their satisfaction with the teaching quality and their self assessment of the acquired skills. Clinical skills training by student peer teachers have to be supervised

  10. Evaluating paediatric brain injury services in NSW.

    Science.gov (United States)

    Badge, H; Hancock, J; Waugh, M-C

    2010-01-01

    Rehabilitation professionals strive to provide high-quality evidence-based services for children. Developing systems to measure and monitor the benefits of our services, and health outcomes for children is complex and challenging. The Community Outcome Project aims to introduce systematic outcome measurement across the network of paediatric community-based brain injury services within the New South Wales Brain Injury Rehabilitation Program (BIRP) to support clinical practice and service evaluation. A literature review informed the development of the evaluative framework and identified available paediatric outcome measures which may be appropriate. Extensive consultation with clinicians supported project planning and identified clinical priorities that the outcome measures needed to capture. Outcome measures were shortlisted by matching them to identified clinical priorities, and then trialled in clinical practice. Qualitative feedback regarding clinical utility and feasibility was obtained from clinical staff. The process has utilized change management strategies to ensure the success of the project and keep staff engaged. The process identified the three main clinical priorities for outcome measurement - family functioning, school performance and participation. Three outcome measures were chosen for the pilot project that is currently underway. They are Family Burden of Injury Interview, Academic Competence and Evaluation Scales and Child and Adolescent Scale of Participation. Plans for analyses of outcome data within the paediatric BIRP services are discussed. Extensive preparation is required to optimize staff engagement in a project that systematically introduces outcome measures that are useful to clinicians, clients and service providers. Managing the change required is a key focus of the project. Benefits and costs to clinicians and services will be discussed.

  11. Voluntary Informed Consent in Paediatric Oncology Research.

    Science.gov (United States)

    Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M

    2016-07-01

    In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. © 2015 John Wiley & Sons Ltd.

  12. Texting preferences in a Paediatric residency.

    Science.gov (United States)

    Draper, Lauren; Kuklinski, Cadence; Ladley, Amy; Adamson, Greg; Broom, Matthew

    2017-12-01

    Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. A prospective study with paediatrics and internal medicine-paediatrics residents. Residents were divided into subgroups: adolescent medicine (AM) and developmental medicine (DM). Messages were derived from ITE questions and sent Monday-Friday with a 20 per cent variance in messages specific to the sub-group. Residents completed surveys gauging perceptions of the programme, and pre- and post-programme ITE scores were analysed. Forty-one residents enrolled and 32 (78%) completed a post-programme survey. Of those, 21 (66%) preferred a Q&A format with an immediate text response versus information-only texts. The percentage change in ITE scores between 2013 and 2014 was significant. Comparing subgroups, there was no significant difference between the percentage change in ITE scores. Neither group performed significantly better on either the adolescent or developmental sections of the ITE. Text messaging… remains an underused educational tool CONCLUSIONS: Overall, participants improved their ITE scores, but no improvement was seen in the targeted subgroups on the exam. Although Q&A texts are preferred by residents, further assessment is required to assess the effect on educational outcomes. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  13. High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

    NARCIS (Netherlands)

    Morsing, IE; Tinnevelt, Marcel; Jansen, Nicolaas J.G.; Koomen, E

    2015-01-01

    High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation

  14. MIH: epidemiologic clinic study in paediatric patient.

    Science.gov (United States)

    Condò, R; Perugia, C; Maturo, P; Docimo, R

    2012-04-01

    The Molar Incisor Hypomineralization (MIH) is a qualitative and quantitative defect of the enamel structure of the first permanent molars, which may vary from 1 to 4 with involvement of maxillary and jaw permanent incisors. AIM.: Aim of this study is that to evaluate, among 1500 paediatric patients chosen at random aged between 0 and 14 years, afferent by the Paediatric Dentistry of the Azienda Ospedialiera Policlinico Tor Vergata of Rome from 1996 to 2011, the incidents and the prevalence of the MIH distribution, and furthermore to ascertain the possible relationship with the data described in the literature. RESULTS AND DISCUSSION.: From the sample of 1500 paediatric patients, the number of those affections from MIH has turned out to be pairs to 110 (7.3%) aged between 4 and 15 years, and an average age equal to 9.7. The incidence of the hypoplastic defects is greater in the elements of the permanents series in which the functional class mainly interested is that of the first molars, with a percentage of 39.8%. Regarding the elements of the deciduous series affections from hypoplasia, they turn out to be in all in number of 20 represented in 80% of the cases from the seconds molars while in the remaining 20% of the cases the items involved are the central incisors. About the percentage of elements involved in the MIH: the molars, involved with a frequency of 56%, turn out to be more hit regarding incisors (44%). As reported in the literature, it can be asserted that the MIH can hit in equal measure both the male sex that feminine one. CONCLUSIONS.: MIH represents a condition quite frequent in the paediatric population. In managing this anomaly takes an essential role in the early diagnosis and in the differential one. The study done underlined the importance of a correct application of the therapeutic protocol which, starting from a careful diagnosis and articulating themselves in the execution of preventive treatments and in severe cases restorative and

  15. Summarized institutional experience of paediatric airway surgery†.

    Science.gov (United States)

    Hoetzenecker, Konrad; Schweiger, Thomas; Schwarz, Stefan; Roesner, Imme; Leonhard, Matthias; Denk-Linnert, Doris-Maria; Schneider-Stickler, Berit; Bigenzahn, Wolfgang; Klepetko, Walter

    2016-04-01

    The management of paediatric airway stenosis is complex, and requires a dedicated team, consisting of thoracic surgeons, phoniatricians, logopaedics, paediatricians and anaesthetists. The majority of paediatric laryngotracheal stenosis is a sequela of prematurity and prolonged post-partal intubation/tracheostomy. Surgical correction is often difficult due to a frequent combination of glottic and subglottic defects. In 2012, the Laryngotracheal Program Vienna was launched. Since then, 18 paediatric patients were surgically treated for (laryngo-)tracheal problems. The median age of our patients was 26 months (range 2-180 months). Laryngotracheal stenosis extending up to the level of the vocal cords was evident in 9 patients. Three children were diagnosed with an isolated subglottic, and four with a short-segment tracheal stenosis or malacia. Two patients had a long-segment congenital malformation together with vascular ring anomalies. Five children were pretreated by rigid endoscopy before surgical correction, 12 of our 18 patients had a tracheostomy, 3 children were intubated at the time of operation. Different techniques of corrections were applied: laryngotracheal reconstruction (n = 4), extended partial cricotracheal resection (n = 4), cricotracheal resection with or without anterior split or dorsal mucosal flap (n = 4), slide tracheoplasty (n = 2), tracheal resection (n = 4). In 8 patients, a rib cartilage interposition was necessary in order to obtain a sufficient lumen enlargement and in 7 of these patients, an LT-Mold was placed to stabilize the reconstruction. We lost 2 patients, who were referred to our institution after failure of multiple preceding interventions, 2 and 3 months after the operation. Twelve patients are currently in an excellent condition, one is in an acceptable condition without a need for an intervention. Two patients required an endoscopic reintervention 18 and 33 months after the operation, 1 child is currently still cannulated

  16. Myroides Species in a Paediatric Burn Patient

    Directory of Open Access Journals (Sweden)

    Sevda Soydan

    2017-11-01

    Full Text Available Members of the genus Myroides are non-motile, Gram negative bacteria that are mostly found in environmental sources such as soil and water. They are not a part of human flora. For a long time they were evaluated as low grade opportunistic pathogens causing infections in immunocompromised patients whereas a few life-threatening infections were reported in immunocompetent individuals due to Myroides species. The child having a 64% of total body surface area burn was admitted to the burn unit. Myroides spp. was isolated first in urine culture then in blood culture. This is the first time Myroides spp. is reported in a paediatric patient with serious burn.

  17. Collaborative Care

    OpenAIRE

    Schuyler, Dean

    2005-01-01

    本書を著したHornbyは英国のソーシャルワーカーである。彼女は1983年に「Collaboration in social work(Journal of social work practice,1.1)」を発表し、ソーシャルワークでの職種間の連携の重要性について報告している。さらに1993年に発刊した本書では、同一機関内の人間関係 ...

  18. Archaeogeophysical data acquisition and analysis at Tel Burna, Israel: a valuable opportunity for ongoing ground-truth investigation and collaboration (Invited)

    Science.gov (United States)

    Pincus, J. A.

    2013-12-01

    , acquired in a zigzag east-west direction, proceeding south. The area extended from the present excavation border to the north and east. The following paper will discuss the method of data acquisition, post-processing, and analysis of the results. The final conclusions of the survey show a continuation of several key walls to the east, a valuable sub-surface tracing of the limestone bedrock, and the limit to which the archaeological material is present spatially in Area B to the north. These results play a major role in determining where to focus excavation efforts in the 2014 excavation season. This unique collaboration with the archaeological team and ongoing opportunity for archaeological ground-truthing will be documented and published as the site develops. As there is a limited presence of such data within the corpus of published archaeogeophysical research, we look forward to further investigations at the site in the coming years.

  19. International Longitudinal Paediatric Reference Standards for Bone Mineral Content

    Science.gov (United States)

    Baxter-Jones, Adam DG; McKay, Heather; Burrows, Melonie; Bachrach, Laura K; Lloyd, Tom; Petit, Moira; Macdonald, Heather; Mirwald, Robert L; Bailey, Don

    2014-01-01

    To render a diagnosis pediatricians rely upon reference standards for bone mineral density or bone mineral content, which are based on cross-sectional data from a relatively small sample of children. These standards are unable to adequately represent growth in a diverse pediatric population. Thus, the goal of this study was to develop sex and site specific standards for BMC using longitudinal data collected from four international sites in Canada and the United States. Data from four studies were combined; Saskatchewan Paediatric Bone Mineral Accrual Study (n=251), UBC Healthy Bones Study (n=382); Penn State Young Women’s Health Study (n=112) and Stanford’s Bone Mineral Accretion study (n=423). Males and females (8 to 25 years) were measured for whole body (WB), total proximal femur (PF), femoral neck (FN) and lumbar spine (LS) BMC (g). Data were analyzed using random effects models. Bland-Altman was used to investigate agreement in predicted and actual data. Age, height, weight and ethnicity independently predicted BMC accrual across sites (P accrual; Hispanic 75.4 (28.2) g less BMC accrual; Blacks 82.8 (26.3) g more BMC accrual with confounders of age, height and weight controlled. Similar findings were found for PF and FN. Female models for all sites were similar with age, height and weight all independent significant predictors of BMC accrual (P accounting for age, size, sex and ethnicity. In conclusion, when interpreting BMC in paediatrics we recommend standards that are sex, age, size and ethnic specific. PMID:19854308

  20. Parental perceptions of clown care in paediatric intensive care units.

    Science.gov (United States)

    Mortamet, Guillaume; Merckx, Audrey; Roumeliotis, Nadia; Simonds, Caroline; Renolleau, Sylvain; Hubert, Philippe

    2017-05-01

    The objective of this study was to report family satisfaction with regards to the presence of clowns in the paediatric intensive care unit (PICU). This is a single-centre survey-based study, conducted over 4 months in a 12-bed third level PICU in a university hospital. All parents present at the bedside of their child during clowning were considered as potential participants. Eligible parents were approached by one of the two intensivists as investigators and asked to complete a survey within the 48 h following the clowns' intervention. Thirty-three parents consented to complete the survey. Median age of children was 14 months (15 days to 16 years) and median Pediatric Logistic Organ Dysfunction (PELOD) score was 1 (0-22). Twenty-four (72.7%) were considered as clinically stable while the clowns intervened. Twenty-eight parents (84.8%) and 27 (81.8%) considered that clowns had a positive effect on themselves and on their child, respectively. Clown care was considered as necessary in 19 cases (57.6%), optional in 13 (39.4%) and unnecessary in 1 (3.0%). The degree of parental satisfaction was not significantly associated with the child's clinical stability. We suggested that medical clowning in the PICU is well accepted by parents, regardless of severity of their child's condition. This study supports the adoption of medical clowning in PICUs as a patient- and family-centred care practice. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  1. Pilot case-control study of paediatric falls from windows.

    Science.gov (United States)

    Johnston, Brian D; Quistberg, D Alexander; Shandro, Jamie R; Partridge, Rebecca L; Song, Hyun Rae; Ebel, Beth E

    2011-12-01

    Unintentional falls from windows are an important cause of paediatric morbidity. There have been no controlled studies to identify modifiable environmental risk factors for window falls in young children. The authors have piloted a case-control study to test procedures for case identification, subject enrolment, and environmental data collection. Case windows were identified when a child 0-9 years old presented for care after a fall from that window. Control windows were identified (1) from the child's home and (2) from the home of an age- and gender-matched child seeking care for an injury diagnosis not related to a window fall. Study staff visited enrolled homes to collect window measurements and conduct window screen performance tests. The authors enrolled and collected data on 18 case windows, 18 in-home controls, and 14 matched community controls. Six potential community controls were contacted for every one enrolled. Families who completed the home visit viewed study procedures positively. Case windows were more likely than community controls to be horizontal sliders (100% vs 50%), to have deeper sills (6.28 vs 4.31 inches), to be higher above the exterior surface (183 vs 82 inches), and to have screens that failed below a threshold derived from the static pressure of a 3-year-old leaning against the mesh (60.0% vs 16.7%). Case windows varied very little from in-home controls. Case-control methodology can be used to study risk factors for paediatric falls from windows. Recruitment of community controls is challenging but essential, because in-home controls tend to be over-matched on important variables. A home visit allows direct measurement of window type, height, sill depth, and screen performance. These variables should all be investigated in subsequent, larger studies covering major housing markets.

  2. Profile of urinary tract infections in paediatric patients

    Directory of Open Access Journals (Sweden)

    Palak Gupta

    2015-01-01

    Full Text Available Background & objectives: This cross-sectional study was conducted at a tertiary care centre in Puducherry, south India, with the aim of finding the profile of the paediatric urinary tract infection (UTI, bacterial pathogens involved, and also to observe vesicoureteric reflux (VUR and renal scarring in these patients. Methods: A total of 524 paediatric patients ≤13 yr, suspected to have UTI, were included in the study. Urine samples were collected, processed for uropathogen isolation and antibiotic susceptibility test was performed as per the Clinical and Laboratory Standards Institute (CLSI guidelines. Thirty two culture proven children with UTI underwent micturating cysto-urethrography (MCU and dimercaptosuccinic acid (DMSA scanning was done for 69 children. Results: o0 f the 524 children, 186 (35.4% had culture proven UTI with 105 (56.4% being infants, 50 (27.4% between 1-5 yr, 30 (16.12% between 5-13 yr and 129 (69.35% males. Posterior urethral valve (PUV was noted in three, hydronephrosis in one, VUR in 18 and renal scarring in 33. VUR as well as renal scarring were more in males >1 yr of age. A significant association (P=0.0054 was noted with a combined sensitivity and specificity of these investigations being 83 and 90 per cent, respectively of the MCU and DMSA scans for detecting VUR. Escherichia coli was the most common pathogen isolated, sensitive to nitrofurantoin, followed by cefoperazone-sulbactam, aminoglycosides and meropenem. Interpretation & conclusions: Our results indicate that UTI varies with age and gender and extensive evaluation is required in boys under one year of age with UTI. This study also highlights the better efficacy of aminoglycosides, cefoperazone-sulbactam and nitrofurantoin in vitro compared with meropenem in Gram-negative uropathogens.

  3. Profile of urinary tract infections in paediatric patients

    Science.gov (United States)

    Gupta, Palak; Mandal, Jharna; Krishnamurthy, Sriram; Barathi, Deepak; Pandit, Nandini

    2015-01-01

    Background & objectives: This cross-sectional study was conducted at a tertiary care centre in Puducherry, south India, with the aim of finding the profile of the paediatric urinary tract infection (UTI), bacterial pathogens involved, and also to observe vesicoureteric reflux (VUR) and renal scarring in these patients. Methods: A total of 524 paediatric patients ≤13 yr, suspected to have UTI, were included in the study. Urine samples were collected, processed for uropathogen isolation and antibiotic susceptibility test was performed as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Thirty two culture proven children with UTI underwent micturating cysto-urethrography (MCU) and dimercaptosuccinic acid (DMSA) scanning was done for 69 children. Results: of the 524 children, 186 (35.4%) had culture proven UTI with 105 (56.4%) being infants, 50 (27.4%) between 1-5 yr, 30 (16.12%) between 5-13 yr and 129 (69.35%) males. Posterior urethral valve (PUV) was noted in three, hydronephrosis in one, VUR in 18 and renal scarring in 33. VUR as well as renal scarring were more in males >1 yr of age. A significant association (P=0.0054) was noted with a combined sensitivity and specificity of these investigations being 83 and 90 per cent, respectively of the MCU and DMSA scans for detecting VUR. Escherichia coli was the most common pathogen isolated, sensitive to nitrofurantoin, followed by cefoperazone-sulbactam, aminoglycosides and meropenem. Interpretation & conclusions: Our results indicate that UTI varies with age and gender and extensive evaluation is required in boys under one year of age with UTI. This study also highlights the better efficacy of aminoglycosides, cefoperazone-sulbactam and nitrofurantoin in vitro compared with meropenem in Gram–negative uropathogens. PMID:26112850

  4. La cuerda dulce – a tolerability and acceptability study of a novel approach to specimen collection for diagnosis of paediatric pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Escombe A Roderick

    2006-04-01

    Full Text Available Abstract Background Recent data demonstrate the utility of the string test for the diagnosis of sputum-scarce HIV-associated TB in adults. We hypothesized that, if well-tolerated by children, this simple tool might offer a breakthrough in paediatric TB diagnosis. Thus the objective of this study, undertaken in the paediatric service of the Hospital Nacional Dos de Mayo, Lima, Perú, was to determine the tolerability and acceptability of the string test to paediatric TB suspects, their parents and nursing staff. Methods 22 paediatric subjects aged 3–14 years (median 8 under investigation for TB were invited to undergo 2 string tests (four-hour downtime each. Subjective and objective pain and discomfort rating scales were used to assess the perception of the subject, parent and attending nurse. Results Patients as young as 4 years tolerated the procedure extremely well with 84% willing to undergo a second procedure. Peak discomfort at the time of swallowing and of string retrieval was mild (30% of maximum possible score and brief as judged by visual analogue ratings and objective indicators. Good concordance of parent/child and objective/subjective ratings strengthened the validity of these findings. Conclusion The string test is well tolerated and achievable for most paediatric TB suspects as young as 4 years. A formal prospective paediatric efficacy study is now needed.

  5. The imaging of paediatric thoracic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael A.; Westra, Sjirk J. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Wallace, E.C. [UMass Memorial Medical Center and University of Massachusetts Medical School, Department of Radiology, Worcester, MA (United States)

    2009-05-15

    Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity. (orig.)

  6. Osteoporosis in paediatric patients with spina bifida.

    Science.gov (United States)

    Marreiros, Humberto; Marreiros, Humberto Filipe; Loff, Clara; Calado, Eulalia

    2012-01-01

    The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB.

  7. A paediatric X-ray exposure chart

    Energy Technology Data Exchange (ETDEWEB)

    Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au [Department of Medical Imaging, Royal Children' s Hospital, Brisbane, Queensland (Australia)

    2014-09-15

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

  8. The imaging of paediatric thoracic trauma

    International Nuclear Information System (INIS)

    Moore, Michael A.; Westra, Sjirk J.; Wallace, E.C.

    2009-01-01

    Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity. (orig.)

  9. Microscale damage mechanisms and degradation of fiber-reinforced composites for wind energy applications: results of Danish–Chinese collaborative investigations

    DEFF Research Database (Denmark)

    Mishnaevsky, Leon; Zhou, H.W.; Yi, H.Y.

    2014-01-01

    Recent research works in the area of experimental and computational analyses of microscale mechanisms of strength, damage and degradation of glass fiber polymer composites for wind energy applications, which were carried out in the framework of a series of Sino–Danish collaborative research...... projects, are summarized in this article. In a series of scanning electron microscopy in situ experimental studies of composite degradation under off-axis tensile, compressive and cyclic loadings as well as three-dimensional computational experiments based on micromechanics of composites and damage...

  10. Re-envisioning paediatric nurse training in a re-engineered health care system

    Directory of Open Access Journals (Sweden)

    Minette Coetzee

    2014-10-01

    Method: In response to the Committee on Morbidity and Mortality in Children recommendation, a colloquium was convened as a national forum for schools of nursing, departments of health, health care facilities, clinicians and regulatory bodies to advance children’s nursing in South Africa. Objectives: The goals of the colloquium were to thoroughly investigate the situation in South Africa’s paediatric nurse training, plot ways to strengthen and expand postgraduate paediatric programmes to meet priority child health needs, and to build relationships between the various schools and stakeholders. Results: Outcomes included the clarification and strengthening of a ‘stakeholder grid’ in nurse training, recognition of the need for more active teaching and learning strategies in curricula linked to national child health priorities, as well as the need to develop and support clinical nursing practice in facilities.

  11. Collaborative Environments. Considerations Concerning Some Collaborative Systems

    Directory of Open Access Journals (Sweden)

    Mihaela I. MUNTEAN

    2009-01-01

    Full Text Available It is obvious, that all collaborative environments (workgroups, communities of practice, collaborative enterprises are based on knowledge and between collaboration and knowledge management there is a strong interdependence. The evolution of information systems in these collaborative environments led to the sudden necessity to adopt, for maintaining the virtual activities and processes, the latest technologies/systems, which are capable to support integrated collaboration in business services. In these environments, portal-based IT platforms will integrate multi-agent collaborative systems, collaborative tools, different enterprise applications and other useful information systems.

  12. Developing a Culture to Facilitate Research Capacity Building for Clinical Nurse Consultants in Generalist Paediatric Practice

    Directory of Open Access Journals (Sweden)

    Lesley Wilkes

    2013-01-01

    Full Text Available This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW, Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge.

  13. Collaborative innovation

    DEFF Research Database (Denmark)

    Torfing, Jacob; Sørensen, Eva; Hartley, Jean

    2013-01-01

    , which emphasizes market competition; the neo-Weberian state, which emphasizes organizational entrepreneurship; and collaborative governance, which emphasizes multiactor engagement across organizations in the private, public, and nonprofit sectors. The authors conclude that the choice of strategies......-driven private sector is more innovative than the public sector by showing that both sectors have a number of drivers of as well as barriers to innovation, some of which are similar, while others are sector specific. The article then systematically analyzes three strategies for innovation: New Public Management......There are growing pressures for the public sector to be more innovative but considerable disagreement about how to achieve it. This article uses institutional and organizational analysis to compare three major public innovation strategies. The article confronts the myth that the market...

  14. Program of scientific investigations and development of solid-oxide fuel cells (SOFC) in VIITF proposals on scientific and technical collaboration and SOFC commercialization

    Energy Technology Data Exchange (ETDEWEB)

    Kleschev, Yu.N.; Chulharev, V.F.

    1996-04-01

    Investigations being performed at VNIITF covers the whole cycle of solid oxide fuel cell manufacturing. This report describes the main directions of investigations in materials, technologies, and commercialization.

  15. Clowning as a supportive measure in paediatrics - a survey of clowns, parents and nursing staff.

    Science.gov (United States)

    Barkmann, Claus; Siem, Anna-Katharina; Wessolowski, Nino; Schulte-Markwort, Michael

    2013-10-10

    Hospital clowns, also known as clown doctors, can help paediatric patients with the stress of a hospitalization and to circumvent the accompanying feelings of fear, helplessness and sadness, thus supporting the healing process. The objectives of the present study were to clarify the structural and procedural conditions of paediatric clowning in Germany and to document the evaluations of hospital clowns, parents and hospital staff. A nationwide online survey of hospital clowns currently active in paediatric departments and an accompanying field evaluation in Hamburg hospitals with surveys of parents and hospital staff were conducted. In addition to items developed specifically for the study regarding general conditions, procedures, assessments of effects and attitudes, the Work Satisfaction Scale was used. The sample included n = 87 hospital clowns, 37 parents and 43 hospital staff members. The online survey showed that the hospital clowns are well-trained, motivated and generally satisfied with their work. By their own estimate, they primarily boost morale and promote imagination in the patients. However, hospital clowns also desire better interdisciplinary collaboration and financial security as well as more recognition of their work. The Hamburg field study confirmed the positive results of the clown survey. According to the data, a clown intervention boosts morale and reduces stress in the patients. Moreover, there are practically no side effects. Both parents and hospital staff stated that the patients as well as they themselves benefited from the intervention. The results match those of previous studies and give a very positive picture of hospital clowning, so that its routine use and expansion thereof can be recommended. Furthermore, the intervention should be subject to the rules of evidence-based medicine like other medical treatments.

  16. STUDY ABOUT CLINICAL APPLICATION OF BRAIN ATLAS IN PAEDIATRICS

    Institute of Scientific and Technical Information of China (English)

    MENG Fanhang; LIU Cuiping; RENG Xiaoping; JIANG Lian

    2002-01-01

    Objectives To explore clinical application on brain atlas in paediatrics. Methode: Brain atlas was applied in diagnosis and treatment of paediatric diseases and its clinical value was discussed in 1990 ~2001. The manifestation of these diseases in brain atlas were analysed and the manifestation of CT of 67 cases and manifestations of EEG of 37 cases with that of BA were compared. Results The changes of cerebral electrical activity of these diseases were reflected objectively and showed directly in BA. Conclusion Brain atlas not only can point out quality of disease but also define position of disease. Therefore, brain atlas has important clinical value in paediatrics.

  17. Optimization of paediatric radiation doses with CR systems

    International Nuclear Information System (INIS)

    Zatelli, Giovanna; Mazzocchi, S.; Ciccarone, A.; Fonda, C.; De Otto, G.

    2008-01-01

    Full text: Radiation protection of paediatric patients is a primary objective in paediatric radiology due the higher life expectance of the little patients undergoing radiology examinations and due to the higher radiosensitivity of tissues. Aim of this work is the study of the optimization process in paediatric doses needed after the recent installation of a new Computed Radiography System in the Radiology of the Meyer paediatric Hospital, in Florence, Italy. This process involves both the use of new dedicated digitizer (Agfa DX-S) and elaboration software (Agfa NX2.0). The choice of the DX-S systems has been performed in consideration of high resolution (Scanhead technology - DirectriX detector), image sharpness and portability of the cassettes that make DX-S ideal in paediatric applications as neonatal intensive care. The NX software for image processing has been installed with the 'Paediatric' licence that optimizes paediatric images especially for exposures of premature newborns. Paediatric NX automatically selects the paediatric age group, depending on the patient's birth date. Each age group contains enhanced algorithms and settings adapted to age group, for optimized visibility of fine details. All the CR system has been accepted by mean of quality control acceptance tool AGFA AutoQC2, and all the automatic exposure control devices installed on radiographic devices were previously calibrated in accordance to literature with signal to noise vs dose considerations [S. Mazzocchi et al. 'AEC set-up optimization with computed radiography imaging' Radiat. Prot. Dosim. 117, 169-173 2005]. Paediatric patients were then divided into age-weight categories and the Entrance Surface Doses (ESD) were calculated by output x-rays measurements. ESD for thorax examinations were correlated to the image evaluations performed by experienced radiologists following European Guidelines on quality criteria for diagnostic radiographic images in paediatrics (EUR 16261, European

  18. Breakdowns in collaborative information seeking

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2010-01-01

    Collaborative information seeking is integral to many professional activities. In hospital work, the medication process encompasses continual seeking for information and collaborative grounding of information. This study investigates breakdowns in collaborative information seeking through analyses...... of the use of the electronic medication record adopted in a Danish healthcare region and of the reports of five years of medication incidents at Danish hospitals. The results show that breakdowns in collaborative information seeking is a major source of medication incidents, that most of these breakdowns...... are breakdowns in collaborative grounding rather than information seeking, that the medication incidents mainly concern breakdowns in the use of records as opposed to oral communication, that the breakdowns span multiple degrees of separation between clinicians, and that the electronic medication record has...

  19. Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland.

    Science.gov (United States)

    Bernstein, Judith; Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul; Tinanoff, Norman

    2017-03-29

    To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format. Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care. Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively. Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records. NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children. Published by the BMJ Publishing Group Limited. For permission to use (where not

  20. Managing collaborative innovation in public bureaucracies

    DEFF Research Database (Denmark)

    Agger, Annika; Sørensen, Eva

    2018-01-01

    Public planners are increasingly recruited to manage collaborative innovation processes, but there is hardly any research on how they deal with the tensions they encounter in managing collaborative innovation in the institutional context of a public bureaucracy. Drawing on emerging theories...... of collaborative planning, network management and public innovation, the article develops a taxonomy of tasks related to managing collaborative innovation, identifies potential tensions between these tasks and the institutional logic of public bureaucracies and investigates how these tensions are experienced...

  1. Remote Collaboration With Mixed Reality Displays

    DEFF Research Database (Denmark)

    Müller, Jens; Rädle, Roman; Reiterer, Harald

    2017-01-01

    HCI research has demonstrated Mixed Reality (MR) as being beneficial for co-located collaborative work. For remote collaboration, however, the collaborators' visual contexts do not coincide due to their individual physical environments. The problem becomes apparent when collaborators refer...... to physical landmarks in their individual environments to guide each other's attention. In an experimental study with 16 dyads, we investigated how the provisioning of shared virtual landmarks (SVLs) influences communication behavior and user experience. A quantitative analysis revealed that participants used...

  2. Contemporary collaborations between museums and universities

    DEFF Research Database (Denmark)

    Knudsen, Line Vestergaard; Simonsen, Celia Ekelund

    2017-01-01

    Numerous new types of cross-institutional collaborations have been conducted recently at the intersection between museums and universities. Museums of all subject areas have collaborated with university researchers, just as scholars from a broad range of disciplines including communications, media...... studies, IT and performance design and tourism increasingly collaborate with museums. Based on qualitative evaluation material and autobiographical experiences, this article analyzes a large Danish research project in which collaborations between several museums and universities took place. We investigate...

  3. Integration of research and practice to improve public health and healthcare delivery through a collaborative 'Health Integration Team' model - a qualitative investigation.

    Science.gov (United States)

    Redwood, Sabi; Brangan, Emer; Leach, Verity; Horwood, Jeremy; Donovan, Jenny L

    2016-06-22

    Economic considerations and the requirement to ensure the quality, safety and integration of research with health and social care provision have given rise to local developments of collaborative organisational forms and strategies to span the translational gaps. One such model - the Health Integration Team (HIT) model in Bristol in the United Kingdom (UK) - brings together National Health Service (NHS) organisations, universities, local authorities, patients and the public to facilitate the systematic application of evidence to promote integration across healthcare pathways. This study aimed to (1) provide empirical evidence documenting the evolution of the model; (2) to identify the social and organisational processes and theory of change underlying healthcare knowledge and practice; and (3) elucidate the key aspects of the HIT model for future development and translation to other localities. Contemporaneous documents were analysed, using procedures associated with Framework Analysis to produce summarised data for descriptive accounts. In-depth interviews were undertaken with key informants and analysed thematically. Comparative methods were applied to further analyse the two data sets. One hundred forty documents were analysed and 10 interviews conducted with individuals in leadership positions in the universities, NHS commissioning and provider organisations involved in the design and implementation of the HIT model. Data coalesced around four overarching themes: 'Whole system' engagement, requiring the active recruitment of all those who have a stake in the area of practice being considered, and 'collaboration' to enable coproduction were identified as 'process' themes. System-level integration and innovation were identified as potential 'outcomes' with far-reaching impacts on population health and service delivery. The HIT model emerged as a particular response to the perceived need for integration of research and practice to improve public health and

  4. Training fellows in paediatric cardiology: the Harvard experience.

    Science.gov (United States)

    Brown, David W; Allan, Catherine K; Newburger, Jane W

    2016-12-01

    The Fellowship Program of the Department of Cardiology at Boston Children's Hospital seeks to train academically oriented leaders in clinical care and laboratory and clinical investigation of cardiovascular disease in the young. The core clinical fellowship involves 3 years in training, comprising 24 months of clinical rotations and 12 months of elective and research experience. Trainees have access to a vast array of research opportunities - clinical, basic, and translational. Clinical fellows interested in basic science may reverse the usual sequence and start their training in the laboratory, deferring clinical training for 1 or more years. An increasing number of clinical trainees apply to spend a fourth year as a senior fellow in one of the subspecialty areas of paediatric cardiology. From the founding of the Department to the present, we have maintained a fundamental and unwavering commitment to training and education in clinical care and research in basic science and clinical investigation, as well as to the training of outstanding young clinicians and investigators.

  5. Five challenges to ethical communication for interprofessional paediatric practice: A social work perspective.

    Science.gov (United States)

    Delany, Clare; Richards, Angela; Stewart, Helen; Kosta, Lauren

    2017-07-01

    In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.

  6. Circulating rotavirus genotypes in the Irish paediatric population prior to the introduction of the vaccination programme.

    Science.gov (United States)

    Yandle, Z; Coughlan, S; Drew, R J; O'Flaherty, N; O'Gorman, J; De Gascun, C

    2017-11-01

    Rotavirus is the leading cause of viral gastroenteritis in children, and it is anticipated that the introduction of the Rotarix™ vaccine (GlaxoSmithKline Biologicals S.A., Rixensart, Belgium) into the Irish immunisation schedule will result in a significant reduction of rotavirus-associated disease. In the pre- and post-vaccination eras, it is important to determine circulating strains of rotavirus to assess vaccine effectiveness, to monitor vaccine failures, and to detect potential emerging strains. This study was a collaboration between the Temple Street Children's University Hospital (TSCUH), Dublin, and the National Virus Reference Laboratory (NVRL), Dublin, to determine the then circulating rotavirus strains in a paediatric hospital. In the 2015/2016 period (July 2015-June 2016) 89 faecal samples from paediatric patients (53 from TSCUH, 36 from other hospitals) were characterised. The results showed G1P[8] to be the predominant genotype (57%), followed by G9P[8] (34%), G4P[8] (6%), G2P[4] (2%), and G12P[8] (1%). This distribution of genotypes is comparable to those found in other European countries prior to vaccination suggesting that the vaccine should be highly efficacious in the Irish population.

  7. The effect of increased body mass index on patient dose in paediatric radiography

    Energy Technology Data Exchange (ETDEWEB)

    Ladia, Arsenoi P., E-mail: arsenoh@gmail.com; Skiadopoulos, Spyros G., E-mail: skiado@upatras.gr; Karahaliou, Anna N., E-mail: akarahaliou@upatras.gr; Messaris, Gerasimos A.T., E-mail: messaris@upatras.gr; Delis, Harry B., E-mail: hdelis@gmail.com; Panayiotakis, George S., E-mail: panayiot@upatras.gr

    2016-10-15

    Radiation protection is of particular importance in paediatric radiology. In this study, the influence of increased body mass index (BMI) in radiation dose and associated risk was investigated for paediatric patients aged 5–6.5 years, undergoing chest (64 patients) or abdomen (64 patients) radiography. Patients were categorized into normal and overweight, according to the BMI classification scheme. Entrance surface dose (ESD), organ dose, effective dose (ED) and risk of exposure induced cancer death (REID) were calculated using the Monte Carlo based code PCXMC 2.0. Statistically significant increase in patient radiation dose and REID was obtained for overweight patients as compared to normal ones, in both chest and abdomen examinations (Wilcoxon singed-rank test for paired data, p < 0.001). The percentage increase in overweight as compared to normal patients of ESD, organ dose (maximum value), ED and REID was 13.6%, 24.4%, 18.9% and 20.6%, respectively, in case of chest radiographs. Corresponding values in case of abdomen radiographs were 15.0%, 24.7%, 21.8% and 19.8%, respectively. An increased BMI results in increased patient radiation dose in chest and abdomen paediatric radiography.

  8. Overview and recent developments in the medical management of paediatric uveitis.

    Science.gov (United States)

    Pilly, Bertrand; Heath, Greg; Tschuor, Patrizia; Lightman, Susan; Gale, Richard P

    2013-09-01

    Although rarer than its adult counterpart, non-infectious uveitis remains a significant cause of ocular morbidity in children. Owing to the chronicity of the disorder and when refractory to first-line treatment, namely corticosteroids, systemic immunosuppressive treatment may be required to control the disease. Following a literature search using the keywords 'paediatric uveitis', 'juvenile idiopathic arthritis-associated uveitis', 'immunosuppression' and 'treatment', we reviewed the range and effectiveness of treatments employed in the management of non-infectious, paediatric uveitis. Corticosteroids (topical, periocular, intraocular or systemic) remain the initial drug of choice in ameliorating the signs and symptoms of non-infectious paediatric uveitis. Failure to control the disease and/or failure to reduce the oral dose of prednisolone at least 0.15 mg/kg within 4 weeks often requires additional immunosuppressant therapy. Methotrexate and azathioprine have shown to be effective in the management of juvenile idiopathic arthritis (JIA)-associated uveitis with the former considered the first-line corticosteroid-sparing agent. Biologic therapies are increasingly used earlier in the disease with investigators in the UK currently recruiting patients for the SYCAMORE trial evaluating the efficacy of methotrexate and adalimumab vs methotrexate alone for the treatment for JIA-associated uveitis. Until further randomised controlled trials are conducted, the use of other biologic agents should only be used with an appreciation that there are potentially unknown side-effects and that there is not a full knowledge of their efficacy.

  9. Subgroups of Paediatric Acute Lymphoblastic Leukaemia Might Differ Significantly in Genetic Predisposition to Asparaginase Hypersensitivity.

    Directory of Open Access Journals (Sweden)

    Nóra Kutszegi

    Full Text Available L-asparaginase (ASP is a key element in the treatment of paediatric acute lymphoblastic leukaemia (ALL. However, hypersensitivity reactions (HSRs to ASP are major challenges in paediatric patients. Our aim was to investigate genetic variants that may influence the risk to Escherichia coli-derived ASP hypersensitivity. Sample and clinical data collection was carried out from 576 paediatric ALL patients who were treated according to protocols from the Berlin-Frankfurt-Münster Study Group. A total of 20 single nucleotide polymorphisms (SNPs in GRIA1 and GALNT10 genes were genotyped. Patients with GRIA1 rs4958351 AA/AG genotype showed significantly reduced risk to ASP hypersensitivity compared to patients with GG genotype in the T-cell ALL subgroup (OR = 0.05 (0.01-0.26; p = 4.70E-04, while no such association was found in pre-B-cell ALL. In the medium risk group two SNPs of GRIA1 (rs2055083 and rs707176 were associated significantly with the occurrence of ASP hypersensitivity (OR = 0.21 (0.09-0.53; p = 8.48E-04 and OR = 3.02 (1.36-6.73; p = 6.76E-03, respectively. Evaluating the genders separately, however, the association of rs707176 with ASP HSRs was confined only to females. Our results suggest that genetic variants of GRIA1 might influence the risk to ASP hypersensitivity, but subgroups of patients can differ significantly in this respect.

  10. Families' perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers.

    Science.gov (United States)

    Gehring, Nicole D; Ball, Geoff D C; Perez, Arnaldo; Holt, Nicholas L; Neuman, Daniel; Spence, Nicholas; Mercier, Laura; Jetha, Mary

    2018-02-01

    Home visits have successfully been used to deliver various health services, but what role could they play in paediatric weight management? Low treatment initiation and high attrition prompted our multidisciplinary paediatric weight management clinic to investigate how families perceived the benefits and barriers of home visits. We focused on children with obesity aged 2-17 who were enrolled in our tertiary-level clinic in Alberta, Canada. None had received a home visit. The families were interviewed face-to-face from October 2015 to October 2016, and we used a qualitative description methodological framework and manifest content analysis. The parents were the main interviewees. Of the 56 families, 89% were interested in a home visit, 82% wanted support from a dietician and 54% from an exercise specialist. The perceived benefits of home visits included comprehensive assessment (95%), convenience (86%), tailored care (29%) and family involvement (13%), while the costs and barriers included clinicians' potential judgmental attitudes (30%), loss of privacy (19%) and distractions (10%). Some thought clinicians would find home visits inconvenient (25%), with bureaucratic challenges (14%) and sustainability issues (5%). Families felt home visits were a convenient option for managing paediatric obesity and identified important benefits and barriers that could guide such interventions. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. Retrospective evaluation of paediatric oral biopsies over a 10-year period in Western India.

    Science.gov (United States)

    Patil, S S; Kontham, U R; Kontham, R K; Chowdhery, A

    2017-06-01

    This retrospective study reviewed the paediatric oral biopsies received over 10 years at a teaching hospital and dental college in India. It is important that paediatric dentists know the diagnostic tendencies of oral pathological conditions in children, and possess updated information for their diagnosis and treatment. Biopsies of patients 17 years of age or younger were selected. Computerised data regarding age, gender, anatomic location, and histopathological diagnosis was retrieved and classified into nine categories. Of a total 2959 oral biopsies, 359 cases (12.1%) were in the paediatric population with a slight male predominance. Salivary gland pathology (21.4%) was most frequently observed followed by dental pathology, maxillofacial tumours and maxillofacial cysts. More than a third of cases (35.9%) were found to occur in the mandible. Five cases of malignancies were found, two of which were salivary gland tumours. The majority of lesions identified were of a benign nature necessitating minimal intervention; however, it is important to recognise that malignant lesions can occur in children. Any swelling, especially related to the salivary glands, must be investigated immediately, so as to prevent mortality and reduce morbidity. Diverse classifications used by previous authors make comparison of data challenging.

  12. Microneedle technology for immunisation: Perception, acceptability and suitability for paediatric use.

    Science.gov (United States)

    Marshall, Sarah; Sahm, Laura J; Moore, Anne C

    2016-02-03

    To examine published research which explores the perception and acceptability of microneedle technology for immunisation and to investigate the suitability of this technology for paediatric use. A series of keywords and their synonyms were combined in various combinations and permutations using Boolean operators to sequentially search four databases (PubMed, Web of Science, Embase and CINAHL). Following removal of duplications and irrelevant results, 12 research articles were included in the final literature review. The opinions of patients, parents, children and healthcare professionals (HCP) were collated. A positive perception and a high level of acceptability predominated. Microneedle technology research has been focussed on demonstrating efficacy with minimal focus on determining HCP/public perception and acceptability for paediatric use, exemplified by the paucity of studies presented in this review. Commercial viability will depend on HCP/public acceptability of microneedle technology. An effort must be made to identify the barriers to acceptance and to overcome them by increasing awareness and education in stakeholder groups pertaining to the paediatric population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Comparative study of caudal bupivacaine versus bupivacaine with tramadol for postoperative analgesia in paediatric cancer patients

    Institute of Scientific and Technical Information of China (English)

    Mohammed Hegazy; Ayman A. Ghoneim

    2013-01-01

    Objective: Caudal epidural analgesia has become very common analgesic technique in paediatric surgery. Add-ing tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects. The aim of the study was to investigate the different effects of caudal bupivacaine versus bupivacaine with thamadol for postoperative analgesia in paediatric cancer patients. Methods: A prospective randomized controlled trial was conducted over 40 paediatric cancer pa-tients who were recruited from Children Cancer Hospital of Egypt (57357 Hospital). Patients were randomized into 2 groups: bupivacaine group (group B, 20 patients) to receive single shot caudal block of 1 mL/kg 0.1875% bupivacaine; tramadol group (group T, 20 patients) prepared as group B with the addition of 1 mg/kg caudal tramadol. Results: The mean duration of analgesia was significantly longer among group T than group B [(24 ± 13.7) hours versus (7 ± 3.7) hours respectively with P = 0.001]. Group T showed a significantly lower mean FLACC score than group B (2.2 ± 0.9 versus 3.6 ± 0.6 with P = 0.002). The difference in FLACC score was comparable on arrival, and after 2 and 4 hours. At 8 and 12 hours the group B recorded significantly higher scores (P = 0.002 and 0.0001 respectively). There were no significant differences between the groups as regards sedation score [the median in both groups was 1 (0–1) with P value = o.8]. No one developed facial flush or pruritis. Conclusion: Caudal injection of low dose tramadol 1 mg/kg with bupivacaine 0.1875% is proved to be effective, long standing technique for postoperative analgesia in major paediatric cancer surgery and almost devoid of side effect.

  14. Relationship Ethics Between Paediatric Nurses and Patients

    Directory of Open Access Journals (Sweden)

    O. E. Baksansky

    2015-01-01

    Full Text Available The article deals with the problem of establishing communication between the paediatric nursing staff and their patients. It emphasizes the vital role of communication in the treatment process; analyzes the communication types and the typology of nurses offered by R. I. Hardy. The article shows how important the skill of understanding and listening to the patient is and what positive effect it has on establishing a psychological contact. Qualities obligatory for a nurse include patience and the ability to control oneself. This is hard to achieve because of a high degree of emotional stress, which arises as a result of communicating with patients, along with an increased irritability, exactingness and ailing touchiness. In the end, the personality, the style and methods of work and professional characteristics of a medical nurse are a necessary element of effective treatment together with correct diagnostics and prescriptions.

  15. [Paediatric retinal detachment and hereditary vitreoretinal disorders].

    Science.gov (United States)

    Meier, P

    2013-09-01

    The number of retinal detachments in children is very low in comparison to the number in adults. One predisposing factor for development of paediatric retinal detachment is suffering from hereditary vitreoretinal degeneration (e.g., Stickler syndrome, Wagner syndrome, Kniest dysplasia, familial exudative vitreoretinopathy, congenital X-linked retinoschisis, Knobloch syndrome, incontinentia pigmenti, Norrie disease). Hereditary vitreoretinopathies are characterised by an abnormal-appearing vitreous gel with associated retinal changes. In most of these eyes further ocular abnormalities can be diagnosed. A group of hereditary disorders is associated with characteristic systemic abnormalities. Allied conditions should be considered in the clinical diagnosis. Vitreoretinopathies are the most common cause of inherited retinal detachment. In most eyes primary vitrectomy is necessary, and disease-specific surgical treatment is discussed. Georg Thieme Verlag KG Stuttgart · New York.

  16. Ibuprofen in paediatrics: pharmacology, prescribing and controversies.

    Science.gov (United States)

    Moriarty, Camilla; Carroll, Will

    2016-12-01

    Ibuprofen, a propionic acid derivative, is a non-steroidal anti-inflammatory drug. The oral formulation is widely used in paediatric practice and after paracetamol it is one of the most common drugs prescribed for children in hospital. The treatment of fever with antipyretics such as ibuprofen is controversial as fever is the normal response of the body to infection and unless the child becomes distressed or symptomatic, fever alone should not be routinely treated. Combined treatment with paracetamol and ibuprofen is commonly undertaken but almost certainly is not helpful. This article aims to describe the indications and mode of action of the drug, outline its pharmacokinetics and highlight the important key messages regarding its use in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Collaborative information seeking

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2008-01-01

    Since common ground is pivotal to collaboration, this paper proposes to define collaborative information seeking as the combined activity of information seeking and collaborative grounding. While information-seeking activities are necessary for collaborating actors to acquire new information......, the activities involved in information seeking are often performed by varying subgroups of actors. Consequently, collaborative grounding is necessary to share information among collaborating actors and, thereby, establish and maintain the common ground necessary for their collaborative work. By focusing...... on the collaborative level, collaborative information seeking aims to avoid both individual reductionism and group reductionism, while at the same time recognizing that only some information and understanding need be shared....

  18. Sedation for paediatric auditory electrophysiology in South Africa

    African Journals Online (AJOL)

    emergency departments and nuclear medicine.1 Added to this is the periodic need ... electrophysiology in the paediatric population in South Africa were not found. ..... to inadequate information technology infrastructure as well as limited data ...

  19. Cost Burden for Accessing Paediatric Emergency Services at a ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    modalities and economic impacts for accessing paediatric ... Descriptive analysis of the data was done using SPSS ... being discharged home from the emergency ... their homes to the hospital. ..... respondents could be affected by recall bias.

  20. The spectrum and outcome of paediatric traumatic brain injury in ...

    African Journals Online (AJOL)

    The spectrum and outcome of paediatric traumatic brain injury in ... to develop a comprehensive overview of traumatic brain injury (TBI) in children ... We reviewed the age, gender, outcomes, radiological findings and treatment of the patients.

  1. African Journal of Paediatric Surgery - Vol 10, No 2 (2013)

    African Journals Online (AJOL)

    Histopathological review of breast tumours in children and adolescents in Delta ... of early and late oral feeding in intestinal anastomosis surgeries in children ... Paediatric urologic pathologies at the national teaching hospital in Cotonou: A ...

  2. Multidetector row CT for imaging the paediatric tracheobronchial tree

    International Nuclear Information System (INIS)

    Papaioannou, Georgia; Young, Carolyn; Owens, Catherine M.

    2007-01-01

    The introduction of multidetector row computed tomography (MDCT) scanners has altered the approach to imaging the paediatric thorax. In an environment where the rapid acquisition of CT data allows general hospitals to image children instead of referring them to specialist paediatric centres, it is vital that general radiologists have access to protocols appropriate for paediatric applications. Thus a dramatic reduction in the delivered radiation dose is ensured with optimal contrast bolus delivery and timing, and inappropriate repetition of the scans is avoided. This article focuses on the main principles of volumetric CT imaging that apply generically to all MDCT scanners. We describe the reconstruction techniques for imaging the paediatric thorax and the low-dose protocols used in our institution on a 16-slice detector CT scanner. Examples of the commonest clinical applications are also given. (orig.)

  3. Paediatric population neuroimaging and the Generation R Study

    DEFF Research Database (Denmark)

    White, Tonya; Muetzel, Ryan L.; El Marroun, Hanan

    2018-01-01

    Paediatric population neuroimaging is an emerging field that falls at the intersection between developmental neuroscience and epidemiology. A key feature of population neuroimaging studies involves large-scale recruitment that is representative of the general population. One successful approach f...

  4. audit of blood transfusion practices in the paediatric medical ward

    African Journals Online (AJOL)

    2013-01-01

    Jan 1, 2013 ... AUDIT OF BLOOD TRANSFUSION PRACTICES IN THE PAEDIATRIC MEDICAL WARD OF A TERTIARY ..... services and even where available, beneficiaries have ... due to lack of existence of quality assurance protocol.

  5. Clinical features of paediatric pulmonary hypertension : a registry study

    NARCIS (Netherlands)

    Berger, Rolf M. F.; Beghetti, Maurice; Humpl, Tilman; Raskob, Gary E.; Ivy, D. Dunbar; Jing, Zhi-Cheng; Bonnet, Damien; Schulze-Neick, Ingram; Barst, Robyn J.

    2012-01-01

    Background Paediatric pulmonary hypertension, is an important cause of morbidity and mortality, and is insufficiently characterised in children. The Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry is a global, prospective study designed to provide information about

  6. Radiopharmaceutical activities administered for paediatric nuclear medicine procedures in Australia

    International Nuclear Information System (INIS)

    Towson, J.E.; Smart, R.C.; Rossleigh, M.A.; Children's Hospital, Randwick, NSW

    2000-01-01

    A survey of radiopharmaceutical activities used at the eight hospital centres specialising in paediatric nuclear medicine in Australia was conducted in 1999-2000 by the Australian and New Zealand Society of Nuclear Medicine and the Australasian Radiation Protection Society. Data on the maximum and minimum administered activities was obtained for 43 paediatric imaging procedures. The maximum values were significantly less than the corresponding Reference Activities for adults determined in a previous study. Activities for individual patients are calculated using surface area scaling at five centres and body weight scaling at three centres. The median values of A max and A min are recommended as Paediatric Reference Activities. The effective dose to patients of various sizes for the Paediatric Reference Activities and both methods of scaling was calculated for each procedure. Copyright (2000) Australasian Radiation Protection Society Inc

  7. Paediatric retinal detachment: aetiology, characteristics and outcomes

    Directory of Open Access Journals (Sweden)

    Elizabeth McElnea

    2018-02-01

    Full Text Available AIM: To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. METHODS: A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. RESULTS: Twenty-eight eyes of 24 patients, 15 (62.5% of whom were male and 9 (37.5% of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0% cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3% cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6% cases which underwent surgical repair the retina was attached at last follow-up. CONCLUSION: Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

  8. Paediatric retinal detachment: aetiology, characteristics and outcomes.

    Science.gov (United States)

    McElnea, Elizabeth; Stephenson, Kirk; Gilmore, Sarah; O'Keefe, Michael; Keegan, David

    2018-01-01

    To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. Twenty-eight eyes of 24 patients, 15 (62.5%) of whom were male and 9 (37.5%) of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0%) cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3%) cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6%) cases which underwent surgical repair the retina was attached at last follow-up. Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

  9. A concept analysis of holistic nursing care in paediatric nursing

    OpenAIRE

    A.A. Tjale; J. Bruce

    2007-01-01

    Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative a...

  10. Tape measure to aid prescription in paediatric resuscitation.

    OpenAIRE

    Hughes, G; Spoudeas, H; Kovar, I Z; Millington, H T

    1990-01-01

    A tape measure, based on 50th centile weight for height and designed to permit easy drug dosage calculation, endotracheal tube size and DC cardioversion current dosages in childrens' emergencies, was tested for reliability by medical and nursing staff with varying paediatric experience. We found that the tape measure gave a reproducible estimate of weight and suggest that its use would facilitate decision making by inexperienced medical and nursing staff in paediatric resuscitation when there...

  11. Report of the Paediatric Nurse Education Review Group

    OpenAIRE

    Department of Health (Ireland)

    2000-01-01

    10.12.2000 The Department of Health and Children is implementing the recommendations of the Commission on Nursing (1998). It agreed with the Nursing Alliance in early 2000 to set up working groups to inform the implementation of specific recommendations in relation to nurse education. One of these working groups was to address paediatric nurse education. In March 2000, a Steering Group to oversee a review of paediatric nurse education was convened and the following terms of reference agre...

  12. Paediatric cyclical Cushing's disease due to corticotroph cell hyperplasia.

    LENUS (Irish Health Repository)

    Noctor, E

    2015-06-01

    Cushing\\'s disease is very rare in the paediatric population. Although uncommon, corticotroph hyperplasia causing Cushing\\'s syndrome has been described in the adult population, but appears to be extremely rare in children. Likewise, cyclical cortisol hypersecretion, while accounting for 15 % of adult cases of Cushing\\'s disease, has only rarely been described in the paediatric population. Here, we describe a very rare case of a 13-year old boy with cyclical cortisol hypersecretion secondary to corticotroph cell hyperplasia.

  13. Paediatric Pain Management: Using Complementary and Alternative Medicine

    OpenAIRE

    Evans, Subhadra; Tsao, Jennie C.I; Zeltzer, Lonnie K.

    2008-01-01

    Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic paediatric pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic paediatric pain.Altho...

  14. The paediatric change laboratory: optimising postgraduate learning in the outpatient clinic.

    Science.gov (United States)

    Skipper, Mads; Musaeus, Peter; Nøhr, Susanne Backman

    2016-02-02

    This study aimed to analyse and redesign the outpatient clinic in a paediatric department. The study was a joint collaboration with the doctors of the department (paediatric residents and specialists) using the Change Laboratory intervention method as a means to model and implement change in the outpatient clinic. This study was motivated by a perceived failure to integrate the activities of the outpatient clinic, patient care and training of residents. The ultimate goal of the intervention was to create improved care for patients through resident learning and development. We combined the Change Laboratory intervention with an already established innovative process for residents, 3-h meetings. The Change Laboratory intervention method consists of a well-defined theory (Cultural-historical activity theory) and concrete actions where participants construct a new theoretical model of the activity, which in this case was paediatric doctors' workplace learning modelled in order to improve medical social practice. The notion of expansive learning was used during the intervention in conjunction with thematic analysis of data in order to fuel the process of analysis and intervention. The activity system of the outpatient clinic can meaningfully be analysed in terms of the objects of patient care and training residents. The Change Laboratory sessions resulted in a joint action plan for the outpatient clinic structured around three themes: (1) Before: Preparation, expectations, and introduction; (2) During: Structural context and resources; (3) After: Follow-up and feedback. The participants found the Change Laboratory method to be a successful way of sharing reflections on how to optimise the organisation of work and training with patient care in mind. The Change Laboratory approach outlined in this study succeeded to change practices and to help medical doctors redesigning their work. Participating doctors must be motivated to uncover inherent contradictions in their

  15. Collaboration rules.

    Science.gov (United States)

    Evans, Philip; Wolf, Bob

    2005-01-01

    Corporate leaders seeking to boost growth, learning, and innovation may find the answer in a surprising place: the Linux open-source software community. Linux is developed by an essentially volunteer, self-organizing community of thousands of programmers. Most leaders would sell their grandmothers for workforces that collaborate as efficiently, frictionlessly, and creatively as the self-styled Linux hackers. But Linux is software, and software is hardly a model for mainstream business. The authors have, nonetheless, found surprising parallels between the anarchistic, caffeinated, hirsute world of Linux hackers and the disciplined, tea-sipping, clean-cut world of Toyota engineering. Specifically, Toyota and Linux operate by rules that blend the self-organizing advantages of markets with the low transaction costs of hierarchies. In place of markets' cash and contracts and hierarchies' authority are rules about how individuals and groups work together (with rigorous discipline); how they communicate (widely and with granularity); and how leaders guide them toward a common goal (through example). Those rules, augmented by simple communication technologies and a lack of legal barriers to sharing information, create rich common knowledge, the ability to organize teams modularly, extraordinary motivation, and high levels of trust, which radically lowers transaction costs. Low transaction costs, in turn, make it profitable for organizations to perform more and smaller transactions--and so increase the pace and flexibility typical of high-performance organizations. Once the system achieves critical mass, it feeds on itself. The larger the system, the more broadly shared the knowledge, language, and work style. The greater individuals' reputational capital, the louder the applause and the stronger the motivation. The success of Linux is evidence of the power of that virtuous circle. Toyota's success is evidence that it is also powerful in conventional companies.

  16. Paediatric stoma care nursing in the UK and Ireland.

    Science.gov (United States)

    Waller, Marie

    Improving quality of care and developing and maintaining high standards of care are issues that are high on the NHS, nursing, and paediatric care agendas. Stoma formation will have an impact on the wellbeing and lifestyle of the person and their family, whatever the person's age. The specialty of stoma care nursing in the UK and Ireland is well established. However, the sub-specialty of paediatric stoma care nursing is much smaller in its 'membership' and its client group. There are differences in the needs of, and the associated care of, paediatric stoma patients even within this overall patient group. Paediatric stoma care nurses are in an ideal position to increase awareness about the specialty and improve standards of nursing care for neonates, children, adolescents and their families. However, until the establishment of the Paediatric Stoma Nurse Group (PSNG) in 2005, this 'position' had not being utilized. This article discusses the ongoing work of the PSNG to devise standards of paediatric stoma care nursing, best practice guidelines, relevant patient/parental information and establish itself as a valuable, proactive and independent forum for all healthcare professionals involved in the care of children with stomas.

  17. Fast tracking in paediatric cardiac anaesthesia : an update.

    Directory of Open Access Journals (Sweden)

    Lake Carol

    2002-01-01

    Full Text Available A care plan in which cardiac surgical patients progress quickly through the perioperative course to hospital discharge is often referred to as a Fast Track. Such care plans have been used extensively in adult cardiac patients but are also applicable to paediatric patients. Although no randomised controlled trials are available to document a reduction in hospital costs and avoidance of iatrogenic complications with paediatric fast tracks, many healthcare administrators encourage their use. Fast Track clinical guidelines usually include same day surgery, use of short- acting anaesthetic drugs, early extubation, effective pain management, and reduced intensive care unit stays. These protocols are certainly appropriate for simple procedures such as repair of atrial or ventricular septal defects or ligation of a patent ductus arteriosus. However, many paediatric cardiac anaesthesiologists consider that all paediatric patients without significant pulmonary or residual cardiac pathology can be managed using expedited postoperative protocols. Essential components in a "fast track" protocol include use of minimally invasive surgical techniques, modified ultrafiltration during cardiopulmonary bypass, transoesophageal echocardiography to evaluate the cardiac repair, and postoperative pain control. Using such techniques, 80-90% of paediatric patients can be extubated in the operating room or within 2-4 hours postoperatively. Despite the opinions of recognised experts, an appropriately sized and powered multicentre, controlled, randomised, prospective study is still needed to conclusively document the efficiency and effectiveness of the Fast Track in paediatric cardiac patients.

  18. Management of paediatric spontaneous pneumothorax: a multicentre retrospective case series.

    Science.gov (United States)

    Robinson, Paul D; Blackburn, Carol; Babl, Franz E; Gamage, Lalith; Schutz, Jacquie; Nogajski, Rebecca; Dalziel, Stuart; Donald, Colin B; Druda, Dino; Krieser, David; Neutze, Jocelyn; Acworth, Jason; Lee, Mark; Ngo, Peter K

    2015-10-01

    Paediatric guidelines are lacking for management of spontaneous pneumothorax. Adult patient-focused guidelines (British Thoracic Society 2003 and 2010) introduced aspiration as first-line intervention for primary spontaneous pneumothorax (PSP) and small secondary spontaneous pneumothoraces (SSP). Paediatric practice is unclear, and evidence for aspiration success rates is urgently required to develop paediatric-specific recommendations. Retrospective analysis of PSP and SSP management at nine paediatric emergency departments across Australia and New Zealand (2003-2010) to compare PSP and SSP management. 219 episodes of spontaneous pneumothorax occurred in 162 children (median age 15 years, 71% male); 155 PSP episodes in 120 children and 64 SSP episodes in 42 children. Intervention in PSP vs SSP episodes occurred in 55% (95% CI 47% to 62%) vs 70% (60% to 79%), pmanagement, PSP and SSP management did not differ and ICC insertion was the continuing preferred intervention. Overall success of aspiration was lower than reported results for adults, although success was greater for small than for large pneumothoraces. Paediatric prospective studies are urgently required to determine optimal paediatric interventional management strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Survey on sedation in paediatric dentistry: a global perspective.

    Science.gov (United States)

    Wilson, Stephen; Alcaino, Eduardo A

    2011-09-01

    Paediatric dentists receive training in sedation during their advanced education training, but evidence suggests that this training varies widely. The purpose of this study was to survey members of the International Association of Paediatric Dentistry (IAPD) and the European Academy of Paediatric Dentistry (EAPD) on their opinion on pharmacological and other behavioural management techniques and their training related to provision of oral health care of paediatric patients in the dental setting. A request was made for access to the IAPD and EAPD membership email addresses. The responses were recorded anonymously and data uploaded into spss (version 9) and analysed using descriptive analysis and chi-square with and without tabulation processes. A total of 311 respondents of 1973 targeted individuals answered the survey. The response rate was 16%. The majority of the respondents came from the continent of Europe, Asia, and the Americas. The most frequent type of sedation was general anaesthesia (52% of the respondents), followed by nitrous oxide (46%) and then oral sedation (44%). At least 91% of the respondents indicated that they were interested in the development of continuing education on the topic of sedation. Paediatric dentists around the world use relatively few behaviour management techniques, including pharmacological management. There is a definite interest in continuing education in the area of sedation. The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  20. starting infants on antiretroviral therapy clinical: paediatrics

    African Journals Online (AJOL)

    risk factors reported. Data from the KIDS-ART-LINC Cohort Collaboration (an .... with a positive test confirmed by virological testing if possible. .... Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the. Health Sector.

  1. Predictive factors for homologous transfusion during paediatric scoliosis surgery.

    Science.gov (United States)

    Dupuis, Claire; Michelet, Daphné; Hilly, Julie; Diallo, Thierno; Vidal, Christophe; Delivet, Honorine; Nivoche, Yves; Mazda, Keyvan; Dahmani, Souhayl

    2015-12-01

    Blood saving strategies during paediatric spinal surgery often include recombinant erythropoietin (rEPO) and antifibrinolytic therapy (AFT). The goal of this study was to investigate additional preventive factors involved in the risk of blood transfusion. This prospective study was designed with the aim of identifying factors associated with the perioperative (defined as the intraoperative and the first postoperative day) probability of homologous red cell transfusion during scoliosis surgery in children operated during a one year period in our institution. The predictors analysed were: age, weight less than the 3rd percentile (W 255 minutes. ROC analysis for the latter model found an area under the curve of 0.9 (95% confidence interval: 0.8-0.97). The accuracy of the model was 92.3% (97.4% for non-transfusion and 69.2% for transfusion). Multivariate sensitivity analysis excluding patients with no preoperative administration of EPO found similar results. The current results indicate that optimising nutritional status might prevent allogenic blood transfusion and requires further investigation. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  2. WHO and national lists of essential medicines in Mexico, Central and South America, and the Caribbean: are they adequate to promote paediatric endocrinology and diabetes care?

    Science.gov (United States)

    Rowlands, Amanda; Acosta-Gualandri, Alejandra; Guevara-Aguirre, Jaime; Chanoine, Jean-Pierre

    2016-01-01

    Paediatric endocrinology and diabetes is a paediatric specialty with less common conditions and higher cost medicines. Access to medicines for our specialty in low and middle income countries remains limited. We analysed the content of the WHO (children and adults) and of all available national Model Lists of Essential Medicines (EMLs) for Mexico, the Caribbean, Central and South America from a paediatric endocrinology and diabetes standpoint. A master list of medicines deemed necessary in paediatric endocrinology and diabetes was established and compared with the WHO and national EMLs, taking into account the gross national income. The WHO EMLs, which are largely recognised as an international benchmark and drive the content of the national EMLs, included many but not all medicines present on our master list. Interestingly, several national EMLs from richer countries included medicines that were not present in the WHO EMLs. Our analysis suggests that these medicines could be considered by the WHO for inclusion in their EMLs, which may promote the adoption of more medicines by individual countries. We also propose several changes to the WHO and national EMLs that could facilitate access to medicines in our specialty: age cut-off for a child using physical maturity rather than a set age limit; greater standardisation of the formatting of the national EMLs for easier comparison and collaborations between countries; greater emphasis on age-specificity and population-specificity for some medicines; and formatting of the EMLs in a disease-focused manner rather than as individual medicines. PMID:28588968

  3. Managing collaborative design

    NARCIS (Netherlands)

    Sebastian, R.

    2007-01-01

    Collaborative design has been emerging in building projects everywhere. The more complex a building project becomes, the closer and more intensive collaboration between the design actors is required. This research focuses on collaborative design in the conceptual architecture design phase,

  4. Collaborative networks: Reference modeling

    NARCIS (Netherlands)

    Camarinha-Matos, L.M.; Afsarmanesh, H.

    2008-01-01

    Collaborative Networks: Reference Modeling works to establish a theoretical foundation for Collaborative Networks. Particular emphasis is put on modeling multiple facets of collaborative networks and establishing a comprehensive modeling framework that captures and structures diverse perspectives of

  5. Bed Utilisation in an Irish Regional Paediatric Unit A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP)

    LENUS (Irish Health Repository)

    Ó hAiseadha, Coilín

    2016-05-01

    Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources.

  6. Developing family-friendly signage in a South African paediatric healthcare setting.

    Science.gov (United States)

    Leonard, Angela L; Verster, Anchen; Coetzee, Minette

    2014-11-28

    Multiple renovations and changing flow in a tertiary children's hospital in Cape Town resulted in numerous signs being posted in the corridors and units, making wayfinding extremely complex. A request from nursing management prompted the formation of a learning collaborative of nurses from all departments to improve wayfinding signage. The project aimed to contribute to a family-friendly environment by reviewing the current situation and developing signage to improve wayfinding and convey essential information to parents, caregivers and patients. A participative action research method followed a four-stage process to facilitate the development of family-friendly signage. Nurse participants reviewed existing signage and collaboratively developed new signage templates and posted signs. The signage was then evaluated using a rapid appraisal questionnaire involving 50 parents and nurse respondents. At each stage of data collection, thematic content analysis was used to analyse data gathered in process meetings and the reflections of participating nurses. A design template and then 44 new signs were developed and used to replace old signage. Respondents reported that the new signs were noticeable, looked attractive and were easily understandable. Intentional and active participation of nurses in clinical paediatric settings ensured collaborative data gathering and analysis. An inclusive research design allowed for insights into the words and tone of posted signs that nurse participants had not noticed previously. The participative redesign of signage resulted in a sense of ownership of the signs.The support and involvement of hospital management throughout ensured that the resulting signage received wide acceptance.

  7. Dose estimation for paediatric cranial computed tomography

    International Nuclear Information System (INIS)

    Curci Daros, K.A.; Bitelli Medeiros, R.; Curci Daros, K.A.; Oliveira Echeimberg, J. de

    2006-01-01

    In the last ten years, the number of paediatric computed tomography (CT) scans have increased worldwide, contributing to higher population radiation dose. Technique diversification in paediatrics and different CT equipment technologies have led to various exposure levels complicating precise evaluation of doses and operational conditions necessary for good quality images. The objective of this study was to establish a quantitative relationship between absorbed dose and cranial region in children up to 6 years old undergoing CT exams. Methods: X-ray was measured on the cranial surface of 64 patients undergoing CT using thermoluminescent (T.L.) dosimeters. Forty T.L.D.100 thermoluminescent dosimeters (T.L.D.) were evenly distributed on each patients skin surface along the sagittal axis. Measurements were performed in facial regions exposed to scatter radiation and in the supratentorial and posterior fossa regions, submitted to primary radiation. T.L.D. were calibrated for 120 kV X-ray over the acrylic phantom. T.L. measurements were made with a Harshaw 4000 system. Patient mean T.L. readings were determined for position, pi, of T.L.D. and normalized to the maximum supratentorial reading. From integrating the linear T.L. density function (?) resulting from radiation distribution in each of the three exposed regions, dose fraction was determined in the region of interest, along with total dose under the technical conditions used in that specific exam protocol. For each T.L.D. position along the patient cranium, there were n T.L. measurements with 2% uncertainty due to T.L. reader, and 5% due to thermal treatment of dosimeters. Also, mean T.L. readings and their uncertainties were calculated for each patient at each position, p. Results: Mean linear T.L. density for the region exposed to secondary radiation defined by position, 0.3≤p≤6 cm, was ρ((p)=7.9(4)x10 -2 +7(5)x10 -5 p 4.5(4) cm -1 ; exposed to primary X-ray for the posterior fossa region defined by position

  8. Dose estimation for paediatric cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Curci Daros, K.A.; Bitelli Medeiros, R. [Sao Paulo Univ. Federal (Brazil); Curci Daros, K.A.; Oliveira Echeimberg, J. de [Centro Univ. Sao Camilo, Sao Paulo (Brazil)

    2006-07-01

    In the last ten years, the number of paediatric computed tomography (CT) scans have increased worldwide, contributing to higher population radiation dose. Technique diversification in paediatrics and different CT equipment technologies have led to various exposure levels complicating precise evaluation of doses and operational conditions necessary for good quality images. The objective of this study was to establish a quantitative relationship between absorbed dose and cranial region in children up to 6 years old undergoing CT exams. Methods: X-ray was measured on the cranial surface of 64 patients undergoing CT using thermoluminescent (T.L.) dosimeters. Forty T.L.D.100 thermoluminescent dosimeters (T.L.D.) were evenly distributed on each patients skin surface along the sagittal axis. Measurements were performed in facial regions exposed to scatter radiation and in the supratentorial and posterior fossa regions, submitted to primary radiation. T.L.D. were calibrated for 120 kV X-ray over the acrylic phantom. T.L. measurements were made with a Harshaw 4000 system. Patient mean T.L. readings were determined for position, pi, of T.L.D. and normalized to the maximum supratentorial reading. From integrating the linear T.L. density function (?) resulting from radiation distribution in each of the three exposed regions, dose fraction was determined in the region of interest, along with total dose under the technical conditions used in that specific exam protocol. For each T.L.D. position along the patient cranium, there were n T.L. measurements with 2% uncertainty due to T.L. reader, and 5% due to thermal treatment of dosimeters. Also, mean T.L. readings and their uncertainties were calculated for each patient at each position, p. Results: Mean linear T.L. density for the region exposed to secondary radiation defined by position, 0.3{<=}p{<=}6 cm, was {rho}((p)=7.9(4)x10{sup -2}+7(5)x10{sup -5}p{sup 4.5(4)} cm{sup -1}; exposed to primary X-ray for the posterior fossa

  9. Measurement of adult and paediatric patient doses during head CT scan

    International Nuclear Information System (INIS)

    Suliman, S. A.

    2011-03-01

    CT represents only 5% of all x-ray imaging and yet the radiation from CT examination is 40% to 67% of all medical radiation. The dose from single CT examinations can range from 1.0 mSv to 27.0 mSv. The radiation given by diagnostic CT is comparable to the low dose received by Japanese survivors of the atomic bombs. As per united nations scientific committee UNSCEAR 2000(2), CT contributes over 34% collective dose from diagnostic x-ray examinations in the world. This figure is much larger than this for developed countries, approaching as much as 50% to 70% even thought the frequency of CT examinations in these countries is of the order of 5 to 12%. It thus implies a small but statistically significant increased risk for developing cancer as a result of the radiation. The objective of the study were to investigate doses from CT examinations of adult and paediatric patients in brain CT examination and compare the doses with international standard as provided in DRLs. A total of 59 patients (paediatric and adults) were examined at the department of radiology, Al Ribat University Hospital-Khartoum. The mean age was 40.80 years for adults while the mean weight was 70.04 kg and the mean age for paediatric was 5.10 years while the mean weight was 20kg. DLP for adults were 1000.25 mGy.cm, 733.33 for paediatrics. The mean effective dose for adults patient was 0.48 mSv in rang (0.49-0.44)mSv, while for paediatric patients was 0.31 mSv in rang between (0.49-0.11) mSv. The DRL was 1120 mGy.cm, a value which is higher than the European Guidelines on quality criteria for computed tomography. The study has shown a great need for referring criteria, continuous training of staff in radiation dose optimization concepts. Further studies are required in order to establish a reference level in Sudan.(Author)

  10. Paediatric acute epiglottitis: not a disappearing entity.

    Science.gov (United States)

    McEwan, John; Giridharan, Wijayasingham; Clarke, Raymond W; Shears, Paul

    2003-04-01

    Paediatric epiglottitis is a serious, potentially life-threatening condition. Since the widespread introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine in the UK in October 1992, there has been a dramatic reduction in its incidence. Vaccine failure is rare. The purpose of this study is to examine the failure rate of H. influenzae type b vaccine as measured by the number of cases of Haemophilus epiglottitis in fully vaccinated children presenting to a tertiary paediatric centre. A secondary aim is to provide a retrospective review of all cases of epiglottitis over a 13-year period. A retrospective case-note review identifying all cases of epiglottitis presenting to Alder Hey Hospital was undertaken covering the time period December 1987-January 2001. Details of patient age, sex, source of referral, clinical presentation, management and complications along with microbiological and serological findings were obtained. There were 21 males and 19 females. The mean age was 36 months (range 6-125 months). A provisional diagnosis was made on the basis of the clinical features, confirmed by direct laryngoscopy in all but two cases and further supported in 28 cases by a positive blood culture. Of the 40 children presenting with epiglottitis, eight (20%) presented after the introduction of the Hib conjugate vaccine. H. influenzae antibody titres were measured both in the acute and convalescent phases of illness by the central Haemophilus Reference Unit in Oxford. We present the clinical features, management and complications of 40 cases of acute epiglottitis. H. influenzae was isolated from blood cultures in 28 cases (70%). In 12 of these cases, H. influenzae type b was identified, seven prior to 1993 and five thereafter. Four of these five cases presenting after introduction of the Hib vaccine were known to have been fully vaccinated. One child had a history of prematurity and serum immunoglobulin estimation was abnormally low in another child. Acute Hib

  11. Family environment influences emotion recognition following paediatric traumatic brain injury.

    Science.gov (United States)

    Schmidt, Adam T; Orsten, Kimberley D; Hanten, Gerri R; Li, Xiaoqi; Levin, Harvey S

    2010-01-01

    This study investigated the relationship between family functioning and performance on two tasks of emotion recognition (emotional prosody and face emotion recognition) and a cognitive control procedure (the Flanker task) following paediatric traumatic brain injury (TBI) or orthopaedic injury (OI). A total of 142 children (75 TBI, 67 OI) were assessed on three occasions: baseline, 3 months and 1 year post-injury on the two emotion recognition tasks and the Flanker task. Caregivers also completed the Life Stressors and Resources Scale (LISRES) on each occasion. Growth curve analysis was used to analyse the data. Results indicated that family functioning influenced performance on the emotional prosody and Flanker tasks but not on the face emotion recognition task. Findings on both the emotional prosody and Flanker tasks were generally similar across groups. However, financial resources emerged as significantly related to emotional prosody performance in the TBI group only (p = 0.0123). Findings suggest family functioning variables--especially financial resources--can influence performance on an emotional processing task following TBI in children.

  12. Knowledge and use of evidence-based nutrition : a survey of paediatric dietitians

    NARCIS (Netherlands)

    Thomas, DE; Kukuruzovic, R; Martino, B; Chauhan, SS; Elliott, EJ

    2003-01-01

    Objective To survey paediatric dietitians' knowledge and use of evidence-based nutrition (EBN). Design Cross-sectional survey using reply-paid questionnaires. Subjects Paediatric dietitians in Australian teaching hospitals. Main outcome measures Age, sex, appointment, clinical practice, research

  13. Investigation of the degradation mechanisms of a variety of organic photovoltaic devices by combination of imaging techniques—the ISOS-3 inter-laboratory collaboration

    DEFF Research Database (Denmark)

    Rösch, Roland; Tanenbaum, David; Jørgensen, Mikkel

    2012-01-01

    The investigation of degradation of seven distinct sets (with a number of individual cells of n $ 12) of state of the art organic photovoltaic devices prepared by leading research laboratories with a combination of imaging methods is reported. All devices have been shipped to and degraded at Risø...

  14. Current practice in paediatric basic life support

    Directory of Open Access Journals (Sweden)

    Heczková Jana

    2017-06-01

    Full Text Available Introduction. Although the incidence of cardiac arrest in children is much lower than in adults, the condition is still considered a major health problem with a very low chance for survival. As in adults, the timely provision of cardiopulmonary resuscitation (CPR in children is crucial. Current guidelines for CPR in children were published along with the guidelines for CPR in adults in 2015. As in previous years, they are based on consensus provided by International Liaison Committee on Resuscitation (ILCOR. Guidelines of particular ILCOR member councils may vary and reflect regional characteristic such as different access to health care, education methods or willingness of population to provide emergency assistance. Moreover, the conditions requiring CPR in children are characterized not only by different incidence, but also by aetiology or techniques used for different age groups. Therefore, emphasis is put on simplicity and feasibility as well as on consistency with adult guidelines to improve retention of the paediatric sequences. Nurses may be first rescuers not only in health care facilities. Better understanding of CPR guidelines might help them to improve their ability to detect conditions requiring CRP and also initiate and provide effective emergency care.

  15. Paediatric analgesia in an Emergency Department.

    LENUS (Irish Health Repository)

    Hawkes, C

    2012-02-03

    Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. An audit including 145 patients followed this. 55.6% of patients with major fractures received analgesia after a median time of 54 minutes, which improved to 61.1% (p = 0.735) after 7 minutes (p = 0.004). Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.

  16. Radionuclide studies in paediatric nephro-urology

    Energy Technology Data Exchange (ETDEWEB)

    Piepsz, Amy E-mail: amypiepsz@yahoo.com

    2002-08-01

    The main tool of radionuclide techniques applied to paediatric uro-nephrology is the quantitation of function, which is an information not easily obtained by other diagnostic modalities. The radiation burden is low. Drug sedation is only rarely needed, whatever the age of the patient. Accurate determination of glomerular filtration rate can be obtained by means of an intravenous injection of Cr-51 EDTA and one or two blood samples. Tc-99m DMSA scintigraphy is an accurate method for evaluation of regional cortical impairment during acute pyelonephritis and later on, for detection of permanent scarring. Tc-99m MAG3 renography is nowadays a well-standardized method for accurate estimation of the split renal function and of renal drainage with or without furosemide challenge. This technique is particularly indicated in uni- or bilateral uropathies with or without renal and/or ureteral dilatation. Direct and indirect radionuclide cystography are two alternative modalities for X-ray MCUG. Their relative place in the strategy of management of vesicoureteral reflux is discussed.

  17. Paediatrics and psychoanalysis--Miss Anna Freud.

    Science.gov (United States)

    1983-01-01

    Miss Anna Freud died during the winter at the age of 86. She had been a pioneer in the understanding of children through psychoanalysis and a great champion of the rights of children. Her life began in Vienna as the youngest child of Sigmund Freud, and her early work with children was in Austria. In 1938, because of the Nazi régime and even though she was nursing her father during his terminal illness, she had to escape with him to London. Her work with homeless children and with those in residential nurseries in London during the second world war is well known, as is her work on child development and psychopathology in the postwar years. But one less well known aspect of her life that was of immense importance to a few fortunate British paediatricians was the 'paediatric group' that she ran for over a quarter of a century and which Dr Christine Cooper recalled at the memorial meeting in London earlier this year. PMID:6344806

  18. PAEDIATRIC OCULAR TRAUMA IN KUCHING, SARAWAK, MALAYSIA

    Directory of Open Access Journals (Sweden)

    INTAN G

    2011-01-01

    Full Text Available Purpose: To evaluate the demography, aetiology, type and outcome of paediatric ocular trauma in tertiary centre in Malaysia. Method: We retrospectively studied 118 eyes from 117 patients over a period of 36 months (January 2006 to December 2008. All ocular injuries in patients aged 12 and below seen in the Ophthalmology Department for the first time were included in thisstudy. Results: Mean age of patients was 6.1±3.0 years. 68 cases (58.2% occurred in pre-school children, whereas 49 (41.9% in school-aged children. Boys accounted for 65.8% of cases. There was no predilection for either right or the left eye. 47% of cases (56 patients occurred in Malay. Most of the injuries took place at home when the children were alone (p<0.05. Sharp objects were the commonest cause (45 cases, 38.1%. The majority of cases (103, 87.3% were considered preventable. The frequency of open and closed globe injury was similar. Hyphema was more common in closed globe injury compared to open globe injury (p<0.05. Other associated injuries such as cataract, vitreous hemorrhage and retinal hemorrhage are similar between the two groups. Visual outcome is generally poor with only 34 eyes (28.8% had no visual impairment. Conclusion: Ocular trauma in children is an important cause of visual loss. Most cases occurred at home and were preventable. Prevention through education is the best approach.

  19. Gait and Lower Limb Observation of Paediatrics (GALLOP): development of a consensus based paediatric podiatry and physiotherapy standardised recording proforma.

    Science.gov (United States)

    Cranage, Simone; Banwell, Helen; Williams, Cylie M

    2016-01-01

    Paediatric gait and lower limb assessments are frequently undertaken in podiatry and physiotherapy clinical practice and this is a growing area of expertise within Australia. No concise paediatric standardised recording proforma exists to assist clinicians in clinical practice. The aim of this study was to develop a gait and lower limb standardised recording proforma guided by the literature and consensus, for assessment of the paediatric foot and lower limb in children aged 0-18 years. Expert Australian podiatrists and physiotherapists were invited to participate in a three round Delphi survey panel using the online Qualtrics(©) survey platform. The first round of the survey consisted of open-ended questions on paediatric gait and lower limb assessment developed from existing templates and a literature search of standardised lower limb assessment methods. Rounds two and three consisted of statements developed from the first round responses. Questions and statements were included in the final proforma if 70 % or more of the participants indicated consensus or agreement with the assessment method and if there was support within the literature for paediatric age-specific normative data with acceptable reliability of outcome measures. There were 17 of the 21 (81 %) participants who completed three rounds of the survey. Consensus was achieved for 41 statements in Round one, 54 statements achieved agreement in two subsequent rounds. Participants agreed on 95 statements relating to birth history, developmental history, hip measurement, rotation of the lower limb, ankle range of motion, foot posture, balance and gait. Assessments with acceptable validity and reliability were included within the final Gait and Lower Limb Observation of Paediatrics (GALLOP) proforma. The GALLOP proforma is a consensus based, systematic and standardised way to collect information and outcome measures in paediatric lower limb assessment. This standardised recording proforma will assist

  20. Paediatric tracheostomy-An 11 year experience at a Scottish paediatric tertiary referral centre.

    Science.gov (United States)

    Douglas, C M; Poole-Cowley, J; Morrissey, S; Kubba, H; Clement, W A; Wynne, D

    2015-10-01

    The aim of this paper was to review the indications, complications and outcomes for tracheostomy at a Scottish paediatric tertiary referral hospital. All patients undergoing tracheostomy between January 2001 and September 2012 were identified. A retrospective case note analysis was performed. 111 tracheostomies were done in the study period. The mean number per year was 11 (3-12). Full data was available for 95 patients. There were 56 (59%) males and 39 (41%) females. Age at time of tracheostomy ranged from one day to 15 years, the mean age of tracheostomy insertion was 69 weeks. The majority of patients, 75 (79%), were under one year old when they had their tracheostomy. The most common indication was long-term ventilation (20%), followed by craniofacial abnormality causing airway obstruction (18%), followed by subglottic stenosis (14%). 37% of patients were decannulated. This series reflects current trends in the indications for paediatric tracheostomy, with chronic lung disease of prematurity being the most common indication. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Radiation risks knowledge in resident and fellow in paediatrics: a questionnaire survey.

    Science.gov (United States)

    Salerno, Sergio; Marchese, Paola; Magistrelli, Andrea; Tomà, Paolo; Matranga, Domenica; Midiri, Massimo; Ugazio, Alberto G; Corsello, Giovanni

    2015-03-22

    Analyse through a multi-choice anonymous questionnaire the knowledge's level in paediatric residents and fellows in two different main Italian hospital, looking mainly to the information to patients and relatives related to risks of ionizing radiation used in common radiological investigations in children. 65 multi choice questionnaires were distributed to paediatric residents and fellows of two different hospitals, an University Hospital (A.O.U.P. "P. Giaccone"- University of Palermo) and a national reference centre for paediatrics (Ospedale Pediatrico Bambino Gesù - Rome). The questionnaire included twelve multiple-choice questions with the aim of analyzing the knowledge about ionizing radiation related risks in infants and children who undergo common diagnostic radiology investigations. The data obtained were processed using software Stata/MP version 11.2. In order to measure the level of expertise of each interviewee a binary indicator was built. The value 1 was assigned if the percentage of correct answers exceeds the median of the distribution and 0 for values not exceeding the median. The association between the level of competence and demographic characteristics (gender, age) and training experience was measured by means of α(2) test. 51/65 questionnaires were completed, returned and analysed (87.7%). Only 18 surveyed (35%), (95% IC = [22%-48%]) can be defined as competent in radiation risk knowledge for common radiological investigations, considering the percentage of correct answers at least of 50% (sufficient knowledge was given with a minimum score of 8 correct answers out of 12). The study demonstrates an urgent need to implement the radiation protection knowledge in the training programme of paediatricians, that improve if just a short targeted training is performed.

  2. Optimal assessment of paediatric IBD with MRI and barium follow-through.

    Science.gov (United States)

    Giles, Edward; Hanci, Ozan; McLean, Alison; Power, Niall; Cole, Angela; Croft, Nicholas M; McDonald, Kirsteen; Chippington, Sam; Naik, Sandhia

    2012-06-01

    The present UK criterion standard for assessing children with suspected inflammatory bowel disease (IBD) is upper endoscopy, ileocolonoscopy, and barium follow-through (BaFT). Significant doses of radiation, unpalatable contrast, and volume intolerance are involved with BaFT. Practice in investigating Crohn disease (CD) is changing with the increasing use of magnetic resonance imaging (MRI). The aim of the present study was to compare BaFT and a new abdominal MRI protocol in a paediatric IBD population. All consecutive patients with a new diagnosis of IBD or requiring reassessment from September 2008 to December 2010 were investigated with both abdominal MRI and BaFT in accordance with a specific local paediatric IBD protocol. The studies were reported by nonblinded radiologists with an interest in gastrointestinal imaging. The reports were compared in conjunction with case note review. Eighty-seven patients underwent both BaFT and MRI abdomen. Thirty-one percent of patients had additional pathology on MRI, not seen on the BaFT. Sixty-seven percent of patients (n=59) had an MRI finding equivalent to BaFT. Using histology as a criterion standard for detecting terminal ileal disease, BaFT had a sensitivity and specificity of 76% and 67%, and MRI had a sensitivity and specificity of 83% and 95%, respectively. This is the largest series of small bowel MRI in a paediatric population. MRI reports were at least equivalent to BaFT. MRI had higher sensitivity and, particularly, specificity in detecting terminal ileal pathology. These findings suggest that MRI should become the criterion standard investigation in children with IBD in centres with appropriate expertise, with zero radiation exposure being highly advantageous.

  3. Finally in Italy the School of Specialisation in Paediatric Dentistry!

    Science.gov (United States)

    Marzo, G

    2017-06-01

    After over two decades of discussions, promises and indecisions, the year 2016 marked the birth of the School of Specialisation in Paediatric Dentistry, which is now a reality. The importance of dental post-graduate specialisation schools has been debated since the Degree Course in Dentistry was established. Previously, in Italy only two dental branches - Oral Surgery and Orthodontics - had obtained the recognition that a School of Specialisation entails. Today, with specific training and the newly- established hyper-specialisation in Paediatric Dentistry, the future of the profession is brighter than ever. This will allow dental professionals to provide the best cure to our young patients but it especially marks and recognises the importance of prevention in general. Having established a Specialty School in Paediatric Dentistry is also important to keep the pace with the other European countries where this postgraduate course has been already offered for many years. In my opinion, training professionals with a solid specialisation based both on cultural insights and hands-on clinical activities translates into the possibility of making true prevention. The ultimate goal of paediatric dentists, as well as paediatricians, is certainly to treat young patients but also and above all to accompany them toward an adulthood possibly free of pathologies. With an eye to a future where Paediatric Dentistry will be at the core of dental and orthodontic prevention, I wish great success to all the many specialisation schools established within the Italian Universities.

  4. Peer mentoring: evaluation of a novel programme in paediatrics.

    Science.gov (United States)

    Eisen, Sarah; Sukhani, Seema; Brightwell, Alex; Stoneham, Sara; Long, Andrew

    2014-02-01

    Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes within paediatrics described in the literature. We developed a regional peer mentoring programme for postgraduate trainees in paediatrics to assess demand and need for peer mentoring and to explore the benefits for both peer mentees and mentors. Junior postgraduate trainees, randomly selected from volunteers, received peer mentoring from more senior trainees for 1 year. Peer mentors were selected by competitive application and undertook tailored training followed by an experiential learning programme. The programme was evaluated using structured questionnaires. 90% (76/84) of first-year postgraduate trainees in paediatrics applied to participate, demonstrating high demand. 18 peer mentor-mentee pairs were matched. Peer mentors and mentees reported high satisfaction rates, acquisition of new and transferable skills and changed behaviours. All peer mentors intended to use the skills in their workplace and, later, as an educational supervisor. Our programme represents a novel approach to meeting the demonstrated demand and the curriculum requirement for peer mentoring, and enabled peer mentors and mentees to develop a valuable and versatile skill set. To our knowledge, it is the first such programme in paediatrics and provides a feasibility model that may be adapted locally to allow education providers to offer this important experience to postgraduate trainees.

  5. Complementary and alternative medicine use among paediatric emergency department patients.

    Science.gov (United States)

    Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E

    2015-09-01

    To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  6. Use of antibiotics in paediatric long-term care facilities.

    Science.gov (United States)

    Murray, M T; Johnson, C L; Cohen, B; Jackson, O; Jones, L K; Saiman, L; Larson, E L; Neu, N

    2018-06-01

    Adult long-term care (LTC) facilities have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC facilities. To describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. A retrospective cohort study was conducted from September 2012 to December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAIs), antimicrobial use and diagnostic testing. Logistic regression was used to identify predictors for antibiotic use. The association between susceptibility testing results and appropriate antibiotic coverage was determined using Chi-squared test. Fifty-eight percent (413/717) of residents had at least one HAI, and 79% (325/413) of these residents were treated with at least one antibiotic course, totalling 2.75 antibiotic courses per 1000 resident-days. Length of enrolment greater than one year, having a neurological disorder, having a tracheostomy, and being hospitalized at least once during the study period were significantly associated with receiving antibiotics when controlling for facility (all P facilities is widespread. There is further need to assess antibiotic use in paediatric LTC facilities. Evaluation of the adverse outcomes associated with inappropriate antibiotic use, including the prevalence of resistant organisms in paediatric LTC facilities, is critical. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Smartphone applications in paediatric radiology: availability and authority

    International Nuclear Information System (INIS)

    Shelmerdine, Susan C.; Lynch, Jeremy O.

    2015-01-01

    With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families. (orig.)

  8. Prebiotics as a modulator of gut microbiota in paediatric obesity.

    Science.gov (United States)

    Nicolucci, A C; Reimer, R A

    2017-08-01

    This review highlights our current understanding of the role of gut microbiota in paediatric obesity and the potential role for dietary manipulation of the gut microbiota with prebiotics in managing paediatric obesity. The aetiology of obesity is multifactorial and is now known to include microbial dysbiosis in the gut. Prebiotics are non-digestible carbohydrates which selectively modulate the number and/or composition of gut microbes. The goal of prebiotic consumption is to restore symbiosis and thereby confer health benefits to the host. There is convincing evidence that prebiotics can reduce adiposity and improve metabolic health in preclinical rodent models. Furthermore, there are several clinical trials in adult humans highlighting metabolic and appetite-regulating benefits of prebiotics. In paediatric obesity, however, there are very limited data regarding the potential role of prebiotics as a dietary intervention for obesity management. As the prevalence of paediatric obesity and obesity-associated comorbidities increases globally, interventions that target the progression of obesity from an early age are essential in slowing the obesity epidemic. This review emphasizes the need for further research assessing the role of prebiotics, particularly as an intervention in effectively managing paediatric obesity. © 2016 World Obesity Federation.

  9. Smartphone applications in paediatric radiology: availability and authority

    Energy Technology Data Exchange (ETDEWEB)

    Shelmerdine, Susan C. [Great Ormond Street Hospital, Specialist Registrar in Clinical Radiology, Department of Clinical Radiology, London (United Kingdom); Lynch, Jeremy O. [Chelsea and Westminster Hospital, Specialist Registrar in Clinical Radiology, Department of Clinical Radiology, London (United Kingdom)

    2015-08-15

    With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families. (orig.)

  10. The use of the Statscan digital X-ray unit in paediatric polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Pitcher, Richard D. [University of Cape Town, Division of Paediatric Radiology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); Wilde, Jim C.H. [University of Cape Town, Division of Paediatric Surgery, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); University of Amsterdam, Paediatric Surgical Centre of Amsterdam, Emma Children' s Hospital, Academic Medical Centre, Amsterdam (Netherlands); Douglas, Tania S. [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town (South Africa); As, Arjan Bastiaan van [University of Cape Town, Division of Paediatric Surgery, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa)

    2009-05-15

    We present a 3-year review of clinical paediatric experience with the statscan (Lodox Systems, Johannesburg, South Africa), a low-dose, digital, whole-body, slit-scanning X-ray machine. While focusing on the role of the unit in paediatric polytrauma, insight into its applications in other paediatric settings is provided. (orig.)

  11. The use of the Statscan digital X-ray unit in paediatric polytrauma

    International Nuclear Information System (INIS)

    Pitcher, Richard D.; Wilde, Jim C.H.; Douglas, Tania S.; As, Arjan Bastiaan van

    2009-01-01

    We present a 3-year review of clinical paediatric experience with the statscan (Lodox Systems, Johannesburg, South Africa), a low-dose, digital, whole-body, slit-scanning X-ray machine. While focusing on the role of the unit in paediatric polytrauma, insight into its applications in other paediatric settings is provided. (orig.)

  12. A day in the life of a paediatric surgeon: a PAPSA research study ...

    African Journals Online (AJOL)

    Objectives This study aimed to create a snapshot picture of the global workload of paediatric surgeons and identify differences between countries. Methods Surgeons from 13 paediatric surgical units in different countries across the world were asked to record the number and type of admissions to the paediatric surgery ...

  13. Routine studies of swallowed radionuclide transit in paediatrics: experience with 400 patients

    International Nuclear Information System (INIS)

    Guillet, J.; Basse-Cathalinat, B.; Christophe, E.; Blanquet, P.; Wynchank, S.

    1984-01-01

    Scintigraphic studies of swallowed 99 m Tc-sulphur colloid mixed with a few millilitres of liquid, performed on 400 paediatric patients of all ages, allowed visualisation of foregut function and measurement of oesophageal transit time and gastric emptying proportions. This non-invasive and physiological procedure requires a standard gamma camera with computing facilities and was performed as an outpatient routine. It proved very effective for the detection of gastro-oesophageal reflux and aspiration of refluxed liquid in patients of all ages but especially in neonates. The relevance of these scintigraphic results to oesophagitis, repeated respiratory problems, cyanotic and apnoeic spells and alternative methods of investigation is described. (orig.)

  14. Evaluation of the entrance skin dose due to paediatric chest X-rays examinations carried out at a great hospital in Rio de Janeiro city

    International Nuclear Information System (INIS)

    Mohamadain, K.E.M.; Azevedo, A.C.P.; Rosa, L.A.R. da; Mota, H.C.; Goncalves, O.D.; Guebel, M.R.N.

    2001-01-01

    A dosimetric survey in paediatric radiology is currently being carried out at the paediatric unit of a great hospital in Rio de Janeiro city, aiming the assessment of patient doses and image quality. The aim of this work was to estimate the entrance skin dose for frontal and lateral chest X-rays exposure to paediatric patients. Three examination techniques were investigated, namely PA, AP and lateral positions. For entrance skin dose evaluation, two different TL dosimeters were used, namely LiF:Mg,Ti and CaSO4:Dy. The age intervals considered were 0-1 year, 1-5 years, 5-10 years and 10-15 years. The results obtained with both dosimeters are similar and the entrance skin dose values evaluated for the different age intervals considered are compared with previous values found in Brazil and also in Europe. (author)

  15. TOF-SIMS investigation of degradation pathways occurring in a variety of organic photovoltaic devices – the ISOS-3 inter-laboratory collaboration

    DEFF Research Database (Denmark)

    Andreasen, Birgitta; Tanenbaum, David; Hermenau, Martin

    2012-01-01

    -depth in the organic solar cells. Various degradation mechanisms were investigated and correlated with cell performance. For example, photo-oxidation of the active material was quantitatively studied as a function of cell performance. The large variety of cell architectures used (some with and some without......-destructive and destructive techniques in order to identify specific degradation mechanisms responsible for the deterioration of the photovoltaic response. Work presented herein involves time-of-flight secondary ion mass spectrometry (TOF-SIMS) in order to study chemical degradation in-plane as well as in...... of organic solar cells....

  16. Quality of outpatient paediatric chest radiography - a pilot study

    International Nuclear Information System (INIS)

    Engelmann, D.; Duetting, T.; Wunsch, R.; Troeger, J.

    2001-01-01

    A quality control of outpatient paediatric chest X-rays was conducted in a sample of patients of one paediatric practice. During a period of eight months the technical image quality was analysed considering both diagnostic aspects and radiation protection. The quality of the 139 examined chest X-rays was inadequate concerning the collimation and focussing of the X-rays and the positioning of the patients. Exposure was estimated as average, sharpness was rated as good. In total 14% of the X-rays were not suitable for medical diagnosis. Image quality of the X-rays of infants (children younger than 6 years) was significantly lower compared to the total sample. Radiation protection standards were not fulfilled. As a conclusion from our results, improvements in outpatient paediatric radiography are urgently necessary. Quality control committees should pay particular attention in radiographs of infants. (orig.) [de

  17. Use of complementary/alternative medicine among paediatric patients

    DEFF Research Database (Denmark)

    Madsen, Hanne; Andersen, Susie; Nielsen, Rasmus Gaardskaer

    2003-01-01

    Hospital during a 2 week period in the autumn of 2001 were asked to participate. In total, 622 (92%) patients participated. The data were collected in an interviewer administered questionnaire during a short structured interview with the patient and parents. CAM was divided into herbal medicine (herbal......UNLABELLED: The use of complementary/alternative medicine (CAM) is increasing. The aim was to characterise the use of CAM among patients in a paediatric department. All patients (aged 0-18 years), out-patients or hospitalised, in contact with the Department of Paediatrics, Odense University...... patients suffering from gastrointestinal diseases or hospitalised for observation. More than 50% of the users experienced positive effects and 6% had side-effects from AM. Of the CAM users, 11% or 2% of the total paediatric population used CAM instead of conventional medicines. CONCLUSION...

  18. Paediatric Pain Management: Using Complementary and Alternative Medicine.

    Science.gov (United States)

    Evans, Subhadra; Tsao, Jennie C I; Zeltzer, Lonnie K

    2008-09-01

    Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic paediatric pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic paediatric pain.Although research is limited for paediatric pain, CAM interventions receiving the most empirical attention include hypnotherapy, acupuncture and music therapy. Evidence also exists for the therapeutic benefits of yoga, massage, humor therapy and the use of certain biological based therapies.

  19. Review of simulation in paediatrics: The evolution of a revolution

    Directory of Open Access Journals (Sweden)

    Rahul eOjha

    2015-11-01

    Full Text Available Recent changes in medical education have highlighted the importance of experiential learning. Simulation is one model that has gained significant attention in the last decade and has been widely adopted as a training and assessment tool in medical education. Paediatric simulation has been utilized to teach various skills including resuscitation and trauma management, procedural skills and team training. It is also a valuable tool for health care educators, as it allows learners to achieve competence without putting patients at risk. Recent literature demonstrates increased retention of knowledge and skills after simulation based training. Further research is required to improve current simulation curriculums, develop validated assessment tools and to demonstrate improved clinical outcomes after simulation based training. We conducted an online search of original and review articles related to simulation and paediatric medical education and provide an overview of the role and utility of simulation in paediatrics.

  20. Magnetic resonance spectroscopy metabolite profiles predict survival in paediatric brain tumours.

    Science.gov (United States)

    Wilson, Martin; Cummins, Carole L; Macpherson, Lesley; Sun, Yu; Natarajan, Kal; Grundy, Richard G; Arvanitis, Theodoros N; Kauppinen, Risto A; Peet, Andrew C

    2013-01-01

    Brain tumours cause the highest mortality and morbidity rate of all childhood tumour groups and new methods are required to improve clinical management. (1)H magnetic resonance spectroscopy (MRS) allows non-invasive concentration measurements of small molecules present in tumour tissue, providing clinically useful imaging biomarkers. The primary aim of this study was to investigate whether MRS detectable molecules can predict the survival of paediatric brain tumour patients. Short echo time (30ms) single voxel (1)H MRS was performed on children attending Birmingham Children's Hospital with a suspected brain tumour and 115 patients were included in the survival analysis. Patients were followed-up for a median period of 35 months and Cox-Regression was used to establish the prognostic value of individual MRS detectable molecules. A multivariate model of survival was also investigated to improve prognostic power. Lipids and scyllo-inositol predicted poor survival whilst glutamine and N-acetyl aspartate predicted improved survival (pmodel of survival based on three MRS biomarkers predicted survival with a similar accuracy to histologic grading (p5e-5). A negative correlation between lipids and glutamine was found, suggesting a functional link between these molecules. MRS detectable biomolecules have been identified that predict survival of paediatric brain tumour patients across a range of tumour types. The evaluation of these biomarkers in large prospective studies of specific tumour types should be undertaken. The correlation between lipids and glutamine provides new insight into paediatric brain tumour metabolism that may present novel targets for therapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. In-hospital paediatric accidents: an integrative review of the literature.

    Science.gov (United States)

    Da Rin Della Mora, R; Bagnasco, A; Sasso, L

    2012-12-01

    Paediatric hospitals can be perceived by children, parents, health professionals as 'safe' places, but accidents do occur. To review publications relating to in-hospital paediatric accidents and highlight the state-of-the-science concerning this issue especially in relation to falls, and the evolution of research addressing this issue. Integrative review of papers published before March 2011 on accidents and falls occurred in hospitalized children. Electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature and Cochrane Library databases) and further hand searching through references were searched. The inclusion criteria were articles involving observational, quasi-experimental or experimental studies in English or Italian. Exclusion criteria were articles addressing the outcomes of falls caused by suspect violence on children. Thirteen studies in English were included. Of the 13 studies conducted between 1963 and 2010, 10 had been conducted in the last 5 years; 10 in the USA. The studies were divided into two categories: contextualization and prevention of the 'accident' or 'fall' phenomenon (10 studies), and fall risk assessment (three studies). The most frequent type of design was observational explorative/descriptive. Several areas of investigation were explored (hazardous environment, children's characteristics correlated to accidents/falls, characteristics of the accidents/falls and their outcomes, paediatric fall risk factors and risk assessment tools, fall risk prevention programmes, parents' perceptions of accident/fall risks, etc.). No comparable methods were used to investigate the contextualization and prevention of the 'accident' and 'fall' phenomena; proposed fall risk assessment tools were not evaluated for their reliability and validity. Consensus would be needed around the approach to accidents in terms of: the definition of 'accident' and 'fall'; 'fall-related injury' and respective classifications; the frequency and

  2. Inviting parents to take part in paediatric palliative care research: A mixed-methods examination of selection bias

    OpenAIRE

    Crocker, Joanna C; Beecham, Emma; Kelly, Paula; Dinsdale, Andrew P; Hemsley, June; Jones, Louise; Bluebond-Langner, Myra

    2015-01-01

    Background: Recruitment to paediatric palliative care research is challenging, with high rates of non-invitation of eligible families by clinicians. The impact on sample characteristics is unknown. Aim: To investigate, using mixed methods, non-invitation of eligible families and ensuing selection bias in an interview study about parents? experiences of advance care planning (ACP). Design: We examined differences between eligible families invited and not invited to participate by clinicians us...

  3. Participation in paediatric perioperative care: 'what it means for parents'.

    Science.gov (United States)

    Sjöberg, Carina; Svedberg, Petra; Nygren, Jens M; Carlsson, Ing-Marie

    2017-12-01

    To explore what it means for parents to participate in their children's paediatric perioperative care. Allowing parents to participate in paediatric perioperative care can make a major difference for children in terms of their well-being, a decreased need for painkillers, fewer sleeping disorders and a more positive experience for both parties. The nurse anaesthetist should have a holistic view and develop a shared vision for the child, the parents and for themselves to perform successful paediatric perioperative care. Descriptive qualitative study. The study was conducted in 2014. Data were collected in 20 narrative interviews with 15 mothers and five fathers who had experience of participating in their child's paediatric perioperative day surgery. The analysis was carried out with qualitative content analysis to describe the variations, differences and similarities in the experiences. The analysis revealed a main category that describes that parental participation in the context of paediatric perioperative care in day surgery meant 'having strength to participate despite an increased vulnerability'. Three generic categories with additional subcategories explained what was essential for the parents to be able to preserve this strength and participate in their child's care despite their increased vulnerability. The generic categories were named, 'gaining information about what will happen', 'being seen as a resource' and 'gaining access to the environment'. Efforts should be made to improve parents' roles and opportunities to participate in paediatric perioperative care. Nurse anaesthetists have a crucial role in enabling parents' participation and need knowledge to develop strategies and nursing interventions that meet parents' needs. © 2017 John Wiley & Sons Ltd.

  4. Impact of child death on paediatric trainees.

    Science.gov (United States)

    Hollingsworth, Clare E; Wesley, Carla; Huckridge, Jaymie; Finn, Gabrielle M; Griksaitis, Michael J

    2018-01-01

    To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death. A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ 2 test. A p value of death of a child, although 190/284 (67%) had no training in child death. 118/248 (48%) of trainees were given a formal debrief session following their most recent experience. 203/251 (81%) of trainees reported one or more symptoms or behaviours that could contribute to a diagnosis of ASR/PTSD. 23/251 (9%) of trainees met the complete criteria for ASR and 13/251 (5%) for PTSD. Attending a formal debrief and reporting feelings of guilt were associated with an increase in diagnostic criteria for ASR/PTSD (p=0.036 and pdeath of a child. The feeling of guilt should be identified and acknowledged to allow prompt signposting to further support, including psychological assessment or intervention if required. Clear recommendations need to be made about the safety of debriefing sessions as, in keeping with existing evidence, our data suggest that debrief after the death of a child may be associated with the development of symptoms suggestive of ASR/PTSD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Assessment of paediatric hydronephrosis using output efficiency

    International Nuclear Information System (INIS)

    Saundres, C.A.B.; Choong, K.K.L.; Gruenewald, S.M.

    1998-01-01

    Full text: Diuretic renography is an important tool in the evaluation of paediatric hydronephrosis. Recently a newly developed parameter, output efficiency (OE) has allowed normalisation of washout according to renal function. We retrospectively reviewed the diagnostic accuracy of OE in 56 children (70 hydronephrotic kidneys). There were 16 females and 41 males (mean age 1.4 years, range 3 weeks-12 years). Diuretic renography ( 99m Tc-MAG3) was performed using i.v. volume expansion (15 mL/kg), frusemide diuresis (1mg/kg) and urethral catheterisation if VUR was present. Final diagnosis was made using surgery (n = 15) or clinical outcome (n = 42). Clinical follow up exceeded one year and included repeat MAG3 scan (n = 20), resolving hydronephrosis on ultrasound (n = 15) or percutaneous antegrade pyelogram (n = 1). Initial scans were classified as obstructed (n 13), indeterminate (n = 13) or non obstructed (n = 30) based on standard qualitative and quantitative criteria. Using a normal range of >84%, OE correctly predicted 12/13 (92%) obstructed kidneys and 44/44 non-obstructed kidneys (100%). In the indeterminate group, three kidneys developed obstruction at follow -up and 10 became non obstructed. Initial OE predicted outcome in two and four kidneys respectively. Overall, OE sensitivity and specificity were 88% and 89%. In the subgroup of patients (n = 19) with reduced differential function (<40%) the sensitivity of OE was 100% and specificity was 75%. This compares to 83% and 66% for Tl/2 in this subgroup. Therefore OE is a useful marker of renal outflow tract obstruction and maybe superior to other parameters such as Tl/2 particularly when renal function is reduced

  6. Radiographic appearances of uncommon paediatric implants and devices

    Energy Technology Data Exchange (ETDEWEB)

    Urquia, Arlen; Watson, Tom A.; Arthurs, Owen J. [Great Ormond Street Hospital NHS Foundation Trust, Department of Radiology, London (United Kingdom)

    2015-06-15

    As childhood survival of chronic illness improves, long-term implanted devices will be encountered more frequently in routine radiology. In our paediatric tertiary referral hospital, we have come across several types of implanted devices that were not confidently recognised or identified by front-line staff and were often only identified by discussion with the patient, family or clinical team. This pictorial review highlights the appearance of nonvascular devices on paediatric radiographs in order to help clinicians identify the most frequent complications and to improve awareness of these important devices. (orig.)

  7. Paediatric oncology in the developing world: an African perspective.

    Science.gov (United States)

    Nkrumah, F K

    1987-09-01

    Nutritional deficiency and infectious diseases constitute major paediatric priorities in most developing countries in Africa today. It is suggested that successful implementation of the various cost-effective intervention programmes which address themselves to these priorities will gradually unveil other paediatric problems presently considered of low priority. These will include the malignant diseases of childhood. The very high cost of cancer detection and treatment will demand carefully reasoned and planned approaches in most Third World countries. The implications of this in relation to childhood malignancies in Africa are discussed.

  8. MRI of the marrow in the paediatric skeleton

    International Nuclear Information System (INIS)

    Foster, K.; Chapman, S.; Johnson, K.

    2004-01-01

    Magnetic resonance imaging (MRI) has greatly advanced evaluation of marrow diseases of the paediatric skeleton. As with many other aspects of paediatric radiology it is important to recognize the normal variations in the appearance of the marrow that occur in the growing child. These normal variations need to be differentiated from diseases and conditions that affect the marrow. This review describes the normal changes that occur in children with age, and the appearances of the pathological changes seen in infection, infiltration, haematological disorders, transplantation and radiation therapy

  9. Paediatric ultrasonography of the liver, hepatobiliary tract and pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, R.R. van, E-mail: r.r.vanrijn@amc.uva.nl [Department of Radiology, Emma Children' s Hospital – Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Nievelstein, R.A.J. [Department of Radiology, Wilhelmina Children' s Hospital – University Medical Center, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2014-09-15

    In the field of paediatric radiology ultrasonography (US) is the most versatile imaging tool available. Children in general, by virtue of their body composition, are excellent candidates for US exams in whom abdominal anatomy and pathology can be visualised in great detail. The fact that during the US study a clinical history can be obtained strongly adds to the value of the US exam. This does require investment in time and expertise and ideally a paediatric radiologist performing the exam. In this review the role of ultrasonography (US) of the liver, biliary tract and pancreas in children is discussed.

  10. Paediatric trauma imaging: Why do we need separate guidance?

    International Nuclear Information System (INIS)

    Negus, S.; Danin, J.; Fisher, R.; Johnson, K.; Landes, C.; Somers, J.; Fitzsimmons, C.; Ashford, N.; Foster, J.

    2014-01-01

    It is often assumed that the pattern of injury in children mirrors that of the adult population, but children have different anatomical proportions and the relative elasticity of their tissues results in different injury patterns. The authors of this review are members of the British Society of Paediatric Radiologists subgroup and developed the recently published 47 paediatric trauma protocols for imaging children involved in major blunt trauma. The following article has been written to bring these guidelines to the attention of the wider community of UK radiologists, and explain the rationale behind the recommendations

  11. The Swiss regulatory framework for paediatric health research.

    Science.gov (United States)

    Junod, Valerie

    2008-07-01

    Medical research on minors entails both risks and benefits. Under Swiss law, clinical trials on children, including nontherapeutic drug trials, are permissible. However, ethics committees must systematically verify that all clinical studies have a favorable risk-benefit profile. Additional safeguards are designed to ensure that children are not unnecessarily involved in research and that proper consent is always obtained. Federal Swiss law is undergoing revision to extend these protections beyond clinical trials to a broad array of health research. The Swiss drug agency also seeks to improve the incentives for pharmaceutical firms to develop new paediatric drugs and relevant paediatric drug labels.

  12. Only Moderate Intra- and Inter-observer Agreement between Radiologists and Surgeons when Grading Blunt Paediatric Hepatic Injury on CT Scan

    NARCIS (Netherlands)

    Nellensteijn, D. R.; ten Duis, H. J.; Oldenziel, J.; Polak, W. G.; Hulscher, J. B. F.

    2009-01-01

    Introduction: The American Pediatric Surgical Association developed guidelines for the management of haemodynamically stable children with hepatic or splenic injury, based on grade of injury on CF scan. This study investigated the intra- and inter-observer agreement of radiologists, paediatric

  13. Overview of the US-Japan collaborative investigation on hydrogen isotope retention in neutron-irradiated and ion-damaged tungsten

    Energy Technology Data Exchange (ETDEWEB)

    Shimada, Masashi, E-mail: Masashi.Shimada@inl.gov [Fusion Safety Program, Idaho National Laboratory, Idaho Falls, ID (United States); Hatano, Y. [Hydrogen Isotope Research Center, University of Toyama, Toyama (Japan); Oya, Y. [Radioscience Research Laboratory, Faculty of Science, Shizuoka University, Shizuoka (Japan); Oda, T. [Department of Nuclear Engineering and Management, The University of Tokyo, Tokyo (Japan); Hara, M. [Hydrogen Isotope Research Center, University of Toyama, Toyama (Japan); Cao, G. [Department of Engineering Physics, University of Wisconsin-Madison, Madison, WI (United States); Kobayashi, M. [Radioscience Research Laboratory, Faculty of Science, Shizuoka University, Shizuoka (Japan); Sokolov, M. [Oak Ridge National Laboratory, Oak Ridge, TN (United States); Watanabe, H. [Research Institute for Applied Mechanics, Kyushu University, Fukuoka (Japan); Tyburska-Pueschel, B. [Department of Engineering Physics, University of Wisconsin-Madison, Madison, WI (United States); Institute fuer Plasmaphysik, EURATOM Association, Garching (Germany); Ueda, Y. [Graduate School of Engineering, Osaka University, Osaka (Japan); Calderoni, P. [Fusion Safety Program, Idaho National Laboratory, Idaho Falls, ID (United States); Okuno, K. [Radioscience Research Laboratory, Faculty of Science, Shizuoka University, Shizuoka (Japan)

    2012-08-15

    The effect of neutron-irradiation damage has been mainly simulated using high-energy ion bombardment. A recent MIT report (PSFC/RR-10-4, An assessment of the current data affecting tritium retention and its use to project towards T retention in ITER, Lipschultz et al., 2010) summarizes the observations from high-energy ion bombardment studies and illustrates the saturation trend in deuterium concentration due to damage from ion irradiation in tungsten and molybdenum above 1 displacement per atom (dpa). While this prior database of results is quite valuable for understanding the behavior of hydrogen isotopes in plasma facing components (PFCs), it does not encompass the full range of effects that must be considered in a practical fusion environment due to short penetration depth, damage gradient, high damage rate, and high primary knock-on atom (PKA) energy spectrum of the ion bombardment. In addition, neutrons change the elemental composition via transmutations, and create a high radiation environment inside PFCs, which influences the behavior of hydrogen isotope in PFCs, suggesting the utilization of fission reactors is necessary for neutron-irradiation. Under the framework of the US-Japan TITAN program, tungsten samples (99.99 at.% purity from A.L.M.T. Co.) were irradiated by fission neutrons in the High Flux Isotope Reactor (HFIR), Oak Ridge National Laboratory (ORNL), at 50 and 300 Degree-Sign C to 0.025, 0.3, and 2.4 dpa, and the investigation of deuterium retention in neutron-irradiated tungsten was performed in the Tritium Plasma Experiment (TPE), the unique high-flux linear plasma facility that can handle tritium, beryllium and activated materials. This paper reports the recent results from the comparison of ion-damaged tungsten via various ion species (2.8 MeV Fe{sup 2+}, 20 MeV W{sup 2+}, and 700 keV H{sup -}) with that from neutron-irradiated tungsten to identify the similarities and differences among them.

  14. Computer-Mediated Collaborative Learning

    Science.gov (United States)

    Beatty, Ken; Nunan, David

    2004-01-01

    The study reported here investigates collaborative learning at the computer. Ten pairs of students were presented with a series of comprehension questions about Mary Shelley's novel "Frankenstein or a Modern Prometheus" along with a CD-ROM, "Frankenstein Illuminated," containing the novel and a variety of source material. Five students worked with…

  15. Collaborative Contracting in Projects

    NARCIS (Netherlands)

    Suprapto, M.

    2016-01-01

    Project practitioners have increasingly recognized the importance of collaborative relationships to ensure successful executions of projects. However, the ability to sustain and consistenly drive real collaborative attitudes and behavior for achieving the desired outcomes remains of enduring

  16. Global Collaborative STEM Education

    Science.gov (United States)

    Meabh Kelly, Susan; Smith, Walter

    2016-04-01

    Global Collaborative STEM Education, as the name suggests, simultaneously supports two sets of knowledge and skills. The first set is STEM -- science, technology, engineering and math. The other set of content knowledge and skills is that of global collaboration. Successful global partnerships require awareness of one's own culture, the biases embedded within that culture, as well as developing awareness of the collaborators' culture. Workforce skills fostered include open-mindedness, perseverance when faced with obstacles, and resourceful use of technological "bridges" to facilitate and sustain communication. In respect for the 2016 GIFT Workshop focus, Global Collaborative STEM Education projects dedicated to astronomy research will be presented. The projects represent different benchmarks within the Global Collaborative STEM Education continuum, culminating in an astronomy research experience that fully reflects how the global STEM workforce collaborates. To facilitate wider engagement in Global Collaborative STEM Education, project summaries, classroom resources and contact information for established international collaborative astronomy research projects will be disseminated.

  17. [Cerebrovascular accidents in paediatric care. Our experience gained over an 18-year period].

    Science.gov (United States)

    Ruiz del Olmo-Izuzquiza, Ignacio; de Arriba-Muñoz, Antonio; López-Pisón, Javier; García-Iñiguez, Juan Pablo; Romero-Gil, Ruth; Monge-Galindo, Lorena; Pérez-Delgado, Raquel; Peña-Segura, José Luis

    This study reviews our experience over the last 18 years with paediatric patients diagnosed with non-haemorrhagic cerebrovascular accidents (CVA) after the perinatal period. Data were collected for the period between May 1990 and May 2008 (n = 10 270 children) and special attention was given to cases with no previous pathology. We found 41 cases that were diagnosed with post-natal non-haemorrhagic CVA, of which 13 did not present any known pathology at the onset of the symptoms. Nine patients were diagnosed as having ischaemic CVA (ICVA), three cases had thrombosis of the venous sinuses and there was one case of haemorrhagic infarction (HI). No causation was found in five cases, three of which were heterozygotic for the C677T mutation of methylenetetrahydrofolate reductase. ICVA was caused by fibromuscular dysplasia, aneurysm of the auricular septum and patent foramen ovale, homocystinuria and chickenpox. A recent ear infection and diminished levels of protein C were noted in two cases of venous thrombosis. Five patients with ICVA and the case of HI were treated with oral antiaggregants, anticoagulants were administered in two of the thromboses, and the remaining cases did not receive any treatment. Seven patients (four ICVA, two thromboses and the HI) did not present any kind of sequelae, four ICVA presented different degrees of hemiparesis and two died (one ICVA and one thrombosis). The scarcity of studies and therapeutic clinical trials in the paediatric age makes it difficult to lay down clear guidelines of conduct, especially from the therapeutic point of view. The different specialists involved must collaborate with each other.

  18. Psychometric analysis of subjective sedation scales used for critically ill paediatric patients.

    Science.gov (United States)

    Ge, Xiaohua; Zhang, Tingting; Zhou, Lingling

    2018-01-01

    This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales. We searched the Cochrane Library, PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, etc., to obtain relevant articles. The quality of the selected studies was evaluated according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. Articles that had been published or were in press and discussed the psychometric properties of sedation scales were included. The population comprised critically ill infants and non-verbal children ranging in age from 0 to 18 years who underwent sedation in an intensive care unit. Data were independently extracted by two investigators using a standard data extraction checklist: 43 articles were included in this review, and 13 sedation scales were examined. The quality of the psychometric evidence for the Comfort Scale and Comfort Behaviour Scale was 'very good', with the Comfort Scale having a higher quality (total weighted scores, Comfort Scale = 17·3 and Comfort Behaviour Scale = 15·5). We suggest that the scales be systematically and comprehensively tested in terms of development method, reliability, validation, feasibility and correlation with clinical outcome. The Comfort Scale and Comfort Behaviour Scale are useful tools for measuring sedation in paediatric patients. Nursing staff should choose one subjective sedation scale that is suitable for assessing paediatric patients' depth of sedation. We recommend the Comfort Scale and Comfort Behaviour Scale as optimal choices if the clinical

  19. [Spanish funded paediatric research: Contribution of Anales de Pediatría to its dissemination].

    Science.gov (United States)

    Abad-García, María Francisca; González-Teruel, Aurora; Solís Sánchez, Gonzalo

    2017-06-01

    To identify Spanish funded paediatric research published in general paediatric journals included in the Web of Science (WoS) from 2010 to 2014) and those published in the Anales de Pediatría. To examine the relationship between funding and the prestige of the journals. To describe the journal conditions to meet the open access criteria. Spanish funded paediatric articles (FA) were identified by using the WoS Funding Agency field, and by reviewing the original documents for the Anales de Pediatria (AP). For the FA published in AP the number and kind of funding agencies were identified. The possible differences in citations between FA and non-funded was assessed for articles published in this journal using the Kruskal-Wallis non-parametric test. For general journals, the patterns of distribution of FA and non-FA were investigated according to the quartile of the journal. The journal's self-archiving conditions were described using Sherpa/romeo database. Funding was received for 27.5%, being 16.6% for those published in AP. In these, 105 funding agencies were identified, with 80% being national. The FA published in AP did not receive significantly more citations. In general journals, the presence of FA is greater in Q1 and Q2 journals. More than half (56%) of articles were published in subscription journals. All journals that publish FA allow self-archiving in repositories, but with embargos of at least 12 months. The role of AP in the dissemination of FA is still limited. Embargos in self-archiving permits compliance of Spanish open access mandate, but may hinder compliance in Europe. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. The effect of canal fill on paediatric femur fractures treated with titanium elastic nails.

    Science.gov (United States)

    Nielsen, E; Bonsu, N; Andras, L M; Goldstein, R Y

    2018-02-01

    Traditional teaching for fixation of paediatric femur fractures recommends 80% nail diameter/medullary canal diameter ratio (ND/MCD) for successful maintenance of reduction. Prior studies have investigated this with stainless steel Enders nails. Our aim was to assess the impact of ND/MCD on maintenance of reduction and malunion rates in paediatric femur fractures treated with flexible intramedullary nails (FINs). Retrospective data was collected on all paediatric patients treated with FINs for diaphyseal femur fractures at a single tertiary care institution over a ten-year period. Patients with co-morbidities affecting bone quality were excluded. Patients were subdivided into groups based on ND/MCD. A total of 66 patients met inclusion criteria. Mean ND/MCD was 76.3% (32.9% to 98.8%, SD 14.3). In all, 50% (n = 33/66) of patients had > 80% ND/MCD, and only 13.6% (n = 9/66) of patients had less than 60% ND/MCD. When controlling for fracture stability, ND/MCD had no correlation with mean shortening (p = 0.07) There was no correlation between ND/MCD and angulation in the sagittal (p = 0.96) or coronal plane (p = 0.20). Three patients fit malunion criteria. ND/MCD for these patients were 40%, 67% and 79%. There was no correlation between ND/MCD and shortening or malangulation. The majority of patients in this series with less than 80% fill with FIN healed within acceptable parameters. III.

  1. Sickness presenteeism: The prevalence of coming to work while ill among paediatric resident physicians in Canada.

    Science.gov (United States)

    Mitchell, Kevin J; Vayalumkal, Joseph V

    2017-05-01

    Sickness presenteeism is defined as the act of attending one's job despite ill-health. Recently, physicians and other health care workers have become the focus of sickness presenteeism research, because presenteeism in this population can put patients at risk of infection. There are currently no data on this topic among physicians in Canada. The aim of this study was to investigate sickness presenteeism in paediatric resident physicians in Canada. We conducted an anonymous, online, cross-sectional survey study in which all paediatric residents in Canada were eligible. Outcomes of interest included prevalences of sickness presenteeism, sickness during the study period and voluntary self-appointed personal protective equipment use when engaging in sickness presenteeism. Response rate was 56.5% (N=323). During the previous 2 months, 61% (95% confidence interval [CI] 55.7 to 66.3) of respondents reported having experienced an illness and 59% (95% CI 53.7 to 64.5) of respondents had come to work sick. Of those who reported becoming ill during the study period, 97.0% (95% CI 94.6 to 99.4) reported coming to work while sick. There was no difference in prevalence when comparing across post-graduate year training levels. Extra personal protective equipment was used by 86% (95% CI 82.1 to 91.7) when engaging in sickness presenteeism. Sickness presenteeism is a common phenomenon among paediatric resident physicians. Our results should influence residents and supervising staff physicians to encourage appropriate self-care at home, rather than presenteeism.

  2. Physicians' self-reported practice behaviour regarding fertility-related discussions in paediatric oncology in Sweden.

    Science.gov (United States)

    Armuand, G M; Nilsson, J; Rodriguez-Wallberg, K A; Malmros, J; Arvidson, J; Lampic, C; Wettergren, L

    2017-10-01

    The aim of this study was to investigate practice behaviours of Swedish physicians with regard to discussing the impact of cancer treatment on fertility with paediatric oncology patients and their parents, and to identify factors associated with such discussions. A cross-sectional survey study was conducted targeting all physicians in Sweden working in paediatric oncology care settings. Participants responded to a questionnaire measuring practice behaviour, attitudes, barriers, and confidence in knowledge. Multivariable logistic regression was used to determine factors associated with seldom discussing fertility. More than half of the physicians routinely talked with their patients/parents about the treatment's potential impact on fertility (male patients: 62%; female patients: 57%; P = 0.570). Factors associated with less frequently discussing fertility with patients/parents were working at a non-university hospital (male patients: OR 11.49, CI 1.98-66.67; female patients: OR 33.18, CI 4.06-271.07), concerns that the topic would cause worry (male patients: OR 8.23, CI 1.48-45.89; female patients: OR 12.38, CI 1.90-80.70), and perceiving the parents as anxious (male patients: OR 7.18, CI 1.20-42.85; female patients: OR 11.65, CI 1.32-103.17). Based on our findings, we recommend structured training in how to communicate about fertility issues in stressful situations, which in turn might increase fertility-related discussions in paediatric oncology. © 2017 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

  3. IV paracetamol effect on propofol-ketamine consumption in paediatric patients undergoing ESWL.

    Science.gov (United States)

    Eker, H Evren; Cok, Oya Yalçin; Ergenoğlu, Pınar; Ariboğan, Anış; Arslan, Gülnaz

    2012-06-01

    Electroshock wave lithotripsy (ESWL) is a painful procedure performed with sedoanalgesia in paediatric patients. The propofol-ketamine combination may be the preferable anaesthesia for this procedure, and propofol-ketamine consumption may be decreased with the administration of intravenous (IV) paracetamol. In this study we investigated the effect of IV paracetamol administration on propofol-ketamine consumption, recovery time and frequency of adverse events in paediatric patients undergoing ESWL. Sixty children, ranging in age from 1 to 10 years and with American Society of Anesthesiologists Physical Status 1-2, were included in this prospective, randomized, double-blinded study. Thirty minutes prior to the procedure children randomly assigned to Group I received IV 15 mg/kg paracetamol, and those randomly assigned to Group II received 1.5 mL/kg IV saline infusion 30 min. The propofol-ketamine combination was prepared by mixing 25 mg propofol and 25 mg ketamine in a total 10 mL solution in the same syringe. After the administration of 0.1 mg/kg midazolam and 10 μg/kg atropine to both groups and during the procedure, the propofol-ketamine combination was administered at 0.5 mg/kg doses to achieve a Wisconsin sedation score of 1 or 2. Oxygen saturation and heart rate were recorded at 5-min intervals. Propofol-ketamine consumption, recovery times and adverse events were also recorded. Demographic data were similar between groups. Propofol-ketamine consumption (Group I, 25.2 ± 17.7 mg; Group II, 35.4 ± 20.1 mg; p = 0.04) and recovery times (Group I, 19.4 ± 7.9 min; Group II, 29.6 ± 11.4 min; p ESWL procedures in paediatric patients and shortens recovery time.

  4. Effectiveness of Collaborative Learning with 3D Virtual Worlds

    Science.gov (United States)

    Cho, Young Hoan; Lim, Kenneth Y. T.

    2017-01-01

    Virtual worlds have affordances to enhance collaborative learning in authentic contexts. Despite the potential of collaborative learning with a virtual world, few studies investigated whether it is more effective in student achievements than teacher-directed instruction. This study investigated the effectiveness of collaborative problem solving…

  5. Lack of a standardised UK care pathway resulting in national variations in management and outcomes of paediatric small area scalds.

    Science.gov (United States)

    Trevatt, Alexander E J; Kirkham, Emily N; Allix, Bradley; Greenwood, Rosemary; Coy, Karen; Hollén, Linda I; Young, Amber E R

    2016-09-01

    There is a paucity of evidence guiding management of small area partial thickness paediatric scalds. This has prevented the development of national management guidelines for these injuries. This research aimed to investigate whether a lack of evidence for national guidelines has resulted in variations in both management and outcomes of paediatric small area scalds across England and Wales (E&W). A national survey of initial management of paediatric scalds ≤5% Total Body Surface Area (%TBSA) was sent to 14 burns services in E&W. Skin graft rates of anonymised burns services over seven years were collected from the international Burns Injury Database (iBID). Average skin grafting rates across services were compared. Length of stay and proportion of patients receiving general anaesthesia for dressing application at each service were also compared. All 14 burns services responded to the survey. Only 50% of services had a protocol in place for the management of small area burns. All protocols varied in how partial thickness paediatrics scalds ≤5% TBSA should be managed. There was no consensus as to which scalds should be treated using biosynthetic dressings. Data from iBID for 11,917 patients showed that the average reported skin grafting rate across all burns services was 2.3% (95% CI 2.1, 2.6) but varied from 0.3% to 7.1% (P<0.001). Service provider remained associated with likelihood of skin grafting when variations in the %TBSA case mix seen by each service were controlled for (χ(2)=87.3, P<0.001). The use of general anaesthetics across services varied between 0.6 and 35.5% (P<0.001). The median length of stay across services varied from 1 to 3 days (P<0.001). A lack of evidence guiding management of small-area paediatric scalds has resulted in variation in management of these injuries across E&W. There is also significant variation in outcomes for these injuries. Further research is indicated to determine if care pathways and outcomes are linked. An evidence

  6. Birth weight and risk of paediatric Hodgkin lymphoma: Findings from a population-based record linkage study in California.

    Science.gov (United States)

    Triebwasser, Corey; Wang, Rong; DeWan, Andrew T; Metayer, Catherine; Morimoto, Libby; Wiemels, Joseph L; Kadan-Lottick, Nina; Ma, Xiaomei

    2016-12-01

    To evaluate the relationship between birth weight (along with a variety of pre and perinatal characteristics) and the risk of paediatric Hodgkin lymphoma (HL) diagnosed at age birth records from 1978-2009 and cancer diagnosis data from 1988-2011 to conduct a population-based case-control study with 1216 cases and 4485 controls (matched on birth month and year, sex, and race/ethnicity). Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) of paediatric HL overall and by age of diagnosis, controlling for other perinatal factors. Compared to children with a normal birth weight (2500-3999 g), those who had a high birth weight (≥4000 g) had an increased risk of paediatric HL overall (OR = 1.23, 95% CI: 1.02-1.48) after adjusting for birth order, maternal age at the time of delivery, and paternal age at the time of delivery. The magnitude of association appeared larger for subgroups of children whose age of diagnosis was 0-10 years (OR = 1.56, 95% CI: 1.04-2.24) or 15-19 years (OR = 1.43, 95% CI: 1.11-1.83), while no association was observed in 11-14 year olds. Compared with firstborn children, those who were third or higher in birth order had a reduced risk of paediatric HL overall (OR = 0.80, 95% CI: 0.67-0.95), and this association also varied by age of diagnosis. In this study with the largest number of paediatric HL cases, high birth weight was associated with an increased disease risk for most but not all ages of diagnosis. The different findings by age of diagnosis regarding both birth weight and birth order underscore the importance to stratify paediatric HL by age at diagnosis in future etiological investigations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Experiences of Collaborative Research

    Science.gov (United States)

    Kahneman, Daniel

    2003-01-01

    The author's personal history of the research that led to his recognition in economics is described, focusing on the process of collaboration and on the experience of controversy. The author's collaboration with Amos Tversky dealt with 3 major topics: judgment under uncertainty, decision making, and framing effects. A subsequent collaboration,…

  8. Collaboration between IPMA and PMRP

    Directory of Open Access Journals (Sweden)

    Helgi Thor Ingason

    2017-03-01

    Full Text Available The International Project Management Association (IPMA was established by academics, research has always been acknowledged by IPMA and the association has supported research in different ways. We see it as our duty to share knowledge in project management, cooperate and facilitate cooperation between project management researchers and motivate project management researchers…and, by investigating specific areas, and thereby influencing the discipline. To achieve this we collaborate with other organisations that share our interest and I am glad to declare that IPMA will be collaborating with the journal Project Management Research and Practice.

  9. Children's collaborative encounters in pre-school

    DEFF Research Database (Denmark)

    Svinth, Lone

    2013-01-01

    Collaboration is often described as a situation whereby two or more children work together towards a common goal. When viewed from a socio-cultural learning perspective, a broader understanding of collaboration is suggested. This article investigates the forms and pathways of children...

  10. Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit

    Energy Technology Data Exchange (ETDEWEB)

    McCarty, M.; Waugh, R.; McCallum, H.; Montgomery, R.J.; Aszkenasy, O.M. [South Cleveland Hospital, Middlesbrough (United Kingdom)

    2001-09-01

    In 1996, there were local reports of poor gonad protection for paediatric pelvic radiographs. To investigate the nature of the problem and make necessary improvements. Materials and methods: A retrospective audit of 218 paediatric pelvic radiographs was undertaken in 1997. Each radiograph was assessed for the presence of a gonad shield, appropriateness of the device and its position. A multidisciplinary team was formed with representation from radiology, radiography, orthopaedics and medical physics to investigate ways of improving technique and reducing patient dose. These included radiographer training and the introduction of digital fluoroscopy as an alternative imaging technique in follow-up patients. There were further rounds of data collection in 1998 and 1999. In round 1, a gonad shield was present in 77.9 % of boys' films and 76 % of girls' films where one should have been, increasing to 85.2 % and 85.4 % respectively by round 3 of the audit (P < 0.05). Only 31.6 % of boys' devices and 21.9 % of girls' devices were correctly positioned in round 1, increasing to 78.3 % and 94.3 %, respectively, by round 3 of the audit (P < 0.05). After round 1, no inappropriate devices were used. Audit was an effective tool in gaining the resources needed to improve technique and reduce radiation exposure in children. The multidisciplinary approach was vital in the success of this project. (orig.)

  11. Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit.

    Science.gov (United States)

    McCarty, M; Waugh, R; McCallum, H; Montgomery, R J; Aszkenasy, O M

    2001-09-01

    In 1996, there were local reports of poor gonad protection for paediatric pelvic radiographs. To investigate the nature of the problem and make necessary improvements. A retrospective audit of 218 paediatric pelvic radiographs was undertaken in 1997. Each radiograph was assessed for the presence of a gonad shield, appropriateness of the device and its position. A multidisciplinary team was formed with representation from radiology, radiography, orthopaedics and medical physics to investigate ways of improving technique and reducing patient dose. These included radiographer training and the introduction of digital fluoroscopy as an alternative imaging technique in follow-up patients. There were further rounds of data collection in 1998 and 1999. In round 1, a gonad shield was present in 77.9 % of boys' films and 76 % of girls' films where one should have been, increasing to 85.2 % and 85.4 % respectively by round 3 of the audit (P < 0.05). Only 31.6 % of boys' devices and 21.9 % of girls' devices were correctly positioned in round 1, increasing to 78.3 % and 94.3 %, respectively, by round 3 of the audit (P < 0.05). After round 1, no inappropriate devices were used. Audit was an effective tool in gaining the resources needed to improve technique and reduce radiation exposure in children. The multidisciplinary approach was vital in the success of this project.

  12. Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit

    International Nuclear Information System (INIS)

    McCarty, M.; Waugh, R.; McCallum, H.; Montgomery, R.J.; Aszkenasy, O.M.

    2001-01-01

    In 1996, there were local reports of poor gonad protection for paediatric pelvic radiographs. To investigate the nature of the problem and make necessary improvements. Materials and methods: A retrospective audit of 218 paediatric pelvic radiographs was undertaken in 1997. Each radiograph was assessed for the presence of a gonad shield, appropriateness of the device and its position. A multidisciplinary team was formed with representation from radiology, radiography, orthopaedics and medical physics to investigate ways of improving technique and reducing patient dose. These included radiographer training and the introduction of digital fluoroscopy as an alternative imaging technique in follow-up patients. There were further rounds of data collection in 1998 and 1999. In round 1, a gonad shield was present in 77.9 % of boys' films and 76 % of girls' films where one should have been, increasing to 85.2 % and 85.4 % respectively by round 3 of the audit (P < 0.05). Only 31.6 % of boys' devices and 21.9 % of girls' devices were correctly positioned in round 1, increasing to 78.3 % and 94.3 %, respectively, by round 3 of the audit (P < 0.05). After round 1, no inappropriate devices were used. Audit was an effective tool in gaining the resources needed to improve technique and reduce radiation exposure in children. The multidisciplinary approach was vital in the success of this project. (orig.)

  13. Proximity and scientific collaboration : Evidence from the global wine industry

    NARCIS (Netherlands)

    Cassi, Lorenzo; Morrison, Andrea; Rabellotti, Roberta

    2015-01-01

    International collaboration among researchers is a far from linear and straightforward process. Scientometric studies provide a good way of understanding why and how international research collaboration occurs and what are its costs and benefits. Our study investigates patterns of international

  14. admission patterns and outcomes of paediatric patients admitted at ...

    African Journals Online (AJOL)

    OBJECTIVE To determine patterns of admissions due to diarrhea and their outcomes of paediatric patients at Muhimbili National Hospital (MNH). METHODOLOGY A hospital-based prospective study including all children admitted to the Diarrhea Unit during the study period. Data was collected using content analysis ...

  15. Paediatric chronic kidney disease | van Biljon | South African ...

    African Journals Online (AJOL)

    Doctors use various guidelines on paediatric chronic kidney disease (CKD) for managing their patients according to the availability of resources. As with adolescent and adult patients, CKD in children can also progress to end-stage renal failure – the time course being influenced by several modifiable factors. Decline in ...

  16. The six-minute walk test in paediatric populations

    NARCIS (Netherlands)

    Janke de Groot

    2011-01-01

    The six-minute walk test (6MWT) is a self-paced, submaximal exercise test used to assess functional exercise capacity in patients with chronic diseases (Chang 2006, Solway et al 2001). It has been used widely in adults, and is being utilised increasingly in paediatric populations; it has been used

  17. Paediatric surgical abdominal emergencies in a north central ...

    African Journals Online (AJOL)

    Paediatric surgical abdominal emergencies in a north central Nigerian centre. ... The causes of PSAEs vary worldwide, and the management is challenging, often with unimaginably poor outcome if not carefully handled. The aim of this ... Keywords: abdominal emergencies, acute abdomen, children, morbidity, mortality ...

  18. Paediatric Palliative Care and Intellectual Disability--A Unique Context

    Science.gov (United States)

    Duc, Jacqueline K.; Herbert, Anthony Robert; Heussler, Helen S.

    2017-01-01

    Background: Paediatric palliative care is a nuanced area of practice with additional complexities in the context of intellectual disability. There is currently minimal research to guide clinicians working in this challenging area of care. Method: This study describes the complex care of children with life-limiting conditions and intellectual…

  19. Unmet needs in paediatric psychopharmacology : Present scenario and future perspectives

    NARCIS (Netherlands)

    Persico, Antonio M.; Arango, Celso; Buitelaar, Jan K.; Correll, Christoph U.; Glennon, Jeffrey C.; Hoekstra, Pieter J.; Moreno, Carmen; Vitiello, Benedetto; Vorstman, Jacob; Zuddas, Alessandro

    2015-01-01

    Paediatric psychopharmacology holds great promise in two equally important areas of enormous biomedical and social impact, namely the treatment of behavioural abnormalities in children and adolescents, and the prevention of psychiatric disorders with adolescent- or adult-onset. Yet, in striking

  20. The role of computed tomography in modern paediatric uroradiology

    International Nuclear Information System (INIS)

    Maudgil, D.D.; McHugh, K.

    2002-01-01

    Computed tomography (CT) has developed a well-recognised role within paediatric uroradiology, especially in imaging of trauma, malignancy (in particular Wilms' tumour), atypical infection, and congenital urogenital abnormalities. CT can also be used for problem solving in nephrolithiasis and renal transplant assessment. These applications are illustrated and discussed, with an emphasis on particular information that can be gained from the CT study