A Comparison of Parent and Professional Perceptions of Children with Autism Spectrum Disorder in Portugal

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Reis, Helena; Pereira, Ana; Almeida, Leandro

2017-01-01

Improving early intervention in Portugal for children with autism spectrum disorder (ASD) requires parents and professionals to collaborate in assessing and planning intervention programmes. This article analyses parental and professional assessments of children with ASD, in the dimensions of social communication, repetitive behaviours and…

Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study.

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Sharkey, Siobhan; Lloyd, Claire; Tomlinson, Richard; Thomas, Eleanor; Martin, Alice; Logan, Stuart; Morris, Christopher

2016-06-01

Communication is a fundamental part of health care, but can be more difficult with disabled children. Disabled children are more frequently admitted to hospital than other children. To explore experiences of ward staff and families to identify barriers and facilitators to effective communication with disabled children whilst inpatients. This was an exploratory qualitative study. We consulted 25 staff working on paediatric wards and 15 parents of disabled children recently admitted to those wards. We had difficulty in recruiting children and evaluating their experiences. Data were collected through interviews and focus groups. A thematic analysis of the data supported by the Framework Approach was used to explore experiences and views about communication. Emerging themes were subsequently synthesised to identify barriers and facilitators to good communication. Barriers to communication included time, professionals not prioritising communication in their role and poor information sharing between parents and professionals. Facilitators included professionals building rapport with a child, good relationships between professionals and parents, professionals having a family-centred approach, and the use of communication aids. Communication with disabled children on the ward was perceived as less than optimal. Parents are instrumental in the communication between their children and professionals. Although aware of the importance of communication with disabled children, staff perceived time pressures and lack of priority given to communicating directly with the child as major barriers. © 2014 John Wiley & Sons Ltd.

Radiation doses to children with shunt-treated hydrocephalus

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Holmedal, Lise J. [Helse Fonna, Department of Radiology, Stord Hospital, Stord (Norway); Friberg, Eva G.; Boerretzen, Ingelin; Olerud, Hilde [The Norwegian Radiation Protection Authority, Oesteraas (Norway); Laegreid, Liv [Haukeland University Hospital, Department of Paediatrics, Bergen (Norway); Rosendahl, Karen [University of Bergen, Department of Surgical Sciences, Radiology Section, Bergen (Norway); Great Ormond Street Hospital for Children, Department of Diagnostic Radiology, London (United Kingdom)

2007-12-15

Children with shunt-treated hydrocephalus are still followed routinely with frequent head CT scans. To estimate the effective dose, brain and lens doses from these examinations during childhood, and to assess dose variation per examination. All children born between 1983 and 1995 and treated for hydrocephalus between 1983 and 2002 were included. We retrospectively registered the number of examinations and the applied scan parameters. The effective dose was calculated using mean conversion factors from the CT dose index measured free in air, while doses to the lens and brain were estimated using tabulated CT dose index values measured in a head phantom. A total of 687 CT examinations were performed in 67 children. The mean effective dose, lens dose and brain dose to children over 6 months of age were 1.2 mSv, 52 mGy and 33 mGy, respectively, and the corresponding doses to younger children were 3.2 mSv, 60 mGy and 48 mGy. The effective dose per CT examination varied by a factor of 64. None of the children was exposed to doses known to cause deterministic effects. However, since the threshold for radiation-induced damage is not known with certainty, alternative modalities such as US and MRI should be used whenever possible. (orig.)

Children's participation in shared decision-making: children, adolescents, parents and healthcare professionals' perspectives and experiences.

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Coyne, Imelda; Amory, Aislinn; Kiernan, Gemma; Gibson, Faith

2014-06-01

Despite decision-making featuring throughout the trajectory of cancer care, children's participation in decision-making remains an area much under-researched and complicated by conflicting opinions. This study explored children's participation in shared decision-making (SDM) from multiple perspectives from one haematology/oncology unit in Ireland. Qualitative research design was used to explore participants' experiences of children's decision-making. Interviews were conducted with children(1) aged 7-16 years (n = 20), their parents (n = 22) and healthcare professionals (n = 40). Data were managed with the aid of NVivo (version 8). Parents and children's roles in decision-making were significantly influenced by the seriousness of the illness. Cancer is a life-threatening illness and so the treatment 'had to be done'. Children were not involved in major decisions (treatment decisions) as refusal was not an option. They were generally involved in minor decisions (choices about care delivery) with the purpose of gaining their cooperation, making treatment more palatable, giving back a sense of control and building trusting relationships. These choices were termed 'small' decisions that would not compromise the child's welfare. Some adolescents were aware that choices were not 'real' decisions since they were not allowed to refuse and expressed feelings of frustration. Healthcare professionals and parents controlled the process of SDM and the children's accounts revealed that they held a minimal role. Children appeared content that adults held responsibility for the major treatment decisions. However, they desired and valued receiving information, voicing their preferences and choosing how treatments were administered to them. Copyright © 2014 Elsevier Ltd. All rights reserved.

Professionals' Guidance about Spoken Language Multilingualism and Spoken Language Choice for Children with Hearing Loss

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Crowe, Kathryn; McLeod, Sharynne

2016-01-01

The purpose of this research was to investigate factors that influence professionals' guidance of parents of children with hearing loss regarding spoken language multilingualism and spoken language choice. Sixteen professionals who provide services to children and young people with hearing loss completed an online survey, rating the importance of…

Time Perception in Children Treated for a Cerebellar Medulloblastoma

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Droit-Volet, Sylvie; Zelanti, Pierre S.; Dellatolas, Georges; Kieffer, Virginie; El Massioui, Nicole; Brown, Bruce L.; Doyere, Valerie; Provasi, Joelle; Grill, Jacques

2013-01-01

The aim of the present study was to investigate temporal abilities in children treated by surgery for a malignant tumor in the cerebellum. Children with a diagnosed medulloblastoma and age-paired control children were given a temporal discrimination task (bisection task) and a temporal reproduction task with two duration ranges, one shorter than 1…

Antibiotics for treating lower urinary tract infection in children.

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Fitzgerald, Anita; Mori, Rintaro; Lakhanpaul, Monica; Tullus, Kjell

2012-08-15

Urinary tract infection (UTI) is one of the most common bacterial infections in infants and children. Lower UTI is the most commonly presenting and in the majority of cases can be easily treated with a course of antibiotic therapy with no further complications. A number of antimicrobials have been used to treat children with lower UTIs; however is it unclear what are the specific benefits and harms of such treatments. This review aims to summarise the benefits and harms of antibiotics for treating lower UTI in children. We searched the Renal Group's Specialised Register (April 2012), CENTRAL (The Cochrane Library 2012, Issue 5), MEDLINE OVID SP (from 1966), and EMBASE OVID SP (from 1988) without language restriction. Date of last search: May 2012. Randomised controlled trials (RCTs) and quasi-RCTs in which antibiotic therapy was used to treat bacteriologically proven, symptomatic, lower UTI in children aged zero to 18 years in primary and community healthcare settings were included. Two authors independently assessed study quality and extracted data. Statistical analyses were performed using the random effects model and the results expressed as risk ratios (RR) with 95% confidence intervals (CI). Sixteen RCTs, analysing 1,116 children were included. Conventional 10-day antibiotic treatment significantly increased the number of children free of persistent bacteriuria compared to single-dose therapy (6 studies, 228 children: RR 2.01, 95%CI 1.06 to 3.80). No heterogeneity was observed. Persistent bacteriuria at the end of treatment was reported in 24% of children receiving single-dose therapy compared to 10% of children who were randomised to 10-day therapy. There were no significant differences between groups for persistent symptoms, recurrence following treatment, or re-infection following treatment. There was insufficient data to analyse the effect of antibiotics on renal parenchymal damage, compliance, development of resistant organisms or adverse events. Despite

Fatigue in children and adolescents with cancer from the perspective of health professionals

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Michele Cristina Miyauti da Silva

Full Text Available ABSTRACT Objective: to investigate health professionals' knowledge about the concept, assessment and intervention in fatigue in children and adolescents with cancer. Method: exploratory study with qualitative approach, with 53 health professionals (10 nurses, 33 assistant nurses, 3 physicians, 3 nutritionists, 2 psychologists and 2 physical therapists. Semi structured interviews were held, which were recorded and analyzed by means of inductive thematic content analysis. Results: the data were organized around three themes: knowledge of health professionals about fatigue; identification of fatigue and interventions to relieve fatigue. Conclusion: the results indicate the health professionals' limited knowledge about fatigue, as well as the lack of investment in their training and continuing education. Most of all, the lack of research on the theme in the Brazilian context remains a barrier to support improvements in care for this symptom in children and adolescents with cancer.

Brazilian Children's Behavioural Differentiation between the Mother, Unfamiliar Adults and Professional Caregivers

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Pingault, Jean-Baptiste

2010-01-01

This study took place in two organisations with opposite socio-economic characteristics which gather children (one to four years), their mothers (or nannies), unfamiliar adults and professional caregivers. Pursuant to attachment theory, the children clearly differentiated their mothers from unfamiliar adults according to proximity indicators and…

The emergence of personal growth amongst healthcare professionals who care for dying children.

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Beaune, Laura; Muskat, Barbara; Anthony, Samantha J

2018-06-01

ABSTRACTObjective:Compassion fatigue, burnout, and vicarious traumatization are prominent topics in the current literature on the impact of the rewarding but challenging work of healthcare professionals who care for patients with life-limiting illnesses. The positive effects of caregiving constitute a newly emerging outcome that has been relatively unexplored in the pediatric literature, and yet they may play an important role in contributing to the satisfaction and well-being of the healthcare professionals who care for children who have a life-limiting illness. This paper reports the results of a secondary analysis of qualitative interview transcripts that explored the experiences of hospital-based pediatric healthcare providers caring for children with varied life-limiting illnesses. In-depth qualitative interviews were conducted with 25 healthcare professionals (9 social workers, 8 nurses, and 8 physicians). The majority of participants were women (80%), with an age range between 20 and 60 years, and most (84%) had the experience of caring for more than 15 dying children. Thematic analysis was conducted using interpretive description and constant comparison. Every healthcare professional interviewed experienced personal growth as a result of their providing care for dying children. Three dimensions of personal growth were most consistently reported: (1) new or altered life perspectives, (2) enhanced personal resources, and (3) benevolence. A deeper understanding of the phenomenon of personal growth could help healthcare organizations to implement innovative approaches that would counterbalance compassion fatigue, and thereby enhance both healthcare provider well-being and child and family outcomes.

Professional Competences of Preschool Teachers for Working with Gifted Young Children in Slovenia

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Sonja ČOTAR KONRAD

2016-12-01

Full Text Available Recognizing giftedness in young preschool children presents an important challenge to all educators. Because giftedness needs nurturing, the aim of the research was to emphasize the importance of gifted children’s right to adequate educational opportunities, which will stimulate the optimal development of their potentials. In order to achieve the latter, appropriately qualified preschool teachers are needed, in both diagnostic (the identification of the preschool gifted children and educational field. The main purpose of the study (N=180 was to analyse professional qualifications and attitudes of preschool teachers in the area of identifying and working with gifted children from age 2 to age 6. The non–experimental causal method was used. The results of the research in Slovenia show the following problems: preschool teachers are inadequately informed about the issues concerning working with gifted children; they tend to have low self-competence in identifying personal characteristics of gifted children and in the appropriate use of teaching strategies when working with them; they stress the necessity for further education and professional training in the field of gifted children education.

Barriers and facilitators to parents seeking and accessing professional support for anxiety disorders in children: qualitative interview study.

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Reardon, Tessa; Harvey, Kate; Young, Bridget; O'Brien, Doireann; Creswell, Cathy

2018-01-25

Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7-11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child's difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents.

The evaluation of results and complications of radiotherapy in children treated for orbital rhabdomyosarcoma

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Skowronska-Gardas, A.; Pedziwiatr, K.; Chojnacka, M.

2002-01-01

To analyse treatment results and late complications of radiotherapy in children treated for orbital rhabdomyosarcoma. Between the years 1980 and 2000 34 children (median age 7 yrs. range: 1-15) with orbital RMS, were treated in the 1st Department of the MCCMCC in Warsaw. All but two of the patients received induction chemotherapy; 3 children were treated after ablative surgery (exenteration); 6 children were irradiated due to recurrence after chemotherapy. All the children were treated with megavoltage radiotherapy from a Co-60 unit or linear accelerator. We applied individual lens and lacrimal apparatus shielding in 16 patients. Five children, treated between 1996-2000, received conformal radiotherapy, with CT and 3-D treatment planning system.To obtain information about late side effects, we developed a questionnaire, including questions about the status of the affected eye, appearance of the orbit and facial structures.Thirty one patients (91%) are still living (between 24 and 264 months - median 138 mos) after completion of radiotherapy and 28 (82%) with no recurrence. In six patients treated due to recurrent tumour OS and DFS was 80% and 60%, respectively. Late complications were evaluated in 24 patients. We observed lacrimal duct stenosis in 33%, cataract in 29%, enophtalmos in 20% of patients. Retinopathy developed in 2 children, glaucoma in 2 pts, and facial asymmetry in 3 pts. In one case enucleation of blind eye was performed. Thirteen children have preserved adequate vision in the treated eye. In children treated with conformal radiotherapy we did not observe any late complications. Radiotherapy in orbital RMS allows to obtain good local control and excellent survival rate. Late complications could be limited with the application of individual treatment planning and conformal radiotherapy. (author)

Children's, parents' and health professionals' views on the management of childhood asthma: a qualitative study.

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Searle, Aidan; Jago, Russell; Henderson, John; Turner, Katrina M

2017-09-11

The management of childhood asthma is often sub-optimal. Parents and other caregivers are primarily responsible for disease management and this responsibility includes communication with health professionals. The aim of this multi-perspective qualitative study was to explore the views of children, parents and health professionals to gain insight into the approach to clinical care in the management of childhood asthma. Interviews were held with nine parent-child (6-8 years) dyads, and 13 health professionals working in primary and secondary care. Interviews were transcribed verbatim and analysed thematically. Three key themes emerged that were common to all data sets; (1) Child and parent awareness of symptoms; (2) Management and child wellbeing; and (3) Professional communication education and consultation with families. Although some children demonstrate good awareness of symptoms and appropriate use of medication, some parents expressed difficulty in identifying triggers and symptoms of asthma. Furthermore, parents lacked awareness regarding appropriate use of medication for preventing and managing symptoms of asthma. Health professionals believed that communication and education was lacking. Data from all participants suggested that consultations could be enhanced with greater emphasis on children's and parents' perceptions of asthma in the development of asthma management plans. GUIDING FAMILIES THROUGH DISEASE MANAGEMENT: Both parents' and children's perceptions and understanding of childhood asthma should be considered when developing asthma management plans. The management of asthma is challenging and can result in poor disease outcomes if care is not taken. An individual's perception of their (or their child's) asthma can also affect the efficacy of treatment. Aidan Searle at the Bristol Biomedical Research Centre, UK, and co-workers, interviewed nine parent-child groups and thirteen health professionals to determine their perceptions of childhood asthma

Psychological trauma in professionals working with traumatised children

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Ireland, Carol Ann; Huxley, Siona

2018-01-01

STRUCTURED ABSTRACT: \\ud Purpose of this paper: Clinical professionals working with psychologically traumatised children in the care system can experience potential challenges maintaining their own positive psychological health, and when repeatedly being exposed to the traumatic histories of those in their care. The aim of this paper is to increase understanding of vicarious trauma and provide a guide for focusing future research.\\ud Design/methodology/approach: This is a systematic literatur...

Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

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McCue Horwitz, Sarah; Storfer-Isser, Amy; Kerker, Bonnie D; Szilagyi, Moira; Garner, Andrew S; O'Connor, Karen G; Hoagwood, Kimberly E; Green, Cori M; Foy, Jane M; Stein, Ruth E K

2016-01-01

To assess the availability of on-site mental health professionals (MHPs) in primary care; to examine practice/pediatrician characteristics associated with on-site MHPs; and to determine whether the presence of on-site MHPs is related to pediatricians' comanaging or more frequently identifying, treating/managing, or referring mental health (MH) problems. Analyses included American Academy of Pediatrics (AAP) members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (n = 321). Measures included sociodemographics, practice characteristics, questions about on-site MHPs, comanagement of MH problems, and pediatricians' behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate, and multivariable analyses were performed. Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools, universities, health maintenance organizations, managed, or referred 5 common child MH problems. Among the subset of pediatricians who reported comanaging, there was an association with comanagement when the on-site MHP was a child psychiatrist, substance abuse counselor, or social worker. On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who comanage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, substance abuse counselor, or social worker. Overall, on-site MHPs were not associated with comanagement or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review.

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Fearnley, Rachel; Boland, Jason W

2017-03-01

Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family's needs would help ensure appropriate support. To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals' communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents' feelings of supporting their children. A systematic literature review and narrative synthesis. Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent's illness. There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents' illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent's illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise.

Putting children forward for epilepsy surgery: A qualitative study of UK parents' and health professionals' decision-making experiences.

Science.gov (United States)

Heath, Gemma; Abdin, Shanara; Begum, Rahima; Kearney, Shauna

2016-08-01

Against a backdrop of recommendations for increasing access to and uptake of early surgical intervention for children with medically intractable epilepsy, it is important to understand how parents and professionals decide to put children forward for epilepsy surgery and what their decisional support needs are. The aim of this study was to explore how parents and health professionals make decisions regarding putting children forward for pediatric epilepsy surgery. Individual interviews were conducted with nine parents of children who had undergone pediatric epilepsy surgery at a specialist children's hospital and ten healthcare professionals who made up the children's epilepsy surgery service multidisciplinary healthcare team (MDT). Three MDT meetings were also observed. Data were analyzed thematically. Four themes were generated from analysis of interviews with parents: presentation of surgery as a treatment option, decision-making, looking back, and interventions. Three themes were generated from analysis of interviews/observations with health professionals: triangulating information, team working, and patient and family perspectives. Parents wanted more information and support in deciding to put their child forward for epilepsy surgery. They attempted to balance the potential benefits of surgery against any risks of harm. For health professionals, a multidisciplinary approach was seen as crucial to the decision-making process. Advocating for the family was perceived to be the responsibility of nonmedical professionals. Decision-making can be supported by incorporating families into discussions regarding epilepsy surgery as a potential treatment option earlier in the process and by providing families with additional information and access to other parents with similar experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

Interventions for treating femoral shaft fractures in children and adolescents.

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Madhuri, Vrisha; Dutt, Vivek; Gahukamble, Abhay D; Tharyan, Prathap

2014-12-01

Fractures of the femoral shaft in children are relatively uncommon but serious injuries that disrupt the lives of children and their carers and can result in significant long-term disability. Treatment involves either surgical fixation, such as intramedullary nailing or external fixation, or conservative treatment involving prolonged immobilisation, often in hospital. To assess the effects (benefits and harms) of interventions for treating femoral shaft fractures in children and adolescents. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (accessed 16 August 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013 Issue 7), MEDLINE (1946 to August Week 1 2013), EMBASE (1980 to 2012 week 9), CINAHL (16 August 2013), clinical trials registries, conference proceedings and reference lists; and contacted trial authors and experts in the field. Randomised and quasi-randomised controlled trials comparing conservative and surgical interventions for diaphyseal fractures of the femur in children under 18 years of age. Our primary outcomes were functional outcome measures, unacceptable malunion, and serious adverse events. Two authors independently screened and selected trials, assessed risk of bias and extracted data. We assessed the overall quality of the evidence for each outcome for each comparison using the GRADE approach. We pooled data using a fixed-effect model. We included 10 trials (six randomised and four quasi-randomised) involving a total of 527 children (531 fractures). All trials were at some risk of bias, including performance bias as care provider blinding was not practical, but to a differing extent. Just one trial was at low risk of selection bias. Reflecting both the risk of bias and the imprecision of findings, we judged the quality of evidence to be 'low' for most outcomes, meaning that we are unsure about the estimates of effect. Most trials failed to report on self-assessed function or when

THE EFFECTS OF EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT) AND CRYOTHERAPY IN TREATING PATELLAR TENDINOPATHIES IN PROFESSIONAL ATHLETES

OpenAIRE

Dobreci Iulian

2014-01-01

Aim: this paper tries to optimize the existent classical treatments for patellar tendinopathies that are resistant to classical forms of therapy, in professional athletes. Hypotheses: this research wants to highlight the effectiveness of the ESWT and cryotherapy in treating patellar tendinopathies in professional athletes who previously underwent classical treatments that had no positive results. Material: the research was conducted at the Bacau Spinal Care Rehabilitation Clinic, where the sy...

Growth in children treated for acute lymphoblastic leukemia with and without prophylactic cranial irradiation

International Nuclear Information System (INIS)

Moell, C.; Garwicz, S.; Marky, L.; Melander, L.; Karlberg, J.

1988-01-01

Growth and weight gain were studied longitudinally over a period of four years in thirty-nine children treated for acute lymphoblastic leukemia. The children were divided into two groups according to treatment. Twenty-eight children were given prophylactic cranial irradiation and eleven children were treated without such irradiation. The duration of cytostatic treatment was three years in all cases. Average growth during the first two years was similar in the two groups, and the standard deviation scores (SDS) were below average. The rate of growth during the fourth year was significantly higher among those children who had not received cranial irradiation. After four years the average attained height had declined 0.5 SD for children treated with cranial irradiation and 0.2 SD for children without such treatment. Attained weight after four years had increased 0.4 SD more among those children who had not received irradiation. The results suggest that prophylactic cranial irradiation is responsible for the greater part of the prepubertal growth inhibition in these children. (authors)

Children in Divorce, Custody and Access Situations: The Contribution of the Mental Health Professional.

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Fine, Stuart

1980-01-01

Reviews literature concerned with the contribution of mental health professionals to the well-being of children of divorce. Topics include effects of divorce on children, divorce prevention, predivorce counseling, custody conflicts, postdivorce counseling, and changes in social and educational practices. (Author/DB)

[Children with learning disabilities and handicaps in inclusive schools or in special schools? The view of parents and professionals].

Science.gov (United States)

Bode, H; Hirner, V

2013-03-01

To investigate the view of parents and professionals on sending children with special educational needs to inclusive schools. 54 preschool children in the year before school entry and 155 school children attending a Social Pediatric Center. They displayed motor-, mental-, speech- or sensory handicaps, learning or behavioral disabilities. Questionnaires for parents of preschool- and of school children and questionnaires for the professional caring for the child were evaluated and compared. Parental expectations, experiences concerning school and the severity of disability were determined. 135 pupils attended special schools and 20 integrative schools. The parents were generally very content with both types of schools despite the fact that 33% of parents had not have a free choice of the school. They had a positive attitude to inclusive education. Preference for inclusive schooling decreased with increasing severity of the child's disability. The severity of disability was rated similar by parents and by professionals. Parents of preschool children tended more often and parents of school children less often than professionals towards sending the individual child to an inclusive school. Some parents of children with special educational needs would like to send their child to a special school, others prefer inclusive schools. It is paramount to improve the professional advice and guidance to parents since parental options to choose the school for their child are increasing in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Oral zinc for treating diarrhoea in children

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Lazzerini, Marzia; Wanzira, Humphrey

2016-01-01

Background In developing countries, diarrhoea causes around 500,000 child deaths annually. Zinc supplementation during acute diarrhoea is currently recommended by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Objectives To evaluate oral zinc supplementation for treating children with acute or persistent diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (the Cochrane Library 2016, Issue 5), MEDLINE, Embase, LILACS, CINAHL, mRCT, and reference lists up to 30 September 2016. We also contacted researchers. Selection criteria Randomized controlled trials (RCTs) that compared oral zinc supplementation with placebo in children aged one month to five years with acute or persistent diarrhoea, including dysentery. Data collection and analysis Both review authors assessed trial eligibility and risk of bias, extracted and analysed data, and drafted the review. The primary outcomes were diarrhoea duration and severity. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses (using either a fixed-effect or random-effects model) and assessed heterogeneity. We assessed the certainty of the evidence using the GRADE approach. Main results Thirty-three trials that included 10,841 children met our inclusion criteria. Most included trials were conducted in Asian countries that were at high risk of zinc deficiency. Acute diarrhoea There is currently not enough evidence from well-conducted RCTs to be able to say whether zinc supplementation during acute diarrhoea reduces death or number of children hospitalized (very low certainty evidence). In children older than six months of age, zinc supplementation may shorten the average duration of diarrhoea by around half a day (MD −11.46 hours, 95% CI −19.72 to −3.19; 2581 children, 9 trials, low

Natural history of Hymenoptera venom allergy in children not treated with immunotherapy.

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Lange, Joanna; Cichocka-Jarosz, Ewa; Marczak, Honorata; Krauze, Agnieszka; Tarczoń, Izabela; Świebocka, Ewa; Lis, Grzegorz; Brzyski, Piotr; Nowak-Węgrzyn, Anna

2016-03-01

Differences in treatment approach still exist for children after systemic sting reactions. In addition, there are still some doubts about when systemic reactors should be treated with venom immunotherapy (VIT). To determine the rate of sting recurrence and natural history of Hymenoptera venom allergy (HVA) in children not treated with VIT. A total of 219 children diagnosed as having HVA who were not treated with VIT were identified in 3 pediatric allergology centers. Survey by telephone or mail with the use of a standardized questionnaire was conducted. The number of field re-stings, subsequent symptoms, and provided treatment were analyzed. A total of 130 of the 219 patients responded to the survey, for a response rate of 59.4%. During the median follow-up period of 72 months (interquartile range, 52-85 months), 44 children (77% boys) were stung 62 times. Normal reactions were most common, occurring in 27 patients (62%). Severe systemic reactions (SSRs) occurred in 8 (18%) of those who were re-stung. The subsequent reaction was significantly milder (P insect (P insect (P = .03). In children with SSRs, median time from diagnosis to re-sting was 2 times longer than that in those with large local reactions and normal reactions (P = .007). Most children with HVA not treated with VIT reported milder reactions after a re-sting. Probability of SSR to re-sting increases along with the severity of initial reaction. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Parenting Interventions for Children with Tic Disorders: Professionals' Perspectives.

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Evans, Gemma A L; Wittkowski, Anja; Butler, Hannah; Hedderly, Tammy; Bunton, Penny

Tic disorders can have an emotional and social impact on children and families, which can in turn have a reciprocal impact on tics. Research into parenting interventions within this population is limited. Twenty-five professionals' views on the acceptability, effectiveness, feasibility and utility of parenting interventions were explored using Q-methodology. Three highly correlated factors emerged, indicating three viewpoints with discrete elements that were underpinned by similar general perspectives. All factors endorsed a psychological approach, the importance of parenting practices, and theoretical and clinical justifications for parenting interventions. Discrete elements of the viewpoints debated the advocated focus, barriers and audience of interventions. Multidisciplinary professionals endorsed parenting interventions as a therapeutic tool within tic disorders. Results provide suggestions to further develop and implement interventions.

Professionals' views on the use of smartphone technology to support children and adolescents with memory impairment due to acquired brain injury.

Science.gov (United States)

Plackett, Ruth; Thomas, Sophie; Thomas, Shirley

2017-04-01

Purpose To identify from a health-care professionals' perspective whether smartphones are used by children and adolescents with acquired brain injury as memory aids; what factors predict smartphone use and what barriers prevent the use of smartphones as memory aids by children and adolescents. Method A cross-sectional online survey was undertaken with 88 health-care professionals working with children and adolescents with brain injury. Results Children and adolescents with brain injury were reported to use smartphones as memory aids by 75% of professionals. However, only 42% of professionals helped their clients to use smartphones. The only factor that significantly predicted reported smartphone use was the professionals' positive attitudes toward assistive technology. Several barriers to using smartphones as memory aids were identified, including the poor accessibility of devices and cost of devices. Conclusion Many children and adolescents with brain injury are already using smartphones as memory aids but this is often not facilitated by professionals. Improving the attitudes of professionals toward using smartphones as assistive technology could help to increase smartphone use in rehabilitation. Implications for Rehabilitation Smartphones could be incorporated into rehabilitation programs for young people with brain injury as socially acceptable compensatory aids. Further training and support for professionals on smartphones as compensatory aids could increase professionals' confidence and attitudes in facilitating the use of smartphones as memory aids. Accessibility could be enhanced by the development of a smartphone application specifically designed to be used by young people with brain injury.

Healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions: a qualitative systematic review protocol.

Science.gov (United States)

Ekberg, Stuart; Bradford, Natalie; Herbert, Anthony; Danby, Susan; Yates, Patsy

2015-11-01

-quality communication with and about children who have life-limiting conditions, this does not mean that these stakeholders necessarily share the same perspective of what constitutes high-quality communication and the best way of accomplishing this. Focusing on healthcare users' experiences of communication with healthcare professionals about children who have life-limiting conditions, the present review will explore the subjective impact of professionals' communication on the people for whom they provide care.It may be necessary to consider a range of contextual factors to understand healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions. For instance, age, developmental stage, cognitive capacity, emotional and social strengths, and family dynamics can influence a child's level of involvement in discussions about their condition and care. Although there are factors that appear more consistent across the range of pediatric palliative care users, such as parents' preferences for being treated by healthcare professionals as partners in making decisions about the care of their child, there is not always such consistency. Nor is it clear whether such findings can be generalized across different cultural contexts. In appraising existing research, this systematic review will therefore consider the relationship between the context of individual studies and their reported findings.The primary aim of this review is to identify, appraise and synthesize existing qualitative evidence of healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions. The review will consider relevant details of these findings, particularly whether factors like age are relevant for understanding particular experiences of communication. An outcome of this review will be the identification of best available qualitative evidence that can be used to inform professional practice, as well

Parent and medical professional willingness to enroll children in a hypothetical pediatric optic neuritis treatment trial

Directory of Open Access Journals (Sweden)

Amy eWaldman

2011-11-01

Full Text Available The Optic Neuritis Treatment Trial and subsequent studies have had a tremendous impact on the treatment and prognosis of optic neuritis and multiple sclerosis in adults. The results of these studies have been extrapolated to children; however, pediatric data are sparse. Using the method of prospective preference assessment, the willingness of parents and medical professionals to enroll children in a hypothetical Pediatric Optic Neuritis Treatment Trial was assessed using a mock consent form and questionnaire. A 3-arm trial was proposed: 1 intravenous corticosteroids, 2 high-dose oral corticosteroids, and 3 an oral placebo. The forms were completed by 198 parents and 49 physicians. After reviewing the hypothetical scenario, trial design, risks and benefits, and alternatives to the study, 21% of parents would enroll their children in the trial whereas 98% of medical professionals would enroll their patients. With medical professional recommendation, 43% of parents would enroll their children. The manner in which this hypothetical trial was presented to parents, specifically with respect to the recommendation of their child’s health care team, influenced a parent’s willingness to participate.

Parenting Interventions for Children with Tic Disorders: Professionals? Perspectives

OpenAIRE

Evans, Gemma A. L.; Wittkowski, Anja; Butler, Hannah; Hedderly, Tammy; Bunton, Penny

2015-01-01

Tic disorders can have an emotional and social impact on children and families, which can in turn have a reciprocal impact on tics. Research into parenting interventions within this population is limited. Twenty-five professionals? views on the acceptability, effectiveness, feasibility and utility of parenting interventions were explored using Q-methodology. Three highly correlated factors emerged, indicating three viewpoints with discrete elements that were underpinned by similar general per...

Working with children with special needs in Finnish kindergartens: Professionals and/or specialists?

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Mari Nislin

2016-02-01

Full Text Available The aim is to investigate the links between job satisfaction of Finnish early childhood professionals (ECPs and the appreciation they receive for their work, and how these are associated with their competence to work with children with diverse needs and backgrounds. Data was collected via nationwide online survey for practitioners (n = 885 working in Finnish kindergartens. The main findings show that ECPs experience their work as satisfactory and receive appreciation from colleagues, friends and the children’s parents. It was also evident form the data that ECPs felt themselves to be incompetent to work with children with disabilities or children who had experienced trauma. This may reflect that more in-service training regarding these special education issues is needed. We argue that satisfaction, appreciation and competence, are key factors in the development of a strong professional identity, enhanced well-being at work and in other domains of life and particularly for high quality and inclusive early childhood education.

Willingness to treat drug dependence and depression: comparisons of future health professionals

Directory of Open Access Journals (Sweden)

Ríos-Bedoya CF

2011-03-01

treat nicotine and alcohol dependence-affected patients as compared to depression-affected patients. Personal history was not associated with the students' willingness to treat, but men were less willing to treat. Drawing strength from the randomized reinforcer experimental design nested within this survey approach, the study evidence suggests potential nonparticipation bias in standard surveys on this topic.Conclusion: These results indicate that future health professionals may prefer to treat depression as opposed to drug dependence conditions. For SBIRT success, curriculum change with educational interventions may be needed to increase willingness to treat patients with neuropsychiatric conditions such as drug dependence. Future research requires attention to a possible problem of nonparticipation bias in surveys of this type.Keywords: alcohol dependence, nicotine dependence, depression, health professionals, stigma 

(Unreceptiveness in interactions with professionals: experiences of parents of children with retinopathy of prematurity

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Beatriz Castanheira Facio

Full Text Available Abstract OBJECTIVE To analyze the influence of health professionals' receptiveness on parental care of children with retinopathy of prematurity (ROP. METHOD A qualitative study developed under the theoretical framework of Symbolic Interactionism and using a narrative research methodology. Six women and three men, being parents of children with retinopathy of prematurity were individually interviewed in depth. RESULTS From the scope of information, emotions and their rights, the parents experienced receptiveness from some professionals and unreceptiveness from others. The predominance of unreceptive attitudes in the parental narratives originated the following analysis themes: Informational (unreceptiveness, Emotional (unreceptiveness, and (Unreceptiveness of rights. CONCLUSION The study supports human and comprehensive healthcare in the context of retinopathy of prematurity by pointing out the interactive process with health professionals as a potential stressor of parental care. The results signal a nuclear of attitudinal changes and reinforce challenges to the child and family-centered approach.

Intellectual development in preschool children with early treated congenital hypothyroidism.

Science.gov (United States)

Seo, Min Kyoung; Yoon, Jong Seo; So, Chul Hwan; Lee, Hae Sang; Hwang, Jin Soon

2017-06-01

Delayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH. We retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence. The patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ) of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76-126). None had intellectual disability (defined as an IQ scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis. IQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

Growth hormone for short children--whom should we be treating and why?

Science.gov (United States)

Kelnar, C J

2012-03-01

The objective of this paper was to determine systematically the impact of growth hormone (GH)therapy on adult height of children with (so-called) 'idiopathic short stature' (ISS) using the Cochrane Central Register of Controlled Trials, Medline, and the bibliographic references from retrieved articles of randomised controlled trials (RCTs) and non-RCTs from 1985 to April 2010. Inclusion criteria were initial short stature (defined as height >2 standard deviation[SD] below the mean), peak growth hormone responses>10 micrograms per litre (μg/L), prepuberty, no previous growth hormone therapy, and no comorbid conditions that would impair growth. Data extracted were adult height and overall gain in height from baseline measurement in childhood.Three RCTs (115 children) met the inclusion criteria.The adult height of the GH treated children exceeded that of the controls by 0.65 SD score (~4 cm). The mean height gain in treated children was 1.2 SD score compared with 0.34 SD score in untreated children. A difference of ~1.2 cm in adult height was observed between two GH dose regimens. In the seven non-RCTs, adult height of the GH-treated group exceeded that of controls by 0.45 SD score (~3 cm).The authors conclude that 1) GH therapy in children with ISS seems effective in partially reducing the deficit in height as adults, although less so than in other conditions for which GH is licensed; treated individuals remain relatively short compared with normal height peers. 2)Individual responses to therapy are highly variable; further studies are needed to identify responders. 3) High quality evidence from long-term RCTs of GH therapy that continue until adult height is necessary to determine the ideal dosage and long-term safety.

Intellectual development in preschool children with early treated congenital hypothyroidism

Directory of Open Access Journals (Sweden)

Min Kyoung Seo

2017-06-01

Full Text Available PurposeDelayed treatment of congenital hypothyroidism (CH is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH.MethodsWe retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence.ResultsThe patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76–126. None had intellectual disability (defined as an IQ <70. Twenty-one subjects were treated with a low dose (6.0–9.9 µg/kg/day and 22 with a high dose of levothyroxine (10.0–16.0 µg/kg/day. There was no significant difference in the mean full-scale IQ (FSIQ, verbal IQ (VIQ, and performance IQ (PIQ scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis.ConclusionIQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

Residual Renal Function in Children Treated with Chronic Peritoneal Dialysis

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Maria Roszkowska-Blaim

2013-01-01

Full Text Available Residual renal function (RRF in patients with end-stage renal disease (ESRD receiving renal replacement therapy is defined as the ability of native kidneys to eliminate water and uremic toxins. Preserved RRF improves survival and quality of life in adult ESRD patients treated with peritoneal dialysis. In children, RRF was shown not only to help preserve adequacy of renal replacement therapy but also to accelerate growth rate, improve nutrition and blood pressure control, reduce the risk of adverse myocardial changes, facilitate treatment of anemia and calcium-phosphorus balance abnormalities, and result in reduced serum and dialysate fluid levels of advanced glycation end-products. Factors contributing to RRF loss in children treated with peritoneal dialysis include the underlying renal disease such as hemolytic-uremic syndrome and hereditary nephropathy, small urine volume, severe proteinuria at the initiation of renal replacement therapy, and hypertension. Several approaches can be suggested to decrease the rate of RRF loss in pediatric patients treated with chronic peritoneal dialysis: potentially nephrotoxic drugs (e.g., aminoglycosides, episodes of hypotension, and uncontrolled hypertension should be avoided, urinary tract infections should be treated promptly, and loop diuretics may be used to increase salt and water excretion.

Timing variability in children with early-treated congenital hypothyroidism

NARCIS (Netherlands)

Kooistra, L.; Snijders, T.A.B.; Schellekens, J.M.H.; Kalverboer, A.F.; Geuze, R.H.

This study reports on central and peripheral determinants of timing variability in self-paced tapping by children with early-treated congenital hypothyroidism (CH). A theoretical model of the timing of repetitive movements developed by Wing and Kristofferson was applied to estimate the central

Concerns and Issues in Treating Children of Parents Diagnosed with Dissociative Identity Disorder.

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Boat, Barbara W.; Peterson, Gary

1997-01-01

Describes reasons why therapists may hesitate to address the needs of children when treating parents with Dissociative Identity Disorder (DID) (formerly Multiple Personality Disorder). Summarizes the literature supporting assessment of these children, relates clinical observations on the potential impact of DID on children, and suggests…

Life habits of school-aged children with specific language impairment as perceived by their parents and by school professionals.

Science.gov (United States)

Croteau, Claire; McMahon-Morin, Paméla; Morin, Claudia; Jutras, Benoît; Trudeau, Natacha; Le Dorze, Guylaine

2015-01-01

Describe social participation of a group of children with specific language impairment. 26 parents of children with specific language impairment (SLI) aged from 5 to 13 years and 11 school professionals participated in the study. Data collection was performed with the adapted version for children aged from 5 to 13 years old of the Assessment of Life Habits (Fougeyrollas et al., 2001). The questionnaire encompasses 196 life habits, grouped in 12 dimensions: nutrition, fitness, personal care, communication, housing, mobility, responsibilities, interpersonal relationships, community life, education, work and recreation (Fougeyrollas, 2010). According to their parents and school professionals, children in this study carried out without difficulty life habits related to housing and mobility. However, they experienced difficulty with life habits related to interpersonal relationships, recreation and responsibilities, in addition to communication and education. Children with SLI are perceived by their parents and school professionals as having reduced social participation in many aspects of their daily life. Social participation should be considered as a major outcome when offering services in school to these children. This study proposes specific ways to help children with SLI. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Enduring large use of acetaminophen suppositories for fever management in children: a national survey of French parents and healthcare professionals' practices.

Science.gov (United States)

Bertille, Nathalie; Fournier-Charrière, Elisabeth; Pons, Gérard; Khoshnood, Babak; Chalumeau, Martin

2016-07-01

The pharmacological specificities of the rectal formulation of acetaminophen led to a debate on its appropriateness for managing fever in children, but few data are available on the formulation's current use and determinants of use. In a national cross-sectional study between 2007 and 2008, healthcare professionals were asked to include five consecutive patients with acute fever. Among the 6255 children (mean age 4.0 years ± 2.8 SD) who received acetaminophen given by parents or prescribed/recommended by healthcare professionals, determinants of suppository use were studied by multilevel models. A suppository was given by 27 % of parents and prescribed/recommended by 19 % of healthcare professionals, by 24 and 16 %, respectively, for children 2 to 5 years old, and by 13 and 8 %, respectively, for those 6 to 12 years old. Among children who received suppositories from parents and healthcare professionals, 83 and 84 %, respectively, did not vomit. Suppository use was independently associated with several patient- and healthcare professional-level characteristics: young age of children, presence of vomiting, or lack of diarrhea. We report an enduring large use of suppositories in France for the symptomatic management of fever in children, including in non-vomiting and/or older children. The rational for such use should be questioned. • The pharmacological specificities of the rectal formulation of acetaminophen have led to a debate on its appropriateness for managing fever in children. Few data are available on the formulation's current use and determinants of the use. What is New: • In a national cross-sectional study, we observed a large use of suppositories in France for symptomatic management of fever in children. Suppositories were frequently used for the youngest children but also for older and/or non-vomiting children.

Analyses of inter-rater reliability between professionals, medical students and trained school children as assessors of basic life support skills.

Science.gov (United States)

Beck, Stefanie; Ruhnke, Bjarne; Issleib, Malte; Daubmann, Anne; Harendza, Sigrid; Zöllner, Christian

2016-10-07

Training of lay-rescuers is essential to improve survival-rates after cardiac arrest. Multiple campaigns emphasise the importance of basic life support (BLS) training for school children. Trainings require a valid assessment to give feedback to school children and to compare the outcomes of different training formats. Considering these requirements, we developed an assessment of BLS skills using MiniAnne and tested the inter-rater reliability between professionals, medical students and trained school children as assessors. Fifteen professional assessors, 10 medical students and 111-trained school children (peers) assessed 1087 school children at the end of a CPR-training event using the new assessment format. Analyses of inter-rater reliability (intraclass correlation coefficient; ICC) were performed. Overall inter-rater reliability of the summative assessment was high (ICC = 0.84, 95 %-CI: 0.84 to 0.86, n = 889). The number of comparisons between peer-peer assessors (n = 303), peer-professional assessors (n = 339), and peer-student assessors (n = 191) was adequate to demonstrate high inter-rater reliability between peer- and professional-assessors (ICC: 0.76), peer- and student-assessors (ICC: 0.88) and peer- and other peer-assessors (ICC: 0.91). Systematic variation in rating of specific items was observed for three items between professional- and peer-assessors. Using this assessment and integrating peers and medical students as assessors gives the opportunity to assess hands-on skills of school children with high reliability.

Use of insecticide-treated mosquito nets for children under five years ...

African Journals Online (AJOL)

2011-06-13

Jun 13, 2011 ... Background: Insecticide-treated nets (ITNs) have proven to be one of the most effective means of reducing malaria morbidity and mortality in children and pregnant women. This study is carried out to determine the practice and determinants of ITN use for children under five years among care givers in an ...

AbobotulinumtoxinA Efficacy and Safety in Children With Equinus Foot Previously Treated With Botulinum Toxin.

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Dabrowski, Edward; Bonikowski, Marcin; Gormley, Mark; Volteau, Magali; Picaut, Philippe; Delgado, Mauricio R

2018-05-01

The effects of botulinum toxin are transient, and repeat injections are required in children with lower-limb spasticity. However, the efficacy of botulinum toxin in patients who have received previous injections has remained largely unexplored. We present subgroup analyses of a phase III study conducted in ambulatory children (aged two to 17) with spastic equinus foot. Patients were randomized to single doses of abobotulinumtoxinA 10 U/kg/leg, 15 U/kg/leg, or placebo injected into the gastrocnemius-soleus complex (one or both legs). The first analysis was prespecified to review the effect of abobotulinumtoxinA in children previously treated with botulinum toxin versus those children new to the treatment; a second post hoc analysis evaluated the effect of abobotulinumtoxinA in children who changed botulinum toxin formulation. Of the 241 randomized patients, 113 had previously received botulinum toxin, including 86 who had been treated with another formulation. In both analyses, muscle tone (Modified Ashworth Scale) and the Physicians Global Assessment, at week 4, improved with abobotulinumtoxinA treatment versus placebo, regardless of baseline botulinum toxin status. Placebo responses in patients new to treatment were consistently higher than in the previously treated group. These results demonstrate similar abobotulinumtoxinA efficacy and safety profiles in children with spasticity who are new to botulinum toxin treatment and those children who were previously treated. The efficacy and safety of abobotulinumtoxinA treatment in these previously treated patients were comparable with the overall trial population, indicating that doses of 10 and 15 U/kg/leg are suitable starting doses for children with spasticity regardless of the previous botulinum toxin preparation used. Copyright © 2018 Elsevier Inc. All rights reserved.

Competence in Serving Children: Credentials Protectionism and Public Policy.

Science.gov (United States)

Koocher, Gerald P.

Professional competency in psychologists wishing to treat children and families is an area of considerable concern and disagreement. Three types of practitioners comprise the bulk of the problem: clinical psychologists, who lack specific child-oriented training; developmental psychologists, who wish to serve children but lack traditional clinical…

[Health-related quality of life of the children of health professionals].

Science.gov (United States)

Gamallo, Silvia Maria Moussi; Caparroz, Fábio; Terreri, Maria Teresa Ramos Ascensão; Hilário, Maria Odete Esteves; Len, Claudio Arnaldo

2012-12-01

In this study, we measured the health-related quality of life (HRQOL) and fatigue of the children of health professionals, aged between two and eleven years, and assessed the daytime and sleep habits of these children and their parents. The study included children from a public school. Data regarding demographics and daily habits were collected. The HRQOL, sleep habits and fatigue were measured using questionnaires. A total of 249 parents participated - 63.5% reported getting an adequate amount of sleep, while 47.4% woke up feeling tired. The children's mean age was 5.6 years - 62.2% watched television in their rooms, 50% used the computer (> 4 hours/day) and 27.8% engaged in extracurricular physical exercise. The sleep score was 45.8 ± 12.2. The HRQOL scores were higher in the physical and lower in the emotional aspects. We found that poorer sleep on the part of both children and parents may be related to the children's lower HRQOL. We conclude that the inadequate habits of parents as well as children, are related to a decrease in HRQOL, particularly regarding the emotional aspect.

Professionals and interfamily violence against children and adolescents: in between legal and conceptual precepts.

Science.gov (United States)

Schek, Gabriele; Silva, Mara Regina Santos da; Lacharité, Carl; Bueno, Maria Emilia Nunes

2016-01-01

To identify the conceptions of professionals regarding interfamily violence against children and adolescents. A qualitative study conducted with 15 professionals who had taken children and adolescents under their care as a result of interfamily violence. Data were collected between November, 2013, and March, 2015, through semi-structured interviews. Data were organized and analyzed using the Textual Discourse Analysis technique. The professional discourse highlighted that some legal aspects regarding the handling of interfamily violence against children and adolescents are neglected; an omission supported by the justification of professionals to preserve the family. We highlight the confrontation between the concept of family as a caregiver and the family that commits violence against children, in addition to the positioning of professionals, which does not include the family or the aggressor in the intervention process in facing situations of interfamily violence attended to by the services. Acting against interfamily violence requires professionals to do away with some pre-established concepts in ordee to put the actual needs of victims and families into evidence. Identificar, com base no discurso dos profissionais, suas concepções a respeito da violência intrafamiliar contra crianças e adolescentes. Estudo qualitativo, realizado com 15 profissionais, que tiveram sob seus cuidados crianças e adolescentes atendidas em decorrência da violência intrafamiliar. Os dados foram coletados entre novembro de 2013 e março de 2015, por meio de entrevistas semiestruturadas. Os dados foram organizados e analisados utilizando a técnica de Análise Textual Discursiva. O discurso dos profissionais colocou em evidência que alguns aspectos legais em relação ao manejo da violência intrafamiliar contra crianças e adolescentes são negligenciados, omissão respaldada pela justificativa dos profissionais de preservar a família. Destaca-se o confronto entre a concep

Contact Burn with Blister Formation in Children Treated with Sennosides.

Science.gov (United States)

Cogley, Kimberly; Echevarria, Andrea; Correa, Catalina; De la Torre-Mondragón, Luis

2017-03-01

Eight children treated for severe constipation with sennosides unexpectedly developed contact burns with blisters secondary to the use of these laxatives. All patients wore diapers, and the injuries occurred overnight. To avoid this side effect, we recommend that patients treated with sennosides, especially those in diapers, receive the medication at a time that allows for bowel movements to occur during the day and not overnight. © 2017 Wiley Periodicals, Inc.

We are not alone: international learning for professionals caring for children requiring palliative care.

Science.gov (United States)

Price, Jayne; Quinn, Karen; McNeilly, Patricia; Heywood, Melissa

2015-06-01

Educational opportunities for professionals working with children requiring palliative care are central to future development within the specialty across countries. International educational initiatives involving a range of professionals are important for learning with and from others working within the field. To explore the experiences and value to students from participating in an international online discussion forum. This article examines one such initiative; the use of an international asynchronous discussion forum with students in Melbourne, Australia and Belfast, UK who work with children and families. The innovation is examined and student perspectives of the forum's value are presented. Students endorsed the value of the forum, identifying three main areas of learning: differences across locations within countries, respecting different views and being open, and need for continued learning within children's palliative care. The overarching theme 'we are not alone' supported the idea that participation in the international discussion forum enabled students to see a broader perspective. Ideas for future developments of similar forums are also explored.

Leading multi-professional teams in the children's workforce: an action research project.

Science.gov (United States)

Stuart, Kaz

2012-01-01

The 2004 Children Act in the UK saw the introduction of integrated working in children's services. A raft of change followed with processes designed to make joint working easier, and models and theories to support the development of integrated work. This paper explores the links between key concepts and practice. A practitioner action research approach is taken using an autoethnographic account kept over six months. The research question was, to what extent is this group collaborating? When the architecture of practice was revealed, differences between espoused and real practice could be seen. Whilst understanding and displaying the outward signs of an effective multi professional group, the individuals did not trust one another. This was exhibited by covert interprofessional issues. As a result, collaborative inertia was achieved. This realisation prompted them to participate in further developmental and participative action research. The paper concludes that trust and relational agency are central to effective leadership of multi professional teams.

Effective Nutrition Intervention to Treat Children Under 5 Years Old Suffering MAM in Public Primary Health Care Services in El Salvador

International Nuclear Information System (INIS)

Sanchez, Ana

2014-01-01

Full text: Background: In El Salvador Moderate Acute Malnutrition (MAM) affects less than 1% of children under 5 years old. The importance of MAM has been neglected as a public health issue. Although moderate wasting is not a condition of medical urgency, it can easily deteriorate. If some of these undernourished children with moderate wasting do not receive adequate support, they may progress towards severe acute malnutrition (SAM), defined by the presence of severe wasting and/or bilateral pitting oedema, which is a life-threatening condition. Since 2010, a complementary feeding program for children from 6 to 59 months old was implemented at the primary health clinics for the management of moderate malnutrition. Program was implemented in 100 municipalities identified with the greatest levels of poverty at national level and it consists of a corn-soy fortified flour to be prepared at home as a poudrige given to children during the routine health controls. During the first months of program implementation, an acceptability test was conducted and it was determined that more than 85% of children had good acceptance of the product. The treatment consists of 45 grams per day of complementary food. Mothers were instructed on how to prepare the product and every month they would have to bring their children to the clinic to receive complementary food and control weight gain. If mothers did not attend the control, a health promotion worker would go visit the mother at their home and bring the complementary food to the child. Objective: Assess the results on nutritional status of children under 5 years old with MAM treated with complementary food during health controls at primary health facilities in El Salvador during January to October 2013. Methods: Transversal study. Inclusion criteria was children 6 to 59 months old attending health controls coming from prioritize municipalities, diagnose with MAM by a health professional without other disease or infections that

Parents' experiences of collaboration between welfare professionals regarding children with anxiety or depression - an explorative study

Directory of Open Access Journals (Sweden)

Catharina Widmark

2013-10-01

Full Text Available Introduction: Well-functioning collaboration between professionals in the welfare sector has a strong influence on the contact with parents of children and adolescents with mental illness, and it is a precondition for the availability of support for these parents. This paper reports how such parents experience collaboration between professionals in mental health care, social services, and schools.Methods: Data were collected by in-depth interviews with seven parents of children and adolescents diagnosed with anxiety and depression. The families were selected from the Child and Adolescent Mental Health (CAMH patient records kept by the Stockholm County Council (Sweden, and they all lived in a catchment area for CAMH outpatient services in Stockholm.Results and discussion: We conclude that when the encounter between parents and professionals is characterized by structure and trust, it is supportive and serves as a holding environment. Coordination and communication links are needed in the collaboration between the professionals, along with appropriately scheduled and well-performed network meetings to create structure in the parent-professional encounter. Indeed, establishment of trust in this interaction is promoted if individual professionals are available, provide the parents with adequate information, are skilled, and show empathy and commitment. 

Parents' experiences of collaboration between welfare professionals regarding children with anxiety or depression - an explorative study

Directory of Open Access Journals (Sweden)

Catharina Widmark

2013-10-01

Full Text Available Introduction: Well-functioning collaboration between professionals in the welfare sector has a strong influence on the contact with parents of children and adolescents with mental illness, and it is a precondition for the availability of support for these parents. This paper reports how such parents experience collaboration between professionals in mental health care, social services, and schools. Methods: Data were collected by in-depth interviews with seven parents of children and adolescents diagnosed with anxiety and depression. The families were selected from the Child and Adolescent Mental Health (CAMH patient records kept by the Stockholm County Council (Sweden, and they all lived in a catchment area for CAMH outpatient services in Stockholm. Results and discussion: We conclude that when the encounter between parents and professionals is characterized by structure' and trust', it is supportive and serves as a holding environment'. Coordination and communication links are needed 'in the collaboration between the professionals, along with appropriately scheduled and well-performed network meetings 'to create structure in the parent-professional encounter. Indeed, establishment of trust in this interaction is promoted if individual professionals are available, provide the parents with adequate information, are skilled, and show empathy and commitment. 

Parents' Perceptions of Professional Support for the Emergent Literacy of Young Children with Visual Impairments

Science.gov (United States)

Brennan, Susan A.; Luze, Gayle J.; Peterson, Carla

2009-01-01

This survey explored the emergent literacy experiences that parents provided for their children with visual impairments, aged 1-8, as well as the parents' perceptions of the professional support that they received to facilitate these activities. The results indicated that the parents and children engaged in reading, singing songs, and writing or…

Aripiprazole for treating irritability in children & adolescents with autism: A systematic review.

Science.gov (United States)

Ghanizadeh, Ahmad; Tordjman, Sylvie; Jaafari, Nematollah

2015-09-01

No clear therapeutic benefits of antipsychotics have been reported for the treatment of behavioural symptoms in autism. This systematic review provides an assessment of evidence for treating irritability in autism by aripiprazole. The databases of MEDLINE/PubMed and Google Scholar were searched for relevant articles about the effect of aripiprazole in children with autism. The articles were searched according to the inclusion and exclusion criteria specifed for this review. All the double-blind, controlled, randomized, clinical trials examining the efficacy of aripiprazole for treating children and adolescents with autism were included. From the 93 titles identified, 26 were irrelevant and 58 were evaluated for more details. Only five articles met the inclusive criteria. The evidence from precise randomized double blind clinical trials of aripiprazole for the treatment of autism in children and adolescents was convincing enough to recommend aripiprazole. Adverse effects were not very common and were usually mild. Current evidence suggests that aripiprazole is as effective and safe as risperidone for treating irritability in autism. However, further studies with larger sample size and longer duration are required.

Identification of children with psychosocial problems differed between preventive child health care professionals

NARCIS (Netherlands)

Vogels, A.G.C.; Jacobusse, G.W.; Hoekstra, F.; Brugman, E.; Crone, M.; Reijneveld, S.A.

2008-01-01

Objective: To assess whether differences between individual Preventive Child Health Care (PCH) professionals in the percentage of children they identify as having psychosocial problems are larger than expected based on chance and whether such differences can be explained by differences in

Evaluating and treating neurobehavioral symptoms in professional American football players

Science.gov (United States)

Possin, Katherine L.; Hess, Christopher P.; Huang, Eric J.; Grinberg, Lea T.; Nolan, Amber L.; Cohn-Sheehy, Brendan I.; Ghosh, Pia M.; Lanata, Serggio; Merrilees, Jennifer; Kramer, Joel H.; Berger, Mitchel S.; Miller, Bruce L.; Yaffe, Kristine; Rabinovici, Gil D.

2015-01-01

Summary In the aftermath of multiple high-profile cases of chronic traumatic encephalopathy (CTE) in professional American football players, physicians in clinical practice are likely to face an increasing number of retired football players seeking evaluation for chronic neurobehavioral symptoms. Guidelines for the evaluation and treatment of these patients are sparse. Clinical criteria for a diagnosis of CTE are under development. The contribution of CTE vs other neuropathologies to neurobehavioral symptoms in these players remains unclear. Here we describe the experience of our academic memory clinic in evaluating and treating a series of 14 self-referred symptomatic players. Our aim is to raise awareness in the neurology community regarding the different clinical phenotypes, idiosyncratic but potentially treatable symptoms, and the spectrum of underlying neuropathologies in these players. PMID:26336629

The Knowledge of Rehabilitation Professionals Concerning Fetal Alcohol Spectrum Disorders.

Science.gov (United States)

Birch, Stephanie M; Carpenter, Heidi A; Marsh, Anna M; McClung, Kimberly A; Doll, Joy D

2016-01-01

The purpose of this study was to explore rehabilitation professionals' knowledge regarding signs and symptoms, prevention, and intervention of fetal alcohol spectrum disorders (FASD). Participants were 111 rehabilitation practitioners (e.g., occupational therapy, physical therapy, and speech-language pathology practitioners) recruited through email using a quantitative online survey design with purposive, snowball sampling. Results showed the majority of participants' demonstrated accurate knowledge of the signs and symptoms of FASD. Since professionals who received formal education on FASD reported significantly higher feelings of preparedness to identify children with FASD and manage/coordinate intervention plans, this study suggests rehabilitation professionals may be better prepared to treat individuals with FASD if they participate in formal training.

The cognitive profile of children treated with radiation for acute ...

African Journals Online (AJOL)

The cognitive profile of children treated with radiation for acute lymphoblastic leukaemia. ... to disrupt the myelination and integrity of white matter tracts in the brain. ... The current study focused on the assessment of memory and learning, two ...

EARLY DIAGNOSIS AS DETERMINATING FACTOR FOR PROFESSIONAL, RATIONAL AND EFFECTIVE TREATMENT OF CHILDREN WITH DEVELOPMENTAL DIFFICULTIES

Directory of Open Access Journals (Sweden)

Goran AJDINSKI

1997-06-01

Full Text Available Early diagnosis of children with developmental difficulties is one of the most important segments in the process of rehabilitation. It is not only an assessment and evaluation of the functional conditions, but also and detection of the possibilities for treatment and it’s improvement.In our presentation we give the first noticing for diagnostics of children with developmental difficulties in the Republic of Macedonia, the present capacities, possibilities, needs and suggestions for it’s improvement and advancement. Speaking about that we stress the need of multidisciplinary and complete professional team in the present institutions and solving out a number of problems that exist on that plan. It especially relates to the unique terminology, the procedure and involvement of defectologists in the diagnostic process.Having in mind the bio-psycho and social aspects of the personality of children with developmental difficulties, together with the need of a complex diagnostic procedure, we have tried to give the professional activities of all the profiles of professionals that take part in the diagnostic process. So, we give a review of the work of:· physician-pediatrician who is involved in the diagnostics of all children· audiologist who is involved in the diagnostics of children with damaged hearing from a medical point of view.· the clinical psychologist who works in the institute for medical rehabilitation and whose task is to prepare and realize all the necessary tests for the personality of the child with developmental difficulties.· physiologist for children with somatic damages.· neuropsychiatrist for children with psychological difficulties· specialist for eye diseases giving his report about the child’s damaged eyesight etc.We consider that we shouldn’t neglect the role of the defectologist, his examinations on psycho-motor status, speech, i. e. the functions of the individual in relation to the social aspect in a close

Enabling professionals to change practices aimed at tackling social inequality through professional development

DEFF Research Database (Denmark)

Jensen, Bente; Brandi, Ulrik

2018-01-01

the impact of a professional development programme on changing practices that can address social inequality in ECEC. The article explores how a professional development programme, VIDA, can contribute to enabling professionals in enhancing the change potentials in ECEC, with a view to enhancing the learning......Research has shown the potential for early childhood education and care (ECEC) in making a difference for all children. However, research also highlights how hard overcoming the ‘gaps’ between children from differing social backgrounds still is. The overall aim of this article is to examine...... conditions and well-being of all children, and socially disadvantaged children in particular. The overall argument is that co-construction as well as openness and reflection in the ECEC field is needed when professionals are to change their pedagogical practices towards tackling the issues of social...

Prevalence of hearing-loss among HAART-treated children in the Horn of Africa.

Science.gov (United States)

Smith, Alden F; Ianacone, David C; Ensink, Robbert J H; Melaku, Abebe; Casselbrant, Margaretha L; Isaacson, Glenn

2017-07-01

The prevalence of hearing loss (HL) in children infected with HIV/AIDS is not well studied. Even fewer studies focus on stable HIV-infected children treated with high-effective antiretroviral therapy (HAART). We aim to compare the prevalence of ear disease and HL in HAART-treated, HIV + children in Addis Ababa, Ethiopia with a well, similarly-aged elementary school population with unknown HIV status (HIVU). Children underwent standard head and neck examination and cerumen removal by board certified otolaryngologists. Next, certified audiologists performed hearing screening with pure-tone audiometry using a circumaural headset but without an ambient noise reducing environment. Children failing audiometric screening underwent full behavioral audiometry including air and bone testing. The primary outcome parameter was HL > 25 dB with the audiologist accounting for background noise. A second endpoint was PTA >40 dB (500, 1000, 2000 Hz) without assessment of background noise. 107 HIV+ and 147 HIVU children met inclusion criteria. In the HIV + cohort 17.8% had evidence of TM perforations and 8.4% had otorrhea. In the HIVU group 2.7% had a TM perforation and 0% had otorrhea. Hearing was significantly worse in HIV + children. (Audiologist determination: 38.3% HL HIV+, 12.2% HIVU, Fisher's-Exact-Test OR: 4.5, 95% CI 2.4-8.3, p-value hearing-ear PTA > 40 dB: 19.6% HL HIV+, 6.1% HIVU, OR: 3.7, 95% CI 1.7-8.4, p-value hearing losses are significantly more common in HAART-treated HIV + children than in well, similarly-aged controls. Rates of SNHL are similar. Copyright © 2017 Elsevier B.V. All rights reserved.

Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report.

Science.gov (United States)

Bernkopf, Edoardo; Lovato, Andrea; Bernkopf, Giulia; Giacomelli, Luciano; De Vincentis, Giovanni Carlo; Macrì, Francesco; de Filippis, Cosimo

2016-01-01

Aim . To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods . The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results . 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate ( p children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.

Aripiprazole for treating irritability in children & adolescents with autism: A systematic review

Directory of Open Access Journals (Sweden)

Ahmad Ghanizadeh

2015-01-01

Full Text Available Background & objectives: No clear therapeutic benefits of antipsychotics have been reported for the treatment of behavioural symptoms in autism. This systematic review provides an assessment of evidence for treating irritability in autism by aripiprazole. Methods: The databases of MEDLINE/PubMed and Google Scholar were searched for relevant articles about the effect of aripiprazole in children with autism. The articles were searched according to the inclusion and exclusion criteria specifed for this review. All the double-blind, controlled, randomized, clinical trials examining the efficacy of aripiprazole for treating children and adolescents with autism were included. Results: From the 93 titles identified, 26 were irrelevant and 58 were evaluated for more details. Only five articles met the inclusive criteria. The evidence from precise randomized double blind clinical trials of aripiprazole for the treatment of autism in children and adolescents was convincing enough to recommend aripiprazole. Adverse effects were not very common and were usually mild. Interpretation & conclusions: Current evidence suggests that aripiprazole is as effective and safe as risperidone for treating irritability in autism. However, further studies with larger sample size and longer duration are required.

Adrenal function in children with bronchial asthma treated with beclomethasone dipropionate or budesonide

DEFF Research Database (Denmark)

Bisgaard, H; Damkjaer Nielsen, M; Andersen, B

1988-01-01

. The unstimulated diurnal production of glucocorticosteroids was assessed by measurements of free cortisol in 24-hour urine samples. Free cortisol in urine was found a valid measure of the total diurnal excretion of cortisol metabolites, since it exhibited a good correlation to the fractional cortisol metabolites...... difference was found between the two topical steroids (probability value 5.3%), and yet the suppression was apparent in the group of children treated with beclomethasone dipropionate but not in the group of children treated with budesonide. Further studies are desirable in order to ascertain whether...

Puberty and Pubertal Growth in GH-treated SGA Children: Effects of 2 Years of GnRHa Versus No GnRHa.

Science.gov (United States)

van der Steen, Manouk; Lem, Annemieke J; van der Kaay, Danielle C M; Hokken-Koèelega, Anita C S

2016-05-01

Most studies on puberty in children born small for gestational age (SGA) report height and age at onset of puberty. GH-treated SGA children with an adult height (AH) expectation below -2.5 SDS at onset of puberty can benefit from an additional 2 years of GnRH analog (GnRHa) treatment. There are no data on puberty and growth after discontinuation of GnRHa treatment in GH-treated SGA children. This study aimed to investigate the effects on puberty and pubertal growth of 2 years GnRHa vs no GnRHa in GH-treated SGA children. This was a GH trial involving 76 prepubertal short SGA children (36 girls) treated with GH. Thirty-two children received additional GnRHa for 2 years. Pubertal stages were 3-monthly assessed according to Tanner. Age, bone age, and median height at pubertal onset were lower in girls and boys in the GH/GnRHa group compared with the GH group. In girls and boys treated with GH/GnRHa, pubertal duration after stop of GnRHa treatment was shorter than pubertal duration in those with GH only (40.9 vs 46.7 mo; P = .044; 50.8 vs 57.5 months; P = .006; respectively). Height gain from onset of puberty until AH, including height gain during 2 years of GnRHa treatment, was 25.4 cm in girls and 33.0 cm in boys, which was 6.6 cm more than girls and boys treated with GH only. AH was similar in children treated with GH/GnRHa compared with those with GH only. GH-treated SGA children who start puberty with an AH expectation below -2.5 SDS and are treated with 2 years of GnRHa have a shorter pubertal duration after discontinuation of GnRHa compared with pubertal duration in children treated with GH only. Height gain from onset of puberty until AH is, however, more due to adequate growth during 2 years of GnRHa treatment resulting in a similar AH as children treated with GH only.

[Nasogastric rehydration for treating children with gastroenteritis].

Science.gov (United States)

Rébeillé-Borgella, B; Barbier, C; Moussaoui, R; Faisant, A; Michard-Lenoir, A-P; Rubio, A

2017-06-01

When oral rehydration is not feasible, enteral rehydration via the nasogastric route has been the ESPGHAN recommended method of rehydration since 2008, rather than intravenous rehydration (IVR), for children with acute gastroenteritis. However, these recommendations are rarely followed in France. Since 2011, in case of failure of oral rehydration, enteral rehydration has been used as a first-line therapy in the Children's Emergency Department at the Grenoble-Alpes University Hospital. The aims of the study were to compare the length of the hospital stay, the duration of initial rehydration, and the incidence of complications and failure with the use of enteral nasogastric versus intravenous rehydration. This study compared two cohorts of children (rehydration via the oral route. The first group (winter 2010-2011) was managed according to the previous protocol (intravenous rehydration). The second group (winter 2011-2012) was managed according the new protocol (nasogastric tube rehydration [NGR]). The rest of the gastroenteritis management was identical in both groups. A total of 132 children were included, 65 were treated with nasogastric tube rehydration (NGR) and 67 with intravenous rehydration. There was a significant reduction in the duration of hospitalization in the post-emergency unit in the NGR group: 23.6h vs 40.1h (Prehydration was also significantly reduced (10.5h vs 22.0h). There was no significant difference regarding serious adverse events. However, the NGR group presented more mild adverse events (22 vs 7, Prehydration reduces the duration of rehydration and the length of the hospital stay without increasing the incidence of serious adverse events for dehydrated children hospitalized for acute gastroenteritis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review

Directory of Open Access Journals (Sweden)

de Frey Albie

2008-10-01

Full Text Available Abstract Background The efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria in children is not clearly understood. The objective of this review was to assess the efficacy of parenteral artemisinin derivatives versus parenteral quinine in treating severe malaria in children. Methods All randomized controlled studies comparing parenteral artemisinin derivatives with parenteral quinine in treating severe malaria in children were included in the review. Data bases searched were: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007, MEDLINE (1966 to February 2008, EMBASE (1980 to February 2008, and LILACS (1982 to February 2008. Dichotomous variables were compared using risk ratios (RR and the continuous data using weighted mean difference (WMD. Results Twelve trials were included (1,524 subjects. There was no difference in mortality between artemisinin derivatives and quinine (RR = 0.90, 95% CI 0.73 to 1.12. The artemisinin derivatives resolved coma faster than quinine (WMD = -4.61, 95% CI: -7.21 to -2.00, fixed effect model, but when trials with adequate concealment only were considered this differences disappeared. There was no statistically significant difference between the two groups in parasite clearance time, fever clearance time, incidence of neurological sequelae and 28th day cure rate. One trial reported significantly more local reactions at the injection site with intramuscular quinine compared to artemether. None of the trials was adequately powered to demonstrate equivalence. Conclusion There was no evidence that treatment of children with severe malaria with parenteral artemisinin derivatives was associated with lower mortality or long-term morbidity compared to parenteral quinine

Establishing oral health promoting behaviours in children - parents' views on barriers, facilitators and professional support: a qualitative study.

Science.gov (United States)

Duijster, Denise; de Jong-Lenters, Maddelon; Verrips, Erik; van Loveren, Cor

2015-12-10

The prevention of childhood dental caries relies on adherence to key behaviours, including twice daily tooth brushing with fluoride toothpaste and reducing the consumption of sugary foods and drinks. The aim of this qualitative study was to explore parents' perceptions of barriers and facilitators that influence these oral health behaviours in children. A further objective was to explore parents' views on limitations and opportunities for professional support to promote children's oral health. Six focus group interviews were conducted, including a total of 39 parents of 7-year old children, who were recruited from paediatric dental centres in The Netherlands. Interviews were held with Dutch parents of low and high socioeconomic status and parents from Turkish and Moroccan origin. Focus group interviews were conducted on the basis of a pre-tested semi-structured interview guide and topic list. Content analysis was employed to analyse the data. Analysis of interview transcripts identified many influences on children's oral health behaviours, operating at child, family and community levels. Perceived influences on children's tooth brushing behaviour were primarily located within the direct family environment, including parental knowledge, perceived importance and parental confidence in tooth brushing, locus of control, role modelling, parental monitoring and supervision, parenting strategies and tooth brushing routines and habituation. The consumption of sugary foods and drinks was influenced by both the direct family environment and factors external to the family, including the school, the social environment, commercials and television, supermarkets and affordability of foods. Parents raised several suggestions for professional oral health support, which included the provision of clear and consistent oral health information using a positive approach, dietary regulations at school and a multidisciplinary approach among dental professionals, child health centres and

What parents of mentally ill children need and want from mental health professionals.

Science.gov (United States)

Scharer, Kathleen

2002-09-01

Child psychiatric hospitalization is a time of crisis for the parents of a child with a mental disorder. Prior to hospitalization, the child's problematic behavior has escalated. Parents have various types of contact with mental health professionals prior to, during, and after the hospitalization, which influence their ability to care for their child. This paper reports a qualitative descriptive study of what parents need and want from mental health professionals during this time frame. During the study, parents spontaneously talked about what they needed and wanted from mental health professionals, including nursing personnel. The perspectives of 38 parents of 29 hospitalized children were obtained through interviews. Parents identified needing informational, emotional, and instrumental support most often in the interviews. Specific examples from the data are included in this report.

Advocacy for Children with Social-Communication Needs: Perspectives from Parents and School Professionals

Science.gov (United States)

Burke, Meghan M.; Meadan-Kaplansky, Hedda; Patton, Kimberly A.; Pearson, Jamie N.; Cummings, Katrina P.; Lee, Chung eun

2018-01-01

Although parents of children with disabilities often advocate for special education services, most research has only examined advocacy from the perspectives of parents. Given that advocacy is an interpersonal exchange, it is crucial to understand the perspectives of parents and school professionals. In this study, focus groups were conducted with…

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

Irradiation spine deformity in children treated for neuroblastoma

International Nuclear Information System (INIS)

Mayfield, J.K.; Riseborough, E.J.; Nehme, M.

1978-01-01

A retrospective long-term follow-up review of 56 children with neuroblastoma surviving five years and longer following treatment since 1946 revealed that 57% had developed spine deformity (S.D.) following treatment with 250 kilovolt irradiation at the time of review. The average age at diagnosis was 17 months. Irradiation therapy was delivered to most children before 24 months of age. Follow-up averaged 12.9 years with a range of 5-31 years. Eighty-five per cent of the children had developed structural spine deformity at skeletal maturity and 54% of these children had scoliosis greater than 20 degrees. Sixteen per cent of irradiated children developed structural kyphosis. Non-midline opposing anterior and posterior ports were used most frequently. Mean dosage in patients who developed scoliosis of 20 degrees or more was 3588 rads (spine dosage) and 3746 rads in patients who developed kyphosis. Irradiation through opposing anterior and posterior ports was more commonly associated with the development of S.D. Sixty-six per cent of children who had more than 2000 rads developed S.D. The adolescent growth spurt was associated with an increase in the frequency and severity of spine deformity. This study indicated that moderate to severe S.D. was produced by irradiation in excess of 2000 rads administered with a 250-kilovoltage machine. This study would also suggest that children with neuroblastoma treated with orthovoltage irradiation should be followed closely by the orthopaedic surgeon, the oncologist, the radiotherapist and the paediatrician until the completion of skeletal growth for the development of unsightly structural spine deformity. Early bracing and surgery may be helpful in controlling these deformities in the pre-adolescent to early adolescent years. Continued observation is necessary to determine if current irradiation techniques will minimize or eradicate the incidence and severity of these complications. (author)

Sustained attention problems in children with early treated congenital hypothyroidism

NARCIS (Netherlands)

Kooistra, L.; Van der Meere, J.J.; Vulsma, T.; Kalverboer, A.F.

Sustained attention was studied in 48 children with early treated congenital hypothyroidism and 35 healthy controls, using a computer-paced and a self-paced continuous performance task. The performance of the patients, particularly those in the low T4 group (38 patients with T4 levels 50 nmol/l at

Late sequelae in children treated for brain tumors and leukemia

International Nuclear Information System (INIS)

Jereb, B.; Petric-Grabnar, G.; Zadravec-Zaletel, L.; Korenjak, R.; Krzisnik, C.; Anzic, J.; Stare, J.

1994-01-01

Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients. (orig.)

Late sequelae in children treated for brain tumors and leukemia

Energy Technology Data Exchange (ETDEWEB)

Jereb, B. (Institute of Oncology, Ljubljana (Slovenia)); Petric-Grabnar, G. (Institute of Oncology, Ljubljana (Slovenia)); Zadravec-Zaletel, L. (Institute of Oncology, Ljubljana (Slovenia)); Korenjak, R. (Clinical Center, Psychiatric Outpatient Dept., Ljubljana (Slovenia)); Krzisnik, C. (Clinical Center, Dept. of Pediatrics, Ljubljana (Slovenia)); Anzic, J. (Clinical Center, Dept. of Pediatrics, Ljubljana (Slovenia)); Stare, J. (Institute of Biomedical Informatics, Medical Faculty, Ljubljana (Slovenia))

1994-01-01

Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients. (orig.).

Late sequelae in children treated for brain tumors and leukemia.

Science.gov (United States)

Jereb, B; Korenjak, R; Krzisnik, C; Petric-Grabnar, G; Zadravec-Zaletel, L; Anzic, J; Stare, J

1994-01-01

Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients.

QUALITY OF LIFE IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS TREATED WITH INFLIXIMAB

Directory of Open Access Journals (Sweden)

R.V. Denisova

2008-01-01

Full Text Available Juvenile rheumatoid arthritis (JRA is chronic disease, leading to early incapacitating injury in patients. Treatment of JRA with new expensive biological agents allows obtaining long term remission of disease and improving its prognosis. Estimation of quality of life is one of the main effectiveness criteria of treatment. A quality of life in children who were 2–4 years old treated with infliximab was estimated. 43 patients with different types of JRA were examined. A quality of life was estimated with the help of questionnaire PEDSQL generic core scale, PEDSQL rheumatology module. Index of functional disability was estimated by childhood health assessment questionnaire (CHAQ. Significant increase of quality of life rates and decrease of index of functional disability was registered in 6 weeks of therapy with infliximab. The rates of quality of life in patients with JRA treated with infliximab were significantly equal to that in healthy children in the same age in 6, 12 and 24 months of treatment. Thus, treatment with infliximab significantly increases quality of life in children in 2–4 years old with JRA and their families, decreases negative influence of disease on child's living, improves physical activity and emotional state of patients, and allows improving contact between patients and healthy children in the same age.Key words: children, juvenile rheumatoid arthritis, quality of life, infliximab.

Speech and Language Skills in Children with Early Treated Phenylketonuria.

Science.gov (United States)

Ozanne, Anne E.; And Others

1990-01-01

The study of 29 children, age 7 months to 16 years, with early treated phenylketonuria found no significant differences on speech and/or language measures when compared with controls matched for age, sex, and socioeconomic level. Examination of individual scores, however, did reveal linguistic impairment in a small number of subjects. (Author/JDD)

Incidence and consequences of varicella in children treated for cancer in Guatemala.

Science.gov (United States)

Brown, Amy E Caruso; Asturias, Edwin J; Melgar, Mario; Antillon-Klussmann, Federico A; Mettler, Pamela; Levin, Myron J

2016-08-01

Varicella-zoster virus infection is associated with significant morbidity and mortality in immune-compromised children, despite treatment with antiviral agents. Universal varicella vaccine programs have significantly decreased this risk in many highincome countries, but in most low-income and middleincome countries, the burden of varicella in children treated for malignancy is poorly defined. We retrospectively reviewed records of children at the National Unit of Pediatric Oncology (UNOP) in Guatemala diagnosed with varicella between January 2009 and March 2013 in order to calculate incidence of varicella and evaluate morbidity, mortality, treatment interruption, and cost. Fifty-nine cases of varicella were identified. Incidence was 23.4 cases per 1000 person-years (p-y). 66.1% of cases occurred in children with leukemia (median age 5.2 years; interquantile range 3.4-7 years) and 41.0% of these occurred during maintenance therapy. Source of exposure was identified for 14/59 (23.7%) children. Most were hospitalized (71.2%) and given intravenous acyclovir (64.4%). Eight (13.6%) children required critical care, and two (3.4%) died from disseminated varicella with multiorgan failure. Chemotherapy was delayed or omitted due to varicella in 50%. No significant differences in outcomes based on nutritional and immunologic status were detected. The minimum average cost of treatment per episode was 598.75 USD. Varicella is a significant problem in children treated for cancer in Guatemala, where effective post-exposure prophylaxis is limited. In the absence of universal varicella vaccination, strategies to improve recognition of exposure and the future use of novel inactivated vaccines currently under investigation in clinical trials could mitigate this burden.

Extended Daily Eye Patching Effective at Treating Stubborn Amblyopia in Children

Science.gov (United States)

... Spanish Spanish Stargardt Disease Stem Cells Usher Syndrome Uveitis/Inflammatory Eye Disease Vision Screening World Sight Day Extended daily eye patching effective at treating stubborn amblyopia in children News Brief 09/20/13 The standard treatment for amblyopia, a condition of poor vision in ...

Respect for nursing professional: Silence must be heard

Directory of Open Access Journals (Sweden)

Sundeep Mishra

2015-09-01

Full Text Available The value of care giving seems to be at an all-time low. whether it is clinical (bedside or for children and elderly at home (homemakers. Currently, individuals who pass away any opportunity (for themselves to care for another individual instead are considered weak and/or unmotivated. Thus, it is not surprising that modern society often fails to respect the nursing professionals to the extent of underplaying their strengths, skills, and even clinical abilities. While qualities such as kindness, team spirit, and willingness to get their hands dirty are the core of this profession, nursing professionals have a complex variety of set duties, involving drug dosage, trouble-shooting, ongoing patient monitoring, and providing holistic comfort and support to the sick and needy. Beyond classical role, the nursing professional has currently ventured into other roles as well, as a nurse practitioner, administrator, researcher, or even an educator. Thus, considering the wide spectrum of duties performed by nursing professionals, they do deserve more status and power rather than be treated like “ward housewives.”

Deep data science to prevent and treat growth faltering in Maya children

OpenAIRE

Varela-Silva, M I; Bogin, B; Sobral, J A G; Dickinson, F; Monserrat-Revillo, S

2016-01-01

The Maya people are descended from the indigenous inhabitants of southern Mexico, Guatemala and adjacent regions of Central America. In Guatemala, 50% of infants and children are stunted (very low height-for-age), and some rural Maya regions have >70% children stunted. A large, longitudinal, intergenerational database was created to (1) provide deep data to prevent and treat somatic growth faltering and impaired neurocognitive development, (2) detect key dependencies and predictive relations ...

Quality of life, anxiety and concerns among statin-treated children with familial hypercholesterolaemia and their parents

NARCIS (Netherlands)

de Jongh, S.; Kerckhoffs, M. C.; Grootenhuis, M. A.; Bakker, H. D.; Heymans, H. S. A.; Last, B. F.

2003-01-01

Aim: To assess the quality of life, anxiety and concerns among statin-treated children with familial hypercholesterolaemia (FH) and their parents. Methods: 69 FH children on statin therapy and 87 parents (51 families) participated in this study. Quality of life of the children, and anxiety levels of

Preschool professionals' (self)perception of competency and attitudes in the field of team work with children with special needs

OpenAIRE

Rozman, Katjuša

2017-01-01

Preschool period is very important for children's growth. Preschool period is also important for children with special needs, because we need to discover their problems, disabilities or obstacles as soon as possible. In Slovenia preschool children with special needs are divided in one of the three different educational programs definite by law. In ordinary preschool program they carry out special program for children with special needs. This special program has extra professional assistance, ...

Professional choice early education teachers’ views

Directory of Open Access Journals (Sweden)

Ive Carina Rodrigues Lima Brasil

2012-05-01

Full Text Available This qualitative and exploratory research aimed at investigating the underlying reasons for the professional choice of teachers who work with early education. 17 teachers (7 from public schools and 10 from private schools were interviewed in depth in a semi-structured manner. Questions concerned the reasons that guided participants’ professional choice. According to the results, the main reasons for choosing to work with children were associated with love for children, family influence, opportunity, idealism, enchantment and special talent to work with children. Some of the interviewees’ had working with children as a professional option consciously made, whether others were merely taken by the circumstances. Stereotyped views of the profession (feminine profession are also addressed.

Barriers to successful recruitment of parents of overweight children for an obesity prevention intervention: a qualitative study among youth health care professionals

Directory of Open Access Journals (Sweden)

Gerards Sanne MPL

2012-05-01

Full Text Available Abstract Background The recruitment of participants for childhood overweight and obesity prevention interventions can be challenging. The goal of this study was to identify barriers that Dutch youth health care (YHC professionals perceive when referring parents of overweight children to an obesity prevention intervention. Methods Sixteen YHC professionals (nurses, physicians and management staff from eleven child health clinics participated in semi-structured interviews. An intervention implementation model was used as the framework for conducting, analyzing and interpreting the interviews. Results All YHC professionals were concerned about childhood obesity and perceived prevention of overweight and obesity as an important task of the YHC organization. In terms of frequency and perceived impact, the most important impeding factors for referring parents of overweight children to an intervention were denial of the overweight problem by parents and their resistance towards discussing weight issues. A few YHC professionals indicated that their communication skills in discussing weight issues could be improved, and some professionals mentioned that they had low self-efficacy in raising this topic. Conclusions We consider it important that YHC professionals receive more training to increase their self-efficacy and skills in motivating parents of overweight children to participate in obesity prevention interventions. Furthermore, parental awareness towards their child’s overweight should be addressed in future studies.

Prevalence of alveolar bone loss in healthy children treated at private pediatric dentistry clinics.

Science.gov (United States)

Guimarães, Maria do Carmo Machado; de Araújo, Valéria Martins; Avena, Márcia Raquel; Duarte, Daniel Rocha da Silva; Freitas, Francisco Valter

2010-01-01

The purpose of this study was to evaluate the prevalence of alveolar bone loss (BL) in healthy children treated at private pediatric dentistry clinics in Brasília, Brazil. The research included 7,436 sites present in 885 radiographs from 450 children. The BL prevalence was estimated by measuring the distance from the cementoenamel junction (CEJ) to alveolar bone crest (ABC). Data were divided in groups: (I) No BL: distance from CEJ to ABC is 2 and 3 mm. Data were treated by the chi-square nonparametric test and Fisher's exact test (pchildren should never be underestimated because BL occurs even in healthy populations, although in a lower frequency.

Follow-up study of children whose mothers were treated with transcranial magnetic stimulation during pregnancy: preliminary results.

Science.gov (United States)

Eryılmaz, Gul; Sayar, Gökben Hızlı; Özten, Eylem; Gül, Işıl Göğcegöz; Yorbik, Özgür; Işiten, Nuket; Bağcı, Eda

2015-06-01

The purpose of this study is to determine the impact of repetitive transcranial stimulation (rTMS) treatment during pregnancy on neurodevelopment of children. Women who were treated with rTMS during pregnancy and delivered liveborn children between 2008 and 2013 were selected. A control group consisted of children whose mothers had a history of untreated depression during their pregnancy (N = 26). Early developmental characteristics of all the children in the study were evaluated, and their developmental levels were determined using the Ankara Developmental Screening Inventory. The mean age of the children in the rTMS treatment group was 32.4 months (range 16-64 months), and that of the untreated group was 29.04 (range 14-63 months). Jaundice (N = 2) and febrile convulsion (N = 1) were the reported medical conditions in the children of the rTMS-treated group; jaundice (N = 3) and low birth weight (N = 1) were reported in the untreated group. In the rTMS group, mothers' perception of delay in language development was observed, but there were not any statistically significant differences in the prevalence rate compared with the untreated group (OR = 0.38; 95% CI 0.0860-1.6580). Our results suggest that rTMS exposure during pregnancy is not associated with poorer cognitive or motor development outcomes in children aged 18-62 months. Although language development as reported by the mothers was found to be poorer than expected in the rTMS-treated group, the delay was found to be similar to the language delay observed in offspring of untreated mothers, as reported in previous studies of prenatal depression treated with selective serotonin reuptake inhibitors. © 2014 International Neuromodulation Society.

The effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital in 2013-2014

OpenAIRE

Rahmati, M; Moayedi, A; Zakery Shahvari, S; Golmirzaei, J; Zahirinea, M; Abbasi, B

2015-01-01

Introduction. Bruxism is to press or grind teeth against each other in non-physiologic cases, when an individual does not swallow or chew. If not treated, teeth problems, stress, mental disorders, frequent night waking, and headache is expected. This research aimed to study the effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital. Methodology. In this clinical trial, 143 children with the ages between 4-12 years were ...

How can professionals carry out recognition towards children of parents with alcohol problems? A qualitative interview study.

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Werner, Anne; Malterud, Kirsti

2017-02-01

The aim of this study was to explore informal adult support experienced by children with parental alcohol problems to understand how professionals can show recognition in a similar way. We conducted a qualitative interview study with retrospective accounts from nine adults growing up with problem-drinking parents. Data were analysed with systematic text condensation. Goffman's concept "frame" offered a lens to study how supportive situations were defined and to understand opportunities and limitations for translation of recognition acts and attitudes to professional contexts. Analysis demonstrated frames of commonplace interaction where children experienced that adults recognised and responded to their needs. However, the silent support from an adult who recognised the problems without responding was an ambiguous frame. The child sometimes felt betrayed. Concentrating on frames of recognition which could be passed over to professional interactions, we noticed that participants called for a safe harbour, providing a sense of normality. Being with friends and their families, escaping difficulties at home without having to tell, was emphasised as important. Recognition was experienced when an adult with respect and dignity offered an open opportunity to address the problems, without pushing towards further communication. Our study indicates some specific lessons to be learnt about recognition for professional service providers from everyday situations. Frames of recognition, communicating availability and normality, and also unconditional confidentiality and safety when sharing problems may also be offered by professionals in public healthcare within their current frames of competency and time.

Does working with child abuse cases affect professionals' parenting and the psychological well-being of their children?

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Dursun, Onur Burak; Sener, Mustafa Talip; Esin, Ibrahim Selcuk; Ançi, Yüksel; Yalin Sapmaz, Sermin

2014-01-01

Work in the field of sexual abuse is extremely stressful and may arouse negative personal reactions. Although these secondary trauma effects are well described on a personal level, there is not enough evidence to understand whether these professionals carry these effects to their homes, families, and offspring. This study aims to identify the effects of working with child abuse cases on the anxiety level and parenting styles of childhood trauma workers and on their children's well-being. A total of 43 health and legal system workers who worked with abused children in any step of their process and who had children constituted the study group, and 50 control cases, each working in the same institution and having the same occupation as 1 of the participants from the study group and having children but not working directly with children and child abuse cases, were included in the study. Participants were asked to fill out a sociodemographic form, the Parental Attitude Research Instrument, the trait portion of the State-Trait Anxiety Inventory, and an age-appropriate form of the Child Behavior Checklist for each child they had. Professionals in the study working with child abuse cases demonstrated significantly higher democratic parenting attitudes. Law enforcement workers working with child abuse cases demonstrated stricter and more authoritarian parenting strategies, as well as more democratic attitudes, than their colleagues. There was not a statistically significant relationship between child abuse workers' anxiety level and their children's well-being among control subjects.

Dental anomalies and dental age assessment in treated children with acute lymphoblastic leukemia.

Science.gov (United States)

Khojastepour, L; Zareifar, S; Ebrahimi, M

2014-01-01

This cross sectional study was performed to evaluate dental ages and incidence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL). A total of 25 ALL patient who passed at least 2 years of chemotherapy and 25 healthy sex and age matched children were evaluated. Dental age as well as dental anomalies in shape, size, number, and structure was recorded based on their panoramic radiographies which were taken for dental purposes. The number of dental anomalies significantly increased in ALL treated children. Seven ALL cases (28%) in compression to only one (4%) in control group had at least one dental anomaly. However, there was neither statistically significant differences between the mean of dental (p=0.32) and chronologic age (p=0.12) in both groups, nor between dental age of cases and control group (p=0.62).The age at the onset of treatment as well as treatment durations has not affected dental age and the incidence of dental anomalies significantly (pdental anomaly. Dental age, maturity, and development process however seems to be independent from chemotherapy.

Widening Access; Developing an eLearning Resource for Health and Social Care Professionals Caring for Children and Young People with Cancer.

Science.gov (United States)

McInally, Wendy; Pouso Lista, Maria J; McLaren, Natalia; Willis, Diane S

2017-09-29

Cancer is a key priority worldwide, and caring for children and young people with cancer requires a range of specific knowledge, skills and experience in order to deliver the complex care regimes both within the hospital or community environment. The aim of this paper is to disseminate work undertaken to design and develop pedagogical practice and innovation through an eLearning resource for health care professionals caring for children and young people with cancer across the globe. The work undertaken evaluated an existing cancer course (which has been withdrawn) that was developed and delivered through the Paediatric Oncology Nurses Forum, Royal College Nursing (Nurse Educators) and Warwick University. The evaluation consisted of 26 open and closed questions relating to the previous resource and was circulated to all health and social care professionals involved directly within specialist oncology services through the Children's Cancer and Leukaemia Group. Questionnaires were sent out to a convenience sample of 773 health care professionals and the response rate was 14%. The findings identified that the course was predominantly accessed by nurses, but other health care professionals also found it useful. Participants highlighted several areas where they believed content could be developed or was lacking. This included areas such as palliative and end of life care, nutrition, sepsis and teenagers and young people. This feedback was then used to develop a site dedicated to the care of children and young people with cancer.

Personal and Professional Emotional Characteristics of Early Childhood Teachers and Their Proneness to Communicate with Parents and Colleagues about Children's Emotions

Science.gov (United States)

Ciucci, Enrica; Baroncelli, Andrea; Toselli, Monica; Denham, Susanne A.

2018-01-01

Background: Early childhood teachers represent important socializers of children's emotions providing professional practices, such as communication about children's emotions, influencing children's development. According to an ecological framework, early childhood teachers' emotional practices are guided by both their personal and professional…

Attitudes, beliefs, and perceived norms about corporal punishment and related training needs among members of the "American Professional Society on the Abuse of Children".

Science.gov (United States)

Taylor, Catherine A; Fleckman, Julia M; Lee, Shawna J

2017-09-01

Hitting children for disciplinary purposes (i.e., spanking or corporal punishment [CP]) is a strong risk factor for child physical abuse and is highly prevalent in the U.S. Yet, little is currently known about the relevant attitudes, beliefs, or training needs of key professionals who often advise parents regarding child discipline strategies. A survey of the American Professional Society on the Abuse of Children (APSAC) membership, comprised of mental health professionals, physicians, child welfare professionals, and other professionals in the child maltreatment field, was conducted to assess attitudes, beliefs, perceived norms, training needs, and motivations to change norms regarding CP (N=571, response rate=51%). Most respondents agreed that spanking is a bad disciplinary technique (82%), is harmful for children (74%), and leads to negative outcomes (M=3.0, SD=0.6) more frequently than positive outcomes (M=2.1, SD=0.6; t=20.8; p<0.0001) for children. Professionals reported perceiving that their colleagues' level of endorsement of CP (M=2.4, SD=1.0) was higher than their own (M=1.9, SD=1.0; t(568)=-10.7, p<0.0001) though still below the midpoint. Professionals reported high levels of preparedness to effectively advise parents on non-physical child discipline strategies, but reported perceiving lower levels of preparedness amongst their colleagues. They reported highly valuing giving such advice to parents and being very motivated to participate in activities designed to change social norms regarding CP. Most APSAC members are poised to change these norms and, in doing so, to help reduce rates of child physical abuse in the U.S. Copyright © 2017 Elsevier Ltd. All rights reserved.

Misconceptions about children`s pain

OpenAIRE

Miloseva, Lence; Vukosavljevic-Gvozden, Tanja; Milosev, Vladimir

2014-01-01

Managing hospitalized children's pain is challenging for health care professionals. The ethical principles of the duty to benefit another and the duty to do no harm oblige health care professionals to provide pain management to all patients, including children, who are vulnerable because of their constant developmental changes, being ill, and being hospitalized. During the last 20 years, researchers started to show an interest in misconceptions about children`s pain. Literature review showed...

ASSESSING CHILDREN'S EXPOSURES TO THE WOOD PRESERVATIVE CCA (CHROMATED COPPER ARSENATE) ON TREATED PLAYSETS AND DECKS

Science.gov (United States)

Concerns have been raised regarding the safety of young children contacting arsenic and chromium residues while playing on and around Chromated Copper Arsenate (CCA) treated wood playground structures and decks. Although CCA registrants voluntarily canceled treated wood for re...

Notifications of violence against children and teens by health professionals

Directory of Open Access Journals (Sweden)

Jakelline Miranda Alves

2017-03-01

Full Text Available Objective: Describing the notifications of violence against children and adolescents at the 19th Health Region of Brejo Santo, Ceará, Brazil. Methods: Cross-sectional study. All reports of violence against children and adolescents contained in the Notifiable Diseases Information System (SINAN between 2010 and 2014 were used. The following variables were considered: gender, age, race, place of occurrence, recurrence, relationship to the victim and type of violence. Data were extracted and presented in tables in the form of absolute and percentage frequency. Results: During the study period, 40 reports of violence against children and adolescents were recorded in the municipalities of the 19th Health Region of Brejo Santo, representing 53.3% of the total 75 calls. There was an increase in reports of almost 1050%, from 3 notifications in 2010 to 23 reports in 2014. The psychological and moral violence had the highest number of notifications. Regarding gender, moral/psychological (59% and sexual (100% violence prevailed in females; physical violence (46.1% and negligence (100% prevailed in males. Conclusion: There was a significant increase in the number of notifications, which gave visibility to the issue. This shows a need for constant qualification of the professionals who participate in the process of care for people who have suffered or who live in situations of violence; and the importance of effective and standardized filling of the notifications files; as information obtained by its filling, besides giving visibility to the issue, are essential for the development of consistent service policies, committed to the reality of victimized children.

Application of laser therapy in treating inherited forms of psychoverbal retardation in children

Science.gov (United States)

Ulas, V. Y.; Voinova, V. M.; Il'in, L. B.; Troitskaya, L. A.; Dobrynina, E. V.; Kazantseva, L. Z.

2001-04-01

An investigation was made of applying combined laser therapy in the treatment of 619 children (422 children constituted the experimental group and 197 children composed the control group) affected by inherited forms of psychoverbal retardation. It was found that low-intensity He-Ne laser radiation with the wavelength of 632.8 nm and the output power of 2 mW made it possible to improve the children's mental development. Moreover, it effectively increased their mental activities, such as speech, communication, arbitrary behavior regulation, and locomotory functions. Laser therapy applied in treating children affected by the arrested mental development aggravated by obesity additionally decreased their body weight, increased their field of vision, and eliminated dyslipidemia. It was also found that contraindications to He-Ne laser acupuncture included phenylketonuria-related noncorrected metabolic defects, convulsive syndromes, epileptic activities, convulsive readiness, and cerebrolysine intramuscular injections.

Core competencies for health professionals' training in pediatric behavioral sleep care: a Delphi study.

Science.gov (United States)

Boerner, Katelynn E; Coulombe, J Aimée; Corkum, Penny

2015-01-01

The need to train non-sleep-specialist health professionals in evidence-based pediatric behavioral sleep care is well established. The objective of the present study was to develop a list of core competencies for training health professionals in assisting families of 1- to 10-year old children with behavioral insomnia of childhood. A modified Delphi methodology was employed, involving iterative rounds of surveys that were administered to 46 experts to obtain consensus on a core competency list. The final list captured areas relevant to the identification and treatment of pediatric behavioral sleep problems. This work has the potential to contribute to the development of training materials to prepare non-sleep-specialist health professionals to identify and treat pediatric behavioral sleep problems, ideally within stepped-care frameworks.

Written Communication with Families during the Transition from Childcare to School: How Documents Construct and Position Children, Professionals, and Parents

Science.gov (United States)

Lehrer, Joanne S.

2018-01-01

This article explores how documents play a role in shaping perceptions of children, professionals, and parents during the transition from childcare to kindergarten in Québec. Positioning analysis was used to explore governmentality, documentality, and interobjectivity in the communication agendas and child assessment documents of seven children.…

Dental Anomalies and Dental Age Assessment in Treated Children with Acute Lymphoblastic Leukemia

OpenAIRE

Khojastepour, L; Zareifar, S; Ebrahimi, M

2014-01-01

Background This cross sectional study was performed to evaluate dental ages and incidence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL). Methods and materials A total of 25 ALL patient who passed at least 2 years of chemotherapy and 25 healthy sex and age matched children were evaluated. Dental age as well as dental anomalies in shape, size, number, and structure was recorded based on their panoramic radiographies which were taken for dental purposes. Results ...

Conceptions held by health professionals on violence against children and adolescents within the family.

Science.gov (United States)

Nunes, Cristina Brandt; Sarti, Cynthia Andersen; Ohara, Conceição Vieira da Silva

2008-01-01

The present study sought to understand the conceptions held by health professionals with regards to violence within the family against children and adolescents. Qualitative case-study methodology and techniques of participant observation, interviewing, and search in documents were used. Participants were staffed in a government-run Family Health Basic Unit in Brazil. Health professionals were found to associate violence with the economic, social, and political juncture and with cultural aspects; for some, violent acts are part of the intergenerational cycle and family dynamics. Physical punishment, considered as violence by some, is advocated as an educational measure by others. Participants also base their definition of violence on an a priori construction of subjects as either victims or aggressors, thus missing the relational dimension of the phenomenon. Health professionals were found to have difficulty in understanding violence in the context that gives it a meaning and to recognize it as consequence of a complex relational dynamics.

Prevalence of oral soft tissue lesions in HIV-infected minority children treated with highly active antiretroviral therapies.

Science.gov (United States)

Flanagan, M A; Barasch, A; Koenigsberg, S R; Fine, D; Houpt, M

2000-01-01

This project studied the prevalence of oral soft tissue disease in HIV-infected children treated with highly active antiretroviral therapy (HAART). Thirty-eight HIV-infected children participated in the study. Twenty-three of these patients were treated with HAART while 14 received exclusively reverse transcriptase inhibitors (RTI) and served as controls. The children were examined three times at approximately one-month intervals while their health history and laboratory data were abstracted from medical charts. Analyses were performed to determine differences in lesion prevalence between treatment groups as well as between lesion and no lesion groups with regard to immune differences. Thirty patients (79%) had oral lesions detected in at least one visit. There were no differences in specific lesion prevalence between HAART compared with RTI-treated children. However, a trend for more oral candidiasis in the latter group was observed. Subjects with oral soft tissue lesions had lower CD4 counts (P = 0.04) and percentage (P = 0.01) but similar viral loads when compared to patients without oral soft tissue disease. HAART does not appear to significantly affect oral soft tissue disease prevalence in HIV-infected children. Presence of lesions was associated with decreased immunity and may signal advancing disease.

Epilepsy and febrile seizures in children of treated and untreated subfertile couples

DEFF Research Database (Denmark)

Sun, Yuelian; Vestergaard, Mogens; Christensen, Jakob

2007-01-01

BACKGROUND: Only few studies have addressed the long-term neurological outcomes of children born by subfertile couples. We studied the risk of epilepsy and febrile seizures in children of treated and untreated subfertile couples. METHODS: The study included 83 194 live singletons born by mothers...... who took part in the Danish National Birth Cohort (DNBC). Information on time to pregnancy (TTP) and infertility treatment was reported by the mothers in computer-assisted telephone interviews. Data on epilepsy and febrile seizures were extracted from the Danish National Hospital Register. RESULTS......: Overall, children of subfertile couples (TTP > 12 months) had a 51% higher risk of epilepsy [incidence rate ratio (IRR): 1.51; 95% confidence interval (95% CI): 1.17-1.94] compared with children of couples with a TTP of 0-5 months. The corresponding estimates were 1.71 (95% CI: 1.21-2.42) if the couples...

Parent-professional partnerships in young children's care and education in the United States and Brazil

Directory of Open Access Journals (Sweden)

Lia B. L. Freitas

2005-01-01

Full Text Available There is increasing evidence that the most promising practices in intervening with young children at risk for adverse developmental outcomes include respectful partnerships between professionals and children’s families. Often referred to as the family-centered system of care, this approach has been incorporated into policy both in the United States and Brazil. This paper focuses on outlining historical changes in young children’s care and education in these two societies, changes in the views of child care and the importance of socio-emotional development, and the key elements of meaningful professionalfamily partnerships. It also presents a set of necessary conditions to translate the family-centered system’s principles and research findings into practice

Evaluation of Nutritional Status in Children during Predialysis, or Treated By Peritoneal Dialysis or Hemodialysis.

Science.gov (United States)

Yılmaz, Dilek; Sönmez, Ferah; Karakaş, Sacide; Yavaşcan, Önder; Aksu, Nejat; Ömürlü, İmran Kurt; Yenisey, Çiğdem

2016-06-01

Malnutrition is one of the major causes of morbidity and mortality in children with chronic kidney disease (CKD). The objective of this study was to evaluate nutritional status of children with stage 3-4 CKD and treated by peritoneal dialysis or hemodialysis using anthropometric measurements, biochemical parameters and bioelectrical impedance analysis. The study included a total of 52 patients and 46 healthy children. In anthropometric evaluation, the children with CKD had lower values for standard deviation score for weight, height, body mass index, skinfold thickness and mid-arm circumference than those of healthy children (p nutritional evaluation in children. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Professionals' views of children's everyday life situations and the relation to participation.

Science.gov (United States)

Adolfsson, Margareta; Granlund, Mats; Pless, Mia

2012-01-01

The aim was to determine professionals' views of everyday life situations (ELS) of importance for children and to explore how ELS correlate with the construct "Participation". This study was part of a larger work to develop a structured tool with code sets to identify child participation and support children with disabilities to describe what matters most for them in intervention planning. The study had a concurrent mixed methods design. Information from one open-ended question and questionnaires were linked to the ICF-CY component Activities and Participation. Two concurrent data sets were compared. Proposed ELS were distributed across ICF-CY categories from low to high level of complexity and context specificity. The correlation with participation became stronger for the later chapters of the component (d7-d9). Differences between respondents due to working field, country, and children's ages were explored. Acts and tasks seemed most important for the youngest children, whereas ELS shifted towards societal involvement for adolescents. Eleven categories related to ICF-CY chapters d3-d9 emerged as ELS. Two age groups (infants/preschoolers and adolescents) are required to develop code sets for the new tool. The results need triangulation with other concurrent studies to provide corroborating evidence and add a family perspective.

Influences on selection of assistive technology for young children in South Africa: perspectives from rehabilitation professionals.

Science.gov (United States)

van Niekerk, Karin; Dada, Shakila; Tönsing, Kerstin

2017-12-20

Selection of assistive technology for young children is a complex process. Within a context with limited resources, such as South Africa, research is needed to determine the factors influencing the assistive technology selection process, as these could ultimately either facilitate or hinder the availability and accessibility of affordable, adaptable, acceptable, and high quality assistive technology for this age group. Two asynchronous online focus groups were conducted with 16 rehabilitation professionals to identify the factors they perceived to influence the selection and provision of assistive technology to young children within the South African context. A process of deductive thematic analysis was followed by inductive analysis of the data. Components of the Assistive Technology Device Selection Framework were used as themes to guide the deductive analysis, followed by inductive analysis to create subthemes. The important role of the professional was highlighted in negotiating all the factors to consider in the assistive technology selection and provision process. Adaptation of the Assistive Technology Device Selection Framework is suggested in order to facilitate application to low resourced contexts, such as South Africa. Implications for rehabilitation Assistive technology selection is a complex process with factors pertaining to the users (child and family) of the assistive technology, as well as the rehabilitation professional recommending the assistive technology influencing the process. Although it may be an important factor, the availability of financial resources to purchase assistive technology is not the only determining factor in providing appropriate assistive technology to young children in contexts with limited resources. Formalized support, such as reflective supervision or mentorship programs should be facilitated and utilized by recommending professionals. Home and school visits during assessment ensure a good match between assistive

Interventions to Improve the Response of Professionals to Children Exposed to Domestic Violence and Abuse: A Systematic Review.

Science.gov (United States)

Turner, William; Hester, Marianne; Broad, Jonathan; Szilassy, Eszter; Feder, Gene; Drinkwater, Jessica; Firth, Adam; Stanley, Nicky

2017-01-01

Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short- and long-term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole-system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children. We searched 22 bibliographic databases and contacted topic experts for studies reporting quantitative outcomes for any type of intervention aiming to improve professional responses to disclosure of DVA with child involvement. We included interventions for physicians, nurses, social workers and teachers. Twenty-one studies met the inclusion criteria: three randomised controlled trials (RCTs), 18 pre-post intervention surveys. There were 18 training and three system-level interventions. Training interventions generally had positive effects on participants' knowledge, attitudes towards DVA and clinical competence. The results from the RCTs were consistent with the before-after surveys. Results from system-level interventions aimed to change organisational practice and inter-organisational collaboration demonstrates the benefit of coordinating system change in child welfare agencies with primary health care and other organisations. Implications for policy and research are discussed. © 2015 The Authors. Child Abuse Review published by John Wiley & Sons Ltd. 'We searched 22 bibliographic databases and contacted topic experts'. We reviewed published evidence on interventions aimed at improving professionals' practice with domestic violence survivors and their children.Training programmes were found to improve participants' knowledge, attitudes and clinical competence up to a year after delivery.Key elements of

[Medium-term outcome, follow-up, and quality of life in children treated for type III esophageal atresia].

Science.gov (United States)

Lepeytre, C; De Lagausie, P; Merrot, T; Baumstarck, K; Oudyi, M; Dubus, J-C

2013-10-01

The aim of this study was to evaluate the medium-term outcome (health status, medical and surgical French National Health Authority-recommended follow-up, and quality of life) of children born with type III esophageal atresia (EA). Previous events (during the perinatal period, associated abnormalities, respiratory and digestive complications) of children treated for type III EA at the Marseille university hospitals between 1999 and 2009 were noted. Parents completed a standardized questionnaire concerning the health of their children during the previous year, and a quality-of-life questionnaire (PedsQL 4.0) was also completed by children aged more than 8 years. Among the 68 children treated, 44 responded to our solicitation (mean age, 7.6 years; range, 3-12.8 years). Previous important events were : pneumonia(s) (65%), asthma before the age of 3 years (66%), hospitalization for a respiratory event (45%), fundoplication (20%), and esophageal dilatation (45%). We noted current chronic cough (16%), asthma (30%), dysphagia (39%), and symptomatic gastroesophageal reflux (9%). National guidelines were not respected, except for the surgical indications in children aged less than 6 years. The quality-of-life scores (n=43 children) were similar to healthy controls but were negatively influenced by a gastrostomy procedure (P=0.020), pneumonia (P=0.013), and hospitalization due to a respiratory event (P=0.006) or a digestive event (P=0.010), and also by current asthma (P=0.004). In conclusion, despite recurrent respiratory or digestive symptoms and inadequate recommended follow-up, the quality of life of children treated for type III of EA is good. Copyright © 2013. Published by Elsevier SAS.

Comparing recurrent antibiotic prescriptions in children treated with a brand name or a generic formulation.

Science.gov (United States)

Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bortolotti, Angela; Fortino, Ida; Merlino, Luca; Bonati, Maurizio

2015-02-01

The aim of this study was to investigate the rate of recurrent prescriptions and hospital admissions in children receiving a brand name or generic antibiotic prescription. The data source was a database of reimbursed prescriptions. Outpatient children/adolescents brand name formulations and for each age strata (0-5, 6-11, and 12-17 years old) for four antibiotics: amoxicillin, amoxicillin clavulanate, clarithromycin, and cefaclor. The percentage of therapy switches was calculated. Cochran-Mantel-Haenszel test was used to compare the age-adjusted outcomes. In all, 17.5% (57 346) of children received at least one recurrent prescription. The rate of recurrent prescriptions was slightly lower in children receiving any generic (OR 0.96; 95%CI 0.93-0.98), compared with any brand name, antibiotic. The percentage of hospital admissions occurring in children initially treated with a brand name (1.01%; 95%CI 0.98-1.08) or generic (1.03%; 0.96-1.06) antibiotic was not different (p = 0.43). For children receiving amoxicillin clavulanate, the hospital admission rate was slightly higher in the brand name group (p = 0.002), while no differences were found for the other active substances. Children treated with generic antibiotics had no worse safety and effectiveness outcomes when compared with those receiving brand name ones. These results provide additional evidence on the safety of generic antibiotics. Copyright © 2014 John Wiley & Sons, Ltd.

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands.

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Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

2010-02-01

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified in 115 pharmacies and a questionnaire was sent to their stimulant prescribing physician. Of 773 questionnaires sent out, 556 were returned and were suitable for analysis (72%). The results are based on 510 questionnaires concerning stimulant-treated children for whom a diagnosis of ADHD was reported. Of the 510 children diagnosed with ADHD, 31% had also received one or more other psychiatric diagnoses, mainly pervasive developmental disorder or oppositional defiant disorder/conduct disorder. We found an association between the presence of co-morbidity and the use of psychosocial interventions for the child (P parents (P receive any form of additional interventions, while psychosocial interventions varied from 8 to 18% in children with ADHD and psychiatric co-morbidity. The presence of diagnostic co-morbidity was also associated with the use of psychotropic co-medication (overall, P = 0.012) and antipsychotics (P received more psychosocial interventions and psychotropic co-medication than children with ADHD-only. The type of psychosocial interventions and psychotropic co-medication received by the children and their parents, depended on the specific co-morbid psychiatric disorder being present.

[Professional opinion about hospitalising Latin-American immigrant children in Andalucía, Spain].

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Fernández-Castillo, Antonio; Vílchez-Lara, María J

2009-01-01

There has been an increase in paediatric hospital attention being provided for Latin-American immigrant patients in Spain during the recent years. This work was aimed at ascertaining professionals' opinion regarding this population's specific and differential needs concerning Latin-American immigrant children being hospitalised. The study consisted of a qualitative, phenomenological type of investigation, based on semi-structured interviews of key informers in Andalusia (Spain). The subjects of the study were professionals from paediatric services in hospital centres in Andalusia. One of the most prominent (positive) results revealed that the Latin-American immigrant population presented less difficulties regarding hospital functioning when compared to other immigrant groups. The psychological aspects which had most impact on paediatric hospitalisation would be emotional alterations, such as the presence of anxiety and stress, or other aspects, like a lack of trust when being hospitalised.

Confidence amongst Multidisciplinary Professionals in Managing Paediatric Rheumatic Disease in Australia

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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.

The Formation of Professional Readiness of a Social Teacher to Organization of Children's Leisure Time Activities

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Sadovaya, Victoriya V.; Khakhlova, Olga N.; Reznikov, Aleksandr A.

2015-01-01

Thematic justification of the study is conditioned by the fact that in contemporary system of higher professional pedagogical education we can see serious drawbacks in training the future teachers for the methods of organizing leisure time activities and interacting with children. Therefore, this article studies the problem of future social…

Safeguarding children in dentistry: 1. Child protection training, experience and practice of dental professionals with an interest in paediatric dentistry.

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Harris, J C; Elcock, C; Sidebotham, P D; Welbury, R R

2009-04-25

Following several highly publicised inquiries into the deaths of children from abuse and neglect, there has been much recent interest in the role and responsibility of all health professionals to protect children at risk of maltreatment. The findings of a postal questionnaire, sent in March 2005 to 789 dentists and dental care professionals with an interest in paediatric dentistry working in varied settings in the UK, are presented in a two-part report and discussed in the context of current multi-agency good practice in safeguarding and promoting the welfare of children. This first part explores reported child protection training, experience and practice. There was a significant gap between recognising signs of abuse and responding effectively: 67% of respondents had suspected abuse or neglect of a child patient at some time in their career but only 29% had ever made a child protection referral. The dental profession is alerted to the need to ensure necessary appropriate action to safeguard children is always taken when child abuse or neglect are suspected.

[Overweight and obesity in children treated for congentital heart disease].

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Perin, Francesca; Carreras Blesa, Carmen; Rodríguez Vázquez Del Rey, Maria Del Mar; Cobo, Inmaculada; Maldonado, José

2018-04-21

The negative impact of overweight and obesity is potentially greater in children affected by a congenital heart disease (CHD). The aim of this study is to calculate the proportion of overweight and obesity in children who underwent an intervention for CHD, and to investigate systolic arterial hypertension as a possible early cardiovascular complication. A retrospective study was conducted on patients aged 6 to 17 years treated for CHD, and healthy control subjects, followed-up in a Paediatric Cardiology Clinic. Body mass index percentiles were calculated according to the criteria of WHO. A review was performed on the anthropometric and clinical data, as well as the systolic blood pressure (SBP). A total of 440 patients were included, of which 220 had CHD. The proportion of combined obesity and overweight (body mass index percentile≥85) was 36.4% (37.3% in healthy subjects and 35.4% in patients with CHD, P=.738). A higher prevalence of obesity (body mass index percentile≥97) was found in CHD patients (22.7%) compared to 15.5% in healthy subjects (P=.015). SBP percentiles were higher in overweight compared to normal-weight patients (P<.001). The prevalence of SBP readings≥the 95th percentile was greater in overweight than in normal weight CHD patients (29.5% versus 7.7%, P<.001) and also in the overweight healthy controls compared to those of normal weight (12.2% versus 0.7%, P<.001). The proportion of obesity is high in treated CHD children and is associated with high SBP levels. The risk of long-term complications needs to be reduced by means of prevention and treatment of obesity in this very vulnerable population. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Clinical relevance of retinal structure in children with laser-treated retinopathy of prematurity versus controls - using optical coherence tomography.

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Stoica, Florina; Chirita-Emandi, Adela; Andreescu, Nicoleta; Stanciu, Alina; Zimbru, Cristian G; Puiu, Maria

2018-03-01

We aimed to assess the macular anatomy using spectral domain optical coherence tomography (SD-OCT), in children born preterm who had laser-treated retinopathy of prematurity (ROP), and to investigate the relationship between structural changes in macula and visual function. Thirty-seven 3-8 years old children were included in the study in two groups: 20 children born preterm [(<34 weeks of gestation, birthweight (BW) <2000 g)] who had laser-treated ROP in the Neonatology Department, Municipal Clinical Emergency Hospital of Timisoara, Romania; and 17 controls (children born at term, without eye disease, matched for age and gender). Spectral domain optical coherence tomography (SD-OCT) imaging (Spectralis OCT) was performed at central fovea and 1 mm nasally. In the ROP group (total 34 eyes), we included both eyes in 14 children, and on one eye in six other children. In the control group, both eyes for all 17 children were included. Central fovea thickness (CFT) was significantly higher in children born preterm and with laser-treated ROP as compared to controls (275 ± 34.8 μm versus 224 ± 27.2 μm; p < 0.001). The laser-treated eyes with ROP had mean best-corrected visual acuity (BCVA) = 0.19 logMAR (20/31 Snellen); 35% had BCVA ≥0.3 logMAR (20/40 Snellen). In receiver operating characteristic curve (ROC) analysis, with BCVA as static variable (category 0 = BCVA ≤0.3 logMAR), the CFT cut-off was 257 μm (sensitivity: 0.917; specificity: 0.661; area under the curve: 0.810, p = 0.001). Years after the laser intervention, central fovea was significantly thicker in ROP laser-treated children born preterm when compared to controls. Central fovea thickness (CFT) correlated strongly and inversely with BW and gestational age (GA) at birth, while a CFT value above 257 μm was suggestive for suboptimal visual acuity. The proposed cut-off value needs to be validated in future larger studies. © 2017 Acta Ophthalmologica Scandinavica Foundation

Assessing the quality of life of children with sickle cell anaemia using self-, parent-proxy, and health care professional-proxy reports.

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Constantinou, Christina; Payne, Nicola; Inusa, Baba

2015-05-01

The quality of life (QoL) of children with sickle cell anaemia (SCA) in the United Kingdom has not been examined, and a discrepancy measure based on Gap theory has rarely been used. This study investigated whether (1) child self-reports of QoL using a discrepancy measure (the Generic Children's QoL Measure; GCQ) are lower than those from healthy children, (2) proxy reports from parents and health care professionals are lower than child self-reports, and (3) demographic and disease severity indicators are related to QoL. An interdependent groups, cross-sectional design was implemented. Seventy-four children with SCA, their parent, and members of their health care team completed the GCQ. Demographic and disease severity indicators were recorded. GCQ data from healthy children were obtained from the UK Data Archive. Contrary to past research, when examining generic discrepancy QoL, children with SCA did not report a lower QoL than healthy children, and parent- and health care professional-proxy reports were not lower than child self-reports. Few of the demographic and disease severity indicators were related to QoL. Proxy reports may be used to gain a more complete picture of QoL, but should not be a substitute for self-reports. The explanation for the relatively high levels of QoL reported is not clear, but children with SCA may have realistic expectations about their ideal-self, place greater emphasis on aspects other than health in shaping their QoL, and define achievements within the limits of their illness. Future research should focus on psychological factors in explaining QoL. Statement of contribution What is already known on this subject? Children with sickle cell disease (SCD) generally have a reduced QoL compared with healthy children, but there appears to be no research measuring QoL in paediatric SCD in the United Kingdom. Proxy QoL reports from parents are often lower than child self-reports, but there is less research examining proxy reports from health

E-Professionalism for Early Care and Education Providers

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Harte, Helene Arbouet

2011-01-01

Teachers of young children work hard to be professional and to be viewed by others as professionals. These efforts to maintain professionalism must include e-professionalism. E-professionalism involves behavior related to professional standards and ethics when using electronic communication (Evans & Gerwitz, 2008). Cellular telephones, social…

'Do It Yourself' in the Parent-Professional Partnership for the Assessment and Diagnosis of Children with Autism Spectrum Conditions in Hong Kong: A Qualitative Study

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Ho, Hilda S. W.; Yi, Huso; Griffiths, Sian; Chan, Dorothy F. Y.; Murray, Stuart

2014-01-01

Timely and appropriate care for children with autism spectrum conditions is affected by the interaction between healthcare professionals and parents. Despite the importance of the parent-professional partnership, there is a dearth of cultural-specific data on parent-professional partnership in the Chinese context. We conducted 10 in-depth…

Validation of Omron HBP-1300 professional blood pressure monitor based on auscultation in children and adults.

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Meng, Linghui; Zhao, Di; Pan, Yan; Ding, Wenqing; Wei, Qing; Li, Hua; Gao, Pingjin; Mi, Jie

2016-01-13

BACKGROUnD: To determine whether the professional Omron HBP-1300 blood pressure (BP) monitor meets American Association for the Advancement of Medical Instrumentation (AAMI) accuracy standards in Chinese children and adults. According to the AAMI protocol, simultaneous auscultatory measurements by two observers using a mercury manometer were obtained in participants using the Omron HBP-1300. Triple measurements were obtained after a minimum 5-min rest with a 1-min interval between adjacent measurements. A total of 85 participants submitted to 255 doctor-measured BP and 255 successful professional monitor readings. The initial auscultation systolic BP was 160 mmHg in seven participants (8.2%). All of the simultaneous measurements agreed to within ± 10 mmHg, while 95% agreed to within ± 4 mmHg for both systolic and diastolic BP, and the consistency between two observers was satisfactory. The difference between the devices was -1.3 ± 3.6 mmHg for systolic BP and 0.7 ± 3.8 mmHg for diastolic BP and by AAMI method 1, which met this guideline. The average difference between two devices by AAMI method 2 was 1.4 ± 3.2 mmHg for systolic BP and 1.0 ± 3.9 mmHg for diastolic BP, which met this guideline. The professional BP monitor Omron HBP-1300 is desirable for measuring the BP for Chinese children and adults.

Understandings of how Professional Practice and Problem Definitions Influence the Possibilities of Children's Conduct of Life

DEFF Research Database (Denmark)

Røn Larsen, Maja

are being covered up by the unifying administrative processes, it seems to undermine an understanding of the way these conflicts are of importance to the child’s concrete conditions of life. So saying, a more precise comprehension of children’s actual difficulties involves the analysis of, how the process...... practices (School, institutions family etc.). However the administrative bureaucracy’s call for unambiguous determination of “special needs” undermines the comprehension of plurality of professional perspectives. In this way a gap occurs between a multifaceted understanding of the child’s conduct of life...... and the production of the “child as a case”. I intend to explore the connections between bureaucratic, interdisciplinary and professional practices that are organised to support children, including the bureaucratic process of defining children’s “special needs”. In the process different professionals understand...

The neurological assessment in young children treated with artesunate monotherapy or artesunate-mefloquine combination therapy for uncomplicated Plasmodium falciparum malaria

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Singhasivanon Pratap

2009-09-01

Full Text Available Abstract Background Mefloquine and artesunate combination therapy is the recommended first-line treatment for uncomplicated malaria throughout much of south-east Asia. Concerns have been raised about the potential central nervous system (CNS effects of both drug components and there are no detailed reports in very young children. Methods Children, aged between three months and five years, with acute uncomplicated Plasmodium falciparum malaria were randomized to either 7 days of artesunate monotherapy or the same schedule of artesunate plus mefloquine on day 7 and 8. Neurological testing targeting coordination and behaviour was carried out at day 0, 7, 9, 10, 14 and 28. Non-febrile healthy control children from the same population were tested on days 0, 7, 14 and 28. Results From December 1994 to July 1997, 91 children with uncomplicated P. falciparum, 45 treated with artesunate monotherapy, 46 treated with mefloquine and artesunate combination therapy and 36 non-febrile controls, underwent neurological testing. Malaria and fever had a significant negative impact on testing performance. By contrast, the anti-malarial treatments were not associated with worsening performances in the various components of the test. Artesunate and mefloquine do not appear to have a significant influence on coordination and behaviour. Children treated with mefloquine were significantly less likely to suffer recurrent malaria infection during follow-up compared to those treated with artesunate alone (P = 0.033. Conclusion In keeping with the results of randomized controlled trials in adults, mefloquine was not associated with a decrease in specific items of neurological performance. Likewise, children treated with artesunate did not perform significantly differently to control children. This study does not exclude subtle or rare treatment CNS effects of artesunate or mefloquine. Treatment of acute uncomplicated malaria results in a significant improvement on items of

Critical Professional Issues in Labour Force Development for Teachers with Children up to Two Years of Age: A New Zealand Perspective

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Rockel, Jean

2014-01-01

This paper critically examines current concerns regarding professional issues in labour force development for teachers with children up to two years of age (UtoT). The concerns in New Zealand (NZ) relate to whether initial teacher-education (ITE) qualifications prepare teachers to work with children UtoT, involving synergy between ITE and the…

Acute health care utilization and outcomes for outpatient-treated urinary tract infections in children.

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Copp, Hillary L; Hanley, Janet; Saigal, Christopher S; Saperston, Kara

2016-08-01

The majority of urinary tract infections (UTIs) in children are treated in the ambulatory setting. The goal of this study is to describe the course of outpatient UTI management, including health services utilization, antibiotic switching (change from empirically prescribed antibiotic to another antibiotic), and antibiotic side effects. Using a large claims database, Truven Health MarketScan Research Database, we analyzed all children younger than 18 years old who had an antibiotic prescribed for an outpatient UTI from 2002 to 2010. We evaluated health services utilization and antibiotic switching in the 21-day period after UTI diagnosis. We compared side effects with rates in patients receiving narrow versus broad-spectrum antibiotic treatment. Chi-square analysis was used for descriptive statistics. We identified 242,819 outpatient, antibiotic-treated, UTI episodes. During the 21-day period after presentation, 26% required more than one visit for UTI management and children did not have imaging within 21 days of UTI: renal bladder ultrasound in 6%, VCUG in 2.6%, and DMSA in 0.05%. Broad-spectrum antibiotics were empirically prescribed to 34% of patients. Antibiotic switching occurred in only 8% of UTI episodes, indicating that empiric prescription covered the offending uropathogen the majority of the time. Antibiotic side effects occurred in 8% of UTI episodes. The most common side effects were gastrointestinal (∼3% of UTI episodes). All other side effects occurred in UTI episodes. Although there were statistically significant differences in side effects between broad- and narrow-spectrum antibiotics, these differences were not clinically relevant. Most outpatient UTIs in children do not require more than one healthcare visit, hospital admission, or change in empiric antibiotic therapy. This study supports the fact that pediatric UTIs can be effectively treated in the ambulatory setting. Copyright © 2016. Published by Elsevier Ltd.

The Effects of Language- and Literacy-Focused Professional Development on Early Educators and Children

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Markussen-Brown, Justin; Juhl, Carsten Bogh; Piasta, Shayne B.

2017-01-01

Professional development (PD) is increasingly used to improve early childhood educators' skills and lcnowledge in providing quality language and emergent literacy environments for children. However, the literature does not clearly indicate the extent to which such efforts reach their goals......, or whether improvements in educator outcomes translate to learning gains for children. In the current synthesis, we conducted meta-analyses to evaluate the effects of language- and literacy-focused PD on process quality, structural quality, and educator knowledge as primary outcomes. Furthermore, we...... estimated effects for three child outcomes: receptive vocabulary, phonological awareness, and alphabet knowledge. PD produced a medium effect for process quality and a large effect for structural quality but no effect for educator knowledge. PD also produced a small to medium effect for phonological...

Late orthopedic effects in children with Wilms' tumor treated with abdominal irradiation

International Nuclear Information System (INIS)

Rate, W.R.; Butler, M.S.; Robertson, W.W. Jr.; D'Angio, G.J.

1991-01-01

Between 1970 and 1984, 31 children with biopsy-proven Wilms' tumor received nephrectomy, chemotherapy, and abdominal irradiation and were followed beyond skeletal maturity. Three patients (10%) developed late orthopedic abnormalities requiring intervention. Ten children received orthovoltage irradiation, and all cases requiring orthopedic intervention or developing a scoliotic curve of greater than 20 degrees were confined to this group, for a complication frequency of 50%. Those children who developed a significant late orthopedic abnormality (SLOA) as defined were treated to a higher median dose (2,890 cGy) and a larger field size (150 cm2) than those who did not (2,580 cGy and 120 cm2). Age at irradiation, sex, and initial stage of disease did not appear to influence the risk of developing an SLOA. No child who received megavoltage irradiation developed an SLOA despite treatment up to 4,000 cGy or to field sizes of 400 cm2. We conclude that modern radiotherapy techniques rarely lead to significant late orthopedic abnormalities previously associated with abdominal irradiation in children with Wilms' tumor

Reducing the Incidence of Cast-related Skin Complications in Children Treated With Cast Immobilization.

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Difazio, Rachel L; Harris, Marie; Feldman, Lanna; Mahan, Susan T

2017-12-01

Cast immobilization remains the mainstay of pediatric orthopaedic care, yet little is known about the incidence of cast-related skin complications in children treated with cast immobilization. The purposes of this quality improvement project were to: (1) establish a baseline rate of cast-related skin complications in children treated with cast immobilization, (2) identify trends in children who experienced cast-related skin complications, (3) design an intervention aimed at decreasing the rate of cast-related skin complications, and (4) determine the effectiveness of the intervention. A prospective interrupted time-series design was used to determine the incidence of cast-related skin complications overtime and compare the rates of skin complications before and after an intervention designed to decrease the incidence of cast-related heel complications. All consecutive patients who were treated with cast immobilization from September 2012 to September 2014 were included. A cast-related skin complications data collection tool was used to capture all cast-related skin complications. A high rate of heel events was noted in our preliminary analysis and an intervention was designed to decrease the rate of cast-related skin complications, including the addition of padding during casting and respective provider education. The estimated cast-related skin events rate for all patients was 8.9 per 1000 casts applied. The rate for the total preintervention sample was 13.6 per 1000 casts which decreased to 6.6 in the postintervention sample. When examining the heel-only group, the rate was 17.1 per 1000 lower extremity casts applied in the preintervention group and 6.8 in the postintervention group. Incorporating padding to the heel of lower extremity cast was an effective intervention in decreasing the incidence of cast-related skin complications in patients treated with cast immobilization. Level II.

 Treating Children Without Antibiotics in Primary Healthcare

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Narayanan Kutty

2011-09-01

Full Text Available The overuse of antibiotics in children is becoming a major public health problem. Although most of the common childhood infections such as diarrhea and upper respiratory tract infections are caused by viruses, large volumes of antibiotics are prescribed for these infections in children in the primary care settings. Excessive use of antibiotics is the fundamental risk factor for the development of antibiotic resistance. It is estimated that 90�0of upper respiratory tract infections are self limiting viral illnesses and even bacterial infections like acute otitis media often run a self limiting course. Clinical trials have shown that antibiotic use to treat common upper respiratory tract infections like sore throat, nasopharyngitis and otitis media has no or minimal benefit on the clinical outcome. This report discusses two strategies considered to reduce the use of antibiotic in these conditions: i No prescription, and ii Delayed prescription of antibiotics for common upper respiratory tract infections. Moreover, this report calls for a significant modification of the prescribing habits of physicians, and to also extend community awareness on the harms of the misuse and overuse of antibiotics. It is imperative to educate health workers as well as the Community in a coordinated and sustainable manner about the growing public health problem of antibiotic resistance.

Posttraumatic Stress Disorder in Children Exposed to Man-Made Disasters.

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Manix, Mary M.

This paper reviews the literature published in the last 10 years that focused on posttraumatic stress disorder (PTSD) in children exposed to man-made disasters such as war, school shootings, and the Oklahoma City bombing. As mass violence continues in society, mental health professionals need to be prepared to treat child victims of such…

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

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Simone Vidal Santos

2014-12-01

Full Text Available Objective To understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method Qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results The following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion There is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.

Predictors of outcome in children and adolescents with overactive bladder treated with parasacral transcutaneous electrical nerve stimulation.

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Hoffmann, Anselmo; Sampaio, Clara; Nascimento, Ana Aparecida; Veiga, Maria Luiza; Barroso, Ubirajara

2018-02-01

Parasacral transcutaneous electrical nerve stimulation (TENS) has emerged as an effective treatment for overactive bladder (OAB) in view of its high success rates in improving lower urinary tract symptoms and constipation, with no direct side effects. However, the clinical characteristics associated with the outcomes remain to be established. The aim of this study was to evaluate potential predictors of outcome in children with OAB treated using parasacral TENS. This was a prospective study of children with symptoms of isolated OAB, enrolled consecutively to the study and treated with parasacral TENS (figure). Isolated OAB was defined as the presence of urinary urgency with no signs of dysfunctional voiding. The symptoms were considered completely resolved when a patient's parents/guardians or the patients themselves reported a 100% improvement. Parasacral TENS was performed twice weekly for a total of 20 sessions of 20 min each at 10 Hz. The potential predictive factors evaluated were: sex, age, daytime incontinence, nocturia, a prior history of urinary tract infection, the presence of nocturnal enuresis, constipation and holding maneuvers. Eighty-three patients with a mean age of 7.8 ± 2.8 years were included in the study. Complete resolution of symptoms was achieved in 47 (56.6%). Following parasacral TENS treatment, a significant response was reported in 96.4% of cases. Of the 55 patients with nocturnal enuresis, partial resolution was achieved in 30 cases (54.5%), with a statistically significant association between nocturnal enuresis and the patient's response to treatment (p < 0.004; OR = 4.4, 95% CI 1.5-12.5). No other factor was associated with response to treatment. To the best of our knowledge, this association between nocturnal enuresis and failure to respond to parasacral TENS treatment for lower urinary tract dysfunction has not previously been reported. The identification of factors capable of predicting therapeutic failure may allow

Effects of Web-Mediated Teacher Professional Development on the Language and Literacy Skills of Children Enrolled in Pre-Kindergarten Programs

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Downer, Jason; Pianta, Robert; Fan, Xitao; Hamre, Bridget; Mashburn, Andrew; Justice, Laura

2012-01-01

As early education grows in the United States, in-service professional development in key instructional and interaction skills is a core component of capacity-building in early childhood education. In this paper, we describe results from an evaluation of the effects of MyTeachingPartner, a web-based system of professional development, on language and literacy development during pre-kindergarten for 1338 children in 161 teachers’ classrooms. High levels of support for teachers’ implementation of language/literacy activities showed modest but significant effects for improving early language and literacy for children in classrooms in which English was the dominant language spoken by the students and teachers. The combination of web-based supports, including video-based consultation and web-based video teaching exemplars, was more effective at improving children’s literacy and language skills than was only making available to teachers a set of instructional materials and detailed lesson guides. These results suggest the importance of targeted, practice-focused supports for teachers in designing professional development systems for effective teaching in early childhood programs. PMID:23144591

[Social intelligence deficits in autistic children and adolescents--subjective theories of psychosocial health care professionals].

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Krech, M; Probst, P

1998-10-01

The paper is concerned with personal theories of health care professionals about deficiencies in social intelligence of autistic persons. In the component-model of social intelligence means the ability of individuals or groups, to interact with each other in social situations. This contains social perception, social behavior as well as social conceptions and refers to emotional, cognitive and normative aspects. 33 interviewees, working as psychologists or teachers in kindergartens, schools or therapy institutions, are questioned by a half-standardized single interview concerning their beliefs about nonverbal social abilities, social perspective taking, and construction of a theory of mind in autistic persons. The major finding is: The impairments can be found in all aspects of social intelligence. Especially emotional handicaps, which are quoted by more than 80% of the interviewees, and low cognitive preconditions of mastering social stimuli, which are quoted by nearly all interviewees, are relevant. The subjective theories of the interviewees are in accordance to the models of parents as well as the models of the leading experts. The professional relationship to autistic persons and the practical experiences of the health care professionals lead to their specific personal theories of deficiencies in social intelligence of autistic people with wide consequences in respect to the professional contact with the autistic children and young adults.

Primary School Children and Self Harm: The Emotional Impact upon Education Professionals, and Their Understandings of Why Children Self Harm and How This Is Managed

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Simm, Rebecca; Roen, Katrina; Daiches, Anna

2010-01-01

There is evidence suggesting that self harm among young people is beginning earlier, in childhood and adolescent years. This paper reports on a qualitative study of primary school staff responses to self harm among children. Some studies with adolescents show self harm presents challenges to education professionals who may lack training or…

Computer-aided diagnosis of leukoencephalopathy in children treated for acute lymphoblastic leukemia

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Glass, John O.; Li, Chin-Shang; Helton, Kathleen J.; Reddick, Wilburn E.

2005-04-01

The purpose of this study was to use objective quantitative MR imaging methods to develop a computer-aided diagnosis tool to differentiate white matter (WM) hyperintensities as either leukoencephalopathy (LE) or normal maturational processes in children treated for acute lymphoblastic leukemia with intravenous high dose methotrexate. A combined imaging set consisting of T1, T2, PD, and FLAIR MR images and WM, gray matter, and cerebrospinal fluid a priori maps from a spatially normalized atlas were analyzed with a neural network segmentation based on a Kohonen Self-Organizing Map. Segmented regions were manually classified to identify the most hyperintense WM region and the normal appearing genu region. Signal intensity differences normalized to the genu within each examination were generated for two time points in 203 children. An unsupervised hierarchical clustering algorithm with the agglomeration method of McQuitty was used to divide data from the first examination into normal appearing or LE groups. A C-support vector machine (C-SVM) was then trained on the first examination data and used to classify the data from the second examination. The overall accuracy of the computer-aided detection tool was 83.5% (299/358) with sensitivity to normal WM of 86.9% (199/229) and specificity to LE of 77.5% (100/129) when compared to the readings of two expert observers. These results suggest that subtle therapy-induced leukoencephalopathy can be objectively and reproducibly detected in children treated for cancer using this computer-aided detection approach based on relative differences in quantitative signal intensity measures normalized within each examination.

[The role of music therapy in impaired hearing recovery. A survey among professionals working with deaf children and between users].

Science.gov (United States)

Comincini, Valeria; Del Piccolo, Lidia

2013-02-01

In this study, two groups are interviewed: the first study includes a sample of 60 physicians and health providers in the field of deafness, whose opinion on music therapy is collected by a specific questionnaire; the second involves 8 parents of deaf children attending music therapy lessons, who are asked to give an evaluation on the effect of music therapy, based on the experience of their children. Results show that health professionals know very little about the rehabilitative effectiveness of music therapy, whereas the parents of deaf children give a positive evaluation on the psychological, behavioral and linguistic benefits that music therapy gives to their deaf children.

Are the kids really all right? Direct-to-consumer genetic testing in children: are company policies clashing with professional norms?

Science.gov (United States)

Howard, Heidi Carmen; Avard, Denise; Borry, Pascal

2011-01-01

The genetic testing of minors within the direct-to-consumer (DTC) genetic testing (GT) context has been given relatively little attention. The issue of testing healthy children for diseases that would only develop in adulthood raises many important ethical, legal and social issues. As genetic testing is now available outside of the traditional health care system, often without even the intermediate of a health care professional, we surveyed 37 DTC GT companies regarding their policies for testing in children. Although the response rate is relatively low (35%, 13/37), our findings reveal that a clear majority of companies do perform genetic testing in minors. As such, companies testing for adult onset diseases are acting in contradiction of established professional guidelines, which state, among others, that, for predictive genetic testing, the availability of therapeutic or preventive measures is necessary for testing to be performed in asymptomatic minors. The community of stakeholders in children's health care and genetic testing should, therefore, decide which standards need to be upheld by DTC GT companies and ensure that these are met. PMID:21629297

Are the kids really all right? Direct-to-consumer genetic testing in children: are company policies clashing with professional norms?

Science.gov (United States)

Howard, Heidi Carmen; Avard, Denise; Borry, Pascal

2011-11-01

The genetic testing of minors within the direct-to-consumer (DTC) genetic testing (GT) context has been given relatively little attention. The issue of testing healthy children for diseases that would only develop in adulthood raises many important ethical, legal and social issues. As genetic testing is now available outside of the traditional health care system, often without even the intermediate of a health care professional, we surveyed 37 DTC GT companies regarding their policies for testing in children. Although the response rate is relatively low (35%, 13/37), our findings reveal that a clear majority of companies do perform genetic testing in minors. As such, companies testing for adult onset diseases are acting in contradiction of established professional guidelines, which state, among others, that, for predictive genetic testing, the availability of therapeutic or preventive measures is necessary for testing to be performed in asymptomatic minors. The community of stakeholders in children's health care and genetic testing should, therefore, decide which standards need to be upheld by DTC GT companies and ensure that these are met.

Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow-up care.

Science.gov (United States)

Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

2006-08-01

The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. A total of 115 pharmacies detected current stimulant users parents a questionnaire regarding their child's stimulant treatment. Parents returned 924 of 1,307 questionnaires (71%). The median age of the stimulant users was 10 years and 85% were boys. In all, 91% were diagnosed with attention-deficit/hyperactivity disorder (ADHD). In 77% of the cases, the child or parents received other therapies besides stimulants-21% received psychotropic co-medication, with melatonin (11%) and antipsychotics (7%) being mentioned most frequently. Stimulant use was primarily initiated by child psychiatrists (51%) and pediatricians (32%), but most children received repeat prescriptions from general practitioners (61%). Of these 924 children, 19% did not receive any follow-up care, and transfer of prescribing responsibility increased the risk of not receiving follow-up care. The 732 children (79%) who were monitored visited a physician approximately twice a year. During follow-up visits, pediatricians performed physical check ups significantly more often. Stimulant treatment in The Netherlands is initiated mainly by specialists such as child psychiatrists and pediatricians. In the current study, follow-up care for stimulant-treated children in The Netherlands appeared to be poor, suggesting an urgent need for improvement.

Children treated for lawn mower-related injuries in US emergency departments, 1990-2014.

Science.gov (United States)

Ren, Karen S; Chounthirath, Thiphalak; Yang, Jingzhen; Friedenberg, Laura; Smith, Gary A

2017-06-01

Investigate the epidemiology of lawn mower-related injuries to children in the US. A retrospective analysis was conducted of children younger than 18years of age treated in US emergency departments for a lawn mower-related injury from 1990 through 2014 using data from the National Electronic Injury Surveillance System. An estimated 212,258 children lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11.9 injuries per 100,000 US children. The annual injury rate decreased by 59.9% during the 25-year study period. The leading diagnosis was a laceration (38.5%) and the most common body region injured was the hand/finger (30.7%). Struck by (21.2%), cut by (19.9%), and contact with a hot surface (14.1%) were the leading mechanisms of injury. Patients Lawn mower-related injuries continue to be a cause of serious morbidity among children. Although the annual injury rate decreased significantly over the study period, the number of injuries is still substantial, indicating the need for additional prevention efforts. In addition to educational approaches, opportunities exist for improvements in mower design and lawn mower safety standards. Copyright © 2017 Elsevier Inc. All rights reserved.

How do professionals assess the quality of life of children with advanced cancer receiving palliative care, and what are their recommendations for improvement?

Science.gov (United States)

Avoine-Blondin, Josianne; Parent, Véronique; Fasse, Léonor; Lopez, Clémentine; Humbert, Nago; Duval, Michel; Sultan, Serge

2018-05-08

It is known that information regarding the quality of life of a patient is central to pediatric palliative care. This information allows professionals to adapt the care and support provided to children and their families. Previous studies have documented the major areas to be investigated in order to assess the quality of life, although it is not yet known what operational criteria or piece of information should be used in the context of pediatric palliative care. The present study aims to: 1) Identify signs of quality of life and evaluation methods currently used by professionals to assess the quality of life of children with cancer receiving palliative care. 2) Collect recommendations from professionals to improve the evaluation of quality of life in this context. We selected a qualitative research design and applied an inductive thematic content analysis to the verbal material. Participants included 20 members of the Department of Hematology-Oncology at CHU Sainte-Justine from various professions (e.g. physicians, nurses, psychosocial staff) who had cared for at least one child with cancer receiving palliative care in the last year. Professionals did not have access to pre-established criteria or to a defined procedure to assess the quality of life of children they followed in the context of PPC. They reported basing their assessment on the child's non-verbal cues, relational availability and elements of his/her environment. These cues are typically collected through observation, interpretation and by asking the child, his/her parents, and other members of the care. To improve the assessment of quality of life professionals recommended optimizing interdisciplinary communication, involving the child and the family in the evaluation process, increasing training to palliative care in hematology/oncology, and developing formalized measurement tools. The formulation of explicit criteria to assess the quality of life in this context, along with detailed

'Just wait then and see what he does': a speech act analysis of healthcare professionals' interaction coaching with parents of children with autism spectrum disorders.

Science.gov (United States)

McKnight, Lindsay M; O'Malley-Keighran, Mary-Pat; Carroll, Clare

2016-11-01

There is evidence indicating that parent training programmes including interaction coaching of parents of children with autism spectrum disorders (ASD) can increase parental responsiveness, promote language development and social interaction skills in children with ASD. However, there is a lack of research exploring precisely how healthcare professionals use language in interaction coaching. To identify the speech acts of healthcare professionals during individual video-recorded interaction coaching sessions of a Hanen-influenced parent training programme with parents of children with ASD. This retrospective study used speech act analysis. Healthcare professional participants included two speech-language therapists and one occupational therapist. Sixteen videos were transcribed and a speech act analysis was conducted to identify the form and functions of the language used by the healthcare professionals. Descriptive statistics provided frequencies and percentages for the different speech acts used across the 16 videos. Six types of speech acts used by the healthcare professionals during coaching sessions were identified. These speech acts were, in order of frequency: Instructing, Modelling, Suggesting, Commanding, Commending and Affirming. The healthcare professionals were found to tailor their interaction coaching to the learning needs of the parents. A pattern was observed in which more direct speech acts were used in instances where indirect speech acts did not achieve the intended response. The study provides an insight into the nature of interaction coaching provided by healthcare professionals during a parent training programme. It identifies the types of language used during interaction coaching. It also highlights additional important aspects of interaction coaching such as the ability of healthcare professionals to adjust the directness of the coaching in order to achieve the intended parental response to the child's interaction. The findings may be used

Can Long-lasting Insecticide-treated Bednets with Holes Protect Children from Malaria?

Science.gov (United States)

Nonaka, Daisuke; Maazou, Abani; Yamagata, Shigeo; Oumarou, Issofou; Uchida, Takako; Jg Yacouba, Honoré; Toma, Nami; Takeuchi, Rie; Kobayashi, Jun; Mizoue, Tetsuya

2014-09-01

Although long-lasting insecticide-treated bednets (LLINs) have been widely used for malaria control, little is known about how the condition of LLINs affects the risk of malaria infection. The objective of this cross-sectional study was to examine the association between the use of LLINs with holes and caregiver-reported malaria diagnosed in children under five years of age (U5). Data were collected in Boboye health district, Niger, in 2010. Surveyors conducted interviews and bednet inspections in 1,034 households. If a household had a U5 child, the surveyor asked the caregiver whether the child had experienced a fever episode in the past two weeks that entailed standard treatment for uncomplicated malaria at a healthcare facility. The authors analyzed the association between the use of LLINs with holes and caregiver-reported malaria episodes in U5 children using logistic regression, adjusted for possible confounders. Of the 1,165 children included in the analysis, approximately half (53.3%) used an intact LLIN while far fewer (10.6%) used a LLIN with holes. Compared to children using an intact LLIN, children using a LLIN with holes were significantly more likely to have a caregiver-reported malaria episode (8.7% vs. 17.1%; odds ratio: 2.23; 95% confidence interval: 1.24-4.01). In this study site, LLINs with holes were less protective than intact LLINs.

Evaluation of a Web-Based Professional Development Program (Project ACE) for Teachers of Children with Autism Spectrum Disorders

Science.gov (United States)

Rakap, Salih; Jones, Hazel A.; Emery, Alice Kaye

2015-01-01

This article describes the development, implementation, and second-year evaluation of Project Autism Competencies for Endorsement (ACE), a web-based professional development (PD) program that is designed to train teachers currently working in the field to meet the unique and diverse needs of children with autism spectrum disorders (ASDs). A…

The Ecuadorian Professional Preparation Program

Science.gov (United States)

Berzins, Anton Robert

2008-01-01

Across all fields of psychology within the United States, many mental health and educational professionals involved in the assessment of school-age children are not members of a minority population. As a result, these professionals are unfamiliar with the diverse cultural and linguistic characteristics of the individuals that they serve. This…

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

NARCIS (Netherlands)

Faber, Adrianne; Kalverdijk, Luuk J.; de Jong-van den Berg, Lolkje T. W.; Hugtenburg, Jacqueline G.; Minderaa, Ruud B.; Tobi, Hilde

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

NARCIS (Netherlands)

Faber, A.; Kalverdijk, L.J.; de Jong-van den Berg, L.T.W.; Hugtenburg, J.G.; Minderaa, R.B.; Tobi, H.

2010-01-01

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

[Autoimmunity in children with chronic hepatitis C treated with interferon alpha and ribavirin].

Science.gov (United States)

Gora-Gebka, Magdalena; Liberek, Anna; Bako, Wanda; Raczkowska-Kozak, Janina; Sikorska-Wisniewska, Grazyna; Korzon, Maria

2004-01-01

The role of interferon alpha or the virus itself in the pathogenesis and the risk of autoimmunological disorders in patients infected with HCV, still remain unknown, especially in children. The aim of the study was to evaluate the incidence of autoantibodies and the risk of autoimmunological disorders in children with chronic hepatitis C, treated with interferon alpha and ribavirin in the Department of Paediatrics, Paediatric Gastroenterology and Oncology in Gdansk. In the studied group of 12 patients, in 4 cases autoantibodies were present in low titers prior to the treatment and they had no prognostic value for the response to the therapy or the risk of autoimmunological disorders. Positive response for the treatment was achieved in 4 cases; in 3 cases indications for discontinuation of the therapy were established. During the therapy with interferon alpha and ribavirin, in 2 children elevation of serum titers of antibodies to liver-kidney microsome type 1 (anti-LKM1) (> 1:640) with normal gammaglobulin levels was noted. In none of the children autoimmunological disorders were observed.

Educational and Health Outcomes of Children Treated for Attention-Deficit/Hyperactivity Disorder.

Science.gov (United States)

Fleming, Michael; Fitton, Catherine A; Steiner, Markus F C; McLay, James S; Clark, David; King, Albert; Mackay, Daniel F; Pell, Jill P

2017-07-03

Attention-deficit/hyperactivity disorder (ADHD) affects 39 million people worldwide; in isolation, it doubles annual health care costs and, when associated with comorbid mental health problems, it quadruples the costs. To compare the education and health outcomes of schoolchildren treated for ADHD with their peers. In this population-based cohort study, individual-level record linkage was performed of 8 Scotland-wide administrative databases covering dispensed prescriptions, admissions to acute and psychiatric hospitals, maternity records, annual pupil census, examinations, school absences and exclusions, and unemployment. The study cohort comprised 766 244 children attending Scottish primary, secondary, and special schools at any point between September 21, 2009, and September 18, 2013. Data analysis was performed from June 1, 2015, to December 6, 2016. Medication approved solely for ADHD treatment. Special educational needs, academic attainment, unauthorized absence, exclusion, age at leaving school, unemployment after leaving, and hospitalization. Outcomes were adjusted for potential sociodemographic, maternity, and comorbidity confounders. Of the 766 244 schoolchildren, 7413 (1.0%) were treated for ADHD; 6287 (84.8%) were male. These children had higher rates of unauthorized absence (adjusted incidence rate ratio [IRR], 1.16; 95% CI, 1.14-1.19) and exclusion (adjusted IRR, 5.79; 95% CI, 5.45-6.16), more commonly had a record of special educational need (adjusted odds ratio [OR], 8.62; 95% CI, 8.26-9.00), achieved lower academic attainment (adjusted OR, 3.35; 95% CI, 3.00-3.75), were more likely to leave school before age 16 years (1546 [64.3%] vs 61 235 [28.4%]), and were more likely to be unemployed (adjusted OR, 1.39; 95% CI, 1.25-1.53). Children with ADHD were more likely to require hospitalization overall (adjusted hazard ratio [HR], 1.25; 95% CI, 1.19-1.31) and for injury (adjusted HR, 1.52; 95% CI, 1.40-1.65). Even while receiving medication

Career Mapping for Professional Development and Succession Planning.

Science.gov (United States)

Webb, Tammy; Diamond-Wells, Tammy; Jeffs, Debra

Career mapping facilitates professional development of nurses by education specialists and nurse managers. On the basis of national Nursing Professional Development Scope and Standards, our education and professional development framework supports the organization's professional practice model and provides a foundation for the professional career map. This article describes development, implementation, and evaluation of the professional career map for nurses at a large children's hospital to support achievement of the nursing strategic goals for succession planning and professional development.

Deep data science to prevent and treat growth faltering in Maya children.

Science.gov (United States)

Varela-Silva, M I; Bogin, B; Sobral, J A G; Dickinson, F; Monserrat-Revillo, S

2016-06-01

The Maya people are descended from the indigenous inhabitants of southern Mexico, Guatemala and adjacent regions of Central America. In Guatemala, 50% of infants and children are stunted (very low height-for-age), and some rural Maya regions have >70% children stunted. A large, longitudinal, intergenerational database was created to (1) provide deep data to prevent and treat somatic growth faltering and impaired neurocognitive development, (2) detect key dependencies and predictive relations between highly complex, time-varying, and interacting biological and cultural variables and (3) identify targeted multifactorial intervention strategies for field testing and validation. Contributions to this database included data from the Universidad del Valle de Guatemala Longitudinal Study of Child and Adolescent Development, child growth and intergenerational studies among the Maya in Mexico and studies about Maya migrants in the United States.

Developing a parent-professional team leadership model in group work: work with families with children experiencing behavioral and emotional problems.

Science.gov (United States)

Ruffolo, Mary C; Kuhn, Mary T; Evans, Mary E

2006-01-01

Building on the respective strengths of parent-led and professional-led groups, a parent-professional team leadership model for group interventions was developed and evaluated for families of youths with emotional and behavioral problems. The model was developed based on feedback from 26 parents in focus group sessions and recommendations from mental health professionals in staff meetings. Evaluations of an implementation of the model in a support, empowerment, and education group intervention (S.E.E. group) have demonstrated the usefulness of this approach in work with families of children with behavioral and emotional problems. This article discusses the challenges of instituting the model in an S.E.E. group. It explores how parents and professionals build the team leadership model and the strengths of this approach in working with parents of youths with serious emotional disturbances.

Shared responsibility for children in care

DEFF Research Database (Denmark)

Schwartz, Ida

2014-01-01

as other kids. These differences are often explained by pointing at individual or family inheritance. This paper takes the perspective that social exclusion is multi-dimensional, and the cross-professional structuring of children´s everyday life plays an important role. Processes of social exclusion...... and institutions. These groups of professionals contribute to the children’s everyday lives according to historically developed divisions of responsibility. It is a daily challenge to professionals, how they jointly support children in care so the children can be part of children´s communities in the places where......The responsibility of children in care is shared by a number of professionals placed in different contexts. Parents are responsible for the “big issues” in these children’s lives, while many professionals are involved in the children´s everyday life across home, residential home, schools...

Combination therapy versus monotherapy for gastroesophageal reflux in children with difficult-to-treat bronchial asthma

Directory of Open Access Journals (Sweden)

Adel Salah Bediwy

2014-01-01

Conclusions: Combination of domperidone and esomeprazole was more effective in improving the endoscopic reflux score, childhood-asthma control test (C-ACT and FEV1 (% of predicted and significantly reduced the sputum SP than the use of esomeprazole only in children with difficult-to-treat asthma.

[Results of 30 children treated under dental general anesthesia in pediatric dentistry].

Science.gov (United States)

Chen, Xu; Liu, Yao; Jin, Shi-fu; Zhang, Qian; Jin, Xuan-yu

2008-12-01

To determine the age and sex characteristics of the children and type of dental procedures performed under dental general anesthesia (DGA) and to assess the results after six months to one year's follow-up. A sample of 30 patients treated under dental general anesthesia (DGA) during 2006-2007 in the Department of Pediatric Dentistry of China Medical University was reviewed. All the teeth were treated one time. The dental procedures performed included caries restoration, indirect pulp capping, pulpotomy, root canal therapy (RCT) and dental extraction. Oral prophylaxis and topical fluoride applications were performed on all teeth. Pit and fissure sealing was performed on all healthy premolars and molars. SPSS10.0 software package was used for statistical analysis. Chi-square test was used to analyze the difference of the sex distribution in different age group and the difference of dental procedures performed between the primary teeth and the permanent teeth. The age of the patients ranged from 19 months to 14 years. The mental retardation patients accounted for 10% and mental healthy patients accounted for 90% of the sample studied. Males were more than females with the ratio about 2 to 1 in each age group. The dental procedures performed were caries restoration (18.67%), indirect pulp capping (23.26%), pulpotomy (0.77%), RCT (29.16%), dental extractions (2.05%) and fissure sealants (26.09%). The percentage of RCT was higher than that of caries restoration in the primary teeth, whereas the result was opposite as for the permanent teeth as indicated by Chi-square test (X(2)=11.630, P=0.001). New dental caries was not found except 2 patients who suffered from dysnoesia and were not cooperative to have regular examination. Fillings were lost in 3 cases, with 3 anterior teeth and 2 posterior teeth after RCT. All the children could cooperate except two mental retardation patients during the follow-up visit. Caries restoration and RCT are the most frequently performed

'Treats', 'sometimes foods', 'junk': a qualitative study exploring 'extra foods' with parents of young children.

Science.gov (United States)

Petrunoff, Nicholas A; Wilkenfeld, Rachel L; King, Lesley A; Flood, Victoria M

2014-05-01

The present study investigated parents' understanding and approaches to providing energy-dense and nutrient-poor 'extra foods' to pre-school children and explored variation between parents of low and high socio-economic status in relation to these issues. We conducted thirteen focus groups. Data were subject to framework analysis. Child-care centres in distinctly socially disadvantaged and socially advantaged areas. Eighty-eight parents of children aged 3-5 years. The three most common terms parents identified to describe foods that are not 'everyday foods' were 'treats', 'sometimes foods' and 'junk'. Parents' perceptions regarding what influences them in providing food to their children included seven sub-themes: (i) the influence of the child; (ii) food-related parenting practices; (iii) health considerations; (iv) food costs and convenience; (v) external factors perceived as influencing their child; (vi) factors related to child care; and (vii) social influences and occasions. Parents' decision-making processes regarding provision of 'extra foods' related to moderation and balance. Parents generally expressed the position that as long as a child is eating healthy foods, then treats are appropriate; and for many parents, this might apply frequently. All groups described the health of their child as an influence, but parents in low socio-economic groups were more likely to describe immediate concerns (dental health, behaviour) in relation to avoiding sugar-dense food or drink. The belief that provision of 'extra foods' can be frequent as long as children are eating a healthy balance of foods is factored into parents' decision making. Challenging this belief may be important for reducing the consumption of 'extra foods' by young children.

Understanding, Treating, and Preventing STDs / Questions to Ask your Health Care Professional

Science.gov (United States)

... Preventing STDs / Questions to Ask your Health Care Professional Past Issues / Fall 2008 Table of Contents For ... sexual partner Questions to Ask Your Health Care Professional How can I prevent getting an STD? If ...

Child-rearing practices of primary caregivers of children with sickle cell disease: the perspective of professionals and caregivers.

Science.gov (United States)

Noll, R B; McKellop, J M; Vannatta, K; Kalinyak, K

1998-04-01

To obtain caregiver and medical professional opinions regarding the child-rearing practices of caregivers of children with sickle cell diseases (SCD). We obtained self-reports of parenting practices from 48 caregivers of children with SCD and 48 caregivers of matched classroom comparison peers using the Child-Rearing Practices Report (CRPR). CRPR ratings were also obtained from 12 experts in pediatric SCD regarding their predictions of how a parent of a child with SCD would respond. The experts predicted differences in protectiveness, discipline, and excessive worry. Objective interim and lifetime illness severity scores were obtained for the children with SCD. Caregivers showed similarity between the two groups, disagreement with the experts, and minimal relationship to illness severity. Experts who work with children with chronic illnesses such as SCD seem to have stereotyped ideas that do not correspond with parental reports of their child-rearing practices, suggesting the need for careful clinical evaluations.

Probing community nurses' professional basis

DEFF Research Database (Denmark)

Schaarup, Clara; Pape-Haugaard, Louise; Jensen, Merete Hartun

2017-01-01

Complicated and long-lasting wound care of diabetic foot ulcers are moving from specialists in wound care at hospitals towards community nurses without specialist diabetic foot ulcer wound care knowledge. The aim of the study is to elucidate community nurses' professional basis for treating...... diabetic foot ulcers. A situational case study design was adopted in an archetypical Danish community nursing setting. Experience is a crucial component in the community nurses' professional basis for treating diabetic foot ulcers. Peer-to-peer training is the prevailing way to learn about diabetic foot...... ulcer, however, this contributes to the risk of low evidence-based practice. Finally, a frequent behaviour among the community nurses is to consult colleagues before treating the diabetic foot ulcers....

[Comparison of long-term dental treatment effects of children treated under general anesthesia and passive restraint].

Science.gov (United States)

Zhou, F; Xia, B; Zhang, S; Ma, W L; Xiao, Y M; Ge, L H

2017-02-09

Objective: To compare the long-term dental treatment effects, oral health habits and oral-health-related qualities of life of children treated under general anesthesia (GA) and passive restraint (PR), respectively. Methods: Twenty seven 2 to 4-year-old children treated under GA and thirty four children treated under PR were recruited in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. Up to 2 years after the treatment, a follow up assessment was conducted. The data of general information, dental plaque level and the unplanned treatments were recorded and analyzed. The questionnaire of oral health habits and early childhood oral health impact scale (ECOHIS) for each child was also completed and analyzed. The survival rate and median survival time of the deciduous teeth were calculated. Multivariate analysis was performed by using Cox proportional hazard model. Results: Twenty-five children under GA and 32 under PR were finally included, with a total of 1 098 deciduous teeth. The postoperative dental plaque indicesin both GA and PR groups had significantly improved than that of before the treatments ( P= 0.019, P< 0.001). The oral health habits had also improved, and the improvement in PR group was more obvious than that in GA group. Totally 128 teeth (27.0%) appeared unplanned treatments in GA group and 232 teeth (37.2%) in PR group during the follow-ups. The new caries and recurrent caries in PR group were significantly more than that in GA group ( P< 0.001, P= 0.012). No significant differences were found between the two groups in restoration failure, secondary caries and endodontic diseases ( P= 0.129, P= 0.822, P= 0.642). However, the time of occurrence of endodontic disease and secondary caries in GA group were significantly longer than that in PR group ( P< 0.01, P< 0.001). The median survival time of teeth in GA group was 1 018 days comparing to 944 days in PR group. The difference was statistically significant ( P

Total brain, cortical and white matter volumes in children previously treated with glucocorticoids

DEFF Research Database (Denmark)

Holm, Sara K; Madsen, Kathrine S; Vestergaard, Martin

2018-01-01

BACKGROUND: Perinatal exposure to glucocorticoids and elevated endogenous glucocorticoid-levels during childhood can have detrimental effects on the developing brain. Here, we examined the impact of glucocorticoid-treatment during childhood on brain volumes. METHODS: Thirty children and adolescents...... with rheumatic or nephrotic disease previously treated with glucocorticoids and 30 controls matched on age, sex, and parent education underwent magnetic resonance imaging (MRI) of the brain. Total cortical grey and white matter, brain, and intracranial volume, and total cortical thickness and surface area were...... were mainly driven by the children with rheumatic disease. Total cortical thickness and cortical surface area did not significantly differ between groups. We found no significant associations between glucocorticoid-treatment variables and volumetric measures. CONCLUSION: Observed smaller total brain...

Professional Knowledge and Everyday Practice

DEFF Research Database (Denmark)

Schmidt, Camilla

their professional knowledge with regards to collective reflection and creating coherent practices and everyday lives for children and families. I propose an alternative perspective on development of professional knowledge, which takes aspects of professional knowledge and everyday practice......Professional care work in preschools in Denmark is faced with a knowledge crisis, due to increasing influence by regulations from state and market. As a consequence the professionals seem more inclined to focus on how to meet demands for documentation, rather than focusing on developing...... and professional knowledge must involve an understanding of the importance of routines, habits and practical tasks. The analysis takes its point of departure in observations and interviews in a daycare institution with a combined nursery and preschool (age 0-6 years) In order to grasp the knowledge quality...

In Defense of Teacher Professionalism as a Policy Choice.

Science.gov (United States)

Sykes, Gary

1991-01-01

Whereas democracy institutionalizes distrust, professionalism relies on trust. Responding to Berbules and Densmore, this article identifies strong normative reasons, grounded in the interests of children, for promoting teacher professionalism. Exorcising the evils of classic professionalism will eliminate neither equity nor quality problems.…

Children of parents treated by irradiation and chemotherapy for Hodgkin's disease

International Nuclear Information System (INIS)

Dienstbier, Z.; Hermanska, Z.; Skala, E.; Vackova, B.; Melinova, L.

1994-01-01

Data are presented on the course of pregnancy, delivery and subsequent development of 20 children born to parents treated for Hodgkin's disease. Thirteen women in clinical stage II and III were delivered of 16 infants (10 daughters and 6 sons), and three men (IIA and IIIA) had 4 daughters. The parents were in one case treated by irradiation only, twice by chemotherapy only and thirteen times by a combination of irradiation and chemotherapy (COPP/ABVD). The gestation period, parameters of the infants at delivery and their subsequent physical and mental development were normal. In one instance (a girl, now ten and a half years old) the child was born with malformations of the extremities; according to the geneticist this is not related to the previous treatment of the mother. The second child (a son) of this mother is normal. The authors apply their opinion in the therapeutic protocol not to irradiate nodes in the pelvic region in patients of fertile age. In treated patients they allow pregnancy only after three or preferably five years following the end of treatment. Survival of patients in the whole group (269 subjects) regardless of age and clinical stage is 75%. A data base of Hodgkin patients has been set up since 1968. (author) 2 tabs., 14 refs

Treating Children as Individuals

Science.gov (United States)

... her own style and needs, initially because of birth order and inborn traits, and later because of experiences. ... appropriately for their child's developmental age and needs. Birth order and family size also influence your children's development. ...

Keeping the focus on children: the challenges of safeguarding children affected by domestic abuse.

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Peckover, Sue; Trotter, Fiona

2015-07-01

Safeguarding children affected by domestic abuse is a key responsibility for all professionals working with children and families, but can be difficult to achieve in practice. Despite a policy emphasis on early intervention and child-centred work, limited attention has been paid to how professionals in universal and additional support services address this important area of work. This paper reports findings from qualitative research undertaken in one local authority area in the north of England during 2011 which examines the challenges facing professionals in safeguarding children affected by domestic abuse. Six mixed professional focus groups were held, attended by a total of 23 participants. Discussion focused upon participants' awareness of domestic abuse, how they assessed and met children and young peoples' needs, and their views about service provision and safeguarding processes. Data were transcribed and thematic analysis undertaken. The themes presented in this paper--embodied recognition, someone else's job, service gaps, skills deficits, and focusing upon children and young people--illustrate the scope and limitations of professionals' work with children and young people affected by domestic abuse. Areas for practice improvement are discussed. © 2014 John Wiley & Sons Ltd.

Base of skull and cervical spine chordomas in children treated by high-dose irradiation

International Nuclear Information System (INIS)

Benk, Veronique; Liebsch, Norbert J.; Munzenrider, John E.; Efird, John; McManus, Patricia; Suit, Herman

1995-01-01

Purpose: To evaluate the outcome of children with base of skull or cervical spine chordomas treated by high dose irradiation. Methods and Materials: Eighteen children, 4 to 18 years of age, with base of skull or cervical spine chordomas, received fractionated high-dose postoperative radiation using mixed photon and 160 MeV proton beams. The median tumor dose was 69 Cobalt Gray-equivalent (CGE) with a 1.8 CGE daily fraction. Results: The median follow-up was 72 months. The 5-year actuarial survival was 68% and the 5-year disease-free survival (DFS) was 63%. The only significant prognostic factor was the location: patients with cervical spine chordomas had a worse survival than those with base of skull lesions (p = 0.008). The incidence of treatment-related morbidity was acceptable: two patients developed a growth hormone deficit corrected by hormone replacement, one temporal lobe necrosis, and one fibrosis of the temporalis muscle, improved by surgery. Conclusion: Chordomas in children behave similarly to those in adults: children can receive the same high-dose irradiation as adults with acceptable morbidity

Base of skull and cervical spine chordomas in children treated by high-dose irradiation

Energy Technology Data Exchange (ETDEWEB)

Benk, Veronique; Liebsch, Norbert J; Munzenrider, John E; Efird, John; McManus, Patricia; Suit, Herman

1995-02-01

Purpose: To evaluate the outcome of children with base of skull or cervical spine chordomas treated by high dose irradiation. Methods and Materials: Eighteen children, 4 to 18 years of age, with base of skull or cervical spine chordomas, received fractionated high-dose postoperative radiation using mixed photon and 160 MeV proton beams. The median tumor dose was 69 Cobalt Gray-equivalent (CGE) with a 1.8 CGE daily fraction. Results: The median follow-up was 72 months. The 5-year actuarial survival was 68% and the 5-year disease-free survival (DFS) was 63%. The only significant prognostic factor was the location: patients with cervical spine chordomas had a worse survival than those with base of skull lesions (p = 0.008). The incidence of treatment-related morbidity was acceptable: two patients developed a growth hormone deficit corrected by hormone replacement, one temporal lobe necrosis, and one fibrosis of the temporalis muscle, improved by surgery. Conclusion: Chordomas in children behave similarly to those in adults: children can receive the same high-dose irradiation as adults with acceptable morbidity.

Transnational organizing: Issue professionals in environmental sustainability networks.

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Henriksen, Lasse Folke; Seabrooke, Leonard

2016-09-01

An ongoing question for institutional theory is how organizing occurs transnationally, where institution building occurs in a highly ambiguous environment. This article suggests that at the core of transnational organizing is competition and coordination within professional and organizational networks over who controls issues. Transnational issues are commonly organized through professional battles over how issues are treated and what tasks are involved. These professional struggles are often more important than what organization has a formal mandate over an issue. We highlight how 'issue professionals' operate in two-level professional and organizational networks to control issues. This two-level network provides the context for action in which professionals do their institutional work. The two-level network carries information about professional incentives and also norms about how issues should be treated and governed by organizations. Using network and career sequences methods, we provide a case of transnational organizing through professionals who attempt issue control and network management on transnational environmental sustainability certification. The article questions how transnational organizing happens, and how we can best identify attempts at issue control.

Examining professionals' and parents' views of using transanal irrigation with children: Understanding their experiences to develop a shared health resource for education and practise.

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Sanders, Caroline; Bray, Lucy

2014-06-01

Irrigation as a bowel management approach has been reportedly used with children for more than 20 years. Parents managing their child's chronic bowel problem have previously been shown to have increased emotional stress. The aim of this study was to explore professionals' (n = 24) understanding and parents' (n = 18) experiences of using transanal irrigation with children at home as a mid to longer term bowel management approach. This study was underpinned by action research methodology and used mixed methods determined by an action research group of parents, professionals, researchers, a voluntary sector worker, commercial representative and independent observer. Data informed the study outcome which was the development and evaluation of a shared health resource to support professionals in their holistic approach when prescribing transanal irrigation and guide parents in the areas of education, management, problem solving, support and goal setting. The resource includes constructed case studies from parents of their experiences to inform choice and decision-making between parents and professionals. The shared health resource provides an approach to initiating and evaluating transanal irrigation and is available in a paper format from key Internet sites across hospital, community and voluntary services. © The Author(s) 2013.

Treating Children and Adolescents

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... intravenously (through a vein), steroids are effective for short-term control of flare-ups but are not recommended to maintain remission in children due to undesirable long-term side effects, including stunted growth. For that reason, corticosteroids are ...

Treating Arrhythmias in Children

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... drugs may need to be tried before the right one is found. Some children must take medication every ... is done with several catheters in the heart. One is positioned right over the area that's causing the tachycardia. Then ...

Long-term follow-up results in children and adolescents treated with radioactive iodine (131I) for hyperthyroidism

International Nuclear Information System (INIS)

Safa, A.M.; Schumacher, O.P.; Rodriguez-Antunez, A.

1975-01-01

To evaluate the long-term results of 131 I therapy for children, the course of 87 patients (three to 18 years old, 24 boys and 63 girls) treated from 1949 through 1968, for hyperthyroidism due to Graves's disease was studied. Dose of 131 I per patient ranged from 2.9 to 31 mCi (mean +- S. D., 9.75 +- 6.5). Patients were followed for five to 24 years (mean, 12.3 +- 3.5). Hyperthyroidism was controlled in 85 within one to 14 months (mean, 3.3 +- 2.6). Recurrence of thyrotoxicosis due to toxic diffuse goiter, observed in only one case after 11 years, was successfully re-treated with 131 I. Reproductive history and health status of the progeny of 131 I-treated patients were not different from those of the general population. No deaths and no cancer or leukemia were observed in patients or their offspring. The major cause of goiter regrowth was Hashimoto's thyroiditis. Hypothyroidism developed in 35 of 76 patients (46 percent). 131 I deserves further use in treatment of hyperthyroid children with Graves's disease

The effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital in 2013-2014.

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Rahmati, M; Moayedi, A; Zakery Shahvari, S; Golmirzaei, J; Zahirinea, M; Abbasi, B

2015-01-01

Introduction. Bruxism is to press or grind teeth against each other in non-physiologic cases, when an individual does not swallow or chew. If not treated, teeth problems, stress, mental disorders, frequent night waking, and headache is expected. This research aimed to study the effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital. Methodology. In this clinical trial, 143 children with the ages between 4-12 years were admitted to the Children Hospital and were divided randomly into test and control groups. The test group consisted of 88 hydroxyzine-treated children and the control group consisted of 55 children who used hot towels. Both groups were examined in some stages including the pre-test stages or the stage before starting treatments at two, four, and six weeks and four months after stopping the treatment. The effects of each treatment on reducing bruxism symptoms were assessed by a questionnaire. The data were analyzed by using SPSS in descriptive statistics, t-test, and ANOVA. Results. As far as bruxism severity was concerned, the results showed a significant difference between the test group members who received hydroxyzine and the control group members who received no medication. T-test results showed a statistically significant difference between the test and the control groups in the second post-test (four weeks later) (p. value ≤ 0.05). Mean of the scores of bruxism severity in the test group has changed significantly in the post-test (at two weeks, four weeks, and six weeks later) as compared to the pre-test. Whereas, as far as the response to the treatment, no significant difference was recorded between the control group and the test group 4 weeks after the treatment. Discussion. The results showed that prescribing hydroxyzine for 4 weeks had a considerable effect in diminishing bruxism severity between the test groups.

Evolution of the biochemical profile of children treated or undergoing treatment for moderate or severe stunting: consequences of metabolic programming?

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Jullyana F.R. Alves

2014-07-01

Full Text Available OBJECTIVE: to evaluate changes in the biochemical profile of children treated or being treated for moderate or severe stunting in a nutrition recovery and education center. METHODS: this was a retrospective longitudinal study of 263 children treated at this center between August of 2008 to August of 2011, aged 1 to 6 years, diagnosed with moderate (z-score of height-for-age [HAZ] < -2 or severe stunting (HAZ < -3. Data were collected on socioeconomic conditions, dietary habits, and biochemical changes, as well as height according to age. RESULTS: the nutritional intervention showed an increase in HAZ of children with moderate (0.51 ± 0.4, p = 0.001 and severe (0.91 ± 0.7, p = 0.001 stunting during the monitoring. Increased levels of insulin-like growth factor 1 (IGF-1 (initial: 71.7 ng/dL; final: 90.4 ng/dL; p = 0.01 were also observed, as well as a reduction in triglycerides (TG in both severely (initial: 91.8 mg/dL; final: 79.1 mg/dL; p = 0.01 and in moderately malnourished children (initial: 109.2 mg/dL; final 88.7 mg/dL; p = 0.01, and a significant increase in high-density lipoprotein cholesterol HDL-C only in the third year of intervention (initial: 31.4 mg/dL; final: 42.2 mg/dL. The values of total cholesterol (TC and low-density lipoprotein cholesterol (LDL-C levels remained high throughout the treatment (initial: 165.1 mg/dL; final: 163.5 mg/dL and initial: 109.0 mg/dL; final: 107.3 mg/dL, respectively. CONCLUSION: the nutritional treatment for children with short stature was effective in reducing stunting and improving TG and HDL-C after three years of intervention. However, the levels of LDL-C and TC remained high even in treated children. It is therefore speculated that these changes may result from metabolic programming due to malnutrition.

Evolution of the biochemical profile of children treated or undergoing treatment for moderate or severe stunting: consequences of metabolic programming?

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Alves, Jullyana F R; Britto, Revilane P A; Ferreira, Haroldo S; Sawaya, Ana L; Florêncio, Telma M M T

2014-01-01

to evaluate changes in the biochemical profile of children treated or being treated for moderate or severe stunting in a nutrition recovery and education center. this was a retrospective longitudinal study of 263 children treated at this center between August of 2008 to August of 2011, aged 1 to 6 years, diagnosed with moderate (z-score of height-for-age [HAZ] < -2) or severe stunting (HAZ < -3). Data were collected on socioeconomic conditions, dietary habits, and biochemical changes, as well as height according to age. the nutritional intervention showed an increase in HAZ of children with moderate (0.51 ± 0.4, p = 0.001) and severe (0.91 ± 0.7, p = 0.001) stunting during the monitoring. Increased levels of insulin-like growth factor 1 (IGF-1) (initial: 71.7 ng/dL; final: 90.4 ng/dL; p = 0.01) were also observed, as well as a reduction in triglycerides (TG) in both severely (initial: 91.8mg/dL; final: 79.1mg/dL; p = 0.01) and in moderately malnourished children (initial: 109.2mg/dL; final 88.7mg/dL; p = 0.01), and a significant increase in high-density lipoprotein cholesterol HDL-C only in the third year of intervention (initial: 31.4mg/dL; final: 42.2mg/dL). The values of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels remained high throughout the treatment (initial: 165.1mg/dL; final: 163.5mg/dL and initial: 109.0mg/dL; final: 107.3mg/dL, respectively). the nutritional treatment for children with short stature was effective in reducing stunting and improving TG and HDL-C after three years of intervention. However, the levels of LDL-C and TC remained high even in treated children. It is therefore speculated that these changes may result from metabolic programming due to malnutrition. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Follow-Up Study of Behavioral Development and Parenting Stress Profiles in Children with Congenital Hypothyroidism

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Mei-Chyn Chao

2009-11-01

Full Text Available Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3–12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1 Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2 Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3 Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 ± 16.2 at the time of the study. However, CHT children had more problems in emotional–behavioral domains than sibling controls (p = 0.01. Overall, 29.8% (14/47 of the CHT children had emotional–behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

Follow-up study of behavioral development and parenting stress profiles in children with congenital hypothyroidism.

Science.gov (United States)

Chao, Mei-Chyn; Yang, Pinchen; Hsu, Hsiu-Yi; Jong, Yuh-Jyh

2009-11-01

Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional-behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3-12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1) Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2) Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3) Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 +/- 16.2) at the time of the study. However, CHT children had more problems in emotional-behavioral domains than sibling controls (p = 0.01). Overall, 29.8% (14/47) of the CHT children had emotional-behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

Research Degrees as Professional Education?

Science.gov (United States)

Barnacle, Robyn; Dall'Alba, Gloria

2011-01-01

There is an increasing trend within higher education and, more specifically, in higher degrees by research, to treat a professional skills set as a desirable graduate outcome. The increasing value that is being placed on a professional skills set in large part reflects growing interest around the world in the role of research degrees in labour…

Follow-up of 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn

DEFF Research Database (Denmark)

Eriksen, Vibeke; Nielsen, Lars Holme; Klokker, Mads

2009-01-01

AIM: Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn (PPHN). METHODS: The index...... group consisted of 85 children and a reference group was matched for age, sex and municipality of current residence. Questionnaires were sent to the families. The families in the index group were asked to participate in an examination of their child's hearing. RESULTS: Seven children (11%) had SNHL...... therapy compared with 8% in the reference group (chi-square test, p = 0.028). In the index group five children had cerebral palsy and two had developmental delay. Nineteen percent in the index group and 5% in the reference group had remedial education (chi-square test, p = 0.008). CONCLUSION: Children...

Event-related potential correlates of selective processing in early- and continuously-treated children with phenylketonuria : Effects of concurrent phenylalanine level and dietary control

NARCIS (Netherlands)

de Sonneville, Leo M. J.; Huijbregts, Stephan C. J.; van Spronsen, Francjan J.; Verkerk, Paul H.; Sergeant, Joseph A.; Licht, Robert

2010-01-01

This Study focused on important characteristics of attentional (selective) processing in children with early-treated phenylketonuria (PKU). Seven to 14-year-old children with PKU were allocated to high phenylalanine (Phe) and low Phe groups and compared with control children on amplitudes and

Event-related potential correlates of selective processing in early- and continuously-treated children with phenylketonuria: Effects of concurrent phenylalanine level and dietary control

NARCIS (Netherlands)

Sonneville, L.M.J. de; Huijbregts, S.C.J.; Spronsen, F.J. van; Verkerk, P.H.; Sergeant, J.A.; Licht, R.

2009-01-01

This study focused on important characteristics of attentional (selective) processing in children with early-treated phenylketonuria (PKU). Seven to 14-year-old children with PKU were allocated to high phenylalanine (Phe) and low Phe groups and compared with control children on amplitudes and

Food additions that consumers in the professional sector in the city

African Journals Online (AJOL)

user

that the health-promoting benefits of consuming plant produce .... and health professionals, teaching professionals, and other professionals as .... food shows and demonstrations from abroad are ... their children (48,9%), and spoke English.

Art Therapy as a Cross-Cultural Means To Assess Psychosocial Health in Homeless and Orphaned Children in Kiev.

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Arrington, Doris; Yorgin, Peter D.

2001-01-01

Reports on medical evaluation processes and art-based assessments used in identifying psychosocial health of children in orphanages in Kiev, Ukraine. Because American health professionals, including an art therapist/psychologist, had actually come to treat orphans, they were invited to state shelters never before open to foreigners. Includes…

(Un)receptiveness in interactions with professionals: experiences of parents of children with retinopathy of prematurity.

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Facio, Beatriz Castanheira; Marski, Bruna de Souza Lima; Higarashi, Ieda Harumi; Misko, Maira Deguer; Silveira, Aline Oliveira; Wernet, Monika

2016-01-01

To analyze the influence of health professionals' receptiveness on parental care of children with retinopathy of prematurity (ROP). A qualitative study developed under the theoretical framework of Symbolic Interactionism and using a narrative research methodology. Six women and three men, being parents of children with retinopathy of prematurity were individually interviewed in depth. From the scope of information, emotions and their rights, the parents experienced receptiveness from some professionals and unreceptiveness from others. The predominance of unreceptive attitudes in the parental narratives originated the following analysis themes: Informational (un)receptiveness, Emotional (un)receptiveness, and (Un)receptiveness of rights. The study supports human and comprehensive healthcare in the context of retinopathy of prematurity by pointing out the interactive process with health professionals as a potential stressor of parental care. The results signal a nuclear of attitudinal changes and reinforce challenges to the child and family-centered approach. Analisar a influência do acolhimento do profissional de saúde no cuidado parental junto ao filho com retinopatia da prematuridade. Estudo qualitativo desenvolvido sob o referencial teórico do Interacionismo Simbólico e metodológico da pesquisa de narrativas. Foram entrevistados em profundidade e individualmente seis mulheres e três homens, pais de crianças com retinopatia da prematuridade. Os pais vivenciam, nos âmbitos informacional, emocional e de direitos, acolhimento com alguns profissionais e destrato com outros. A predominância da postura de desacolhimento nas narrativas parentais deu origem aos temas de análise: (Des)acolhimento informacional, (Des)acolhimento emocional, e (Des)acolhimento de direitos. O estudo oferece subsídios ao cuidado humano e integral em saúde no contexto da retinopatia da prematuridade ao apontar o processo interativo com os profissionais de saúde enquanto potencial

Parents report on stimulant-treated children in the Netherlands : Initiation of treatment and follow-up care

NARCIS (Netherlands)

Faber, Adrianne; Kalverdijk, Luuk J.; de Jong-van den Berg, Lolkje T. W.; Hugtenburg, Jacqueline G.; Minderaa, Ruud B.; Tobi, Hilde

Objectives: The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. Methods: A total of 115 pharmacies detected current stimulant users <16 years old in their pharmacy

The importance of family to health, development and welfare of children.

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Christensen, E; Lynge, I

2004-01-01

Recent investigations have shown that a number of families in Greenland have problems related to parents' use of alcohol. One of the consequences is that children get more difficult conditions during childhood. Children suffer when their parents have alcohol-related problems. An alcoholic parent is generally not able to meet the needs of his or her child. Many children are very lonely and do not discuss their thoughts, their situation or their problems with anyone. Some children get serious psychosocial problems as grown-ups. Professionals who work with children in health services, social services or within the school system are generally not adequately aware of the importance of family to the children's reactions. This means that the children are at risk of being treated only for symptoms when the unity of child and family is not adequately taken into account. Prevention has to focus on the first steps. Children must be allowed to talk about their problems. The whole family should be included in the treatment.

Impact of attention deficit hyperactivity disorder therapy on fracture risk in children treated in German pediatric practices.

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Jacob, L; Kostev, K

2017-04-01

Two thousand eight hundred ninety-four children and adolescents treated by 243 pediatricians were analyzed. Patients receiving attention deficit hyperactivity disorder (ADHD) medications were at a lower risk of fractures than patients without ADHD medications. The strongest impact was in the age group of 6-9 years. Finally, there was a significant association between therapy duration and fracture risk. The aim of this study was to analyze the impact of ADHD therapy on fracture risk in children treated by German pediatricians. Children and adolescents initially diagnosed with ADHD and fractures between 2010 and 2015 were identified by 243 pediatricians. In this nested case-control study, each ADHD case with a fracture was matched (1:1) to an ADHD control without a fracture for age, gender, index year, and physician. In total, 2894 individuals were available for analysis. The main outcome of the study was the risk of fracture as a function of ADHD therapy. Multivariate logistic regression models were created to determine the effect of ADHD therapy on the risk of fracture in the entire population and in three age-specific subgroups. Patients receiving ADHD medications were at a lower risk of fracture than patients without ADHD medications (OR = 0.61). The impact of ADHD therapy on the risk of fracture was stronger in the age group of 6-9 years (OR = 0.41) than in the age groups of 10-13 years (OR = 0.68) and 14-17 years (OR = 0.74). Finally, a significant correlation was found between therapy duration and fracture risk (OR = 0.71 per month). ADHD therapy was associated with a decrease in the risk of fracture in children and adolescents treated by German pediatricians.

Narrative skills of children treated for brain tumours: The impact of tumour and treatment related variables on microstructure and macrostructure.

Science.gov (United States)

Docking, Kimberley; Munro, Natalie; Marshall, Tara; Togher, Leanne

2016-01-01

The narrative skills of children with brain tumours were examined. Influence of tumour location, radiotherapy, time post-treatment and presence of hydrocephalus was also investigated, as well as associations between narrative and language abilities. Seventeen children (aged 5;6-14;11) treated for brain tumour and their matched controls completed a narrative assessment and comprehensive language testing. Audio recorded narratives were analysed for microstructure and macrostructure elements. Between-group comparisons were conducted. Narrative elements were explored in association with tumour and treatment-related variables. Correlation analysis examined relationships between narrative scores and language test performance. While significant differences were not found between two groups of children across narrative elements, sub-group comparisons revealed marginal differences in macrostructure related to tumour location and hydrocephalus. Children treated with methods other than radiotherapy showed a significant increase in number of mazes in their narratives compared to children who received radiotherapy. Strong positive correlations also existed between narrative elements and language performance. Preliminary findings highlight the importance of investigating narrative abilities as part of a comprehensive language assessment. Macrostructure should be routinely examined where children are diagnosed with either posterior fossa tumour or hydrocephalus or have undergone surgery and/or chemotherapy for brain tumour.

Frequency, Etiology and Several Sociodemographic Characteristics of Acute Poisoning in Children Treated in the Intensive Care Unit

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Azemi, Mehmedali; Berisha, Majlinda; Kolgeci, Selim; Bejiqi, Ramush

2012-01-01

Aim: The aim of this work has been to present the frequency, etiology and several other socio-demographic characteristics of acute poisoning in children. The treated patients and methods of work: The treated patients were children of all age groups hospitalized in the Pediatric Clinic of Prishtina during year 2009. The study was done retrospectively. The diagnosis was done on the basis of heteroanamnesis and in several cases on the basis of the anamnesis data of a child, routine laboratory tests and toxicologic analysis. Results: 66 (9.4%) poisoned children were treated in the Intensive Care Unit. The biggest number of patients, 37 (56.06%) of them, were male, and out of that number 36 (54.55%) cases were coming from rural areas. The biggest number of them 49 (74.98%) were over 2-6 years old. The poisoning was mostly caused through the digestive tract (ingestion), it happened with 55 cases (83.33%), 56 cases (84,80%) suffered from severe poisoning, whereas 59 cases (89,50%) suffered from accidental poisoning. Regarding the type of the substances that caused poisoning, the most frequent were drugs in 34 (51.50%) cases and pesticides in 20 (30.30%) cases. Among drugs, the most dominant were those belonging to a group of benzodiazepines (10 cases) and metoclopramide (4 cases). Among pesticides the most dominant one that caused poisoning was malation (5 cases), then paration and cipermetrina appeared in 3 cases each. The biggest number of cases, 64 (96.96%) of them, were treated, whereas 2 cases (3.40%) passed away. Conclusion: The practice proved that that our people are not well informed about the poisoning in general, therefore it is necessary that they be educated by the use of all media, written and electronic, as well as other methods of medical education. PMID:23678312

Burnout in Social Workers Treating Children as Related to Demographic Characteristics, Work Environment, and Social Support

Science.gov (United States)

Hamama, Liat

2012-01-01

This study examined sense of burnout among 126 social workers who directly treat children and adolescents within the human service professions. Burnout was investigated in relation to social workers' demographic characteristics (age, family status, education, and seniority at work), extrinsic and intrinsic work conditions, and social support by…

Patterns of failure in children with medulloblastoma treated with 3D conformal radiotherapy

International Nuclear Information System (INIS)

Skowronska-Gardas, Anna; Chojnacka, Marzanna; Morawska-Kaczynska, Marzena; Perek, Danuta; Perek-Polnik, Marta

2007-01-01

Background and purpose: Craniospinal irradiation for medulloblastoma is one of the most complex techniques employed in radiotherapy. Many reports stress the impact of irradiation quality on survival in these patients. Our report presents the outcome and patterns of failure for 95 patients treated with 3D conformal radiotherapy (3D-CRT). Materials and methods: From 1998 to 2003, 95 children with medulloblastoma received 3D conformal radiotherapy. All of them were previously treated with surgery and chemotherapy. The brain and upper spinal cord were treated with two lateral 6 MV photon fields. In four patients, the cribriform plate was irradiated by the additional field. For primary tumour bed we applied two or three photon beams. Spinal cord was irradiated either with 18-20 MeV electron fields or with a mixed beam. Results: With a median follow-up of 48 months, 32/95 patients suffered a multifocal (21) or isolated (11) recurrence. We evaluated every primary site of failure. In all patients, the recurrence appeared within the isodose level of 95-100%. Conclusions: Patterns of failure in medulloblastoma patients treated with 3D conformal radiotherapy indicated that the relapse was mainly associated with poor response to pre-irradiation chemotherapy. We believe that 3D conformal radiotherapy allows avoiding failures, related to radiotherapy uncertainties

Intellectual functioning in children with congenital heart defects treated with surgery or by catheter interventions

Directory of Open Access Journals (Sweden)

Carmen Ryberg

2016-11-01

Full Text Available Background: Studies suggest that children with congenital heart defects (CHD are at risk for adverse intellectual functioning. However, factors related to lower intellectual functioning in this group are largely unknown. This study describes intellectual functioning in children with CHD in relation to severity of the heart defect, the child´s age and the socioeconomic status of the family (SES.Methods: 228 children treated with surgery or by catheter technique were tested using the Wechsler intelligence scales to determine Full Scale IQ (FSIQ. FSIQ was then analyzed in relation to age (3- 5- , 9-, and 15-year-olds, severity of the diagnosis (mild, moderate, and severe, and SES (low, medium, and high. The median age was 70 months (5.8 years with a range of 162 months (30 months (2.5 years to 192 months (16.0 years. Results: The total mean score on FSIQ was 100.8 (SD = 14.5. Children with severe CHD had significantly lower FSIQ than children with mild and moderate CHD, and 9- and 15-year-olds had significantly lower FSIQ compared to the 3-year-olds. Children from families with low SES had significantly lower FSIQ than children from medium SES and high SES families. No interaction between severity of diagnosis, age, and SES was found for FSIQ.Conclusions: 83% of the children with CHD performed at or above average with respect to FSIQ. SES and severity of diagnosis had significant main effects on FSIQ. These factors should be considered when planning interventions and follow-up programs for children with CHD.

Can a four-session biofeedback regimen be used effectively for treating children with dysfunctional voiding?

Science.gov (United States)

Sener, Nevzat Can; Altunkol, Adem; Unal, Umut; Ercil, Hakan; Bas, Okan; Gumus, Kemal; Ciftci, Halil; Yeni, Ercan

2015-01-01

To compare the outcomes of the open-ended six to ten sessions of biofeedback against a novel regime of four sessions of biofeedback to treat children with dysfunctional voiding. Patients from two centers using different methods were retrospectively analyzed. Group 1 comprised 20 patients treated with four sessions of biofeedback. Group 2 comprised 20 patients treated with six to ten sessions of biofeedback. Each group was evaluated with subjective and objective parameters pre-treatment, immediately post-treatment and 6 months post-treatment. All patients in Group 1 were treated with four sessions of biofeedback and in Group 2 the mean number of sessions was 7.35±1.30 (range 6-10). Normalized voiding flow curves after treatment were determined in 18 patients in Group 1 (90%) and 19 patients in Group 2 (95%) (p=0.553). There were seven patients (35%) in Group 1 and eight patients (40%) in Group 2 with reflux. When units were compared, there were 11 units (4 bilateral) in Group 1 and 13 units (5 bilateral) in Group 2 with reflux (p=0.747). At 6 months post-treatment, in Group 1, seven had resolved (63.6%), three had improved (27.2%) and one persisted (9.01%). In Group 2, ten had resolved (76.9%) and three had improved (23.1%) (p=0.553). Biofeedback therapy is one of the most widely used techniques in dysfunctional voiding in children. The regime of use has not been well defined, and the results of this study showed that a regime of four sessions of biofeedback therapy may be as safe and effective as the previously defined open-ended six to ten sessions.

Professional Development: Focusing on Transition. Issue Brief

Science.gov (United States)

de Azúa, Ramón L.; Keleher, Julia

2017-01-01

In 2017, the National Technical Assistance Center for the Education of Neglected or Delinquent Children and Youth (NDTAC) released its first in a series of professional development briefs that focus on the professional development needs and interests of Neglected or Delinquent (N or D) State coordinators, correctional educators, and providers of…

Home care services for sick children

DEFF Research Database (Denmark)

Castor, Charlotte; Hallström, Inger; Hansson, Eva Helena

2017-01-01

as challenging for healthcare professionals in home care services used to providing care predominately for adults. DESIGN: An inductive qualitative design. METHOD: Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise......AIMS AND OBJECTIVES: To explore healthcare professionals' conceptions of caring for sick children in home care services. BACKGROUND: Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised...... using a phenomenographic analysis. RESULTS: Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges...

Bioimpedance and Fluid Status in Children and Adolescents Treated With Dialysis.

Science.gov (United States)

Milani, Gregorio P; Groothoff, Jaap W; Vianello, Federica A; Fossali, Emilio F; Paglialonga, Fabio; Edefonti, Alberto; Agostoni, Carlo; Consonni, Dario; van Harskamp, Dewi; van Goudoever, Johannes B; Schierbeek, Henk; Oosterveld, Michiel J S

2017-03-01

Assessment of hydration status in patients with chronic kidney failure treated by dialysis is crucial for clinical management decisions. Dilution techniques are considered the gold standard for measurement of body fluid volumes, but they are unfit for day-to-day care. Multifrequency bioimpedance has been shown to be of help in clinical practice in adults and its use in children and adolescents has been advocated. We investigated whether application of multifrequency bioimpedance is appropriate for total-body water (TBW) and extracellular water (ECW) measurement in children and adolescents on dialysis therapy. A study of diagnostic test accuracy. 16 young dialysis patients (before a hemodialysis session or after peritoneal dialysis treatment) from the Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, and the Emma Children's Hospital-Academic Medical Center, Amsterdam, the Netherlands. TBW and ECW volumes assessed by multifrequency bioimpedance. TBW and ECW volumes measured by deuterium and bromide dilution, respectively. Mean TBW volumes determined by multifrequency bioimpedance and deuterium dilution were 19.2±8.7 (SD) and 19.3±8.3L, respectively; Bland-Altman analysis showed a mean bias between the 2 methods of -0.09 (95% limits of agreement, -2.1 to 1.9) L. Mean ECW volumes were 8.9±4.0 and 8.3±3.3L measured by multifrequency bioimpedance and bromide dilution, respectively; mean bias between the 2 ECW measurements was +0.6 (95% limits of agreement, -2.3 to 3.5). Participants ingested the deuterated water at home without direct supervision by investigators, small number of patients, repeated measurements in individual patients were not performed. Multifrequency bioimpedance measurements were unbiased but imprecise in comparison to dilution techniques. We conclude that multifrequency bioimpedance measurements cannot precisely estimate TBW and ECW in children receiving dialysis. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier

[Therapeutic effect of double fill nine tastes soup in treating recurrent respiratory infection (RRI) and change of immune function in children].

Science.gov (United States)

Wang, Youcheng; Zhang, Lijuan; Hu, Guohua; Wang, Menghe; Tang, Xiaoyuan; Guo, Hui; Shi, Yimei; Chen, Shufang; Shi, Changchun

2012-04-01

To investigate the therapeutic effect of double fill nine tastes soup in treating children recurrent respiratory infection (RRTI) and the change of immune function. 77 RRTI patients were randomly selected into observation and control groups. The observation group was treated with Chinese medicine- double fill nine tastes soup,water frying points 2 times oral. The control was treated with transfer factor oral liquid,every 10 mL,2 times daily oral. Treatment periods were both two months. IgA, IgG, IgM and IL-12, TNF-alpha, INF-gamma were detected before and after treatment to assess the clinical effects and the changes of immune factors, meanwhile, a health group was established. Before treatment, compared with the health group, the serum IgA, IgG, IgM, IgE, IL-12, TNF-alpha, IFN-gamma in both groups were significantly different (P soup has significant effects in treating recurrent respiratory infection (RRI) and enhance the immune function in children.

Tricky Treats

Centers for Disease Control (CDC) Podcasts

The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.

Developing Professional Learning for Staff Working with Children with Speech, Language and Communication Needs Combined with Moderate-Severe Learning Difficulties

Science.gov (United States)

Anderson, Carolyn

2011-01-01

This article presents research undertaken as part of a PhD by Carolyn Anderson who is a senior lecturer on the BSc (Hons) in Speech and Language Pathology at the University of Strathclyde. The study explores the professional learning experiences of 49 teachers working in eight schools and units for children with additional support needs in…

Cross-Cultural Issues in Parent-Professional Interactions: A Qualitative Study of Perceptions of Asian American Mothers of Children with Developmental Disabilities

Science.gov (United States)

Jegatheesan, Brinda

2009-01-01

This study investigated the perspectives of 23 first-generation Asian American mothers of children with developmental disabilities. The intent was to explore the working relationships between the mothers and professionals in health care and special education in the United States. The participants in this study were from China, Taiwan, Vietnam,…

Allied health management of technology-related musculoskeletal complaints among children and adolescents.

Science.gov (United States)

Ciccarelli, Marina; Fraser, Kerri; Vaz, Sharmila

2016-12-01

Children and adolescents are prolific users of information and communication technologies (ICT) in learning, leisure, and social communication activities. High exposure to ICT is associated with musculoskeletal injuries in adults; however, the management of ICT physical complaints in children is not well-understood. An online survey of allied health professionals (occupational therapists, physiotherapists, and chiropractors) was undertaken to determine (i) the number of children and adolescents in Perth, Western Australia who accessed treatment for musculoskeletal complaints related to use of technology; (ii) the typical frequency and duration of service provision; and (iii) the nature of treatment provided. Costs associated with service provision were estimated. Data from 101 identified the most commonly treated musculoskeletal complaints among children and adolescents included: non-specific neck pain; thoracic postural pain disorder; non-specific low back pain; and lumbar postural pain disorder. Approximately 1445 children were treated in the previous 12 months; with one-third of chiropractors each reported treating 31+ children. Most common treatments were soft tissue release, mobilisation, flexibility and conditioning exercises, soft tissue massage and kinesio-taping. Verbal education about healthy use of technology was provided by most clinicians (88%), with some inconsistent recommendations. The estimated cost of treatment was AUD$1,057,715; of which AUD$544,886 was health system funded. Children and adolescents received allied health treatment for a range of musculoskeletal complaints associated with ICT use. The potential long-term impacts on their health and wellbeing, and the economic burden associated with this health issue warrant the development of systematic risk reduction strategies. © 2016 Occupational Therapy Australia.

[Social media monitoring of asthmatic children treated in a specialized program: Parents and caregivers expectations].

Science.gov (United States)

Urrutia-Pereira, Marilyn; Ávila, Jennifer Bg; Cherrez-Ojeda, Ivan; Ivancevich, Juan Carlos; Solé, Dirceu

2015-01-01

Social media has been used in support of patients with asthma. However, it remains unclear what are the expectations of parents or caregivers of asthmatic patients. To evaluate the expectations of parents or caregivers of asthmatic children treated at Children's Asthma Prevention Program (PIPA), Uruguaiana, RS, in relation to the use of social media. An observational, descriptive, cross-sectional survey of parents or caregivers of children seen at Children's Asthma Prevention Program through responses to a written questionnaire on the use of new technologies and different applications to enhance information about asthma. 210 parents or caregivers (median age: 25 years; age range: 18-42 years of patients were enrolled. The mean age of their children was 7.3 years (age range: 2 to 18 years), the mean duration of asthma was 4.7 years and 65% of parents/caregivers of these children had less than eight years of schooling. Most of them (72%) had no access to the Internet via cell/mobile phones and only 18% actively used to gathered information about asthma by internet. There was high interest (87%) in receiving information via social media. Parents or caregivers of children attending the PIPA program expressed high interest in using social media. However, few use it to control their children's disease. While providing a great benefit to use social media as a mean of communication in health, the content needs to be monitored for reliability and quality. The privacy of users (doctors and patients) must be preserved and it is very important to facilitate the access to Internet.

Professional activity. How is family physicians' work time changing?

Science.gov (United States)

Woodward, C A; Ferrier, B; Cohen, M; Brown, J

2001-07-01

To examine hours worked professionally, work preferences, and changes in both of these and their correlates. Repeated surveys done in 1993 and 1999. Ontario family practices. Cohort of physicians certified in family medicine between 1989 and 1991 after family medicine residency who were surveyed in 1993 when they resided in Ontario. Self-reported hours spent weekly on professional activities, desired hours of professional work, and balance between work and other activities. Fifty-three percent (293) of 553 physicians responded to the 1999 survey; 91% had remained family physicians; 85% of these had participated in the 1993 survey. The difference between the hours that family physicians preferred to work professionally and their actual hours of work had increased since 1993. Childless physicians, women physicians with preschool children, and women physicians married to other physicians worked fewer hours professionally than other physicians in 1999. Female physicians and physicians without children worked closer to their preferred hours than other physicians. Reporting a preference to work fewer hours professionally in 1993 was linked with a reduction in professional activities by 1999. Greater attention should be paid in physician resource planning to the family life cycle of female physicians. Lifestyle changes could lead to a reduction in professional activity among these physicians.

Dispersion durations of P-wave and QT interval in children treated with a ketogenic diet.

Science.gov (United States)

Doksöz, Önder; Güzel, Orkide; Yılmaz, Ünsal; Işgüder, Rana; Çeleğen, Kübra; Meşe, Timur

2014-04-01

Limited data are available on the effects of a ketogenic diet on dispersion duration of P-wave and QT-interval measures in children. We searched for the changes in these measures with serial electrocardiograms in patients treated with a ketogenic diet. Twenty-five drug-resistant patients with epilepsy treated with a ketogenic diet were enrolled in this study. Electrocardiography was performed in all patients before the beginning and at the sixth month after implementation of the ketogenic diet. Heart rate, maximum and minimum P-wave duration, P-wave dispersion, and maximum and minimum corrected QT interval and QT dispersion were manually measured from the 12-lead surface electrocardiogram. Minimum and maximum corrected QT and QT dispersion measurements showed nonsignificant increase at month 6 compared with baseline values. Other previously mentioned electrocardiogram parameters also showed no significant changes. A ketogenic diet of 6 months' duration has no significant effect on electrocardiogram parameters in children. Further studies with larger samples and longer duration of follow-up are needed to clarify the effects of ketogenic diet on P-wave dispersion and corrected QT and QT dispersion. Copyright © 2014 Elsevier Inc. All rights reserved.

Dandruff: How to Treat

Medline Plus

Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... are still studying the causes, which appear to be complex. The most effective way to treat and ...

Establishing oral health promoting behaviours in children ? parents? views on barriers, facilitators and professional support: a qualitative study

OpenAIRE

Duijster, Denise; de Jong-Lenters, Maddelon; Verrips, Erik; van Loveren, Cor

2015-01-01

Background The prevention of childhood dental caries relies on adherence to key behaviours, including twice daily tooth brushing with fluoride toothpaste and reducing the consumption of sugary foods and drinks. The aim of this qualitative study was to explore parents’ perceptions of barriers and facilitators that influence these oral health behaviours in children. A further objective was to explore parents’ views on limitations and opportunities for professional support to promote children’s ...

Multi-Professional Panics in the Aftermath of Refugee Arrivals

DEFF Research Database (Denmark)

Padovan-Özdemir, Marta; Øland, Trine

professional journals are included representing four major welfare professions (teachers, social educators, nurses and social workers: Folkeskolen [The Public Community School], Børn & Unge [Children & Adolescents], Sygeplejersken [The Nurse], Socialrådgiveren [The Social Worker]. Included are also two...... four major welfare professions; teacher, social educators, nurses, and social workers. The refugee family as a shared object of problematisation and intervention is what binds these professional groups together in the historical educational practices under investigation. For example, professionals...... express concerns regarding single male refugees (without family), polygamous refugee families, unaccompanied refugee children (broken families), dysfunctional (traumatised) families etc.Analytical questions that reflect a theoretically informed understanding the object of study based on readings...

Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.

Science.gov (United States)

Ruiz-Casares, Mónica; Rousseau, Cécile; Laurin-Lamothe, Audrey; Rummens, Joanna Anneke; Zelkowitz, Phyllis; Crépeau, François; Steinmetz, Nicolas

2013-02-01

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.

Subsequent Malignancies in Children Treated for Hodgkin's Disease: Associations With Gender and Radiation Dose

International Nuclear Information System (INIS)

Constine, Louis S.; Tarbell, Nancy; Hudson, Melissa M.; Schwartz, Cindy; Fisher, Susan G.; Muhs, Ann G. B.A.; Basu, Swati K.; Kun, Larry E.; Ng, Andrea; Mauch, Peter; Sandhu, Ajay; Culakova, Eva; Lyman, Gary; Mendenhall, Nancy

2008-01-01

Purpose: Subsequent malignant neoplasms (SMNs) are a dominant cause of morbidity and mortality in children treated for Hodgkin's disease (HD). We evaluated select demographic and therapeutic factors associated with SMNs, specifically gender and radiation dose. Methods and Materials: A total of 930 children treated for HD at five institutions between 1960 and 1990 were studied. Mean age at diagnosis was 13.6 years, and mean follow-up was 16.8 years (maximum, 39.4 years). Treatment included radiation alone (43%), chemotherapy alone (9%), or both (48%). Results: We found that SMNs occurred in 102 (11%) patients, with a 25-year actuarial rate of 19%. With 15,154 patient years of follow-up, only 7.18 cancers were expected (standardized incidence ratio [SIR] = 14.2; absolute excess risk [AER] = 63 cases/10,000 years). The SIR for female subjects, 19.93, was significantly greater than for males, 8.41 (p < 0.0001). After excluding breast cancer, the SIR for female patients was 15.4, still significantly greater than for male patients (p = 0.0012). Increasing radiation dose was associated with an increasing SIR (p = 0.0085). On univariate analysis, an increased risk was associated with female gender, increasing radiation dose, and age at treatment (12-16 years). Using logistic regression, mantle radiation dose increased risk, and this was 2.5-fold for female patients treated with more than 35 Gy primarily because of breast cancer. Conclusions: Survivors of childhood HD are at risk for SMNs, and this risk is greater for female individuals even after accounting for breast cancer. Although SMNs occur in the absence of radiation therapy, the risk increases with RT dose

Combining Natural Ingredients and Beliefs: The Dayak Tribe's Experience Caring for Sick Children with Traditional Medicine.

Science.gov (United States)

Anggerainy, Shinta Widiastuty; Wanda, Dessie; Hayati, Happy

Instead of seeking conventional health care, the Dayak tribe in Borneo, Indonesia, treats sick children at home with traditional medicine. The objective of this descriptive, qualitative study was to explore the Dayak tribe's use of traditional medicine to care for sick children. Comprehensive interviews were conducted with 10 caregivers, with collected data analyzed using content analysis. Key recurring themes identified were: 1) traditional medicine as first aid; 2) ease of access and cost-effectiveness; 3) traditional medicine was not always effective; 4) a combination of natural ingredients and beliefs; 5) the importance of "communicating" with plants; and 6) engagement with metaphysical forces. Health professionals should respect familial cultures' beliefs regarding the provision of health care at home. Furthermore, they need to develop competency in performing cultural assessments and providing information to these parents on the risks of not seeking professional emergency care for children with conditions that can't be handled at home with traditional medicine.

Gross and fine motor skills in children treated for acute lymphoblastic leukaemia.

Science.gov (United States)

De Luca, Cinzia R; McCarthy, Maria; Galvin, Jane; Green, Jessica L; Murphy, Alexandra; Knight, Sarah; Williams, Jacqueline

2013-06-01

Chemotherapy treatment for acute lymphoblastic leukaemia (ALL) may disrupt motor development, with suggestions that gross and fine motor deficits are different depending on time since treatment. Thirty-seven participants aged between 2.5 to 5 years at the time of diagnosis were assessed using the Movement Assessment Battery for Children, 2nd Edition (MABC-2) and the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition, Short Form (BOT-2 SF), and divided into groups (i.e., months-off-treatment): (1) 0-12, (2) 13-24, and (3) 25-60 for comparison. MABC-2 and BOT-2 SF mean total scores fell within the average range. Twenty-six percent of the sample performed in the impaired range on the MABC-2. Group 2 had significantly lower Manual Dexterity scores than the normative population and lower BOT-2 SF scores than Group 1. Most children treated for ALL display appropriate motor skills, yet around a quarter experience general motor difficulties. Time-off-treatment did not affect the prevalence of motor impairments on any measure.

Does occupational therapy play a role for communication in children with autism spectrum disorders?

Science.gov (United States)

Hébert, Michèle L J; Kehayia, Eva; Prelock, Patricia; Wood-Dauphinee, Sharon; Snider, Laurie

2014-12-01

This study investigates occupational therapy for early communication in children with autism spectrum disorders (ASD). The research explored the role of occupational therapists in supporting children with ASD to become better communicators by considering their inter-professional collaboration with speech-language pathologists. Convenience samples of 21 clinical occupational therapists and speech-language pathologists were recruited to participate in semi-structured audio-recorded focus groups, using a qualitative design. Distinct views included a child-centred focus from speech-language pathologists, whereas occupational therapists spoke of the child through societal viewpoints, which later pointed to occupational therapists' proficiency in enabling skill generalization in ASD. An equal partnership was consistently reported between these clinicians, who identified the same objectives, shared strategies, joint treatments, and ongoing collaboration as the four main facilitators to inter-professional collaboration when treating children with ASD. Three unique roles of occupational therapy comprised developing non-verbal and verbal communication pre-requisites, adapting the setting, educating-partnering-advocating for the child, and providing occupation-based intervention. These three themes meshed with the discipline-specific occupational therapy domains represented in the Person-Environment-Occupation framework. When working in inter-professional collaboration, speech-language pathologists and occupational therapists agree that occupational therapy is indispensable to early intervention in enabling communication in ASD.

How to Implement Robots in Interventions for Children with Autism? A Co-Creation Study Involving People with Autism, Parents and Professionals

Science.gov (United States)

Huijnen, Claire A. G. J.; Lexis, Monique A. S.; Jansens, Rianne; de Witte, Luc P.

2017-01-01

The aim of this study was to gain insight into how robots can be practically implemented into current education and therapy interventions for children with autism spectrum disorder (ASD). This qualitative study included focus groups and co-creation sessions. 73 Participants (professionals and adults with ASD) took part in 13 focus groups to elicit…

Late effects of cranial irradiation on visual attention in children treated for hematologic illnesses

International Nuclear Information System (INIS)

Hill, D.L.

1992-01-01

A cross-sectional design was employed to assess the effects of CNS therapy including cranial irradiation (CRT) on visual attention. Forty one children between the ages of 8 and 16 years, 24 with a history of CRT, were tested. The attentional measure was a set of 14 timed, age-normed visual cancellation tasks that permitted an assessment of task-relevant motor response speed in the measurement of attentional efficiency. CRT doses ranged from 1000 to 4800 rads, administered to whole brain between 1 and 12 years prior to testing. It was found that increasing doses of CRT were associated with slower motor responding. Motor speed accounted for a significant proportion of variance in attentional task performance: slowed motor responding must be controlled by covariation in the measurement of attentional abilities in CRT-treated children. No child receiving CRT before age 4 and more than 5 years prior to testing performed above the mean overall on the attentional task, compared to several children demonstrating above-average performance who received CRT less than 5 years prior to testing. Scores for the CRT group were highly correlated with IQ and achievement results. CRT variables (dose, age at earliest CRT, time since CRT) explained half the variance in attentional task performance. Children who received CRT performed significantly below the mean on subtests with the most complex, symbolic or sequential target stimuli, a pattern that has predicted poor academic achievement in non-medically ill children. It was concluded that children receiving CRT should continue to be evaluated more than five years after treatment to monitor potential late effects of neurotoxic treatment. Longitudinal, prospective, well-controlled dose-effect research using a developmentally sensitive, theoretically grounded battery of attentional measures is needed to best compare neurotoxicity of different treatment regima in children

Palonosetron for the prevention of nausea and vomiting in children with acute lymphoblastic leukemia treated with high dose methotrexate

DEFF Research Database (Denmark)

Nadaraja, Sambavy; Mamoudou, Aissata Diop; Thomassen, Harald

2012-01-01

High dose methotrexate (HD-MTX), used in the treatment of children with acute lymphoblastic leukemia (ALL), is moderately emetogenic. First generation 5-HT(3) receptor antagonists are effective prophylactic agents but require multiple administrations. Palonosetron has a half life of 36-42 hours...... of palonosetron (5 µg/kg) for the prevention of chemotherapy-induced nausea and vomiting in children 18 years of age with ALL treated with HD-MTX, 5 g/m(2)....

Yogurt for treating acute gastroenteritis in children: Systematic review and meta-analysis.

Science.gov (United States)

Patro-Gołąb, Bernadeta; Shamir, Raanan; Szajewska, Hania

2015-10-01

In May 2014, the updated guidelines for the management of acute gastroenteritis (AGE) were published. The use of yogurt in the nutritional management of AGE was not addressed, although it is frequently used in many countries for this purpose. We aimed to systematically evaluate the efficacy of yogurt consumption for the management of AGE in children. In this systematic review, a number of databases, including MEDLINE, EMBASE, and the Cochrane Library, with no language restrictions, were searched up to July 2014 for randomized controlled trials (RCTs) evaluating the effect of yogurt consumption in children with AGE. The risk of bias was assessed using the Cochrane risk of bias tool. Four RCTs (n = 448) that were generally low in methodological quality, all performed in hospital setting, were included. Compared with placebo/no intervention, yogurt consumption had no significant effect on stool volume. The data on the effect of yogurt consumption on the duration of diarrhea and stool frequency were not consistent. The chance of treatment success (or failure) was similar in both groups. Compared with placebo, the duration of hospitalization was shorter in children who received yogurt, but the difference was of a borderline significance. Total weight gain increased for those treated with yogurt. The consumption of yogurt had a positive effect on weight gain, but no consistent effect on AGE outcomes in hospitalized children. Given the limited data and the methodological limitations of the included trials, the evidence should be viewed with caution. The effect of yogurt consumption in the ambulatory setting is unknown. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Motor development skills of 1- to 4-year-old Iranian children with early treated phenylketonuria.

Science.gov (United States)

Nazi, Sepideh; Rohani, Farzaneh; Sajedi, Firoozeh; Biglarian, Akbar; Setoodeh, Arya

2014-01-01

Objective : To gauge the gross and fine motor development of early treated phenylketonuria (ETPKU) in children in the age range of 1-4 years. Methods : A cross-sectional analytic study was conducted in PKU clinics (reference clinics for PKU follow-up), Tehran, Iran. Seventy children with ETPKU were selected as the case group for the study. ETPKU children were those with early and continuous treatment with a phenylalanine-restricted diet (the mean of blood phenylalanine level during the recent 6 months was 2-6 mg/dL or 120-360 μmol/L). Also, 100 healthy and normal children matched with the ETPKU group for age were randomly selected from 4 kindergartens in four parts of Tehran as a control group. The measurements consisted of a demographic questionnaire, Peabody Developmental Motor Scale-2 (PDMS-2), and pediatrician assessment. Motor quotients were determined by PDMS-2 and then compared in both groups by two independent samples t-test. Results : The mean ages in case and control group were 28.5 (± 11.6) and 29.7 (± 11.3) months, respectively. Comparison of the mean fine, gross, and total developmental motor quotients (DMQs) showed statistically significant differences between the two groups (p fine and total DMQs of ETPKU children were also correlated with age. In addition, there was a negative correlation between the phenylalanine level and fine (p motor development. It is recommended to plan programs for early detection and intervention of developmental delays in these children.

Shaping parents: impact of contrasting professional counseling on parents' decision making for children with disorders of sex development.

Science.gov (United States)

Streuli, Jürg C; Vayena, Effy; Cavicchia-Balmer, Yvonne; Huber, Johannes

2013-08-01

The management of disorders or differences of sex development (DSD) remains complex, especially with respect to parents' decision for or against early genitoplasty. Most parents still tend to disfavor postponing surgery until the child is old enough to provide consent. To identify the determinants of parental decisions for or against early sex assignment surgery in DSD children, and in particular to assess the influence of contrasting behavior of health-care professionals and the information they dispense. Preliminary data analysis from a focus group identified two broad approaches to counseling information. Two six-minute counseling videos were produced on this basis: one medicalized, by an endocrinologist, the other demedicalized, by a psychologist. Third-year medical students (N = 89) were randomized to watch either video as prospective parents and report its impact on their decision in a self-administered questionnaire. Statistical analysis of questionnaire responses regarding decisions for or against surgery, including self-assessed impact of potential determinants. Thirty-eight of eighty-nine "parents" (43%) chose early surgery for "their" child, including 27/41 "parents" (66%) shown the medicalized video vs. 11/48 (23%) shown the demedicalized video (P parents" perceived their personal attitudes on a four-point Likert scale as the main influence on their decision although their "attitude" was significantly shaped by the video. Parental decisions concerning early sex assignment surgery for DSD children depend on the health professional counseling received, to a degree of which neither parents nor professionals appear fully aware. In the absence of conclusive data for or against early surgery, there is a danger of medicalized or demedicalized parentalism resulting in irreversible and inadequately grounded decisions, regardless of the consensus statement of 2005 and the subsequent call for multidisciplinary management. © 2013 International Society for

Hyperprolactinemia in Thai children and adolescents with autism spectrum disorder treated with risperidone

Directory of Open Access Journals (Sweden)

Hongkaew Y

2015-01-01

Full Text Available Yaowaluck Hongkaew,1,2 Nattawat Ngamsamut,3 Apichaya Puangpetch,1,2 Natchaya Vanwong,1,2 Pornpen Srisawasdi,4 Montri Chamnanphon,1,2 Bhunnada Chamkrachchangpada,3 Teerarat Tan-kam,3 Penkhae Limsila,3 Chonlaphat Sukasem1,2 1Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, 2Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC, Ramathibodi Hospital, Mahidol University, 3Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, 4Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Abstract: Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females aged 3–19 years with ASD received risperidone treatment (0.10–6.00 mg/day for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records – age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern – were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90% subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.30–29.20 of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.65–22.30 and low (11.70, IQR 7.51–16.50 doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with

Second Malignanat Solid Neoplasms in Children Treated with Radiotherapy-Report of Two Cases and Review of Literature

International Nuclear Information System (INIS)

Chung, Eun Ji; Suh, Chang Ok; Kim, Gwi Eon; Lyu, Chuhl Joo; Kim, Byung Soo

1995-01-01

Radiotherapy and chemotherapy can effectively control cancer but can also cause new second cancers to develop as long-term complications especially in childhood cancer. We experienced two patients with second malignant solid neoplasm who had been treated with radiation and chemotherapy for childhood cancers. One female patients with rhabdomyosarcoma of the right popliteal fossa was treated with radiotherapy at total dose of 54 Gy. Three years and seven months later, osteosarcoma developed in the field of radiation therapy. The other male patient with non-Hodgkin's lymphoma of the small bowel was treated with radiotherapy and leiomyosarcoma developed in the field of radiotherapy 18 years later. We reviewed the literature of the second malignant neoplasm in children in respect of risk factors. The risk for a second primary cancer following radiotherapy or chemotherapy emphasizes the need for life long follow-up of patients receiving such treatments. Particularly patients treated for childhood cancers

An Evaluation of Significance of Herbal Acupuncture on Treating Limb Impediment Among the Children with Development Disabilities

Directory of Open Access Journals (Sweden)

Huh Young-Jin

2004-02-01

Full Text Available Objectives : This study was conducted to establish a standard and classify suitability in the treatment of limb impediment among the children with development disabilities using bee venom and eight principles herbal acupuncture. Methods : 10 patients with pediatric development disabilities with limb impediment as the main symptoms were chosen in this study. Bee venom herbal acupuncture and eight principles herbal acupuncture treatments were rendered and evaluated responses as well as pursuing most proper treatment methods. Results : 1. Bee venom herbal acupuncture showed a significant effects when used as supplement treatment technique for the children with partial movement, but insignificant for the children whom were unable to move. 2. Bee venom was effective for severe limb impediment and limb asthenia, whileas eight principles herbal acupuncture effective for mild limb impediment and spasticity. 3. Bee venom herbal acupuncture used in conjunction with eight principles herbal acupuncture for treating limb impediment among the children with development disabilities showed general improvement by intensifying muscular strength.

Professional and Parental Attitudes toward iPad Application Use in Autism Spectrum Disorder

Science.gov (United States)

Clark, Megan L. E.; Austin, David W.; Craike, Melinda J.

2015-01-01

This study explored the attitudes of parents and professionals who work with children with autism spectrum disorder (ASD) toward the utilization of iPads and use of iPad applications by children with ASD. A survey of parents (n = 90) and professionals (n = 31) assessed information and communication technology (ICT) anxiety and self-efficacy,…

Fatigue in children and adolescents with cancer from the perspective of health professionals.

Science.gov (United States)

Silva, Michele Cristina Miyauti da; Lopes, Luís Carlos; Nascimento, Lucila Castanheira; Lima, Regina Aparecida Garcia de

2016-08-29

to investigate health professionals' knowledge about the concept, assessment and intervention in fatigue in children and adolescents with cancer. exploratory study with qualitative approach, with 53 health professionals (10 nurses, 33 assistant nurses, 3 physicians, 3 nutritionists, 2 psychologists and 2 physical therapists). Semi structured interviews were held, which were recorded and analyzed by means of inductive thematic content analysis. the data were organized around three themes: knowledge of health professionals about fatigue; identification of fatigue and interventions to relieve fatigue. the results indicate the health professionals' limited knowledge about fatigue, as well as the lack of investment in their training and continuing education. Most of all, the lack of research on the theme in the Brazilian context remains a barrier to support improvements in care for this symptom in children and adolescents with cancer. investigar quais conhecimentos os profissionais de saúde têm acerca do conhecimento, avaliação e intervenção sobre a fadiga em crianças e adolescentes com câncer. estudo exploratório com abordagem qualitativa, realizado com 53 profissionais de saúde (10 enfermeiros, 33 auxiliares de enfermagem, 3 médicos, 3 nutricionistas, 2 psicólogos e 2 fisioterapeutas). Foram conduzidas entrevistas semiestruturadas as quais foram gravadas e analisadas por meio do modelo de análise de conteúdo do tipo temática indutiva. os dados foram organizados ao redor de três temas: conhecimento dos profissionais da saúde sobre fadiga; identificação da fadiga e intervenções para o alívio da fadiga. os achados apontam para o conhecimento limitado dos profissionais de saúde sobre fadiga, bem como para o pouco investimento em educação continuada e permanente. Sobretudo, a escassez de estudos sobre o assunto no cenário brasileiro ainda é uma barreira para oferecer subsídios para melhoria deste sintoma em crianças e adolescentes com c

Erfahrung und Wissen: Deutungsmuster und Wissensformen von Diplompadagogen und Sozialpadagogen in der ausserschulischen Kinder- und Jugendarbeit (Experience and Knowledge: Interpretative Patterns and Forms of Knowledge among Professional Pedagogues and Social Workers in Out-of-School Work with Children and Adolescents).

Science.gov (United States)

Thole, Werner; Kuster-Schapfl, Ernst-Uwe

1996-01-01

Examines the job-oriented interpretative patterns, plans of action, and professional knowledge of sociopedagogical actors working with children and adolescents out of school. Concludes that actors working with children and adolescents out of school usually rely more on their own biographical resources than on academic or professional knowledge.…

Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

OpenAIRE

Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta

2013-01-01

Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bac...

Care Provision and Prescribing Practices of Physicians Treating Children and Adolescents With ADHD.

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Patel, Ayush; Medhekar, Rohan; Ochoa-Perez, Melissa; Aparasu, Rajender R; Chan, Wenyaw; Sherer, Jeffrey T; Alonzo, Joy; Chen, Hua

2017-07-01

Care provision and prescribing practices of physicians treating children with attention-deficit hyperactivity disorder (ADHD) were compared. A retrospective cohort study was conducted with the 1995-2010 General Electric Centricity Electronic Medical Record database. The sample included children (≤18 years) with newly diagnosed ADHD (ICD-9-CM code 314.XX) who received a prescription for a stimulant or atomoxetine. Identification of comorbid psychiatric disorders, duration from initial ADHD diagnosis to treatment, prescription of other psychotropic medications, and follow-up care during the ten months after the ADHD treatment initiation were compared across provider type (primary care physicians [PCPs], child psychiatrists, and physicians with an unknown specialty). The associations between provider type and practice variations were further determined by multivariate logistic regression accounting for patient demographic characteristics, region, insurance type, and prior mental health care utilizations. Of the 66,719 children identified, 75.8% were diagnosed by PCPs, 2.6% by child psychiatrists, and 21.6% by physicians whose specialty was unknown. Child psychiatrists were less likely than PCPs to initiate ADHD medication immediately after the diagnosis. However, once the ADHD treatment was initiated, they were more likely to prescribe psychotropic polytherapy even after analyses accounted for the comorbid psychiatric disorders identified. Only one-third of ADHD cases identified by both PCPs and child psychiatrists have met the HEDIS quality measure for ADHD medication-related follow-up visits. Differences were found by physician type in care of children with ADHD. Additional studies are needed to understand clinical consequences of these differences and the implications for care coordination across provider specialties.

Factors affecting improvement of children and adolescents who were treated in the child and adolescent psychiatry inpatient unit.

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Serim Demirgoren, Burcu; Ozbek, Aylin; Gencer, Ozlem

2017-08-01

Objective This study aimed to assess the correlates and predictors of improvement in general functioning of children and adolescents who are treated in the child and adolescent psychiatry (CAMHS) inpatient unit. Methods Hospital records of 308 children and adolescents who were treated for at least 1 month in the CAMHS inpatient unit from 2005-2016 were included. Associations with individual, familial, and clinical variables and the difference in Children's Global Assessment Scale (ΔCGAS) scores at admission and discharge were evaluated. Results Positive predictors of ΔCGAS were older age and lower CGAS scores at admission, whereas high familial risk scores at admission and diagnosis of early-onset schizophrenia negatively predicted ΔCGAS (B = 0.698, p = 0002; B = -0.620, p < 0.001; B = -0.842, p = 0.002; B =-9.184, p = 0.000, respectively). Familial risk scores were significantly and negatively correlated with ΔCGAS (p = 0.004, Spearman's rho = -0.2). Conclusions This study indicates that improvement in general functioning during inpatient treatment in CAMHS is better at an older age and with lower general functioning at admission. However, high familial risks and diagnosis of early-onset schizophrenia weakens this improvement.

Investing in the Early Childhood Mental Health Workforce Development: Enhancing Professionals' Competencies to Support Emotion and Behavior Regulation in Young Children.

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Ritblatt, Shulamit N; Hokoda, Audrey; Van Liew, Charles

2017-09-19

This paper delineates a preventive approach to early childhood mental health by preparing the workforce to provide relational, sensitive care to young children ages 0-5. One of the most prevalent issues in early childhood is behavioral challenges and the inability of young children to regulate themselves. This leads to an expulsion rate in early childhood (3-4 times higher than K-12 expulsion rate) and future mental health issues. The Early Childhood Social-Emotional and Behavior Regulation Intervention Specialist (EC-SEBRIS) graduate level certificate program was created to strengthen early care and education providers with the knowledge and practice of how to support emotion and behavior regulation in young children in their groups. Evaluation data provide evidence that early care and education professionals increased in their perception of self-efficacy and in their sensitivity of care and skills to support behavioral health in young children. Results indicated that the children in their care showed less challenging behaviors and increased social competencies. This manuscript highlights the importance of prevention and the dire need to provide young children with high-quality, appropriate care to support their mental health.

Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues.

Science.gov (United States)

Plavšić, Ljiljana; Mitrović, Katarina; Todorović, Sladjana; Vuković, Rade; Milenković, Tatjana; Zdravković, Dragan

2014-09-01

An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM) should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and the occurance of hypoglycaemic episodes in children and adolescents with T1DM. The study group consisted of 151 children and adolescents (90 boys, 61 girls) treated with human insulins for at least 12 months before introducing insulin analogues. All the patients were divided into two groups: the group I consisted of 72 (47.7%) patients treated with three injections of regular human insulin before meals and long-acting analogue (RHI/LA), and the group II of 79 (52.30%) patients treated with a combination of rapid-acting and long-acting analogue (RA/LA). The levels of glycated hemoglobin (HbA1c) and the number of hypoglycaemic episodes were assessed at the beginning of therapy with insulin analogues, and after 6 and 12 months. The mean HbA1c was significantly lower in the group I (RHI/LA) after 6 months (9.15% vs 8.20%, p < 0.001) and after 12 months (9.15% vs 8.13%, p < 0.001) as well as in the group II (RA/LA) after 6 months (9.40% vs 8.240%, p < 0.001) and after 12 months of insulin analogues treatment (9.40% vs 8.38%, p < 0.001). The frequency of severe hypoglycaemia was significantly lower in both groups after 6 months (in the group I from 61.1% to 4.2% and in the group II from 54.4% to 1.3%, p < 0.001), and after 12 months (in the group I from 61.1% to 1.4% and in the group II from 54.4% to 1.3%, p < 0.001). Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.

Quality of life in Danish children and adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections

DEFF Research Database (Denmark)

Birkebæk, Niels; Kristensen, Lene Juel; Mose, Anne

2014-01-01

), and to investigate whether HRQoL assessments were influenced by treatment duration. METHODS: Participants were recruited through the Danish Registry for Diabetes in Childhood and Adolescence. A total of 700 children and adolescents (360 girls), 8-17 years, were included. Of these, 295 were treated with CSII (160......AIMS: The aims of the study were to compare health-related quality of life (HRQoL) in a National Danish population of children and adolescents with type 1 diabetes (T1D) treated with either continuous subcutaneous insulin injection (CSII) or multiple daily insulin injections (MDI...... for more than one year) and 405 with MDI (238 for more than one year). Participants and their parents completed the Pediatric Quality of Life Inventory Diabetes and Generic Module. HbA1c was analyzed centrally. RESULTS: Parents reported children and adolescents on CSII for more than one year to have less...

Social pedagogy in children´s everyday life

DEFF Research Database (Denmark)

Schwartz, Ida

A large part of most children’s childhood is about taking part in educational and leisure time activities together with other children across various contexts of childhood. However, children who are in out-of-home care do not always have easy access to these resources. Theoretically the paper dra...... concludes that for children in out-of-home care their possibilities of learning how to conduct their everyday lives are closely related to the ways professionals cooperate across contexts and that puts inter-professional cooperation at the core of social pedagogy....... on a German version of Critical Psychology and discusses how to understand social pedagogy in relation to the support of children’s conduct of everyday life. In general parents coordinate their children´s everyday lives, but for the case of children in out-of-home care, the responsibility of care...... is distributed between several professionals and institutions. The paper builds on two research projects that followed children in out-of-home care in their everyday lives, exploring how professionals work together in order to support children´s agency in communities of children in residential home, school...

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

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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.

Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children.

Science.gov (United States)

Hawke, Kate; van Driel, Mieke L; Buffington, Benjamin J; McGuire, Treasure M; King, David

2018-04-09

Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs each year. Although these infections are self limiting, the symptoms can be distressing. Many treatments are used to control symptoms and shorten the duration of illness. They often have minimal benefit and may lead to adverse effects. Oral homeopathic medicinal products could play a role in the treatment of ARTIs for children if evidence for effectiveness is established. To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat acute respiratory tract infections in children. We searched CENTRAL (2017, Issue 11), which contains the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 27 November 2017), Embase (2010 to 27 November 2017), CINAHL (1981 to 27 November 2017), AMED (1985 to December 2014), CAMbase (searched 29 March 2018), British Homeopathic Library (searched 26 June 2013 - no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov trials registers (29 March 2018), checked references, and contacted study authors to identify additional studies. Double-blind, randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. We used standard methodological procedures expected by Cochrane. We included eight RCTs of 1562 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for upper respiratory tract infections (URTIs). Four treatment studies examined the effect on recovery from URTIs, and four studies investigated the effect on preventing URTIs after one to three months of treatment and followed up for the remainder of the year. Two treatment and two prevention studies

Surgical antibiotic prophylaxis in children: a mixed method study on healthcare professionals attitudes.

Science.gov (United States)

Giusti, Angela; Spila Alegiani, Stefania; Ciofi Degli Atti, Marta Luisa; Colaceci, Sofia; Raschetti, Roberto; Arace, Pasquale; Spiazzi, Raffaele; Raponi, Massimiliano

2016-12-05

Qualitative and quantitative research investigating determinants of adherence to clinical guidelines (GLs) on surgical antibiotic prophylaxis (SAP) are scarce. We conducted a mixed-method study aimed at investigating barriers and at describing attitudes of healthcare professionals (HCPs) regarding SAP in three Italian children's hospitals. The study comprised two sequential phases: 1) collection of qualitative data through focus groups; 2) conduction of a survey on HCPs attitudes towards SAP. Focus groups were carried out in each hospital with a theoretical convenience sample of 10-15 HCPs. Categorical analysis was conducted. Emerging categories and additional topics derived by literature search were used to develop the survey questionnaire, which included 13 questions expressed through a 4-point Likert scale. Members of surgical teams were invited by e-mail to fill in the questionnaire. We summed up the points assigned to each 4-point Likert scale response and calculated a cumulative score expressing overall concordance to expected HCPs attitudes on SAP. We conducted univariate and multivariate analysis to evaluate the relationship among characteristics of respondents and concordance with expected attitudes. The main categories identified in the qualitative phase included determinants of general adherence to GLs (e.g., relevance of clinical judgment), individual determinants (e.g., poor knowledge on hospital data) and organizational/structural determinants (e.g., patient flows). A total of 357 HCPs participated in the survey (response rate: 82.1%). Among respondents, 75% reported that SAP should be performed with first or second-generation cephalosporins, 44% that 2-3 days of antibiotic administration are useful as a precaution after surgery, 32% that SAP is needed for all surgical procedures. At multivariate analysis, professional category (physicians vs nurses; OR: 3.31; 95%CI: 1.88-5.82), and hospital (hospital 1 and 2 vs hospital 3; ORs: 2.79, 95%CI: 1

Motor Development Skills of 1- to 4-Year-Old Iranian Children with Early Treated Phenylketonuria

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Firouzeh Sajedi

2014-03-01

Full Text Available Objective: To gauge the gross and fine motor development of early treated phenylketonuria (ETPKU in children in the age range of 1–4 years. Materials & Methods: A cross-sectional analytic study was conducted in PKU clinics (reference clinics for PKU follow-up, Tehran, Iran. Seventy children with ETPKU were selected as the case group for the study. ETPKU children were those with early and continuous treatment with a phenylalaninerestricted diet (the mean of blood phenylalanine level during the recent 6 months was 2–6 mg/dL or 120–360 mmol/L. Also, 100 healthy and normal children matched with the ETPKU group for age were randomly selected from 4 kindergartens in four parts of Tehran as a control group. The measurements consisted of a demographic questionnaire, Peabody Developmental Motor Scale-2 (PDMS-2, and pediatrician assessment. Motor quotients were determined by PDMS-2 and then compared in both groups by two independent samples t-test. Results: The mean ages in case and control group were 28.5 (±11.6 and 29.7 (±11.3 months, respectively. Comparison of the mean fine, gross, and total developmental motor quotients (DMQs showed statistically significant differences between the two groups (P<0.05. The fine and total DMQs of ETPKU children were also correlated with age. In addition, there was a negative correlation between the phenylalanine level and fine (P<0.001 and total (P=0.001 DMQs. Conclusion: It seems that ETPKU Iranian children, regardless of following a phenylalanine-restricted diet or not, have lower motor development. It is recommended to plan programs for early detection and intervention of developmental delays in these children.

Incidence of Severe Osteonecrosis Requiring Total Joint Arthroplasty in Children and Young Adults Treated for Leukemia or Lymphoma

DEFF Research Database (Denmark)

Niinimäki, Riitta; Hansen, Lene Mølgaard; Niinimäki, Tuukka

2013-01-01

diagnosis codes given before the age of 40 were also retrieved. Results: The estimated cumulative incidence of TJA was 4.5% at 20 years for patients treated for chronic myeloid leukemia, followed by 2.1% for patients treated for acute myeloid leukemia. It was considerably lower in patients with acute...... the age of 10 (HR=24; 95% CI: 3.1-176 and HR=26; 95% CI: 3.6-192 respectively). Conclusion: The incidence of ON requiring TJA was highest among patients with myeloid leukemias and lowest in patients treated for ALL. Allo-SCT and age ≥10 years at diagnosis were the most important risk factors......Purpose: The population-based incidence of severe osteonecrosis (ON) necessitating total joint arthroplasty (TJA) in patients with hematological cancer is unknown. This study assessed the incidence of ON requiring primary TJA in children and young adults treated for leukemia or lymphoma. Methods...

Domestic violence on children: development and validation of an instrument to evaluate knowledge of health professionals

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Lanuza Borges Oliveira

Full Text Available ABSTRACT Objective: to develop and validate an instrument to evaluate the knowledge of health professionals about domestic violence on children. Method: this was a study conducted with 194 physicians, nurses and dentists. A literature review was performed for preparation of the items and identification of the dimensions. Apparent and content validation was performed using analysis of three experts and 27 professors of the pediatric health discipline. For construct validation, Cronbach's alpha was used, and the Kappa test was applied to verify reproducibility. The criterion validation was conducted using the Student's t-test. Results: the final instrument included 56 items; the Cronbach alpha was 0.734, the Kappa test showed a correlation greater than 0.6 for most items, and the Student t-test showed a statistically significant value to the level of 5% for the two selected variables: years of education and using the Family Health Strategy. Conclusion: the instrument is valid and can be used as a promising tool to develop or direct actions in public health and evaluate knowledge about domestic violence on children.

When to invest in clinical guidelines for children? A practice oriented tool to facilitate decision-making.

Science.gov (United States)

Schalkers, Inge; Enthoven, Clair; Bunders, Joske; Dedding, Christine

2017-02-01

Children are not just small adults; they need to be diagnosed and treated in the context of their rapid growth and development. However, in guideline development, children's needs and interests are still overlooked. This study aims (1) to develop a tool that could stimulate guideline developers to take children into account on a more structural basis and (2) to explore how to facilitate children's participation in the process of guideline development. The method used was a three-phase multimethod sequential design. Professionals involved in guideline development participated in interviews (n = 12), filled in a questionnaire (n = 60) and/or participated in the focus group meeting (n = 11). This study results in a comprehensive understanding of the considerations that professionals take into account when deciding whether guidelines need to apply to children specifically. This resulted in a tool that assists guideline developers to make this assessment more accurately. It takes the form of a flowchart that guides users through a series of critical questions. The flowchart reminds guideline developers to consider children as a particular patient population when prioritizing and demarcating new guideline topics. It will help to ensure that clinical guidelines address children's unique health care needs and perspectives. Facilitating children's and parents' participation in the process of guideline development is perceived as challenging; nevertheless, it should be the next step in making paediatric guidelines more child-centred and family-centred. © 2016 John Wiley & Sons, Ltd.

Mental health needs of children and adolescents at camp: are they being assessed and treated appropriately by the camp nurse?

Science.gov (United States)

Courey, Tamra J

2006-11-01

Increasingly, more children and adolescents are attending camps with mental health concerns. This can pose a challenge for camp nurses who may lack experience in assessment and treatment of mental health issues. To focus on the importance of addressing and treating mental health needs of children and adolescents at camp utilizing the Scope and Standards of Psychiatric Mental Health Nursing Practice. Personal observations, camp nursing experience, and scholarly published literature. It is paramount that mental health needs of children and adolescents at camp are addressed and managed appropriately by the camp nurse. Education of camp nurses and camp administrators is also a vital part of providing care.

A PROSPECTIVE STUDY OF SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN TREATED BY CLOSED REDUCTION

Directory of Open Access Journals (Sweden)

Ch. Imobi

2015-08-01

Full Text Available There is no universal agreement regarding the management of displaced supracondylar fracture of the humerous in children. According to some orthopaedic surgeon almost all supracondylar humeral fractures should be treated operatively by reduction and pinning. While according to others closed reduction and pinning should be used for Gartland type II and some type III fractures. We present 50 cases of displaced supracondylar fracture treated by closed manipulative reduction under G.A. and immobilization with a posterior plaster of paris slab and collar and cuff. OBJECTIVE : T o assess the functional results of the injured elbow and to study the incidence of change in the carrying angle of the elbow. MATERIALS AND METHODS: This prospective study was conducted in 50 patients with extension type of displaced supracondylar fractures of humerus in children (Gartland type II and type III treated by closed manipulative reduction and immobilization in flexion of the elbow with a posterior plaster of paris slab and collar and cuff. Patients were followed up for 6 months. Flexion type of supracondylar fracture and those fractures which are absolutely indicated for operative intervention, Viz an open fracture and severe vascular compromise were excluded from the study. The range of movement and carrying angle was measured with the help of a Goniometer and Flynn criteria were used for functional assessment. RESULTS: At the end of follow up period, the end results were graded as excellent in 40%, good in 42%, fair in 12% and poor in 6%. A satisfactory result was therefore obtained in 94% and unsatisfactory result in 6% of the 50 patients who were followed and evaluated. CONCLUSION: This closed method of treatment for all practical proposes produces least complications, shorter hospital stay, can be expected to yield reproducible consistent satisfactory results not surpassed by any other method of treatment.

Serious child and adolescent behaviour disorders; a valuation study by professionals, youth and parents.

Science.gov (United States)

Vermeulen, Karin M; Jansen, Daniëlle E M C; Buskens, Erik; Knorth, Erik J; Reijneveld, Sijmen A

2017-06-02

In child and youth care, quantitative estimates of the impact of serious behaviour problems have not yet been made. Such input is needed to support decision making on investments in treatment. The aim of this paper was to elicit valuations of social and conduct disorders in children and adolescents from three different perspectives: professionals, youth, and parents. We obtained valuations from 25 youth care professionals, 50 children (age 9-10) without serious behaviour problems and 36 adolescents (age 16-17) with and without serious behaviour disorders, and 46 parents with children in the aforementioned age categories. Valuations were estimated from 18 descriptions of behaviour disorders in youth aged 9 and 15 years. Descriptions included Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Disruptive Behaviour Disorder (DBD). Comorbid conditions were Attention Deficit Hyperactivity Disorder and substance abuse. Valuations were obtained with the EuroQol questionnaire (EQ-5D-3 L) and a visual analogue scale (VAS). Valuations were generally severe; problems were by and large reported to worsen quality of life by 50% compared to being fully healthy. Professionals regarded DBD with substance abuse as most severe (VAS values 0.41 for children, and 0.43 for adolescents, i.e. less than half of normal). They rated ODD as least severe (VAS values 0.58 for children, 0.59 for adolescents). Children, adolescents and parents gave lower valuations than professionals, and had a wider range of scores, particularly at the lower end of the scale. Behaviour disorders pose a formidable burden from the perspectives of professionals as well as children, adolescents and parents. These results may support medical decision making to set priorities with regard to prevention and treatment based on perceived severity.

Tricky Treats

Centers for Disease Control (CDC) Podcasts

2008-08-04

The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

Inter-professional education of prospective speech-language therapists and primary school teachers through shared professional practice placements.

Science.gov (United States)

Wilson, Leanne; McNeill, Brigid; Gillon, Gail T

2017-07-01

Preliminary studies of inter-professional education (IPE) among student speech-language therapists (SLTs) and student teachers suggest that workshop-based applications are beneficial in preparing participants for elements of collaborative practice. Situating IPE within the students' professional practice placements may provide another useful avenue to develop attitudes, knowledge and skills for inter-professional collaboration. Research examining the impact of different approaches to IPE is required to advance our understanding of effective design and evaluation of such initiatives. To understand how student SLTs and student teachers develop competency for collaborative practice when co-working during professional practice placements to support children's speech and literacy development. A case study design was used to monitor the impact of the IPE. Student SLTs (n = 4) were paired with student teachers (n = 4) to participate in shared professional practice placements in junior school classrooms. An inductive thematic analysis of interviews conducted with participants after the IPE was employed to explore the development of competencies in collaborative practice. Change in inter-disciplinary knowledge and perceptions over the IPE was evaluated via survey to further explore the development of collaborative competencies. Integration of qualitative and quantitative findings suggested that participants began to develop four broad areas of collaborative competency: understanding of professional roles and expertise, communication skills to support shared decision-making, inter-dependency in supporting children's learning, and flexibility to implement alternative instructional practices. Interview analysis also revealed factors related to the facilitators and learning contexts that supported and/or limited the collaboration between participants. Shared placement experiences between student SLTs and student teachers may be an effective method for building participants

Epidemiology of skateboarding-related injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008.

Science.gov (United States)

McKenzie, Lara B; Fletcher, Erica; Nelson, Nicolas G; Roberts, Kristin J; Klein, Elizabeth G

2016-12-01

The goal was to examine the patterns and trends of skateboarding-related injuries sustained by children and adolescents in the United States. A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System for children and adolescents 5-19 years of age treated in emergency departments for injuries associated with skateboards from 1990 through 2008. An estimated 1 226 868 children/adolescents (95 % CI: 948 733-1 505 003) were treated in emergency departments for skateboarding-related injuries from 1990 through 2008, an average of 64,572 cases per year. From 1990 through 1994, the annual rate of injuries per 10,000 children/adolescents significantly decreased overall and for males (overall: 72.9 %, P = 0.014; males: 73.9 %, P = 0.011; females: 63.6 %, P = 0.062). From 1994 to 2008, annual rates of injuries per 10,000 children/adolescents significantly increased overall and for both males and females (overall: 378.9 %, P Skateboarding continues to be an important source of injury for children and adolescents. Further research, using more rigorous study designs, is required develop a broad perspective of the incidence and determinants of injury, and to further identify risk factors and viable injury countermeasures while simultaneously promoting participation in skateboarding.

Parents' knowledge and attitudes of children treated at the University Children's Hospital in Lublin towards influenza vaccinationw

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Paula Katarzyna Jankowska

2018-01-01

Full Text Available Introduction: In recent times, there is an  intense debate on the the merits of the use of vaccination and post-vaccination complications among Poles. Vaccination against influenza is recommended in Poland. Many of the opponents use arguments which are not scientifically substantiated but widely widespread. Statistics show that the percentage of Poles who decide on vaccination, continues to decline. Aim: The aim of this work is to evaluate level of knowledge about influenza vaccinations among parents of children treated in University Children’s Hospital of Lublin. Material and methods: There were 90 participants who filled surveys prepared by the authors of the study. Data analysis was performed using STATISTICA 12.5. Results: The observed percentage of parents who do vaccinate their children was low - only 17.8% The main reasons for the resignation are: fear of adverse side effects (53.3% and financial reasons (15.6%. Nearly half of parents believe that a healthy diet and daily doses of vitamin C to prevent flu and points to the effectiveness of antibiotics in the treatment of influenza. 14.4% believe that the influenza is the same as cold Over 30% say that regular vaccination weakens our immune system. Most frequently chosen sources of knowledge, from which parents derive knowledge about influenza vaccination, are: Internet (64.4%, doctor (42.2% and TV (32.2%. Conclusions: Most participants in the study presents a relatively low level of knowledge about influenza vaccination, and most of them are aware of the seriousness of this disease. Lack of knowledge about the basic facts about vaccination, may be the cause of the low percentage of vaccinated children. A large part of the parents renounces vaccination due to financial problems.

Running-related injuries in school-age children and adolescents treated in emergency departments from 1994 through 2007.

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Mehl, Ann J; Nelson, Nicolas G; McKenzie, Lara B

2011-02-01

Running for exercise is a popular way to motivate children to be physically active. Running-related injuries are well studied in adults but little information exists for children and adolescents. Through use of the National Electronic Injury Surveillance System database, cases of running-related injuries were selected by using activity codes for exercise (which included running and jogging). Sample weights were used to calculate national estimates. An estimated 225 344 children and adolescents 6 to 18 years old were treated in US emergency departments for running-related injuries. The annual number of cases increased by 34.0% over the study period. One third of the injuries involved a running-related fall and more than one half of the injuries occurred at school. The majority of injuries occurred to the lower extremities and resulted in a sprain or strain. These findings emphasize the need for scientific evidence-based guidelines for pediatric running. The high proportion of running-related falls warrants further research.

Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in children and adults with overweight or obesity.

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Flodgren, Gerd; Gonçalves-Bradley, Daniela C; Summerbell, Carolyn D

2017-11-30

The prevalence of overweight and obesity is increasing globally, an increase which has major implications for both population health and costs to health services. This is an update of a Cochrane Review. To assess the effects of strategies to change the behaviour of health professionals or the organisation of care compared to standard care, to promote weight reduction in children and adults with overweight or obesity. We searched the following databases for primary studies up to September 2016: CENTRAL, MEDLINE, Embase, CINAHL, DARE and PsycINFO. We searched the reference lists of included studies and two trial registries. We considered randomised trials that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in children and adults with overweight or obesity. We used standard methodological procedures expected by Cochrane when conducting this review. We report the results for the professional interventions and the organisational interventions in seven 'Summary of findings' tables. We identified 12 studies for inclusion in this review, seven of which evaluated interventions targeting healthcare professional and five targeting the organisation of care. Eight studies recruited adults with overweight or obesity and four recruited children with obesity. Eight studies had an overall high risk of bias, and four had a low risk of bias. In total, 139 practices provided care to 89,754 people, with a median follow-up of 12 months. Professional interventions Educational interventions aimed at general practitioners (GPs), may slightly reduce the weight of participants (mean difference (MD) -1.24 kg, 95% confidence interval (CI) -2.84 to 0.37; 3 studies, N = 1017 adults; low-certainty evidence).Tailoring interventions to improve GPs' compliance with obesity guidelines probably leads to little or no difference in weight loss (MD 0.05 (kg), 95% CI -0.32 to 0

Young Children and War Play.

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Carlsson-Paige, Nancy; Levin, Diane E.

1988-01-01

In a recent survey of parents and early childhood professionals the prevalence of war play among children and an increase in the amount of violence in children's play was noted. Outlines how the deregulation of children's television during the Reagan administration has affected children's exposure to violence in children's television programming.…

The child audience from TV professionals' viewpoints

OpenAIRE

Pereira, Sara

2010-01-01

This paper aims to discuss the viewpoints of a range of television professionals regarding young audiences - how they define children, how they see this special kind of audience, including its needs and interests, and how they view the role of television in children's lives. Focusing on these ideas, our goal is to understand how they translate into decisions about the format and content of schedules, programming, production, marketing campaigns, regulation measures and also res...

Development and preliminary validation of Brace Questionnaire (BrQ: a new instrument for measuring quality of life of brace treated scoliotics

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Gkoltsiou Konstantina

2006-05-01

Full Text Available Abstract Background The quality of life among children with idiopathic scoliosis during their adolescence has been reported to be affected by the brace itself. However, a controversy exists whether brace treated scoliotics experience a poor quality of life, thus there is a need for the development of a brace-oriented instrument, as the now-existing questionnaires that are commonly used, such as the SRS -22, take into consideration the effects of both the conservative and the surgical treatment on quality of life of scoliotic children. The aim of the present study is to assess the validity and reliability of Brace Questionnaire (BrQ, a new instrument for measuring quality of life of scoliotic adolescents who are treated conservatively with a brace. Material-method Methodology of development involved literature review, patient and health care professionals' in-depth interviews and content validity analysis on patients. A validation study was performed on 28 brace treated scoliotic children aged between 9 and 18 years old. BrQ was assessed for the following psychometric properties: item convergent validity, floor and ceiling effects, internal consistency reliability, clinical validity and responsiveness to change. Results BrQ is self administrated and developmentally appropriate for ages 9 to 18 years old and is consisted of 34 Likert-scale items associated with eight domains: general health perception, physical functioning, emotional functioning, self esteem and aesthetics, vitality, school activity, bodily pain and social functioning of scoliotic children treated conservatively with a brace. The subscales of these eight dimensions can be combined to produce a total score. Higher scores mean a better quality of life. An item convergent validity ≥ 0.40 was satisfied by all items in the present study. A satisfactory internal consistency reliability for the BrQ was recorded (Cronbach's alpha coefficient was 0.82. There were no floor or ceiling

Insiders' Perspectives: A Children's Rights Approach to Involving Children in Advising on Adult-Initiated Research

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Dunn, Jill

2015-01-01

Consulting with children is widely recognised as an essential element in building understanding about children's lives. From a children's rights perspective, it is also a legal requirement on professionals working with children. However, translating the rhetoric into research and practice is still evolving. Previous studies report on working with…

Parental and Professional Beliefs on the Treatment and Management of ADHD

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Dryer, Rachel; Kiernan, Michael J.; Tyson, Graham A.

2012-01-01

Objective: This study examined parental and professional beliefs about the efficacy of various treatment strategies for ADHD. Method: Parents of children with and without ADHD and seven medical and nonmedical professional groups (N = 673) completed a questionnaire examining their beliefs about the efficacy of various treatment regimes. Results:…

HOARSENESS AMONG SCHOOL-AGE CHILDREN

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Robert Šifrer

2004-02-01

Full Text Available Background. The prevalence of dysphonia in schoolchildren has been reported to be from 7.1% to 23.3% and in adolescents from 0 to 80%. In Slovenia, the study on prevalence of dysphonia in schoolchildren has not been performed yet.Methods. The voice samples of 100 4th-graders and 102 8thgraders of elementary school were recorded. A lay judge and a professional assessed independently degree of hoarseness in the voice samples. One to three months after the recording, the dysphonic children were invited to an otorhinolaryngologic examination in order to find out the cause of dysphonia. All children and their parents answered the questionnaires on illnesses and vocal habits that might cause hoarseness. The prevalence of these unfavourable factors was compared between the group of children with long lasting hoarseness and the children without it.Results. At voice samples’ recording there were 34.2% dysphonic children. One to three months later, there were still 14.9% children with hoarse voice. The most frequent causes for acute dysphonia were acute respiratory infection and exacerbation of chronic laryngitis. The most frequent causes for persistent dysphonia were allergic catarrhal laryngitis, muscle tension dysphonia with or without vocal nodules and mutational voice disorder. The fast speaking rate appeared to be characteristic for children with long lasting dysphonia.Conclusions. Dysphonia in school-age children is the result of diseases of upper respiratory tract and/or functional voice disorders. Both causes of dysphonia could be successfully treated if they are detected early and the children are advised to see an otorhinolaryngologist. Adolescence is an ideal period for treatment of functional voice disorders. It is also the period when the children must decide for their future profession.

[Issues in psychiatric evaluation of children and adolescents with visual impairment].

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Saisky, Yaniv; Hasid, Soli; Ebert, Tanya; Kosov, Irene

2014-02-01

Approximately 8% from those who are defined as blind in Israel are children and adolescents. Visual impairment is correlated with a high rate of psychopathology. However, some of these children and adolescents do not receive appropriate diagnosis and treatment. Often, the clinicians and those who treat the children/adolescents lack the proper professional knowledge related to the unique diagnosis and treatment of children/ adolescents who are visually impaired. Visual impairment might influence different aspects of the psychiatric diagnosis. These aspects include the influence of the impairment on different developmental axes; the reciprocal relationship between the child and his/her environment; the clinical presentation of different psychopathologies; and the different treatment modalities. In this review we discuss these issues. Moreover, we raise the question as to whether there is a need to adapt the psychiatric evaluation and the treatment specifically to the visually impaired child. The review is based on the existing literature in addition to our clinical experience, which stems from our work with children and adolescents who are at the "Jewish Institute for the Blind", an institute for children and adolescents with visual impairment in Israel.

Suicide ideation and attempts in children with psychiatric disorders and typical development.

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Dickerson Mayes, Susan; Calhoun, Susan L; Baweja, Raman; Mahr, Fauzia

2015-01-01

Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6-18 years of age. For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0-4% of patients in the other psychiatric groups. It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.

Children and Dietary Supplements

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... Clinical Digest for health professionals Children and Dietary Supplements Share: September 2012 © Matthew Lester Research has shown that many children use herbs and other dietary supplements. However, there are little data available on their ...

Awareness of nutrition problems among Vietnamese health and education professionals.

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Pham, Thi Hai Quynh; Worsley, Anthony; Lawrence, Mark; Marshall, Bernie

2017-10-01

Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

What health professionals should know about the health effects of air pollution and climate change on children and pregnant mothers.

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Poursafa, Parinaz; Kelishadi, Roya

2011-01-01

Health professionals face the adverse health effects of climate change and air pollution in their practices. This review underscores the effects of these environmental factors on maternal and children's health, as the most vulnerable groups to climate change and air pollution. We reviewed electronic databases for a search of the literature to find relevant studies published in English from 1990 to 2011. Environmental factors, notably climate change and air pollution influence children's health before conception and continue during pregnancy, childhood, and adolescence. Experts have suggested that such health hazards may represent the greatest public health challenge that humanity has faced. The accumulation of greenhouse gases such as carbon dioxide, primarily from burning fossil fuels, results in warming which has an impact on air pollution particularly on levels of ozone and particulates. Heat-related health effects include increased rates of pregnancy complications, pre-eclampsia, eclampsia, low birth weight, renal effects, vector-borne diseases as malaria and dengue, increased diarrheal and respiratory disease, food insecurity, decreased quality of foods (notably grains), malnutrition, water scarcity, exposures to toxic chemicals, worsened poverty, natural disasters and population displacement. Air pollution has many adverse health effects for mothers and children. In addition to short-term effects like premature labour, intrauterine growth retardation, neonatal and infant mortality rate, malignancies (notably leukaemia and Hodgkin lymphoma), respiratory diseases, allergic disorders and anaemia, exposure to criteria air pollutants from early life might be associated with increase in stress oxidative, inflammation and endothelial dysfunction which in turn might have long-term effects on chronic non-communicable diseases. Health professionals have an exclusive capability to help prevent and reduce the harmful effects of environmental factors for high-risk groups

Changes in Cerebral Cortex of Children Treated for Medulloblastoma

International Nuclear Information System (INIS)

Liu, Arthur K.; Marcus, Karen J.; Fischl, Bruce; Grant, P. Ellen; Young Poussaint, Tina; Rivkin, Michael J.; Davis, Peter; Tarbell, Nancy J.; Yock, Torunn I.

2007-01-01

Purpose: Children with medulloblastoma undergo surgery, radiotherapy, and chemotherapy. After treatment, these children have numerous structural abnormalities. Using high-resolution magnetic resonance imaging, we measured the thickness of the cerebral cortex in a group of medulloblastoma patients and a group of normally developing children. Methods and Materials: We obtained magnetic resonance imaging scans and measured the cortical thickness in 9 children after treatment of medulloblastoma. The measurements from these children were compared with the measurements from age- and gender-matched normally developing children previously scanned. For additional comparison, the pattern of thickness change was compared with the cortical thickness maps from a larger group of 65 normally developing children. Results: In the left hemisphere, relatively thinner cortex was found in the perirolandic region and the parieto-occipital lobe. In the right hemisphere, relatively thinner cortex was found in the parietal lobe, posterior superior temporal gyrus, and lateral temporal lobe. These regions of cortical thinning overlapped with the regions of cortex that undergo normal age-related thinning. Conclusion: The spatial distribution of cortical thinning suggested that the areas of cortex that are undergoing development are more sensitive to the effects of treatment of medulloblastoma. Such quantitative methods may improve our understanding of the biologic effects that treatment has on the cerebral development and their neuropsychological implications

Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment.

Science.gov (United States)

Scott, Shannon D; Albrecht, Lauren; Given, Lisa M; Hartling, Lisa; Johnson, David W; Jabbour, Mona; Klassen, Terry P

2018-01-01

The majority of children requiring emergency care are treated in general emergency departments (EDs) with variable levels of pediatric care expertise. The goal of the Translating Emergency Knowledge for Kids (TREKK) initiative is to implement the latest research in pediatric emergency medicine in general EDs to reduce clinical variation. To determine national pediatric information needs, seeking behaviours, and preferences of health care professionals working in general EDs. An electronic cross-sectional survey was conducted with health care professionals in 32 Canadian general EDs. Data were collected in the EDs using the iPad and in-person data collectors. Total of 1,471 surveys were completed (57.1% response rate). Health care professionals sought information on children's health care by talking to colleagues (n=1,208, 82.1%), visiting specific medical/health websites (n=994, 67.7%), and professional development opportunities (n=941, 64.4%). Preferred child health resources included protocols and accepted treatments for common conditions (n=969, 68%), clinical pathways and practice guidelines (n=951, 66%), and evidence-based information on new diagnoses and treatments (n=866, 61%). Additional pediatric clinical information is needed about multisystem trauma (n=693, 49%), severe head injury (n=615, 43%), and meningitis (n=559, 39%). Health care professionals preferred to receive child health information through professional development opportunities (n=1,131, 80%) and printed summaries (n=885, 63%). By understanding health care professionals' information seeking behaviour, information needs, and information preferences, knowledge synthesis and knowledge translation initiatives can be targeted to improve pediatric emergency care. The findings from this study will inform the following two phases of the TREKK initiative to bridge the research-practice gap in Canadian general EDs.

Growth and adult height in GH-treated children with nonacquired GH deficiency and idiopathic short stature: the influence of pituitary magnetic resonance imaging findings.

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Coutant, R; Rouleau, S; Despert, F; Magontier, N; Loisel, D; Limal, J M

2001-10-01

We analyzed the final height of 146 short children with either nonacquired GH deficiency or idiopathic short stature. Our purpose was 1) to assess growth according to the pituitary magnetic resonance imaging findings in the 63 GH-treated children with GH deficiency and 2) to compare the growth of the GH-deficient patients with normal magnetic resonance imaging (n = 48) to that of 32 treated and 51 untreated children with idiopathic short stature (GH peak to provocative tests >10 microg/liter). The mean GH dose was 0.44 IU/kg.wk (0.15 mg/kg.wk), given for a mean duration of 4.6 yr. Among the GH-deficient children, 15 had hypothalamic-pituitary abnormalities (stalk agenesis), all with total GH deficiency (GH peak imaging, had better catch-up growth (+2.7 +/- 0.9 vs. +1.3 +/- 0.8 SD score; P imaging, there was no difference in catch-up growth and final height between partial and total GH deficiencies. GH-deficient subjects with normal magnetic resonance imaging and treated and untreated patients with idiopathic short stature had comparable auxological characteristics, age at evaluation, and target height. Although they had different catch-up growth (+1.3 +/- 0.8, +0.9 +/- 0.6, and +0.7 +/- 0.9 SD score, respectively; P imaging findings show the heterogeneity within the group of nonacquired GH deficiency and help to predict the response to GH treatment in these patients. The similarities in growth between the GH-deficient children with normal magnetic resonance imaging and those with idiopathic short stature suggest that the short stature in the former subjects is at least partly due to factors other than GH deficiency.

[Evaluation of the effectiveness of patient-controlled analgesia in children with sickle cell anemia from the perspective of healthcare professionals and parents].

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Turaç, Ayşegül; Rumeli Atıcı, Şebnem

2016-07-01

This study evaluated the efficacy of patient-controlled analgesia (PCA) used by children with sickle cell anemia (SCA) based on the attitudes of parents and healthcare professionals. A total of 86 individuals were involved in the study: 54 parents of children with SCA who were receiving treatment and 32 healthcare providers (doctors, nurses). To evaluate the effectiveness of the PCA method, a questionnaire was prepared to determine the level of knowledge of the participants about the PCA method and their perception of its advantages and disadvantages. According to 65.6% (n=21) of the healthcare providers, PCA should be used during acute phase of pain. The great majority of the participants (93%; n=80) thought that pain was effectively controlled both during the day and at night. PCA reduced the fear of unavailability of analgesic drugs in 83.3% (n=45) of parents and in 87.5% (n=28) of healthcare providers. More parents (37%) reported a reduction in the fear of return of pain than healthcare providers (9.4%) (paddiction. Resolving machine alarms (48%; n=26) and the length of time required to refill the machine (48%; n=26) were reported as disadvantages of PCA method. In this study, parents and healthcare professionals found PCA to be effective in relieving pain in children with SCA; however, fears and biased knowledge of users about the analgesic drug are thought to inhibit reaching sufficient dosage. Educational courses for users about PCA and the drugs used may increase the effectiveness of PCA method.

Professional competence between neoliberal effectiveness and democracy building

DEFF Research Database (Denmark)

Warring, Niels

Developments in modern welfare states over the past twenty years have generally involved an increased focus on resource optimization, liberalization policies and diverse steering mechanisms inspired by New Public Management. For “welfare professions” (especially the health, social and educational...... professions), this has meant that well-established professional identities have been challenged. The traditional key role of educating, treating and providing services for citizens has come under pressure because many professionals feel they have neither the time nor autonomy to fulfil the needs...... of the citizens. The professional ethos of securing societal coherence and equality is challenged, and in a broader perspective it can be discussed whether the potential role of professionals as “democracy builders” is undermined. The paper will explore the professional competence of social educators (preschool...

Barriers and facilitators of sports in children with physical disabilities: a mixed-method study.

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Jaarsma, Eva A; Dijkstra, Pieter U; de Blécourt, Alida C E; Geertzen, Jan H B; Dekker, Rienk

2015-01-01

This study explored barriers and facilitators of sports participation of children with physical disabilities from the perspective of the children, their parents and their health professionals. Thirty children and 38 parents completed a questionnaire, and 17 professionals were interviewed in a semi-structured way. Data from the three groups were combined in a mixed-method design, after which the results were triangulated. Mean age (SD) of the children was 14.1 (2.9) years old, 58% were boys. Sixty-seven percent of the children had cerebral palsy and 77% participated in sports after school. Most commonly practiced sports were swimming, cycling and football. Children specifically experienced dependency on others as a barrier, parents did not have enough information about sports facilities, and professionals observed that the family's attitude had influence on the child's sports participation. Facilitators were health benefits, fun and social contacts. Sports participation of children with physical disabilities is a complex phenomenon because children, their parents and professionals reported different barriers. Sports participation is more physically challenging for children with severe physical disabilities, as their daily activities already require much energy. However, the psychosocial benefits of sports are applicable to all children with physical disabilities. IMPLICATION FOR REHABILITATION: Perceived barriers seemed to differ for children, parents and health professionals, suggesting that sports participation is a complex phenomenon. Sports might be more physically challenging for children with severe physical disabilities, as their daily activities already take much energy. The psychosocial benefits of sports should be emphasized by rehabilitation professionals when advising children with physical disabilities about sports.

Insights from parents of a child with leukaemia and healthcare professionals about sharing illness and treatment information: A qualitative research study.

Science.gov (United States)

Gibson, Faith; Kumpunen, Stephanie; Bryan, Gemma; Forbat, Liz

2018-04-13

Many parents report a strong desire to take on information-giving roles, and believe they are best positioned to discuss their child's illness with their child. Healthcare professionals have a supporting role to reduce the burden on parents who feel responsible for conveying information to their child and other family members. To examine parents' and healthcare professionals' perceptions of roles in receiving and communicating information when a child is diagnosed with and treated for acute lymphoblastic leukaemia. We used the principles of a grounded theory approach. This was a single site study, recruiting from a principal children's cancer treatment centre in the United Kingdom. The sample included parents of children receiving and completed treatment for acute lymphoblastic leukaemia (n = 28), and healthcare professionals (n = 34). Methods included individual interviews, face-to-face and telephone, focus groups, and an online forum. Communication 'touch points' are many over the course of a child's cancer journey. We describe often 'mismatched' communication encounters where those seeking information and those providing information have different goals. Healthcare professionals in the encounter have expertise at the outset while parents have less expertise, but this expertise grows over time and this can increase the perceptions of this 'mismatch' and create different challenges. Considered in the context of middle range transition theory, we might suggest that parental foreground (seeking information directly) and background (passive actors) roles are the result of differing levels of uncertainty, and depend on the situation and preferences and child and family needs that may present differently over time in different contexts. Our work contributes to the emerging consensus that communication is more than a core set of skills that healthcare professionals just need to learn: clear specifications of mutual roles, responsibilities and a shared

Child obesity service provision: a cross-sectional survey of physiotherapy practice trends and professional needs.

Science.gov (United States)

Milne, Nikki; Choy, Nancy Low; Leong, Gary M; Hughes, Roger; Hing, Wayne

2016-01-01

This study explored current physiotherapy practice trends for management of children who are overweight or obese. The professional needs of physiotherapists working with this population were also assessed, including the perceived need for physiotherapy clinical guidelines for prevention and management of children with obesity. A cross-sectional survey design was used, with questionnaires purposefully distributed through 13 key physiotherapy services throughout Australia. Snowball sampling resulted in completed questionnaires from 64 physiotherapists who provided services to children. Half (n=33, 52%) of respondents provided services specifically to overweight or obese children. Of those providing services, one-quarter had prior training specific to working with this population. Most used multi-disciplinary models (n=16, 76%) and provided under 5h of obesity-related services each week (n=29, 88%). Half (n=16, 49%) used body mass index as an outcome measure but more (n=25, 76%) used bodyweight. Only 14 (42%) assessed motor skills. The majority of respondents (n=57, 89%) indicated a need for physiotherapy guidelines to best manage overweight and obese children. Professional development priorities included: 'Educating children and families', 'Assessment methods' and 'Exercise prescription' for overweight and obese children. This data provides workforce intelligence to guide future professional training and inform development of clinical guidelines for physiotherapists in prevention and management of children with obesity and related chronic disease.

Treatment outcomes of severe acute malnutrition in children treated within Outpatient Therapeutic Program (OTP) at Wolaita Zone, Southern Ethiopia: retrospective cross-sectional study.

Science.gov (United States)

Kabalo, Mulugeta Yohannis; Seifu, Canaan Negash

2017-03-09

Children in third world countries suffer from severe acute malnutrition (SAM) in an extent of public health important. SAM management protocol available this time brought the approach from facility-based to community-based by Outpatient Therapeutic Program (OTP). But, little was known about the treatment outcomes of the program in Ethiopia. Thus, this study was aimed to assess treatment outcomes of SAM and identify factors associated among children treated at OTP in Wolaita Zone. A retrospective facility-based cross-sectional study was conducted in OTP records of 794 children, treated at 24 health posts retrieved from January to December 2014. Population proportion to size (PPS) was used to allocate sample for each selected district and OTP sites within district. Individual cards of children were selected by systematic random sampling. Data were entered, thoroughly cleaned, and analyzed in SPSS version 20. The recovery rate was revealed as 64.9% at 95% CI (61, 68). Death rate, default rate, weight gain, and length of stay were 1.2%, 2.2%, 4.2 g/kg/day, and 6.8 weeks respectively. Children living in children residing in ≥25 min (AOR = 1.53 at 95% CI (1.11, 2.12)). The likelihood of recovery was 2.6 times higher for children with kwashiorkor than for those with marasmus (AOR = 2.62 at 95% CI (1.77, 3.89)). Likewise, children provided with amoxicillin were 1.52 times more likely to recover compared to their counterparts (AOR = 1.52 at 95% CI (1.09, 2.11)). The recovery rate and weight gain were lower than sphere standard. Distance from OTP, provision of amoxicillin, and type of malnutrition were factors identified as significantly associated with treatment outcome of SAM. Building capacity of OTP service providers and regular monitoring of service provision based on the management protocol were recommended.

Investigating the Role of Hypothalamic Tumor Involvement in Sleep and Cognitive Outcomes Among Children Treated for Craniopharyngioma.

Science.gov (United States)

Jacola, Lisa M; Conklin, Heather M; Scoggins, Matthew A; Ashford, Jason M; Merchant, Thomas E; Mandrell, Belinda N; Ogg, Robert J; Curtis, Elizabeth; Wise, Merrill S; Indelicato, Daniel J; Crabtree, Valerie M

2016-07-01

Despite excellent survival prognosis, children treated for craniopharyngioma experience significant morbidity. We examined the role of hypothalamic involvement (HI) in excessive daytime sleepiness (EDS) and attention regulation in children enrolled on a Phase II trial of limited surgery and proton therapy. Participants completed a sleep evaluation (N = 62) and a continuous performance test (CPT) during functional magnetic resonance imaging (fMRI; n = 29) prior to proton therapy. EDS was identified in 76% of the patients and was significantly related to increased HI extent (p = .04). There was no relationship between CPT performance during fMRI and HI or EDS. Visual examination of group composite fMRI images revealed greater spatial extent of activation in frontal cortical regions in patients with EDS, consistent with a compensatory activation hypothesis. Routine screening for sleep problems during therapy is indicated for children with craniopharyngioma, to optimize the timing of interventions and reduce long-term morbidity. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Survival of children with neuroblastoma treated at the Institute of oncology in Ljubljana in two periods

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Jasna Perković

2014-04-01

Full Text Available Background: Neuroblastoma is a malignant tumor of the sympathetic nervous system, representning about 5 % of all childhood malignancies. The aim of our study was to compare the survival of neuroblastoma patients treated in Slovenia in two time periods, 1994–2007 and 1980–1993, and analyze the influence of different factors on survival. The hypothesis was that there has been an improvement in the survival of neuroblastoma patients treated after 1994.Methods: Seventy-eight neuroblastoma patients, treated at the Department of Pediatrics and at the Institute of Oncology in Ljubljana in the period 1980–2007 were included in the retrospective study. The list of patients and their basic data were collected from the Cancer Registry of Slovenia. Furtjer data about the patients, tumor characteristics and treatment were collected from patients’ records.Results: Thirty-nine (50 % out of seventy-eight neuroblastoma patients included in the study are alive; of the 39 (50 % dead, 23 (29.5 % died during primary tumor treatment, 15 (19.2 % died after recurrent disease, and the cause of death in one (1.3 % patient remained unknown. The survival rates according to stage of disease, site of primary tumor and tumor size have improved in children treated after 1994, as compared to those treated before 1994. The most important factors influencing the prognosis in both time periods were stage of disease, patients’ age and tumor size at diagnosis while there was no statistical difference in survival according to age at diagnosis and the extent of surgery.Conclusions: The retrospective study confirmed our hypothesis that the survival of our patients treated after 1994 was better than the survival of those treated before. The most important prognostic factors in both periods were stage of the disease, age at diagnosis and tumor size.

Guide to Children's Services: 1975-76. Take Stock in Texas: Invest in Children.

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Texas State Dept. of Community Affairs, Austin. Office of Early Childhood Development.

A reference manual of statewide programs for children under age 6 in Texas, this Guide is designed to help public officials, community groups, professionals who work with children and other interested citizens identify and obtain assistance in meeting the needs of children and families. Information is given on state and public agencies, private…

To treat or not to treat: puberty suppression in childhood-onset gender dysphoria

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Costa, Rosalia; Carmichael, Polly; Colizzi, Marco

2016-01-01

Puberty suppression using gonadotropin-releasing-hormone analogues (GnRHa) has become increasingly accepted as an intervention during the early stages of puberty (Tanner stage 2-3) in individuals with clear signs of childhood-onset gender dysphoria. However, lowering the age threshold for using medical intervention for children with gender dysphoria is still a matter of contention, and is more controversial than treating the condition in adolescents and adults, as children with gender dysphor...

Professional Drift, "Yahweh Complex" Erode J-Education.

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Riley, Sam G.

1979-01-01

Proposes that journalism education in general has been drifting in a strong research current for some years and is at present uncertain how to treat growing opposition by professional journalists to such a research emphasis. (RL)

Disturbances in dental development and craniofacial growth in children treated with hematopoietic stem cell transplantation.

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Vesterbacka, M; Ringdén, O; Remberger, M; Huggare, J; Dahllöf, G

2012-02-01

To investigate the correlation between age, degree of disturbances in dental development, and vertical growth of the face in children treated with hematopoietic stem cell transplantation (HSCT). 39 long-term survivors of HSCT performed in childhood and transplanted before the age of 12, at a mean age of 6.8±3.3 years. Panoramic and cephalometric radiographs were taken at a mean age of 16.2 years. For each patient two age- and sex-matched healthy controls were included. The area of three mandibular teeth was measured and a cephalometric analysis was performed. The mean area of the mandibular central incisor, first and second molar was significantly smaller in the HSCT group, and the vertical growth of the face was significantly reduced, especially in the lower third, compared to healthy controls. A statistically significant correlation between age at HSCT, degree of disturbances in dental development, and vertical growth of the face was found. Children subjected to pre-HSCT chemotherapy protocols had significantly more growth reduction in vertical craniofacial variables compared to children without pre-HSCT chemotherapy. Conditioning regimens including busulfan or total body irradiation had similar deleterious effects on tooth area reduction and craniofacial parameters. The younger the child is at HSCT, the greater the impairment in dental and vertical facial development. This supports the suggestion that the reduction in lower facial height found in SCT children mainly is a result of impaired dental development and that young age is a risk factor for more severe disturbances. © 2012 John Wiley & Sons A/S.

Types of Professional Interactions in Modern Russian Nannies: A Social Psychological Analysis

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Drobysheva T.V.,

2015-09-01

Full Text Available The article describes the concept of the crowd proposed by a Russian lawyer and public The article presents results of a social psychological study of professional interactions in modern Russian nannies. It provides the first ever descriptions of significant interactions between nannies, employers and children. Four types of professional interactions are identified empirically depending on work motivation of nannies. Nannies with an attitude of "the child's older friend" are focused on establishing a close psychological relationship with the child. Their professional interaction with the child can be defined as overprotective. "Nannies-intermediaries" are more aware of their employee status and avoid breaking the psychological distance both with the child and the parents. The choice of interaction strategies in nannies with a "neighbor babysitter" attitude is determined mostly by their desire to gain work experience in their free time. They generally prefer not to establish close relationships with the child. The most professional of all are nannies with an attitude of "servants". They know how to resolve conflicts between children, how to arrange game activities for children, and conform to the requirements set by the parents. However, nannies of this type are more likely to physically suppress the will of the child.

The impact of insecticide-treated school uniforms on dengue infections in school-aged children: study protocol for a randomised controlled trial in Thailand.

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Wilder-Smith, Annelies; Byass, Peter; Olanratmanee, Phanthip; Maskhao, Pongsri; Sringernyuang, Luechai; Logan, James G; Lindsay, Steve W; Banks, Sarah; Gubler, Duane; Louis, Valérie R; Tozan, Yesim; Kittayapong, Pattamaporn

2012-11-15

There is an urgent need to protect children against dengue since this age group is particularly sensitive to the disease. Since dengue vectors are active mainly during the day, a potential target for control should be schools where children spend a considerable amount of their day. School uniforms are the cultural norm in most developing countries, worn throughout the day. We hypothesise that insecticide-treated school uniforms will reduce the incidence of dengue infection in school-aged children. Our objective is to determine the impact of impregnated school uniforms on dengue incidence. A randomised controlled trial will be conducted in eastern Thailand in a group of schools with approximately 2,000 students aged 7-18 years. Pre-fabricated school uniforms will be commercially treated to ensure consistent, high-quality insecticide impregnation with permethrin. A double-blind, randomised, crossover trial at the school level will cover two dengue transmission seasons. Practical issues and plans concerning intervention implementation, evaluation, analysing and interpreting the data, and possible policy implications arising from the trial are discussed. clinicaltrial.gov. NCT01563640.

Reframing Children's Spaces

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Duncan, Sandra

2011-01-01

Like professional photographers, early childhood teachers can reframe their perspectives to create innovative and inspiring spaces for young children by concentrating on reframing two design elements: color and texture. When thinking about designing spaces for young children, one of the first considerations is the equipment and its arrangement.…

Stereotyping and nurses' recommendations for treating pain in hospitalized children.

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Griffin, Ruth A; Polit, Denise F; Byrne, Mary W

2007-12-01

The purpose of this study was to examine whether nurses' recommendations for managing children's pain were influenced by stereotypes based on children's personal attributes. Three vignettes, in which hospitalized children's sex, race, and attractiveness were experimentally manipulated, were mailed to a national random sample of 700 pediatric nurses; 334 nurses responded. Responses to vignette questions indicated little evidence of stereotyping. Nurses perceived similar levels of pain and recommended similar pain treatments, regardless of sex, race, and attractiveness. Nurses, on average, perceived children's pain at levels consistent with the children's self-reports and recommended assertive analgesic and non-pharmacologic pain management strategies. The results appear consistent with prevailing views on providing adequate pain treatment for children.

Parent and Professional Perceptions of Inclusion in Childcare: A Literature Review

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Weglarz-Ward, Jenna M.; Santos, Rosa Milagros

2018-01-01

Many families seek quality, inclusive care for their young children with disabilities. A key to successful inclusion is understanding the needs of families and professionals who serve them. This review examined literature about the inclusion of young children with disabilities in childcare programs and collaboration among early childhood…

Impact of a school-based pediatric obesity prevention program faciliated by health professionals

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This study evaluated a school-based obesity intervention for elementary school children (N=835) where health professionals assisted teachers with the integration of healthy messages into the school curriculum. Schools were randomized into a professional-facilitated intervention (PFI; N=4) or a self-...

Can a Dietary Supplement Treat a Concussion? No!

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... such purposes. These products are sold on the Internet and at various retail outlets, and marketed to consumers using social media, including Facebook and Twitter. One common ... long-term impact of concussions on professional athletes and children who ...

The feasibility, perceived satisfaction, and value of using synchronous webinars to educate clinical research professionals on reporting adverse events in clinical trials: a report from the Children's Oncology Group.

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Borgerson, Dawn; Dino, Jennifer

2012-01-01

Clinical research professionals are faced with decreased funding and increased workloads; innovative methods of professional development programs are necessary to accommodate these factors. This study evaluated the feasibility, perceived satisfaction, and value of using webinars to educate clinical research professionals on reporting adverse events commonly experienced in pediatric oncology clinical trials. The setting incorporated synchronous web-based educational technology. Constructivist learning provides the theoretical framework for this study. Participants evaluated the professional development program at 2 time points: (a) at the conclusion and (b) 4 to 6 weeks afterward, using survey method. Synchronous webinars were both economical and effective in educating clinical research professionals across institutional sites. Participants reported exceptionally high levels of satisfaction with the accessibility, scope, quality, and interactivity of the professional development program. The vast majority of participants reported that the education would assist with reporting adverse events in pediatric oncology clinical trials and this perception persisted into clinical practice. Although the results of this study were intended to guide future educational efforts of the Children's Oncology Group, they may also apply to other cooperative groups.

Music therapy and music medicine for children and adolescents.

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Yinger, Olivia Swedberg; Gooding, Lori

2014-07-01

This article summarizes the research on music therapy and music medicine for children and adolescents with diagnoses commonly treated by psychiatrists. Music therapy and music medicine are defined, effects of music on the brain are described, and music therapy research in psychiatric treatment is discussed. Music therapy research with specific child/adolescent populations is summarized, including disorders usually diagnosed in childhood, substance abuse, mood/anxiety disorders, and eating disorders. Clinical implications are listed, including suggestions for health care professionals seeking to use music medicine techniques. Strengths and weaknesses of music therapy treatment are discussed, as well as areas for future research. Published by Elsevier Inc.

High-Flow, Heated, Humidified Air Via Nasal Cannula Treats CPAP-Intolerant Children With Obstructive Sleep Apnea

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Hawkins, Stephen; Huston, Stephanie; Campbell, Kristen; Halbower, Ann

2017-01-01

Study Objectives: Continuous positive airway pressure (CPAP) is effective but challenging for children with obstructive sleep apnea (OSA). High-flow air via open nasal cannula (HFNC) as treatment in children remains controversial. We report the efficacy of HFNC in children with OSA and CPAP intolerance, a titration protocol, and a discussion of potential mechanisms. Methods: Patients aged 1 to 18 years with OSA (defined by obstructive apnea-hypopnea index [OAHI] greater than 1 event/h) and CPAP intolerance were enrolled. Routine polysomnography data obtained during 1 night wearing HFNC was compared with diagnostic data by Wilcoxon rank-sum test. Results: Ten school-age subjects (representing all patients attempting HFNC at our institution to date) with varied medical conditions, moderate to severe OSA, and CPAP intolerance wore HFNC from 10 to 50 L/min of room air with oxygen supplementation if needed (room air alone for 6 of the 10). HFNC reduced median OAHI from 11.1 events/h (interquartile range 8.7–18.8 events/h) to 2.1 events/h (1.7–2.2 events/h; P = .002); increased oxyhemoglobin saturation (SpO2) mean from 91.3% (89.6% to 93.5%) to 94.9% (92.4% to 96.0%; P Hawkins S, Huston S, Campbell K, Halbower A. High-flow, heated, humidified air via nasal cannula treats CPAP-intolerant children with obstructive sleep apnea. J Clin Sleep Med. 2017;13(8):981–989. PMID:28728621

Immunizing Children

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Geraldine Jody Macdonald

2014-11-01

Full Text Available This article addresses the complex contexts within which Canadian health professionals engage in immunizing children and focuses on the Canadian practice guidelines and current scientific evidence that direct Canadian health professional competencies. The article begins by presenting two current global vaccine initiatives and links these to immunization in Canada. A selected literature review identifies current best immunization practices. With the purpose of promoting quality improvement, three key Canadian immunization competencies for health professional are highlighted: communication with parents, including those who are experiencing vaccine hesitancy; administration of immunizing agents; and documentation of immunizations. Health professionals are encouraged to reflect on immunization competencies and ensure evidence-based practices underpin vaccine delivery in their primary care settings.

Healthcare professionals' perceptions of the ethical climate in paediatric cancer care.

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Bartholdson, Cecilia; Sandeberg, Margareta Af; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2016-12-01

How well ethical concerns are handled in healthcare is influenced by the ethical climate of the workplace, which in this study is described as workplace factors that contribute to healthcare professionals' ability to identify and deal with ethical issues in order to provide the patient with ethically good care. The overall aim of the study was to describe perceptions of the paediatric hospital ethical climate among healthcare professionals who treat/care for children with cancer. Data were collected using the Hospital Ethical Climate Survey developed by Olsson as a separate section in a questionnaire. Descriptive statistics were used to analyse perceptions of the ethical climate. Participants and research context: Physicians, nurses and nurse-aides (n = 89) from three paediatric units participated in this study: haematology/oncology, chronic diseases and neurology. Ethical considerations: The study was approved by the regional ethical review board. Different perceptions of the ethical climate were rated as positive or negative/neutral. Nurses' ratings were less positive than physicians on all items. One-third of the participants perceived that they were able to practice ethically good care as they believed it should be practised. Differences in professional roles, involving more or less power and influence, might explain why physicians and nurses rated items differently. A positive perception of the possibility to practice ethically good care seems to be related to inter-professional trust and listening to guardians/parents. A negative/neutral perception of the possibility to practice ethically good care appears to be influenced by experiences of ethical conflicts as well as a lack of ethical support, for example, time for reflection and discussion. The two-thirds of participants who had a negative/neutral perception of the possibility to practice ethically good care are at risk of developing moral stress. Clinical ethics support needs to be implemented in care

IDENTIFYING AUTISM IN CHILDREN WITH BLINDNESS AND VISUAL IMPAIRMENTS

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Ana VELJANOVSKA

2000-06-01

Full Text Available Often in working with children with blindness or visual impairments we are enchanting children with some specific stereotype behaviors, identified as "blindizms”. Parents and professionals noted that many of these behaviors are the same as or similar to those behaviors seen in students with autism. These similarities led professionals to pursue more information about autism and its relationship to blindness. To assist in this process the professionals from Oregon School for the blind developed some guidelines to compare the characteristics observed in children with blindness and autism alone, across four domains: language and communication, relating to people, discrepancies in developmental rates and responses to sensory stimuli.

Interventions for treating obesity in children

NARCIS (Netherlands)

Oude Luttikhuis, Hiltje; Baur, Louise; Jansen, Hanneke; Shrewsbury, Vanessa A.; O'Malley, Claire; Stolk, Ronald P.; Summerbell, Carolyn D.

2009-01-01

Background Child and adolescent obesity is increasingly prevalent, and can be associated with significant short- and long-term health consequences. Objectives To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood. Search strategy We searched CENTRAL

Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program

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Melkamu Merid Mengesha

2016-07-01

Full Text Available Background: The outpatient therapeutic care program (OTP of children with severe acute malnutrition (SAM has been decentralized to health post level in Ethiopia since 2008–2009. However, there is a lack of evidence regarding treatment outcomes and factors related to the duration of stay on treatment after its decentralization to health post level. Objective: This study was aimed to assess treatment outcome and factors affecting time to recovery in children with SAM treated at OTP. Design: Health facility–based retrospective cohort study was conducted using data from 348 patient cards. The outcome variable was time to recovery. Descriptive analysis was done using percentages for categorical data and mean/median for continuous variables. A robust method of analyzing time to event data, the Cox proportional-hazard regression, was used. All statistical tests in this study are declared significant at p<0.05. Result: 89.1% of children with kwashiorkor and 69.4% of children with marasmus were recovered. Of the total children studied, 22% were readmitted cases. The median time of recovery was 35 days for children with kwashiorkor and 49 days for children with marasmus. Children older than 3 years were 33% less likely to achieve nutritional recovery [adjusted hazard ratio, AHR=0.67, 95% confidence interval, CI (0.46, 0.97]. Similarly, marasmic children stayed longer on treatment [AHR=0.42, 95% CI (0.32, 0.56]. However, children who gained Mid-Upper Arm Circumference (MUAC ≥ 0.24 mm/day were 59% more likely to recover faster [AHR=1.59, 95% CI (1.23, 2.06]. Conclusions: Close monitoring of weight and MUAC gain to assess nutritional improvement with due emphasis given to children with lower admission weight, children of age 3 years and above and marasmic children will have a positive effect on treatment duration and outcome.

Possible adverse events in children treated by manual therapy: a review

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Humphreys B Kim

2010-06-01

Full Text Available Abstract Background Pediatric manual therapy is controversial within the medical community particularly with respect to adverse events. Pediatric manual therapy (Ped MT is commonly used by a number of professions such as chiropractors, osteopaths and naturopaths for a variety of treatments in children. Ped MT interventions range from advice, light touch, massage, through to mobilisation and high velocity spinal manipulation. However, current evidence related to adverse events associated with Ped MT is not well understood. Objective To update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation. Methods A review of the clinical research literature from June 2004 until January 2010 as reported in MEDLINE, PubMed and PubMed Central for adverse events specifically related to the treatment of pediatric cases by manual therapy. Results Only three new clinical studies, one systematic review with meta-analysis and one evidence report were identified. Two clinical studies reported on chiropractic care and one on osteopathic spinal manipulation in children. The systematic review investigated all studies of adverse events and manual therapy and was not specific for pediatric patients. The evidence review focused on effectiveness of spinal manipulation in a variety of musculoskeletal conditions. No serious or catastrophic adverse events were reported in the clinical studies or systematic review. However for adults, it has been estimated that between 0.003% and 0.13% of manual therapy treatments may result in a serious adverse event. Although mild to moderate adverse events are common in adults, an accurate estimate from high quality pediatric studies is currently not available. Conclusions There is currently insufficient research evidence related to adverse events and manual therapy. However, clinical studies and systematic reviews from adult

Relationships between oncohematopediatrics, mothers and children in communicating bad news.

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Afonso, Selene Beviláqua Chaves; Minayo, Maria Cecília de Souza

2017-01-01

We present a study about the relations between pediatric oncological haematologists, mothers, and children in sharing bad news (BN) in a public hospital in Rio de Janeiro. The text emphasizes the intertwining of technique and emotions for the treatment of children with diagnoses in which the fatal outcome is always a probability. We used a qualitative approach, privileging participant observation and open interviews with oncologists (at this service all professionals were female) and mothers. We sought to understand the importance of communication which includes expressions and control of emotions; bioethical issues that require sensitivity, serenity, and truth about approaching the end of life; and how the professionals balance proximity to children and families and objectivity in their activity. The main results showed: intense exchanges on BN among professionals; relapse of children who were evolving positively as the most difficult news; constant update of BN facing terminally ill children; quality of communication influencing the treatment; professionals permanently balancing between closeness and distance from patients and evidence of the their irreplaceable role to secure the family and the child.

Long-term brain structural magnetic resonance imaging and cognitive functioning in children treated for acute lymphoblastic leukemia with high-dose methotrexate chemotherapy alone or combined with CNS radiotherapy at reduced total dose to 12 Gy

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Zajac-Spychala, Olga; Pilarczyk, Jakub; Derwich, Katarzyna; Wachowiak, Jacek [Poznan University of Medical Sciences, Department of Pediatric Oncology, Hematology and Transplantology, Poznan (Poland); Pawlak, Mikolaj A. [Poznan University of Medical Sciences, Department of Neurology and Cerebrovascular Disorders, Poznan (Poland); Karmelita-Katulska, Katarzyna [Poznan University of Medical Sciences, Department of Neuroradiology, Poznan (Poland)

2017-02-15

The aim of this study was to assess the long-term side effects of central nervous system prophylaxis (high-dose chemotherapy alone vs chemotherapy and CNS radiotherapy) according to the ALL IC-BFM 2002. Thirty-tree children aged 6.7-19.9 years have been studied. The control group consisted of 12 children newly diagnosed with acute lymphoblastic leukemia. We assessed subcortical gray matter volume using automatic MRI segmentation and cognitive performance to identify differences between two therapeutic schemes and patients prior to treatment. Patients treated with chemotherapy and CNS radiotherapy had smaller hippocampi than two other subgroups and lower IQ score than patients treated with chemotherapy alone. Both treated groups, whether with chemotherapy only or in combination with CNS radiotherapy, had significantly lower volumes of caudate nucleus and performed significantly worse on measures of verbal fluency in comparison with patients prior to treatment. There were no differences in the mean volumes of total white matter, total gray matter, thalamus, putamen, and amygdala between the studied groups. In all children treated according to the ALL IC-BFM 2002 with high-dose chemotherapy, both decreased volume of selected subcortical structures and cognitive impairment was observed, especially in children who received chemotherapy in combination with reduced dose CNS radiotherapy. In all children treated according to the ALL IC-BFM 2002 with high-dose chemotherapy, both decreased volume of selected subcortical structures and cognitive impairment were observed, especially in children who received chemotherapy in combination with CNS radiotherapy. (orig.)

Long-term brain structural magnetic resonance imaging and cognitive functioning in children treated for acute lymphoblastic leukemia with high-dose methotrexate chemotherapy alone or combined with CNS radiotherapy at reduced total dose to 12 Gy

International Nuclear Information System (INIS)

Zajac-Spychala, Olga; Pilarczyk, Jakub; Derwich, Katarzyna; Wachowiak, Jacek; Pawlak, Mikolaj A.; Karmelita-Katulska, Katarzyna

2017-01-01

The aim of this study was to assess the long-term side effects of central nervous system prophylaxis (high-dose chemotherapy alone vs chemotherapy and CNS radiotherapy) according to the ALL IC-BFM 2002. Thirty-tree children aged 6.7-19.9 years have been studied. The control group consisted of 12 children newly diagnosed with acute lymphoblastic leukemia. We assessed subcortical gray matter volume using automatic MRI segmentation and cognitive performance to identify differences between two therapeutic schemes and patients prior to treatment. Patients treated with chemotherapy and CNS radiotherapy had smaller hippocampi than two other subgroups and lower IQ score than patients treated with chemotherapy alone. Both treated groups, whether with chemotherapy only or in combination with CNS radiotherapy, had significantly lower volumes of caudate nucleus and performed significantly worse on measures of verbal fluency in comparison with patients prior to treatment. There were no differences in the mean volumes of total white matter, total gray matter, thalamus, putamen, and amygdala between the studied groups. In all children treated according to the ALL IC-BFM 2002 with high-dose chemotherapy, both decreased volume of selected subcortical structures and cognitive impairment was observed, especially in children who received chemotherapy in combination with reduced dose CNS radiotherapy. In all children treated according to the ALL IC-BFM 2002 with high-dose chemotherapy, both decreased volume of selected subcortical structures and cognitive impairment were observed, especially in children who received chemotherapy in combination with CNS radiotherapy. (orig.)

Eugenia uniflora Dentifrice for Treating Gingivitis in Children: Antibacterial Assay and Randomized Clinical Trial.

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Jovito, Vanessa de Carvalho; Freires, Irlan Almeida; Ferreira, Danilo Augusto de Holanda; Paulo, Marçal de Queiroz; Castro, Ricardo Dias de

2016-01-01

School-age children are frequently at high risk for the onset of biofilm-dependent conditions, including dental caries and periodontal diseases. The objective of this study was to evaluate the clinical efficacy of a dentifrice containing Eugenia uniflora Linn. (Surinam cherry) extract versus a triclosan-based comparator in treating gingivitis in children aged 10-12 years. The in vitro antibacterial potential of the dentifrice was tested against oral pathogens (Streptococcus mutans, Streptococcus oralis and Lactobacillus casei). Then a phase-II clinical trial was conducted with 50 subjects aged 10-12 years, with clinical signs of gingivitis. The subjects were randomly assigned to the experimental group (n=25) and control group (n=25), in which participants used the experimental dentifrice and a triclosan-based fluoridated dentifrice (Colgate Total 12(r)), respectively. Clinical examinations assessed the presence of gingivitis (primary outcome) and biofilm accumulation (secondary outcome) using the Gingival-Bleeding Index (GBI) and Simplified Oral Hygiene Index (OHI-S), respectively, at baseline and after seven days of tooth brushing 3x/day. The data were analyzed using paired and unpaired t-test (GBI) and Wilcoxon and Mann-Whitney (OHI-S), with p≤0.05. The experimental dentifrice showed efficient antibacterial activity in vitro. In the clinical trial, a significant reduction in gingival bleeding was observed in both experimental and control groups (puniflora dentifrice showed anti-gingivitis properties in children aged 10-12 years. Thus, it may be a potentially efficient and safe product to be used alternatively in preventive dental practice.

Barriers and facilitators of sports in children with physical disabilities : a mixed-method study

NARCIS (Netherlands)

Jaarsma, Eva A.; Dijkstra, Pieter U.; de Blecourt, Alida C. E.; Geertzen, Jan H. B.; Dekker, Rienk

2015-01-01

Purpose: This study explored barriers and facilitators of sports participation of children with physical disabilities from the perspective of the children, their parents and their health professionals. Method: Thirty children and 38 parents completed a questionnaire, and 17 professionals were

Comparison of long-term outcome between white and Vietnamese children treated for acute lymphoblastic leukemia according to the FRALLE 2000 protocol.

Science.gov (United States)

Vu Hoang, Phuong Thu; Ambroise, Jérôme; Dang Chi, Vu Luan; Dekairelle, Anne-France; Dupont, Sophie; Huynh, Nghia; Nguyen, Tan Binh; Robert, Annie; Gala, Jean-Luc; Vermylen, Christiane

2014-10-01

To compare the relapse-free survival (RFS) in Vietnamese (n=141) and white (n=94) children living in Vietnam and Belgium, respectively, and treated in their own country for acute lymphoblastic leukemia according to the same FRALLE 2000 protocol. RFS was significantly worse in Vietnamese children (hazards ratio=4.48; 95% confidence interval [CI], 2.16-9.3; PVietnamese children, respectively. In the latter group, relapses occurred in bone marrow and cerebrospinal fluid at a much earlier stage. The outcome was compared at first relapse only because of different treatments afterward, according to the country. Both series were similar for sex, age at diagnosis, initial white blood cell count, cytogenetic abnormalities, and corticosensitivity at day 8. Higher frequency of L2-acute lymphoblastic leukemia (PVietnamese children. Several factors may contribute to the poor RFS in Vietnamese children, which include the time interval before the first intrathecal therapy and differences in the management of drug-related toxicity. However, additional contribution of socioeconomic factors and/or variations in pharmacogenetic polymorphisms in Vietnamese patients cannot currently be ruled out.

Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals’ challenges

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2018-01-01

Background The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children. Aim To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics. Setting The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa. Methodology The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell’s data analysis spiral. We used Lincoln and Guba’s model to ensure trustworthiness. Ethical standards were applied. Results Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level. Conclusion Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level. PMID:29781680

Isolated olecranon fractures in children affected by osteogenesis imperfecta type I treated with single screw or tension band wiring system: Outcomes and pitfalls in relation to bone mineral density.

Science.gov (United States)

Persiani, Pietro; Ranaldi, Filippo M; Graci, Jole; De Cristo, Claudia; Zambrano, Anna; D'Eufemia, Patrizia; Martini, Lorena; Villani, Ciro

2017-05-01

The purpose of this study is to compare the results of 2 techniques, tension band wiring (TBW) and fixation with screws, in olecranon fractures in children affected with osteogenesis imperfecta (OI) type I. Between 2010 and 2014, 21 olecranon fractures in 18 children with OI (average age: 12 years old) were treated surgically. Ten patients were treated with the screw fixation and 11 with TBW. A total of 65% of olecranon fractures occurred as a result of a spontaneous avulsion of the olecranon during the contraction of the triceps muscle. The average follow-up was 36 months. Among the children treated with 1 screw, 5 patients needed a surgical revision with TBW due to a mobilization of the screw. In this group, the satisfactory results were 50%. In patients treated with TBW, the satisfactory results were 100% of the cases. The average Z-score, the last one recorded in the patients before the trauma, was -2.53 in patients treated with screw fixation and -2.04 in those treated with TBW. TBW represents the safest surgical treatment for patients suffering from OI type I, as it helps to prevent the rigidity of the elbow through an earlier recovery of the range of motion, and there was no loosening of the implant. In analyzing the average Z-score before any fracture, the fixation with screws has an increased risk of failure in combination with low bone mineral density.

Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

LENUS (Irish Health Repository)

Moorhead, Anne

2011-03-31

Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices\\/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups\\' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland. Methods\\/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices\\/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals\\' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices\\/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

Directory of Open Access Journals (Sweden)

Murphy Kathy

2011-03-01

Full Text Available Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a community related public health nurses; (b school public health nurses; (c GPs and practice nurses (primary care; and (d occupational health nurses (workplace from both Northern Ireland and the Republic of Ireland. Methods/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

Learning Among Children with Spina Bifida

Science.gov (United States)

SBA National Resource Center: 800-621-3141 Learning Among Children with Spina Bifida Overview Parents, teachers and health care professionals have observed that children with Spina Bilda have problems with motor ...

Use of insecticide-treated mosquito nets for children under five years in an urban area of Lagos State, Nigeria.

Science.gov (United States)

Okafor, I P; Odeyemi, K A

2012-01-01

Insecticide-treated nets (ITNs) have proven to be one of the most effective means of reducing malaria morbidity and mortality in children and pregnant women. This study is carried out to determine the practice and determinants of ITN use for children under five years among care givers in an urban area of Lagos State. A community-based, cross sectional study was carried out in Lagos State in April 2007 among three hundred and forty (340) care givers primarily responsible for child care at home. They were selected by a multi-stage sampling method using a pre-tested, interviewer-administered, structured questionnaire. ITN use rate for under-fives was high (61.8%) and this was significantly determined by care giver's marital status (P level of care giver and occupation of head of the household were not significant determinants. There is need for health campaigns on ITNs targeted at unmarried care givers of young children. In addition, we also recommend social marketing of modern family planning methods to reduce family size, thereby increasing chances of ITN use among children less than five years to reduce malaria burden.

The impact of insecticide-treated school uniforms on dengue infections in school-aged children: study protocol for a randomised controlled trial in Thailand

Directory of Open Access Journals (Sweden)

Wilder-Smith Annelies

2012-11-01

Full Text Available Abstract Background There is an urgent need to protect children against dengue since this age group is particularly sensitive to the disease. Since dengue vectors are active mainly during the day, a potential target for control should be schools where children spend a considerable amount of their day. School uniforms are the cultural norm in most developing countries, worn throughout the day. We hypothesise that insecticide-treated school uniforms will reduce the incidence of dengue infection in school-aged children. Our objective is to determine the impact of impregnated school uniforms on dengue incidence. Methods A randomised controlled trial will be conducted in eastern Thailand in a group of schools with approximately 2,000 students aged 7–18 years. Pre-fabricated school uniforms will be commercially treated to ensure consistent, high-quality insecticide impregnation with permethrin. A double-blind, randomised, crossover trial at the school level will cover two dengue transmission seasons. Discussion Practical issues and plans concerning intervention implementation, evaluation, analysing and interpreting the data, and possible policy implications arising from the trial are discussed. Trial registration clinicaltrial.gov. Registration number: NCT01563640

A Mobile Early Stimulation Program to Support Children with Developmental Delays in Brazil.

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Dias, Raquel da Luz; Silva, Kátia Cristina Correa Guimarães; Lima, Marcela Raquel de Oliveira; Alves, João Guilherme Bezerra; Abidi, Syed Sibte Raza

2018-01-01

Developmental delay is a deviation development from the normative milestones during the childhood and it may be caused by neurological disorders. Early stimulation is a standardized and simple technique to treat developmental delays in children (aged 0-3 years), allowing them to reach the best development possible and to mitigate neuropsychomotor sequelae. However, the outcomes of the treatment depending on the involvement of the family, to continue the activities at home on a daily basis. To empower and educate parents of children with neurodevelopmental delays to administer standardized early stimulation programs at home, we developed a mobile early stimulation program that provides timely and evidence-based clinical decision support to health professionals and a personalized guidance to parents about how to administer early stimulation to their child at home.

Perceptions of healthcare professionals regarding their own body ...

African Journals Online (AJOL)

reported that older people tend to misperceive their body weight ... To determine healthcare professionals' perceptions of their own body .... 60 years) than younger participants (20 - 30 years) being obese .... Some cultural attitudes lead to women .... risk, nutritional status and refugee children from sub-Saharan Africa.

Do On-site Mental Health Professionals Change Pediatricians’ Responses to Children’s Mental Health Problems?

Science.gov (United States)

Horwitz, Sarah McCue; Storfer-Isser, Amy; Kerker, Bonnie D.; Szilagyi, Moira; Garner, Andrew S.; O’Connor, Karen G.; Hoagwood, Kimberly E.; Green, Cori M.; Foy, Jane M.; Stein, Ruth E.K.

2016-01-01

Objective The objectives were to: assess the availability of on-site mental health professionals (MHP) in primary care; examine practice/pediatrician characteristics associated with on-site MHPs; and determine whether presence of on-site MHPs is related to pediatricians’ co-managing or more frequently identifying, treat/managing or referring MH problems. Methods Analyses included AAP members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (N=321). Measures included socio-demographics, practice characteristics, questions on about on-site MHPs, co-management of MH problems and pediatricians’ behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate and multivariable analyses were performed. Results Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools/universities/HMOs, <100 visits/week, <80% of patients privately insured), and interactions of practice location (urban) with visits and patient insurance, were associated with on-site MHPs. There was no overall association between co-location and co-management or whether pediatricians usually identified, treat/managed or referred 5 common child MH problems. Among the subset of pediatricians who reported co-managing there was an association with co-management when the on-site MHP was a child psychiatrist, SA counselor, or social worker. Conclusions On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who co-manage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, SA counselor, or social worker. Overall, on-site MHPs were not associated with co-management or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems. PMID:27064141

Nutritional assessment and lipid profile in HIV-infected children and adolescents treated with highly active antiretroviral therapy

Directory of Open Access Journals (Sweden)

Marina Hjertquist Tremeschin

2011-06-01

Full Text Available INTRODUCTION: HIV-infected children and adolescents treated with highly active antiretroviral therapy (HAART regimens that include a protease inhibitor (PI can show significant improvements in clinical outcomes, nutritional status and quality of life. The study aimed to report nutritional and metabolic alterations for pediatric patients continuously exposed to HAART and for healthy controls for up to 1 year. METHODS: Clinical, anthropometric, lipid profile and food intake data were collected prospectively over approximately 12-months for each patient. RESULTS: Fifty-one individuals were studied, of these, 16 were healthy. After 12 months follow-up, HIV-positive individuals remained below the healthy control group parameters. No change was observed concerning food intake. Triglyceride serum levels were higher in patients using protease inhibitor at the onset of the study [PI groups: 114 (43 - 336, and 136 (63 - 271 versus control group: 54.5 (20 - 162; p = 0.003], but after twelve months follow-up, only the group using protease inhibitor for up to two months presented higher values [140 (73 - 273 versus 67.5 (33 - 117; p = 0.004]. HDL-cholesterol was lower in HIV-positive individuals [HIV-positive groups: 36 (27 - 58 and 36 (23 - 43; control 49.5 (34 - 69; p = 0.004]. CONCLUSIONS: HIV-infected children and adolescents treated with highly active antiretroviral therapy showed compromised nutritional parameters compared to a paired healthy control group. Individuals using protease inhibitor presented worse triglyceride serum levels compared to their healthy counterparts.

Professional Conversations with Children in Divorce-Related Child Welfare Inquiries

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van Nijnatten, Carolus; Jongen, Esli

2011-01-01

Over the last few decades, the role of children in conversations about post-divorce arrangements has become more prominent. Children are approached as active participants in the (post-)divorce process rather than just victims of matrimonial and post-matrimonial discord. In accordance with the UN Convention on the Rights of the Child, children have…

Second cancers in children treated with modern radiotherapy techniques

International Nuclear Information System (INIS)

Schneider, Uwe; Lomax, Antony; Timmermann, Beate

2008-01-01

Background and Purpose: The scattered radiation from the treatment volume might be more significant for children than for adults and, as a consequence, modern radiotherapy treatment techniques such as IMRT and passive proton therapy could potentially increase the number of secondary cancers. In this report, secondary cancer risk resulting from new treatment technologies was estimated for an adult prostate patient and a child. Material and methods: The organ equivalent dose (OED) concept with a linear-exponential, a plateau and a linear dose-response curve was applied to dose distributions of an adult prostate patient and a child with a rhabdomyosarcoma of the prostate. Conformal radiotherapy, IMRT with 6 MV photons and proton therapy were planned. OED (cancer risk) was estimated for the whole body, the rectum and the bladder. In addition, relative cumulative risk was calculated. Results: Secondary cancer risk in the adult is not more than 15% it increased when IMRT or passive proton therapy was compared to conventional treatment planning. In the child, risk remains practically constant or was even reduced for proton therapy. The cumulative risk in the child relative to that in the adult can be as large as 10-15. Conclusions: By a comparison between an adult patient and a child treated for a disease of the prostate, it was shown that modern radiotherapy techniques such as IMRT and proton therapy (active and passive) do not increase the risk for secondary cancers

Impact of a School-Based Pediatric Obesity Prevention Program Facilitated by Health Professionals

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Johnston, Craig A.; Moreno, Jennette P.; El-Mubasher, Abeer; Gallagher, Martina; Tyler, Chermaine; Woehler, Deborah

2013-01-01

Background: This study evaluated a school-based obesity intervention for elementary school children (N = 835) where health professionals assisted teachers with the integration of healthy messages into the school curriculum. Methods: Schools were randomized into a professional-facilitated intervention (PFI; N = 4) or a self-help (SH; N = 3)…

Acute and preventive management of anaphylaxis in German primary school and kindergarten children.

Science.gov (United States)

Kilger, Magdalena; Range, Ursula; Vogelberg, Christian

2015-10-15

Anaphylaxis is a severe, life-threatening situation. However, little is known about real-life anaphylactic management in children, especially in kindergarten and school settings, where a large number of anaphylaxes take place. Parents, school teachers and child-care providers of 86 primary schools and kindergartens in the city of Dresden, Germany, received questionnaires to report their experience with anaphylaxis in children. The main foci of interest were symptoms, allergens, sites of occurrence, acute treatment and emergency sets. Out of 6352 returned questionnaires, 87 cases of anaphylaxis were identified. Prevalence was calculated at 1.5%. Average age of the patients was 7 years, 58% were boys. The majority of reactions occurred at home (67%/58 children). Fourty seven percent (41 children) had recurrent episodes of anaphylaxis. Eighty two percent (71 children) showed cutaneous symptoms, 40% (35 children) respiratory symptoms, 29% (25 children) gastrointestinal symptoms, and 3.4% (3 children) cardiovascular symptoms. Fourty seven percent were classified as mild reactions. Foods were the most common cause (60%/52 cases). Out of these 52, tree-nuts (23%/12 cases) and peanuts (16%/8 cases) were the most frequent triggers. Sixty percent (52 cases) of reactions were treated by a physician, 35% (30 cases) were treated by non-medical professionals only. Fifty one percent (44 children) received antihistamines, 37% (32 children) corticosteroids, 1% (1 child) intramuscular adrenaline. Sixty one percent of children (53 cases) received an emergency kit. Content were corticosteroids (70%/37 cases) and antihistamines (62%/33 cases). Adrenaline auto-injectors were prescribed to 26% (14 cases). Concerning school and kindergarten-staff, 13% of the child-care providers had no knowledge about the emergency kit's content, compared to 34% of teachers. This study might support the impression of severe under-treatment of anaphylactic children in the use of adrenaline and prescription

Treating cerebral palsy with aculaser therapy

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Anwar, Shahzad; Nazir Khan, Malik M.; Nadeem Khan, Malik M.; Qazi, Faiza M.; Awan, Abid H.; Dar, Irfan

2008-03-01

A single, open and non comparative study was conducted at Anwar Shah Trust for C.P. & Paralysis in collaboration with the Departments of Neurology and Neurosurgery, Children Hospital Lahore, Pakistan to evaluate the effects of ACULASER THERAPY in childern suffering from Cerebral Palsy (C.P.) and associated Neurological Disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, diplegia, quadriplegia, monoplegia, sensory-neural deafness and speech disorders. In all 250 childern were treated and the data was gathered during a period of 3 years from December 2003 till December 2006. These children were further classified according to the type of C.P. (spastic, athetoid, mixed) they suffered from and associated Neurological Disorders. This article shows results in C.P. childern who were treated with ACULASER THERAPY for minimum 6 weeks and more or had minimum of 15 treatment sessions and more. This article also shows that those childern who were given a break in the treatment for 1 month to 1 year did not show any reversal of the signs and symptoms. Analysis of the data showed that out of 171 children with Spasticity and Stiffness 147 showed marked improvement showing 87% success rate, out of 126 children with Epileptic fits, there was a significant reduction in the intensity, frequency and duration of Epileptic fits in 91 children showing 72% success rate, out of 48 children with Cortical Blindness 30 children showed improvement accounting for 63% efficacy rate, out of 105 children with Hearing Difficulties, 63 showed marked improvement accounting for 60% improvement rate, out of 190 children with Speech Disorders 122 showed improvement reflecting 64% improvement rate, out of 96 children with Hemiplegia 71 showed improvement in movement, tone and power accounting for 74% improvement rate, out of 76 children with Quadriplegia 52 showed improvement in gross and fine motor functions showing 69% success rate and out of 58 children with Paraplegia of

A systematic review of interactive multimedia interventions to promote children’s communication with health professionals: implications for communicating with overweight children

Science.gov (United States)

2014-01-01

Background Interactive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes. Methods An extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11-years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods. Results A total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children’s health-related self-efficacy, which could make them more able partners in face-to-face communications with health professionals. Conclusions The findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research

Specially formulated foods for treating children with moderate acute malnutrition in low- and middle-income countries.

Science.gov (United States)

Lazzerini, Marzia; Rubert, Laura; Pani, Paola

2013-06-21

Moderate acute malnutrition, also called moderate wasting, affects around 10% of children under five years of age in low- and middle-income countries. There are different approaches to addressing malnutrition with prepared foods in these settings; for example, providing lipid-based nutrient supplements or blended foods, either a full daily dose or in a low dose as a complement to the usual diet. There is no definitive consensus on the most effective way to treat children with moderate acute malnutrition. To evaluate the safety and effectiveness of different types of specially formulated foods for children with moderate acute malnutrition in low- and middle-income countries, and to assess whether foods complying or not complying with specific nutritional compositions, such as the WHO technical specifications, are safe and effective. In October 2012, we searched CENTRAL, MEDLINE, LILACS, CINAHL, BIBLIOMAP, POPLINE, ZETOC, ICTRP, mRCT, and ClinicalTrials.gov. In August 2012, we searched Embase. We also searched the reference lists of relevant papers and contacted nutrition-related organisations and researchers in this field.     We planned to included any relevant randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs), and interrupted time series (ITS) that evaluated specially formulated foods for the treatment of moderate acute malnutrition in children aged between six months and five years in low- and middle-income countries. Two authors assessed trial eligibility and risk of bias, and extracted and analysed the data. We summarised dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses using the random-effects model and assessed heterogeneity. The quality of evidence was assessed using GRADE methods. Eight randomised controlled trials, enrolling 10,037 children, met our

[Evaluation of stents in treating childhood benign esophageal strictures].

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Reinshagen, K; Kähler, G; Manegold, B C; Waag, K-L

2009-01-01

Esophageal stenting is a popular of treatment of esophageal strictures in adults. It has also been described for children with benign strictures who did not respond to standard dilatation therapy. The aim of the study was to evaluate weather esophageal stents could be used safely and effectively in the treatment of benign esophageal strictures in children. From 1993 to 2005 stenting therapy was performed in 12 children with complicated esophageal strictures. Etiologies of the strictures were caustic burns in 9 patients, postoperative strictures due to complicated esophageal atresia in 2 patients and iatrogenic esophageal injury in 1 patient. Esophageal silicon tubi, covered retrievable expandable nitinol and plastic stents were placed endoscopically. The clinical course and the long term follow up were evaluated retrospectively The stents and tubi were placed in all patients without complications and were later removed successfully. 6 patients were treated with a self expanding plastic stent. The plastic stents showed a distinct tendency to migrate but in 5/6 patients esophageal stricture was treated successfully. 3 patients were treated by a covered self expanding nitinol stent. No migration occurred. One patient was asymptomatic after therapy, one required further dilatation therapy and the third had esophageal resection. 3 patients were treated by esophageal tubi. 2 patients required surgery in the follow up, one patient is asymptomatic. The use of stenting devices in children to treat benign esophageal strictures is safe and efficient. The self expanding plastic stents had the best long term results but required high compliance of parents and children due to the tendency of stent migration. Self expanding nitinol stents are more traumatic at the extraction procedure and are useful in patients with low compliance. Recurrence of strictures occurred most often after esophageal tubi possibly due to the lack of radial expansion.

Viewpoint: learning professionalism: a view from the trenches.

Science.gov (United States)

Brainard, Andrew H; Brislen, Heather C

2007-11-01

The authors, medical students immersed in learning professionalism, observe that most of the professionalism literature misses the mark. Their views on professionalism education, although not the result of qualitative research, were gained from four years of conversations with students from a dozen medical schools, plus online student discussions, focus groups, and meetings with supervisors from five schools. The authors propose that the chief barrier to medical professionalism education is unprofessional conduct by medical educators, which is protected by an established hierarchy of academic authority. Students feel no such protection, and the current structure of professionalism education and evaluation does more to harm students' virtue, confidence, and ethics than is generally acknowledged. The authors maintain that deficiencies in the learning environment, combined with the subjective nature of professionalism evaluation, can leave students feeling persecuted, unfairly judged, and genuinely and tragically confused. They recommend that administrators, medical educators, residents, and students alike must show a personal commitment to the explicit professionalism curriculum and address the hidden curriculum openly and proactively. Educators must assure transparency in the academic process, treat students respectfully, and demonstrate their own professional and ethical behavior. Students overwhelmingly desire to become professional, proficient, and caring physicians. They seek professional instruction, good role models, and fair evaluation. Students struggle profoundly to understand the disconnect between the explicit professional values they are taught and the implicit values of the hidden curriculum. Evaluation of professionalism, when practiced in an often unprofessional learning environment, invites conflict and compromise by students that would otherwise tend naturally toward avowed professional virtues.

Health professional perspectives on lifestyle behaviour change in the paediatric hospital setting: a qualitative study.

Science.gov (United States)

Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole

2014-03-13

Research exists examining the challenges of delivering lifestyle behaviour change initiatives in practice. However, at present much of this research has been conducted with primary care health professionals, or in acute adult hospital settings. The purpose of this study was to identify barriers and facilitators associated with implementing routine lifestyle behaviour change brief advice into practice in an acute children's hospital. Thirty-three health professionals (nurses, junior doctors, allied health professionals and clinical support staff) from inpatient and outpatient departments at a UK children's hospital were interviewed about their attitudes and beliefs towards supporting lifestyle behaviour change in hospital patients and their families. Responses were analysed using thematic framework analysis. Health professionals identified a range of barriers and facilitators to supporting lifestyle behaviour change in a children's hospital. These included (1) personal experience of effectiveness, (2) constraints associated with the hospital environment, (3) appropriateness of advice delivery given the patient's condition and care pathway and (4) job role priorities, and (5) perceived benefits of the advice given. Delivery of lifestyle behaviour change advice was often seen as an educational activity, rather than a behaviour change activity. Factors underpinning the successful delivery of routine lifestyle behaviour change support must be understood if this is to be implemented effectively in paediatric acute settings. This study reveals key areas where paediatric health professionals may need further support and training to achieve successful implementation.

Empathy, burnout and... professional competence. Some reflections.

Science.gov (United States)

Vecchi, Carlos

2016-10-01

Disability is a problem that affects more and more children and adolescents. But in the course of our graduate and postgraduate education, we have received practically no training in this regard. A pediatrician is the primary care physician of every child and adolescent, and the above-mentioned lack of training becomes a hurdle in the care provided to children with disabilities. Our idea of diversity is clearly determined by our culture and the social and family environment where we grew up, and is highly influenced by our human and extracurricular development rather than by our medical training. Every course involved in professional training should include a subject on disability. As pediatricians, we should reflect on how we see children with disabilities. Sociedad Argentina de Pediatría.

PROVIDING DENTAL CARE FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

Directory of Open Access Journals (Sweden)

Diana MURARU

2017-06-01

Full Text Available Given the increasing prevalence of autism spectrum disorders, it is realistic to assume that dental professionals are likely to treat individuals with this diagnosis. Understanding the complexities of this disorder and its behavioral manifestations is indispensable for dentists. The present article presents several characteristics of autism spectrum disorder that impact dental interventions, along with medical and behavioral alternatives to better manage the dental problems of children with autism spectrum disorder. A multidisciplinary approach and family support are important for planning a dental intervention for these patients in order to avoid anxiety. Knowledge on autism, the dentist-patient relationship and the individual preparation for dental interventions is useful for constructing a controllable medical experience

Multiprofessional evaluation in clinical practice: establishing a core set of outcome measures for children with cerebral palsy.

Science.gov (United States)

Mäenpää, Helena; Autti-Rämö, Ilona; Varho, Tarja; Forsten, Wivi; Haataja, Leena

2017-03-01

To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework. The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated. The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland. A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. © 2016 Mac Keith Press.

A qualitative case study in the social capital of co-professional collaborative co-practice for children with speech, language and communication needs.

Science.gov (United States)

McKean, Cristina; Law, James; Laing, Karen; Cockerill, Maria; Allon-Smith, Jan; McCartney, Elspeth; Forbes, Joan

2017-07-01

Effective co-practice is essential to deliver services for children with speech, language and communication needs (SLCN). The necessary skills, knowledge and resources are distributed amongst professionals and agencies. Co-practice is complex and a number of barriers, such as 'border disputes' and poor awareness of respective priorities, have been identified. However social-relational aspects of co-practice have not been explored in sufficient depth to make recommendations for improvements in policy and practice. Here we apply social capital theory to data from practitioners: an analytical framework with the potential to move beyond descriptions of socio-cultural phenomena to inform change. Co-practice in a local authority site was examined to understand: (1) the range of social capital relations extant in the site's co-practice; (2) how these relations affected the abilities of the network to collaborate; (3) whether previously identified barriers to co-practice remain; (4) the nature of any new complexities that may have emerged; and (5) how inter-professional social capital might be fostered. A qualitative case study of SLCN provision within one local authority in England and its linked NHS partner was completed through face-to-face semi-structured interviews with professionals working with children with SLCN across the authority. Interviews, exploring barriers and facilitators to interagency working and social capital themes, were transcribed, subjected to thematic analysis using iterative methods and a thematic framework derived. We identified a number of characteristics important for the effective development of trust, reciprocity and negotiated co-practice at different levels of social capital networks: macro-service governance and policy; meso-school sites; and micro-intra-practitioner knowledge and skills. Barriers to co-practice differed from those found in earlier studies. Some negative aspects of complexity were evident, but only where networked

A Systematic Review (SR) of the Effective Continuing Professional Development (CPD) Training of Welfare Professionals

DEFF Research Database (Denmark)

Torgerson, Carole; Nielsen, Chantal Pohl; Gascoine, Louise

2017-01-01

as demonstrated by pre-tests in the outcomes of interest but excluding studies using an instrumental variable approach), including studies using regression discontinuity design. We will search substantively for studies in the fields of education, social welfare and crime and justice.......The quality of the professional development of education and welfare professionals working with children and young people (for example, pre-school teachers or ‘pedagogues’, school teachers, teaching assistants, social workers, psychologists, police officers etc.) is of key importance to policy...... makers and practitioners in these fields. The general wellbeing of a country’s citizens and the provision of better opportunities in terms of educational and social welfare outcomes (for example, participation in higher education and reduction of anti-social behaviour) have been linked to the quality...

Treating the actions of children as sensible

DEFF Research Database (Denmark)

Rasmussen, Gitte; Brouwer, Rineke; Day, Dennis

2011-01-01

In this study, we investigate patterns in interactions between children with communicative disabilities and their parents. The purpose is to demonstrate how, in play activities at home, parents with varying degrees of success make their children’s contributions sensible. A Conversation Analytic...

Long-term effects in children treated with radiotherapy for head and neck rhabdomyosarcoma

International Nuclear Information System (INIS)

Paulino, Arnold C.; Simon, James H.; Zhen Weining; Wen, B.-C.

2000-01-01

Purpose: To examine the long-term effects of treatment in children receiving radiotherapy for head and neck rhabdomyosarcoma. Methods: From 1967 to 1994, a total of 30 children with head and neck rhabdomyosarcoma received megavoltage radiotherapy at one institution. Seventeen patients (57%) have survived and have at least a 5-year follow-up. There were 11 males and 6 females, with a median age of 5.7 years (range 2.2-11.6) at the time of radiotherapy. Tumor location was orbit in 6 patients, infratemporal fossa in 4, paranasal sinuses in 2, and supraglottic larynx in 2; the nasopharynx, pterygopalatine fossa, and parotid gland were sites for the remaining children. All but 2 patients had tumors of embryonal histology. The Intergroup Rhabdomyosarcoma Study (IRS) Group was I in 2, II in 3, and III in 11 children; 1 patient had a recurrent tumor after surgery alone. Radiotherapy volume was the primary tumor or tumor bed in 13, tumor and whole brain in 3, and tumor and craniospinal axis in 1. Median radiotherapy dose to the primary site was 5,040 cGy (range 4,140-6,500) and to the whole brain was 3,000 cGy. All but 1 were treated with 150-200-cGy fractions; 1 patient received 250-cGy fractions for a tumor in the larynx. Chemotherapy was vincristine (V), actinomycin-D (A), and cyclophosphamide (C) in 10 patients, VAC + adriamycin in 2, VA in 1, VA + ifosfamide in 1, VC + adriamycin in 1, and none in 2. One patient had salvage chemotherapy consisting of cisplatin and etoposide. Median follow-up time was 20 years (range 7.5-33). Results: Late effects of treatment were seen in all patients and included facial growth retardation in 11, neuroendocrine dysfunction in 9, visual/orbital problems in 9, dental abnormalities in 7, hearing loss in 6, and hypothyroidism in 3. Intellectual and academic delays were documented in 3 patients who had received whole brain radiotherapy. While neuroendocrine, thyroid, dental, and cognitive sequelae were primarily attributed to radiotherapy

Surveying the Knowledge and Practices of Health Professionals in China, India, Iran, and Mexico on Treating Tuberculosis.

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Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Randhawa, Harkanwal; Becerra-Posada, Francisco; Dejman, Masoumeh; Falahat, Katayoun; Malek-Afzali, Hossein; Ramachandran, Parasurama; Shi, Guang; Yesudian, C A K

2016-05-04

Research evidence continues to reveal findings important for health professionals' clinical practices, yet it is not consistently disseminated to those who can use it. The resulting deficits in knowledge and service provision may be especially pronounced in low- and middle-income countries that have greater resource constraints. Tuberculosis treatment is an important area for assessing professionals' knowledge and practices because of the effectiveness of existing treatments and recognized gaps in professionals' knowledge about treatment. This study surveyed 384 health professionals in China, India, Iran, and Mexico on their knowledge and practices related to tuberculosis treatment. Few respondents correctly answered all five knowledge questions (12%) or self-reported performing all five recommended clinical practices "often or very often" (3%). Factors associated with higher knowledge scores included clinical specialization and working with researchers. Factors associated with better practices included training in the care of tuberculosis patients, being based in a hospital, trusting systematic reviews of randomized controlled double-blind trials, and reading summaries of articles, reports, and reviews. This study highlights several strategies that may prove effective in improving health professionals' knowledge and practices related to tuberculosis treatment. Facilitating interactions with researchers and training in acquiring systematic reviews may be especially helpful. © The American Society of Tropical Medicine and Hygiene.

The rockets' red glare, the bombs bursting in air: fireworks-related injuries to children.

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Smith, G A; Knapp, J F; Barnett, T M; Shields, B J

1996-07-01

To describe the epidemiology of fireworks-related injuries to children treated in a pediatric emergency department. A descriptive study of a consecutive series of patients. The emergency department of a large urban children's hospital. Children treated for injuries associated with fireworks during the 22-year period from 1972 through 1993. Three hundred sixteen children were treated for fireworks-related injuries. Ninety-five percent of patients were injured during the 3-week period of June 22 to July 14 during the study years. Seventy-one percent of patients were male, and the average age was 8.5 years, with a range of 1 month to 17 years. The child was a bystander in 26% of cases, and adult supervision was present in 54% of cases. One patient died, and 11% of children required admission to the hospital, with an average length of stay of 7.8 days (range, 1 to 37 days). Fifteen children (5%) went to the operating room for treatment of injuries. Thirty-three patients (10%) had permanent sequelae from their injuries, including 7 children (2%) with complete or partial loss of vision in one eye. The eyes were injured in 29% of cases, followed by hands and fingers (22%), other head and face sites (18%), and lower extremities (16%). The primary injury was a burn in 72% of cases. Firecrackers were associated with 42% of injuries, followed by bottle rockets (12%), other types of rockets (7%), Roman candles (11%), sparklers (7%), fountains (5%), jumping jacks (4%), and class B (illegal) fireworks (4%). Sixty-seven percent of sparkler-related injuries occurred among children 5 years and younger (Fisher's exact test, P = .000002; odds ratio [OR] = 10.00, 95% confidence interval 3.52 rockets than eye injuries caused by other types of fireworks (Fisher's exact test, P = .03; OR = 6.72, 95% confidence interval 1.18 < OR < 38.18). Charges for medical care of a fireworks-related injury averaged $1385 per patient (range, $44 to $15 071). Fireworks are associated with serious

Influence of Cranial Radiotherapy on Outcome in Children With Acute Lymphoblastic Leukemia Treated With Contemporary Therapy

Science.gov (United States)

Andreano, Anita; Pui, Ching-Hon; Hunger, Stephen P.; Schrappe, Martin; Moericke, Anja; Biondi, Andrea; Escherich, Gabriele; Silverman, Lewis B.; Goulden, Nicholas; Taskinen, Mervi; Pieters, Rob; Horibe, Keizo; Devidas, Meenakshi; Locatelli, Franco; Valsecchi, Maria Grazia

2016-01-01

Purpose We sought to determine whether cranial radiotherapy (CRT) is necessary to prevent relapse in any subgroup of children with acute lymphoblastic leukemia (ALL). Patients and Methods We obtained aggregate data on relapse and survival outcomes for 16,623 patients age 1 to 18 years old with newly diagnosed ALL treated between 1996 and 2007 by 10 cooperative study groups from around the world. The proportion of patients eligible for prophylactic CRT varied from 0% to 33% by trial and was not related to the proportion eligible for allogeneic stem-cell transplantation in first complete remission. Using a random effects model, with CRT as a dichotomous covariate, we performed a single-arm meta-analysis to compare event-free survival and cumulative incidence of isolated or any CNS relapse and isolated bone marrow relapse in high-risk subgroups of patients who either did or did not receive CRT. Results Although there was significant heterogeneity in all outcome end points according to trial, CRT was associated with a reduced risk of relapse only in the small subgroup of patients with overt CNS disease at diagnosis, who had a significantly lower risk of isolated CNS relapse (4% with CRT v 17% without CRT; P = .02) and a trend toward lower risk of any CNS relapse (7% with CRT v 17% without CRT; P = .09). However, this group had a relatively high rate of events regardless of whether or not they received CRT (32% [95% CI, 26% to 39%] v 34% [95% CI, 19% to 54%]; P = .8). Conclusion CRT does not have an impact on the risk of relapse in children with ALL treated on contemporary protocols. PMID:26755523

The role of CT in professionalism: accreditation, certification and the welfare of our children.

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Frush, Donald P

2011-09-01

Defining, measuring and promoting professionalism in medicine, including radiology, has been increasingly emphasized by organizations such as ACGME, the ACR and ABR. It is clear that we as imaging experts have as an ultimate responsibility the welfare of our patients. This is the essence of professionalism, and major societies such as the ACR, ABR and RSNA are embracing professionalism through ongoing safety and training efforts. Some of those efforts in accreditation of equipment and certification of medical professionals will be discussed.

Attitude of agricultural professionals towards their wards taking ...

African Journals Online (AJOL)

The paper examines the attitude of agricultural professionals towards their children or people under their care taking agriculture and agricultural extension as a career in Kwara State, Nigeria. A structured questionnaire was used to elicit information from one hundred and eighty respondents. The findings revealed that the ...

Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

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McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

2018-01-01

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such ‘experimental’ procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents’ decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children’s Hospital in Melbourne, Australia. PMID:29084865

Television violence and its effect on children.

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Johnson, M O

1996-04-01

Television (TV) has become a large part of children's activities. Much discussion exists as to the level of violence on TV programs and its effect on children's behavior. This article reviews the literature, discusses social issues, and presents some interventions available to nursing professionals to assist children and families in coping with the impact of TV on children's lives.

Inclusive Education for Children with Specific Learning Difficulties: Analysis of Opportunities and Barriers in Inclusive Education in Slovenia

Directory of Open Access Journals (Sweden)

Marija Kavkler

2015-03-01

professionals and their attitude towards children with SpLD, poor knowledge of SpLD, a lack of teamwork in problem solving, and a lack of partnership commitment between education professionals, parents and children. It is expected that changes could be brought about through innovations in the education of future teachers, and through positive cases of children with SpLD being treated effectively in practice. The conditions for the development of the inclusive treatment of children with SpLD could be created through legislative and systematic work.

Long-term cognitive follow-up in children treated for Maroteaux-Lamy syndrome.

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Ebbink, Berendine J; Brands, Marion M G; van den Hout, Johanna M P; Lequin, Maarten H; Coebergh van den Braak, Robert R J; van de Weitgraven, Rianne L; Plug, Iris; Aarsen, Femke K; van der Ploeg, Ans T

2016-03-01

It remains unclear to what extent the brain is affected by Maroteaux-Lamy syndrome (MPS VI), a progressive lysosomal storage disorder. While enzyme replacement therapy (ERT) elicits positive effects, the drug cannot cross the blood-brain barrier. We therefore studied cognitive development and brain abnormalities in the Dutch MPS VI patient population treated with ERT. In a series of 11 children with MPS VI (age 2 to 20 years), we assessed cognitive functioning and brain magnetic resonance imaging prospectively at the start of ERT and at regular times thereafter up to 4.8 years. We also assessed the children's clinical characteristics, their siblings' cognitive development, and their parents' educational levels. The patients' intelligence scores ranged from normal to mentally delayed (range test scores 52-131). In 90%, their scores remained fairly stable during follow-up, generally lying in the same range as their siblings' test scores (median for patients = 104, median for siblings = 88) and comparing well with the parental educational levels. Native-speaking patients had higher intelligence test scores than non-native-speaking patients. Two patients, both with high baseline glycosaminoglycan levels in their urine and severe mutations in the arylsulfatase B gene, scored clearly lower than expected. Patients with pY210C performed best. Brain abnormalities were aspecific, occurring more in patients with severe symptoms. Our study shows that cognitive development in MPS VI patients is determined not only by familial and social-background factors, but, in patients with a severe form of the disease, also by the disease itself. Therefore in patients with severe disease presentation cognition should be monitored carefully.

Opinions of legal professionals: Comparing child and adult witnesses' memory report capabilities

Directory of Open Access Journals (Sweden)

Jens Knutsson

2014-07-01

Full Text Available The opinions of legal professionals about child and adult witnesses might influence the likelihood that a case is allowed to proceed through the different stages of the legal process. With the aim of knowing the opinions of legal practitioners about child and adult witnesses, 84 legal professionals (Swedish police, prosecutors, and attorneys were surveyed about their beliefs about child and adult eyewitness memory (and metamemory abilities. The respondents answered 27 questions relating to nine forensically relevant belief areas in which they compared the memory ability of children (ages 7 to 11 years and adults. The results showed no differences in assessment among members of different professions and a general trend suggesting that, across the professions, children were believed to be poorer witnesses than adults regarding their memory abilities. Moreover, the professionals' within-group consensus was very low. These results are discussed in the context of eyewitness research findings and with respect to the implications for both legal and research practice.

Professional carers' experiences of providing a pediatric palliative care service in Ireland.

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Clarke, Jean; Quin, Suzanne

2007-11-01

In this article the authors present findings on professional carers' experience of providing pediatric palliative care to children with life-limiting conditions. For this qualitative study, part of a national pediatric palliative care needs analysis, the authors engaged in 15 focus group interviews and drew on the responses of open-ended questions to give voice to the experiences of professional carers and to situate the humanity of their caring reality. This humanity is articulated through three themes: clarity of definition and complexity of engagement, seeking to deliver a palliative care service, and the emotional cost of providing palliative care. Further analysis of these themes points to a work-life experience of skilled and emotional engagement with children, and their parents, in complex processes of caregiving and decision making. Pediatric palliative care occurs in an environment where parents shoulder a large burden of the care and professionals find themselves working in underresourced services.

Proton Radiation Therapy for Pediatric Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumors: Outcomes for Very Young Children Treated With Upfront Chemotherapy

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Jimenez, Rachel B., E-mail: rbjimenez@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Sethi, Roshan [Harvard Medical School, Boston, Massachusetts (United States); Depauw, Nicolas [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Pulsifer, Margaret B. [Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts (United States); Adams, Judith [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); McBride, Sean M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Ebb, David [Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts (United States); Fullerton, Barbara C.; Tarbell, Nancy J.; Yock, Torunn I.; MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2013-09-01

Purpose: To report the early outcomes for very young children with medulloblastoma or supratentorial primitive neuroectodermal tumor (SPNET) treated with upfront chemotherapy followed by 3-dimensional proton radiation therapy (3D-CPT). Methods and Materials: All patients aged <60 months with medulloblastoma or SPNET treated with chemotherapy before 3D-CPT from 2002 to 2010 at our institution were included. All patients underwent maximal surgical resection, chemotherapy, and adjuvant 3D-CPT with either craniospinal irradiation followed by involved-field radiation therapy or involved-field radiation therapy alone. Results: Fifteen patients (median age at diagnosis, 35 months) were treated with high-dose chemotherapy and 3D-CPT. Twelve of 15 patients had medulloblastoma; 3 of 15 patients had SPNET. Median time from surgery to initiation of radiation was 219 days. Median craniospinal irradiation dose was 21.6 Gy (relative biologic effectiveness); median boost dose was 54.0 Gy (relative biologic effectiveness). At a median of 39 months from completion of radiation, 1 of 15 was deceased after a local failure, 1 of 15 had died from a non-disease-related cause, and the remaining 13 of 15 patients were alive without evidence of disease recurrence. Ototoxicity and endocrinopathies were the most common long-term toxicities, with 2 of 15 children requiring hearing aids and 3 of 15 requiring exogenous hormones. Conclusions: Proton radiation after chemotherapy resulted in good disease outcomes for a small cohort of very young patients with medulloblastoma and SPNET. Longer follow-up and larger numbers of patients are needed to assess long-term outcomes and late toxicity.

Treating Comorbid Anxiety and Aggression in Children

Science.gov (United States)

Levy, Karyn; Hunt, Caroline; Heriot, Sandra

2007-01-01

Objective: The aim of the study was to evaluate the effectiveness of an intervention that targeted both anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report. Method: The effects of a cognitive-behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared…

The "Shopping" Behavior of Parents of Mentally Retarded Children: The Professional Person's Role

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Anderson, Kathryn A.

1971-01-01

Discussed is the role of the professional in preventing or stopping diagnostic and therapeutic shopping (repeated visits to the same or different professionals without resolution of a resolvable problem), with emphasis on the initial informing interview. (KW)

Serial casting versus stretching technique to treat knee flexion contracture in children with spina bifida: a comparative study.

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Al-Oraibi, S; Tariah, Hashem Abu; Alanazi, Abdullah

2013-01-01

Severe knee contractures that develop soon after muscle imbalance may not improve with stretching exercises and splinting. An alternative treatment is serial casting, which has been used to promote increased range of motion. The purpose of this study was to compare the effectiveness of using serial casting and passive stretching approaches to treat knee flexion contracture in children with spina bifida. In a pre/post randomized controlled study, ten participants were included in the serial casting group, while eight participants were included in the passive stretching intervention group. The degree of knee extension was measured at baseline, immediately after intervention, and at a one-year follow-up using a standard goniometer. Both groups showed significant improvements in the degree of flexion contracture at the post-treatment evaluation and the follow-up evaluation. The serial casting group showed significant improvements in knee flexion contracture at the post-treatment evaluation, t (9)=13.4, p casting group compared with passive stretching group in relation to the degree of flexion contracture were found at the immediate post-treatment evaluation, F(1, 15)=246, p=0.0001, and the one-year follow-up evaluation, F (1, 15)=51.5, p=0.0001. The outcomes of this study provide the first evidence that serial casting may be a useful intervention in treating knee flexion contracture in children with spina bifida. However, further investigations into serial casting, as well as investigations into the use of serial casting with other interventions, are warranted.

Chemotherapy versus supportive care alone in pediatric palliative care for cancer: comparing the preferences of parents and health care professionals.

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Tomlinson, Deborah; Bartels, Ute; Gammon, Janet; Hinds, Pamela S; Volpe, Jocelyne; Bouffet, Eric; Regier, Dean A; Baruchel, Sylvain; Greenberg, Mark; Barrera, Maru; Llewellyn-Thomas, Hilary; Sung, Lillian

2011-11-22

The choice between palliative chemotherapy (defined as the use of cytotoxic medications delivered intravenously for the purpose of our study) and supportive care alone is one of the most difficult decisions in pediatric oncology, yet little is known about the preferences of parents and health care professionals. We compared the strength of these preferences by considering children's quality of life and survival time as key attributes. In addition, we identified factors associated with the reported preferences. We included parents of children whose cancer had no reasonable chance of being cured and health care professionals in pediatric oncology as participants in our study. We administered separate interviews to parents and to health care professionals. Visual analogue scales were shown to respondents to illustrate the anticipated level of the child's quality of life, the expected duration of survival and the probability of cure (shown only to health care professionals). Respondents were then asked which treatment option they would favour given these baseline attributes. In addition, respondents reported what factors might affect such a decision and ranked all factors identified in order of importance. The primary measure was the desirability score for supportive care alone relative to palliative chemotherapy, as obtained using the threshold technique. A total of 77 parents and 128 health care professionals participated in our study. Important factors influencing the decision between therapeutic options were child quality-of-life and survival time among both parents and health care professionals. Hope was particularly important to parents. Parents significantly favoured chemotherapy (42/77, 54.5%) compared with health care professionals (20/128, 15.6%; p parents' desire for supportive care; for health care professionals, the opinions of parents and children were significant factors influencing this decision. Compared with health care professionals, parents more

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

Science.gov (United States)

Bellemare, Steven; Hartling, Lisa; Wiebe, Natasha; Russell, Kelly; Craig, William R; McConnell, Don; Klassen, Terry P

2004-01-01

Background Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. Methods RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. Results The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

Directory of Open Access Journals (Sweden)

McConnell Don

2004-04-01

Full Text Available Abstract Background Despite treatment recommendations from various organizations, oral rehydration therapy (ORT continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs to compare ORT and intravenous therapy (IVT for the treatment of dehydration secondary to acute gastroenteritis in children. Methods RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. Results The quality of the 14 included trials ranged from 0 to 3 (Jadad score; allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6. The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5 favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02. Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100; paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20

Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials.

Science.gov (United States)

Bellemare, Steven; Hartling, Lisa; Wiebe, Natasha; Russell, Kelly; Craig, William R; McConnell, Don; Klassen, Terry P

2004-04-15

Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results may not be generalizable to

Long-term quality of life in children treated for posterior fossa brain tumors.

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Kulkarni, Abhaya V; Piscione, Janine; Shams, Iffat; Bouffet, Eric

2013-09-01

In the face of increasing survival, quality of life (QOL) has become an important indicator of treatment success in children with posterior fossa brain tumors (PFBTs). The authors' objective was to assess the long-term QOL in survivors of PFBT. The authors conducted a cross-sectional study of children who, between birth and age 18 years at diagnosis, had previously been treated at their institution for a PFBT. At the time of assessment for this study, children were between 5 and 19 years old and had received standard treatment for PFBT ending at least 6 months before the assessment. The QOL was measured with the Pediatric Quality of Life Inventory (PedsQL) generic score scales and the Health Utilities Index Mark 3 (HUI3). Multivariate analyses were used to assess several variables (patient related, treatment related, and socioeconomic) for association with QOL. A total of 62 children participated in the study (median age at assessment 11.9 years, interquartile range [IQR] 7.8-14.8, and median age at tumor diagnosis of 4.9 years, IQR 2.5-6.9). Median time since active treatment for their PFBT was 5.2 years (IQR 2.4-10.1). Tumor types included cerebellar pilocytic astrocytoma (45.2%), medulloblastoma (30.6%), ependymoma (11.3%), and brainstem astrocytoma (11.3%). Adjuvant therapy included chemotherapy (40.3%) or radiotherapy (14.5% focal and 21.0% craniospinal radiotherapy). Permanent treatment for hydrocephalus was required in 38.7% of the patients. Tumors recurred in 11.3%, requiring repeat treatment in these patients. The median HUI3 utility score was 0.91 (IQR 0.71-1.00) and the median PedsQL total score was 78.3 (IQR 64.1-92.4). Only the following variables were significantly associated with decreased QOL in multivariable model testing (all p size, decreased family functioning, and lower family income. As a group, long-term survivors of pediatric PFBT appear to have QOL indicators that are similar to those of the general population, although a reasonable

To treat or not to treat: should psychologists treat tobacco use disorder?

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Bodie, Linda P

2014-08-01

The author presented this Presidential Address for Divison 18, Psychologists in Public Service, at the 2012 American Psychological Association Convention in Orlando, Florida. The address challenges public service psychologists to reduce the tobacco disease burden through their roles as researchers, leaders, educators, and practitioners and explains why treating tobacco use disorder is important and relevant for psychologists. The address discusses the prevalence and the resulting mortality and morbidity rates of tobacco use disorder, which call for effective evidence-based interventions that can be integrated by psychologists into other ongoing treatments. Treatment of the underserved populations, including those with serious mental illness and/or substance use disorders, presents many barriers. In addition, education and training for tobacco use disorder in undergraduate and graduate clinical psychology programs present further barriers for psychology trainees. However, progress is being made because of the numerous resources and psychology leaders who are advocates for tobacco use disorder treatment and research. Challenges for the future include increasing awareness of the importance of treatment for tobacco use disorder, finding innovative ways to increase access to comprehensive evidence-based treatment, and acknowledging that psychologists can make a difference in reducing the tobacco use disorder disease burden. Psychologists have an ethical and professional responsibility to treat tobacco use disorder.

Collaborating With Parents of Children With Chronic Conditions and Professionals to Design, Develop and Pre-pilot PLAnT (the Parent Learning Needs and Preferences Assessment Tool).

Science.gov (United States)

Nightingale, Ruth; Wirz, Lucy; Cook, Wendy; Swallow, Veronica

This study aimed to design, develop and pre-pilot an assessment tool (PLAnT) to identify parents' learning needs and preferences when carrying out home-based clinical care for their child with a chronic condition. A mixed methods, two-phased design was used. Phase 1: a total of 10 parents/carers and 13 professionals from six UK's children's kidney units participated in qualitative interviews. Interview data were used to develop the PLAnT. Eight of these participants subsequently took part in an online survey to refine the PLAnT. Phase 2: thirteen parents were paired with one of nine professionals to undertake a pre-pilot evaluation of PLAnT. Data were analyzed using the Framework approach. A key emergent theme identifying parents' learning needs and preferences was identified. The importance of professionals being aware of parents' learning needs and preferences was recognised. Participants discussed how parents' learning needs and preferences should be identified, including: the purpose for doing this, the process for doing this, and what would the outcome be of identifying parents' needs. The evidence suggests that asking parents directly about their learning needs and preferences may be the most reliable way for professionals to ascertain how to support individual parents' learning when sharing management of their child's chronic condition. With the increasing emphasis on parent-professional shared management of childhood chronic conditions, professionals can be guided by PLAnT in their assessment of parents' learning needs and preferences, based on identified barriers and facilitators to parental learning. Copyright © 2017 Elsevier Inc. All rights reserved.

Young children and their conduct of everyday life

DEFF Research Database (Denmark)

Stanek, Anja Hvidtfeldt; Røn Larsen, Maja

2015-01-01

different institutional settings; professional pedagogical work related to supporting children's conduct of everyday life, and finally, the restricted political and bureaucratic conditions for exactly these forms of pedagogical practice. The article addresses the theoretical challenge of understanding...... of problems in day-care. Through a discussion of this apparent contradiction and the conditions for developing a more situated approach, the article aims to contribute to the current professional and political discussions about day-care practice for the youngest children....

Understanding the needs of professionals who provide psychosocial care for children and adults with disorders of sex development

DEFF Research Database (Denmark)

Dessens, Arianne; Guaragna-Filho, Guilherme; Kyriakou, Andreas

2017-01-01

Objective: Disorders in sex development (DSD) can be treated well medically, but families will encounter many psychosocial challenges. Promoting counselling to facilitate acceptance and coping is important yet equality of access is unknown. This study investigated the modalities of psychosocial...... care provided in centres of DSD care. Methods: An international survey conducted among 93 providers of psychosocial care, identified through clinical networks, registries and professional forums. Results: Forty-six respondents from 22 different countries filled out the survey (49%). Most respondents...... related confusion about gender (54%), acceptance of cross gender behaviour (50%), anxiety (43%) and sadness and depression (38%). Conclusions: Most psychosocial care is provided to parents. It is assumed that parental support is important as acceptance is conditional to become affectionate caretakers...

Quantitative MRI assessments of white matter in children treated for acute lymphoblastic leukemia

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Reddick, Wilburn E.; Glass, John O.; Helton, Kathleen J.; Li, Chin-Shang; Pui, Ching-Hon

2005-04-01

The purpose of this study was to use objective quantitative MR imaging methods to prospectively assess changes in the physiological structure of white matter during the temporal evolution of leukoencephalopathy (LE) in children treated for acute lymphoblastic leukemia. The longitudinal incidence, extent (proportion of white matter affect), and intensity (elevation of T1 and T2 relaxation rates) of LE was evaluated for 44 children. A combined imaging set consisting of T1, T2, PD, and FLAIR MR images and white matter, gray matter and CSF a priori maps from a spatially normalized atlas were analyzed with a neural network segmentation based on a Kohonen Self-Organizing Map (SOM). Quantitative T1 and T2 relaxation maps were generated using a nonlinear parametric optimization procedure to fit the corresponding multi-exponential models. A Cox proportional regression was performed to estimate the effect of intravenous methotrexate (IV-MTX) exposure on the development of LE followed by a generalized linear model to predict the probability of LE in new patients. Additional T-tests of independent samples were performed to assess differences in quantitative measures of extent and intensity at four different points in therapy. Higher doses and more courses of IV-MTX placed patients at a higher risk of developing LE and were associated with more intense changes affecting more of the white matter volume; many of the changes resolved after completion of therapy. The impact of these changes on neurocognitive functioning and quality of life in survivors remains to be determined.

Hodgkin lymphoma - children

Science.gov (United States)

... families share common experiences may help ease your stress. American Childhood Cancer Organization - www.acco.org Leukemia and ... Cancer - Hodgkin lymphoma - children; Childhood Hodgkin lymphoma ... Cancer Institute website. Childhood Hodgkin lymphoma treatment (PDQ) - health professional ...

Teaching with Children's Books: The "Wow" Factor

Science.gov (United States)

Von Drasek, Lisa

2006-01-01

No classroom teacher needs convincing of the benefits of using children's picture books in his or her math program. As Marilyn Burns, the creator and founder of Math Solutions Professional Development, and the author of "The Greedy Triangle" (Scholastic, 1996), says, "Evidence shows that teaching math through children's books motivates children to…

Social Inclusion: Meeting the Socio-Emotional Needs of Children with Vision Needs

Science.gov (United States)

Roe, Joao

2008-01-01

To meet the socio-emotional needs of children with vision impairment, it is important that professionals involved have a good understanding of these needs and are able to interpret children's behaviours. Professionals also need to create contexts that promote social inclusion alongside academic achievement. This is a continuous challenge for…

Profile of pregnant women and children treated at a reference center for congenital toxoplasmosis in the northern state of Minas Gerais, Brazil

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Janer Aparecida Silveira Soares

2012-02-01

Full Text Available INTRODUCTION: To describe the clinical and epidemiological profile of pregnant women and children treated at a reference outpatient clinic for congenital toxoplasmosis. METHODS: Pregnant women potentially exposed to Toxoplasma gondii were observed. Diagnoses were made using serologic tests compatible with acute toxoplasmosis. Children presenting with: Toxoplasma-specific antibodies (IgM or IgA or ascending IgG titers higher than maternal titers in the first 3 months of life coupled with toxoplasmosis symptoms; intracranial calcifications (by transfontanelar ultrasound or cephalic segment tomography; or retinochoroiditis (by fundoscopy examination in the first 8 months of life were also included in the study. RESULTS: Fifty-eight mother-child pairs were observed (mean age of the mothers was 22.1 years. Most patients lived in urban areas (86.2% and had attended less than 8 years of school (51.7%. Diagnosis was made after birth in 19 (32.8% children. Thirty-four (58.6% women received some type of treatment during pregnancy. Most (72.4% of the children did not present with clinical alterations at birth. The main findings were ophthalmological: 20 (34.5% children with retinochoroiditis, 17 (29.3% with strabismus, and 7 (12.1% with nystagmus. Of the children with retinochoroiditis, 9 presented with subnormal vision. Ten (32.3% out of 31 children presented with intracranial calcifications by cephalic segment congenital toxoplasmosis, and 9 (42.9% children presented with delayed psychomotor development. CONCLUSIONS: Our results highlight a critical situation. Protocols for follow-up of pregnant women and their children must be created to improve medical care and minimize sequelae.

Paediatric death and dying: exploring coping strategies of health professionals and perceptions of support provision.

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Forster, Elizabeth; Hafiz, Alaa

2015-06-01

Without question a child's death is a devastating event for parents and families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents and families on this painful journey. This is a delicate and sensitive area of practice and has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of wellbeing. To explore health professionals' perceptions of bereavement support surrounding the loss of a child. The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz's (2006) approach. For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs. Analysis of the narratives also revealed health professionals' perceptions of their support provision. Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

Grains Are Similarly Categorized by 8- to 13-Year-Old Children

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Beltran, Alicia; Sepulveda, Karina Knight; Watson, Kathy; Baranowski, Tom; Baranowski, Janice; Islam, Noemi; Missaghian, Mariam

2009-01-01

This study assessed how 8- to 13-year-old children categorized and labeled grain foods and how these categories and labels were influenced by child characteristics. The main hypotheses were that children categorized foods in consistent ways and these food categories differed from the professional food categories. A set of 71 cards with pictures and names of grain foods from eight professionally denned food groups was sorted by each child into piles of similar foods. There were 149 8- to 13-year-old children (133 English-speaking, 16 Spanish-speaking) in this exploratory study. One-way analysis of variance and Robinson matrices for identification of clusters of food items were calculated. Children created a mean (± standard deviation) of 8.3±3.8 piles with 8.6±9.1 cards per pile. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics. For the majority of the piles, children provided “taxonomic-professional” (34.5%) labels, such as bread for the professional category of breads, rolls, and tortillas, or “script” (26.1%) labels, such as breakfast for the professional category of pancakes, waffles, and flapjacks. These categories may be used to facilitate food search in a computerized 24-hour dietary recall for children in this age group. PMID:18954585

Treatment of diabetes in children

OpenAIRE

GAO, YI-QING; GAO, MIN; XUE, YING

2016-01-01

Type 1 diabetes mellitus (T1D) and type 2 diabetes (T2D) mellitus are on the increase in children and adolescents. An increase in T2D is linked to the increasing rates of obesity in children. Usually, in both children and adults, T1D is treated with insulin while T2D is treated with metformin. There are other classes of drugs that are under assessment for their safety and efficacy in relation to pediatric patients. Most of these new drugs, however, have not been studied in children. Thus, the...

A web-based communication system for integrated care in cerebral palsy: experienced contribution to parent-professional communication

NARCIS (Netherlands)

Gulmans, Jitske; Vollenbroek-Hutten, Miriam Marie Rosé; van Gemert-Pijnen, Julia E.W.C.; van Harten, Wim H.; van Harten, Willem H.

2012-01-01

Introduction: to improve communication in the integrated care setting of children with cerebral palsy, we developed a web-based system for parent-professional and inter-professional communication. The present study aimed to evaluate parents' experiences regarding the system's contribution to their

Twice-weekly aripiprazole for treating children and adolescents with tic disorder, a randomized controlled clinical trial.

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Ghanizadeh, Ahmad

2016-01-01

Treating tic disorder is challenging. No trial has ever examined whether twice weekly aripiprazole is effective for treating tic disorders. Participants of this 8-week randomized controlled parallel-group clinical trial were a clinical sample of 36 children and adolescents with tic disorder. Yale global tic severity scale was used to assess the outcome. Both groups received daily dosage of aripiprazole for the first 14 days. Then, one group received daily dose of aripiprazole while the other group received twice weekly dosage of aripiprazole for the next 46 days. The patients were assessed at baseline, week 2, 4, and 8. Tic scores decreased in both group significantly 22.8 (18.5) versus 22.0 (11.6). Moreover, there was no between group difference. The final mean (SD) score of motor and vocal tics in the group treated with daily treatment was not significantly different from the twice weekly group (Cohen's d = 0.36). The odds ratios for sedation and increased appetite were 3.05 and 3, respectively. For the first time, current findings support that twice weekly aripiprazole efficacy was not different from that of daily treatment. The rate of drowsiness in the twice weekly treatment group was less than that of the daily treatment group. This trial was registered at http://www.irct.ir. The registration number of this trial was: IRCT201312263930N32. http://www.irct.ir/searchresult.php?id=3930&number=32.

Constructing Occupational Identities: How Female Preschool Teachers Develop Professionalism

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Kim, Mina

2013-01-01

This study explores how female teachers construct their occupational identities as teachers within early childhood education (ECE) settings. The combination of feminist scholarship and the use of teacher life history method allow these women to describe themselves as professionally trained and educated teachers who love teaching and children even…

Oral Health-Related Quality of Life in Children in Chile Treated for Cleft Lip and Palate: A Case-Control Approach.

Science.gov (United States)

Aravena, Pedro C; Gonzalez, Tania; Oyarzún, Tamara; Coronado, César

2017-03-01

  To compare the oral health-related quality of life of patients treated for cleft lip and/or cleft palate (CL/P) versus unaffected children between 8 and 15 years of age using a Spanish-language version of the Child Oral Health Impact Profile (COHIP-Sp) administered to a Chilean population.   A cross-sectional study with a matched case-control design was used.   Participants were 48 children (mean age 11.3 years) with a history of CL/P from three cities in Chile and one group of 96 children (mean age 11.2 years) unaffected by CL/P. The COHIP-Sp was applied to both groups. Quality of life was compared according to the overall score and the average score of items and domains on the COHIP-Sp scale between the two groups (Mann-Whitney U test; P self-image" (P = .0002).   The oral health-related quality of life of children with a history of CL/P was similar to that of the control group. Nevertheless, a lower quality of life was observed concerning items associated with speech and being understood by other people. Further study into the risk factors associated with surgery and rehabilitative treatment is recommended.

FORMING PROFESSIONAL SKILLS OF THE PROSPECTIVE HEADS OF CHILDREN'S DANCE GROUPS DURING THE CHOREOGRAPHIC ACTIVITIES IN THE COURSE "FOLK DANCE THEORY AND METHODOLOGY"

Directory of Open Access Journals (Sweden)

Volodymyr Kotov

2016-11-01

Full Text Available The article highlights the urgent problem of contemporary art pedagogy – involvement to training future professional choreographic traditions of different nations. Addressing to this problem is caused by a number of socio-political events in Ukraine, mainstreaming of national and international education, integration of Ukrainian education with the European educational space, intensive development of domestic students’ intercultural communication with young people from different countries, which is the basis for updating national art education. Prospective choreographers, who are being training at pedagogical universities to manage children's dance groups, should actively be involved into creating their own productions of folk dance various genres. It promotes the formation of choreographers’ professional competence and pedagogical skills. The development of Georgian "Lezginka" is proposed – a joint creative work of the teacher and students who get higher education degree in SHEE “Donbass State Pedagogical University” (Bachelor's Degree. Development of the dance contains schematic drawings of dance figures, it is recommended for use in forming choreographers’ professional skills while studying the course "Folk Dance Theory and Methodology". The author admits that folklore material requires a cautious, respectful attitude. Therefore, modern folk stage dances are integrally to combine traditional choreographic manner with its new interpretations. The author believes the actual capture of different nations’ choreographic culture improves intercultural youth communication; involves future professionals into the traditions of different nations; form professional skills of managers of children’s dance groups. The author concluded that a dance always reflects consciousness of different nations; future choreographers should be aware of characteristic features of dances of different world nations so that on the basis of traditional

[Tolerability of iron preparation Actiferol Fe® in children treated for iron deficiency anemia].

Science.gov (United States)

Jackowska, Teresa; Sapała-Smoczyńska, Alicja; Kamińska, Ewa

2015-01-01

Iron de„ciency anemia is the most frequently occurring anemia during the childhood period. Supplementation with adequate doses of iron remains a basic method of prevention and treatment. The various available products containing iron are characterized by a different degree of patient tolerability. Actiferol Fe® is a micronized, dispersible ferric pyrophosphate which improves its water solubility, and therefore it has better absorption and bioavailability. The assessment of tolerability of Actiferol Fe® in children who were administered this product to treat or prevent of iron de„ciency anemia. The methods of administration and the incidence of adverse effects were analyzed. Eighty children (64 boys and 16 girls) aged from one month to 6 years who met the criteria of an indication to be treated with iron were included into the study. The assessment of selected parameters was based on the questionnaire which included questions about tolerability, method of administration, convenience of usage and adverse e#ects. The questionnaire was „lled in by parents (usually by the mother). The study indicated that Actiferol Fe® has very good or good tolerability in 87.5% (70/80) of patients - 46.3% (37/80) and 41.2% (33/80), respectively. The most frequent method of administration was in liquid form after dissolving: in water - 31,3% (25/80), in orange juice - 18.8% (15/80) or in milk formulas - in 17.5% (14/80) of patients. The method of administration was assessed as convenient or very convenient by 84% (67/80) of participants. Out of the adverse effects reported, the most frequent were change in the stool consistency into harder, abdominal pain and constipation - in 20% (16/80), 11.25% (9/80), 10% (8/80) cases, respectively. Diarrhea, pain during defecation occurred occasionally. A dark color of the stool was reported by 55% (44/80) of patients. In only one case (1.25%) the parents resigned from the product administration and replaced it with another iron product (no

Ethics of medical records and professional communications.

Science.gov (United States)

Recupero, Patricia R

2008-01-01

In child and adolescent psychiatry, medical records and professional communications raise important ethical concerns for the treating or consulting clinician. Although a distinction may be drawn between internal records (eg, medical records and psychotherapy notes) and external communications (eg, consultation reports and correspondence with pediatricians), several ethical principles apply to both types of documentation; however, specific considerations may vary, depending upon the context in which the records or communications were produced. Special care is due with regard to thoroughness and honesty, collaboration and cooperation, autonomy and dignity of the patient, confidentiality of the patient and family members, maintaining objectivity and neutrality, electronic communications media, and professional activities (eg, political advocacy). This article reviews relevant ethical concerns for child and adolescent psychiatrists with respect to medical records and professional communications, drawing heavily from forensic and legal sources, and offers additional recommendations for further reading for clarification and direction on ethical dilemmas.

Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.

Directory of Open Access Journals (Sweden)

Esther Hafkamp-de Groen

Full Text Available This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006 and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO, airway resistance (Rint, health-related quality of life (HRQOL and ETS exposure at home ever were measured. Linear mixed models were applied.No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05. Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87.Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.Controlled-Trials.com ISRCTN15790308.

Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.

Science.gov (United States)

Hafkamp-de Groen, Esther; van der Valk, Ralf J P; Mohangoo, Ashna D; van der Wouden, Johannes C; Duijts, Liesbeth; Jaddoe, Vincent W; Hofman, Albert; de Koning, Harry J; de Jongste, Johan C; Raat, Hein

2014-01-01

This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals. Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006) and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO), airway resistance (Rint), health-related quality of life (HRQOL) and ETS exposure at home ever were measured. Linear mixed models were applied. No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05). Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87). Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children. Controlled-Trials.com ISRCTN15790308.

[Comparing clinical effects of titanic elastic nail and locking compression pine fixation in treating subtrochanteric fractures in older children].

Science.gov (United States)

Zhu, Kang-xiang; Yin, Shan-qing

2013-12-01

To explore optimal choice of surgical treatment for subtrochanteric fractures in older children. A retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded. All children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications. For the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which

Late bone and soft tissue sequelae of childhood radiotherapy. Relevance of treatment age and radiation dose in 146 children treated between 1970 and 1997

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Doerr, W. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Medical University / AKH Vienna (Austria). Dept. of Radiation Oncology; Kallfels, S. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Kinder- und Jugendmedizin, Chemnitz [Germany; Herrmann, T. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology

2013-07-15

Purpose: The present retrospective study was initiated to characterize the effect of oncological treatments in children and adolescents on bone and soft tissues, and to assess their dependence on radiation dose and age at exposure. Patients and methods: The study included 146 patients treated between 1970 and 1997. All patients received external beam radiotherapy to the trunk or extremities, but no cranial irradiation. Median age at treatment was 8.8 years. Patients were screened at 18 years (median time interval since treatment 9.2 years, range 0.9-17.7 years) for pathological changes in the skeletal system and soft tissues (scoliosis, kyphosis, bony hypoplasia, soft tissue defects, asymmetries), which were classified as minor/moderate (grade 1) or substantial (grade 2). Results: Pathological findings were recorded in 75/146 patients (51 %). These were scored as minor in 44 (59 %) and substantial in 31 patients (41 %). Most pathological changes occurred in children treated under the age of 6 years. At 6 years and older, only doses > 35 Gy caused an effect, and no substantial changes were seen for treatment ages exceeding 12 years. Significant effects of radiation dose and age at exposure were observed for kyphoscoliosis (with vertebral body dose gradients < 35 Gy), hypoplasia and soft tissue defects and asymmetrical growth. Conclusion: Tolerance doses of 20 Gy need to be respected for growing bone, particularly in children treated under the age of 6 years. The late treatment sequelae analysed in the present study are largely avoided with the use of current therapeutic protocols. However, the systematic evaluation, documentation and continuous analysis of adverse events in paediatric oncology remains essential, as does the evaluation of novel radio(chemo)therapeutic approaches. (orig.)

Professional burnout and its correlates in Lithuanian neurosurgeons.

Science.gov (United States)

Pranckeviciene, Aiste; Tamasauskas, Arimantas; Deltuva, Vytenis Pranas; Bunevicius, Adomas

2016-08-01

This study aimed to evaluate prevalence and severity of professional burnout in a sample of Lithuanian neurosurgeons and to analyze its personal, interpersonal, and organizational correlates. Thirty-one out of 79 (response rate 39 %) Lithuanian neurosurgeons participated in the study. Professional burnout was evaluated using the Maslach Burnout Inventory - General Survey. Participants also answered questions about professional stressors, sources of professional dissatisfaction, life-style factors, sickness absenteeism/presenteeism, and professional practice. The majority of neurosurgeons were between 41 and 60 years of age (48 %), were married (97 %), had children (84 %). Most neurosurgeons had 20 or more years of professional experience (54.9 %), worked from 41 to 60 h per week (58 %), and performed up to 150 surgeries per year (77.4 %). Eight (26 %) neurosurgeons reported a high level of emotional exhaustion, five (16 %) reported high level of cynicism, and eight (26 %) reported low professional efficacy. Correlation analyses revealed that higher number of surgeries per year, more hours devoted to clinical work, opportunities for professional development, intellectual challenges at work, appreciation by the patients and prestige of the profession were related to lower level of burnout. Greater general workload, unpredictability of the work schedule, lack of necessary technical equipment, dissatisfaction with colleagues, and uncertainty about the future were related to a higher level of burnout. Burnout was reported by one-quarter of neurosurgeons who chose to participate in the study. Personal, interpersonal, and organizational factors arising while fulfilling professional duties were important correlates of neurosurgeons' burnout. Due to the moderate response rate, our results should be interpreted with caution. Larger studies evaluating burnout among European neurosurgeons are needed.

A Case Study Using Child-Centered Play Therapy Approach to Treat Enuresis and Encopresis.

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Cuddy-Casey, Maria

1997-01-01

Demonstrates an alternative method (nondirective child-centered therapy) in treating enuresis and encopresis resulting from emotional disturbances. Examines various etiologies and approaches to treating these conditions. Provides a case study example. Claims that professionals must differentiate between primary and secondary occurrences of these…

Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

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McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

2018-01-01

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. 'Fertility preservation' for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such 'experimental' procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents' decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children's Hospital in Melbourne, Australia. © 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.

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

Science.gov (United States)

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Treated Mental Illness and the Risk of Child Abuse Perpetration.

Science.gov (United States)

Friedman, Susan Hatters; McEwan, Miranda V

2018-02-01

Despite a limited empirical literature, parental mental illness is often cited as a major risk factor for violence against children. However, mental illness that is adequately treated would not be expected to lead to increased violence risk. This study compared incidents of violence toward children perpetrated by parents who were newly discharged from inpatient psychiatric treatment with violence perpetrated by other parents in the same communities to determine whether parents with treated mental illness had an elevated risk of child abuse perpetration. A secondary analysis of data from the MacArthur Violence Risk Assessment Study was conducted. Violence toward children reported by parents and by collateral informants at the initial ten-week follow-up interview was analyzed for two groups: study participants discharged from inpatient psychiatric facilities and parents in the community matched by neighborhood. Of the 416 parents in the participant group, 20 (5%) committed violence toward a child in the ten weeks after discharge, compared with 41 (14%) of the 299 parents in the comparison group. In the participant group, diagnostic categories of parents who committed violence toward a child were as follows: serious mental illness only (8% of whom were violent), substance use disorder only (3%), both serious mental illness and substance use disorder (4%), and another issue (7%). This study found that parents with treated serious mental illness were not at higher risk than other parents in their community of perpetrating violence toward children. Parents who were admitted to an acute psychiatric facility and treated appeared to be at lower risk of being violent toward children than other parents in their community.

Attention deficit/hyperactivity disorder blame game: a study on the positioning of professionals, teachers and parents.

Science.gov (United States)

Frigerio, Alessandra; Montali, Lorenzo; Fine, Michelle

2013-11-01

Attention deficit/hyperactivity disorder is currently the most debated childhood psychiatric diagnosis. Given the circulation of competing perspectives about the 'real' causes of children's behaviour and the 'best' way to treat them, we aim to analyse the interactions of the central social actors' discourses about attention deficit/hyperactivity disorder children within the Italian context. Adopting a multi-method approach, we focus on the polyphonic chorus of voices surrounding the child, studying the discourses of mental health professionals, teachers and parents. These actors are representative of three contexts that are deeply engaged with attention deficit/hyperactivity disorder: medical institutions, schools and families. Our theoretical and methodological approach integrates positioning theory, the Bakhtinian notion of dialogical thinking and discourse analysis to study stakeholders' reflexive and interactive positioning in terms of the attribution of rights, duties, responsibilities and power issues. The results show that mutual blame is a constitutive element of relational dynamics among the key adults surrounding attention deficit/hyperactivity disorder children. We argue that these conflicting relationships are not merely related to the debate regarding the validity of the attention deficit/hyperactivity disorder diagnosis. Rather, the mutual blame centres on questions of compliance, recognition of authority and morality. Through the blame game, adults negotiate their own and others' subjectivity in ways that simultaneously (re)produce power relationships and resistance efforts.

Adrenal function in asthmatic children treated with inhaled budesonide

DEFF Research Database (Denmark)

Bisgaard, H; Pedersen, S; Damkjaer Nielsen, M

1991-01-01

The effect of the inhaled topical steroid budesonide on adrenal function was evaluated in 33 children (aged 7-15 years) with moderate bronchial asthma. The trial was designed as a prospective single-blind study of the effect of budesonide in daily doses of 200 microgram through 400 microgram to 800...... significantly during treatment with 800 microgram budesonide as compared to treatment with 200 microgram budesonide (95% confidence interval: 74%-112%). It is concluded, that budesonide is a topical steroid with a favourable ratio between topical and systemic effects in asthmatic children....

Stimulating and Enhancing Partnerships Between Transplant Professionals and Law Enforcement: Recommendations.

Science.gov (United States)

Capron, Alexander Morgan; Muller, Elmi; Erlich, Gilad; John, Manoj; Bienstock, Ric Esther; McCarren, Mark; Palmer, Robin; Scheper-Hughes, Nancy; Siegel, Dina; Yankov, Jordan

2016-02-01

To help combat trafficking in human beings for organ removal (THBOR), transplant professionals need to do more than carry out careful, multidisciplinary screening of potential living donors; they also need to communicate and collaborate with law enforcement professionals. This will involve transplant professionals educating investigators and prosecutors about transplant practices and in turn learning about THBOR and how it is prosecuted. Cases of illegal organ transplantation need to be detected at different levels. First, the victims of the crime itself need to be identified, especially when they present themselves for screening. Physicians have a collective responsibility to prevent exploitation of people, including THBOR victims. The second level involves the more difficult matter of making reports that involve transplant tourists who have returned home after receipt of an organ and need follow-up care. Besides counseling patients prospectively about the legal as well as medical risks in receiving a vended organ in a foreign transplant center, physicians treating such patients could have an obligation to report what has happened, if the government has established a mechanism that either allows reporting THBOR that does not include the identity of the patient or that treats patients as victims provided they cooperate in investigation and prosecution of the persons responsible for obtaining or implanting the organs. The third level of cooperation involves transplant professionals who participate in THBOR. Professional societies need to undertake programs to make physicians and nurses aware that their responsibility to protect their professions' reputation includes identifying members of their professions who depart from professional ethics. Doing so allows the local professional societies and state boards to discipline such violators. All 3 of these functions would be facilitated by the creation by an international body such as World Health Organization of a

Stimulating and Enhancing Partnerships Between Transplant Professionals and Law Enforcement: Recommendations

Science.gov (United States)

Capron, Alexander Morgan; Muller, Elmi; Erlich, Gilad; John, Manoj; Bienstock, Ric Esther; McCarren, Mark; Palmer, Robin; Scheper-Hughes, Nancy; Siegel, Dina; Yankov, Jordan

2016-01-01

Abstract To help combat trafficking in human beings for organ removal (THBOR), transplant professionals need to do more than carry out careful, multidisciplinary screening of potential living donors; they also need to communicate and collaborate with law enforcement professionals. This will involve transplant professionals educating investigators and prosecutors about transplant practices and in turn learning about THBOR and how it is prosecuted. Cases of illegal organ transplantation need to be detected at different levels. First, the victims of the crime itself need to be identified, especially when they present themselves for screening. Physicians have a collective responsibility to prevent exploitation of people, including THBOR victims. The second level involves the more difficult matter of making reports that involve transplant tourists who have returned home after receipt of an organ and need follow-up care. Besides counseling patients prospectively about the legal as well as medical risks in receiving a vended organ in a foreign transplant center, physicians treating such patients could have an obligation to report what has happened, if the government has established a mechanism that either allows reporting THBOR that does not include the identity of the patient or that treats patients as victims provided they cooperate in investigation and prosecution of the persons responsible for obtaining or implanting the organs. The third level of cooperation involves transplant professionals who participate in THBOR. Professional societies need to undertake programs to make physicians and nurses aware that their responsibility to protect their professions' reputation includes identifying members of their professions who depart from professional ethics. Doing so allows the local professional societies and state boards to discipline such violators. All 3 of these functions would be facilitated by the creation by an international body such as World Health Organization

Professional socialisation: an influence on professional ...

African Journals Online (AJOL)

Professional socialisation refers to the acquisition of values, attitudes, skills and knowledge pertaining to a profession. This article reviews the definition and conceptualisation of professional socialisation through anticipatory and formal professional socialisation processes. It describes the core elements of professional ...

Early-Treated Phenylketonuria: Neuropsychologic Consequences.

Science.gov (United States)

Brunner, Robert L.; And Others

1983-01-01

The neuropsychologic performance of 27 children (about 6 to 13 years old) with early-treated phenylketonuria (PKU) was evaluated and correlated with their serum phenylalanine concentrations at several ages. (Author/SEW) Journal Availability: The Journal of Pediatrics; The C. V. Mosby Company, 11830 Westline Industrial Drive, St. Louis, MO 63141.

Ideas Exchange: "How Important Is Activity in Young Children (Preschool) to a Lifetime of Physical Activity?"

Science.gov (United States)

Hushman, GLenn; Morrison, Jaime; Mally, Kristi; McCall, Renee; Corso, Marjorie; Kamla, Jim; Magnotta, John; Chase, Melissa A.; Garrahy, Deborah A.; Lorenzi, David G.; Barnd, Sue

2009-01-01

This article presents the opinions of several professionals who were asked: "How important is activity in young children (preschool) to a lifetime of physical activity?" These professionals point out the importance of physical activity to young children.

Trick or Treat and Telescopes

Science.gov (United States)

Buratti, Bonnie J.; Meinke, Bonnie K.; Schmude, Richard W.

2017-10-01

Based on an activity that DPS member Richard Schmude Jr. has been doing for years, with over 5000 children reached, DPS initiated in 2016 a pilot program entitled “Trick-or-Treat and Telescopes.” DPS encouraged its members to put out their telescopes during trick-or-treat time on Halloween, in their own lawns or in a neighbor’s lawn with better viewing (or more traffic). The program will be continued in 2017. This year should offer good viewing with a waxing gibbous moon and Saturn visible. The program was also advertised though the Night Sky Network, a consortium of astronomy clubs. The following website gives advice and connections to resources.https://dps.aas.org/education/trick-or-treat-and-telescopes acknowledged.

Evaluation of an online training program in eating disorders for health professionals in Australia.

Science.gov (United States)

Brownlow, Rachel S; Maguire, Sarah; O'Dell, Adrienne; Dias-da-Costa, Catia; Touyz, Stephen; Russell, Janice

2015-01-01

Early detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals-representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery. One-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants' levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders. Significant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about

Silent suffering: understanding and treating children with selective mutism.

Science.gov (United States)

Manassis, Katharina

2009-02-01

Children with selective mutism (SM) restrict speech in some social environments, often resulting in substantial academic and social impairment. Although SM is considered rare, one or more children with SM can be found in most elementary schools. Assessment is performed to confirm the diagnosis, rule out psychological and medical factors that may account for the mutism, ascertain comorbid and exacerbating conditions needing treatment, and develop an intervention plan. Interventions are often multidisciplinary and focus on decreasing anxiety, increasing social speech and ameliorating SM-related impairment. Research is limited, but symptomatic improvement has been demonstrated with behavioral interventions and multimodal treatments that include school and family participation, as well as behavioral methods. Selective serotonin-reuptake inhibitors, especially fluoxetine, have also been found to be efficacious and merit consideration in severe cases. Persistence of some SM or anxiety symptoms despite treatment is common. Further development of treatments targeting specific etiological factors, comparative treatment studies and determination of optimal involvement of families and schools in treatment are needed to improve outcomes for children with SM.

Music Therapy with Autistic Children: A Multiple Case Study

Science.gov (United States)

Pelayo, Jose Maria G., III; Sanchez, Celeste S.

2013-01-01

The aim of the researchers was to determine if there are alternative methods in treating children with autism. Children diagnosed with autism are currently attending special schools with a different type of curriculum. Many methods have been used by psychologists and psychiatrists to treat children diagnosed with autism. Children with mental or…

Sustainable Professional Learning for Early Childhood Educators: Lessons from an Australia-Wide Mental Health Promotion Initiative

Science.gov (United States)

Askell-Williams, Helen; Murray-Harvey, Rosalind

2016-01-01

New policy initiatives, such as those concerned with promoting young children's positive mental health, highlight the need for good quality professional education in the early childhood education and care sector. However, although a wealth of literature exists from the school sector, little is known about professional education in early childhood…

Spirometry in children.

Science.gov (United States)

Jat, Kana Ram

2013-06-01

Respiratory disorders are responsible for considerable morbidity and mortality in children. Spirometry is a useful investigation for diagnosing and monitoring a variety of paediatric respiratory diseases, but it is underused by primary care physicians and paediatricians treating children with respiratory disease. We now have a better understanding of respiratory physiology in children, and newer computerised spirometry equipment is available with updated regional reference values for the paediatric age group. This review evaluates the current literature for indications, test procedures, quality assessment, and interpretation of spirometry results in children. Spirometry may be useful for asthma, cystic fibrosis, congenital or acquired airway malformations and many other respiratory diseases in children. The technique for performing spirometry in children is crucial and is discussed in detail. Most children, including preschool children, can perform acceptable spirometry. Steps for interpreting spirometry results include identification of common errors during the test by applying acceptability and repeatability criteria and then comparing test parameters with reference standards. Spirometry results depict only the pattern of ventilation, which may be normal, obstructive, restrictive, or mixed. The diagnosis should be based on both clinical features and spirometry results. There is a need to encourage primary care physicians and paediatricians treating respiratory diseases in children to use spirometry after adequate training.

Child-rearing in the context of childhood cancer: perspectives of parents and professionals.

Science.gov (United States)

Long, Kristin A; Keeley, Lauren; Reiter-Purtill, Jennifer; Vannatta, Kathryn; Gerhardt, Cynthia A; Noll, Robert B

2014-02-01

Elevated distress has been well documented among parents of children with cancer. Family systems theories suggest that cancer-related stressors and parental distress have the potential to affect child-rearing practices, but this topic has received limited empirical attention. The present work examined self-reported child-rearing practices among mothers and fathers of children with cancer and matched comparisons. Medical and psychosocial professionals with expertise in pediatric oncology selected items from the Child-Rearing Practices Report (CRPR) likely to differentiate parents of children with cancer from matched comparison parents. Then, responses on these targeted items were compared between parents of children with cancer (94 mothers, 67 fathers) and matched comparisons (98 mothers, 75 fathers). Effect sizes of between-group differences were compared for mothers versus fathers. Pediatric oncology healthcare providers predicted that 14 items would differentiate child-rearing practices of parents of children with cancer from parents of typically developing children. Differences emerged on six of the 14 CRPR items. Parents of children with cancer reported higher levels of spoiling and concern about their child's health and development than comparison parents. Items assessing overprotection and emotional responsiveness did not distinguish the two groups of parents. The effect size for the group difference between mothers in the cancer versus comparison groups was significantly greater than that for fathers on one item related to worry about the child's health. Parents of children with cancer report differences in some, but not all, domains of child-rearing, as predicted by healthcare professionals. © 2013 Wiley Periodicals, Inc.

Treatment of bruxism in children: a systematic review.

Science.gov (United States)

Restrepo, Claudia; Gómez, Sandra; Manrique, Ruben

2009-01-01

To conduct a systematic review to assess and analyze the scientific evidence about the available therapies for bruxism in children. The literature was searched using Medline, PubMed, Ovid, Biomed Central, EBSCOhost, ISI, Cochrane Library, Embase, LILACS, Scielo, Scirus, the Internet at large, and databases of universities from March 1985 to the end of September 2007. Studies had to be intervention studies for bruxism in children, and the children included in the studies had to be 3 to 10 years old. From 52 records found, 2 fulfilled the inclusion criteria. In 1 study, bruxism was treated by widening the upper airway through adenoidectomy, and the other study proposed to treat bruxism in children with psychologic techniques. When analyzed, the 2 considered studies did not fully accomplish the requirements to treat the etiology of bruxism in children. The available literature does not provide adequate support to treat bruxism in children, as the diagnosis methods in the studies are insufficient and are not comparable to confirm the presence of bruxism. Very few studies about therapies for bruxism in children meet the quality criteria required for the evidence-based practice. Treatment for bruxism in children requires further study.

Negotiating Professionalism: The Gendered Social Capital of Flexible Time.

Science.gov (United States)

Seron, Carroll; Ferris,Kerry

1995-01-01

From a sample of 1,000 New York attorneys, data from 553 men and 129 women suggest that professional autonomy depends on social capital arrangements that assume overtime, open-ended work demands, and release from private obligations. Access to time is qualitatively different for men and women, especially married women with children. (SK)

CLASS Reliability Training as Professional Development for Preschool Teachers

Science.gov (United States)

Casbergue, Renée M.; Bedford, April Whatley; Burstein, Karen

2014-01-01

Use of the Classroom Assessment Scoring System (CLASS) is increasing across the United States as an important indicator of the quality of programs for young children. Professional development is required to facilitate teachers' understanding of the instructional behaviors upon which they will be judged. This study investigated the use of the…

Illness in Children and Parental Response

NARCIS (Netherlands)

M.A. Bruijnzeels (Marc)

1997-01-01

textabstractMost children suffer from illnesses from time to time. In only a small part of these ill children parents decide to seek professional help. So, most child health care is carried out by parents. In general, this phenomenon is called the iceberg of symptoms. The part of the iceberg under

Healthy children's perceptions of medicines: a review.

Science.gov (United States)

Hämeen-Anttila, Katri; Bush, Patricia J

2008-06-01

Chronically ill children's perceptions of medicines have been widely studied, but healthy children's less often. However, information on healthy children's beliefs and attitudes about medicine use is needed to be able to target health education messages about medicines appropriately. A literature review was performed to determine schoolchildren's attitudes, beliefs, and knowledge about medicines; autonomy in using medicines; expectations of using medicines; and questions about medicines, so as to guide the development of a medicine education curriculum and to inform health care professionals who communicate with children. This study was a review of literature from 17 countries. The review indicated that children of school age tend to view medicines cautiously. Although age is a factor, children have very limited ideas about how medicines work and issues around medicine efficacy are confusing to them. Even young children recognize that medicines may have harmful effects and, children of all ages and cultures studied want to learn more about medicines. Autonomy in medicine use is surprisingly high and disturbing given that knowledge of medicines is poor. Primary conclusions drawn are (1) children of the same age in different cultures appear similar in their attitudes, beliefs, behaviors, and desires to learn about medicines; (2) children lack information about medicines, especially in view of their levels of autonomy; and (3) health educators and health care professionals should educate children about rational medicine use, at appropriate cognitive development levels, before the children become independent medicine users.

The Art Association/Higher Education Partnership: Implementing Residential Professional Development

Science.gov (United States)

Charland, William

2006-01-01

In-service professional development in education began informally in the early nineteenth-century as a means of disseminating classroom management techniques, specifically addressing ways in which corporal punishment could be delivered to a child without inflicting serious injury. This initial effort paralleled a concern regarding children's…

Measuring Satisfaction with Family-Professional Partnership in Early Intervention and Early Childhood Special Education Programs in Qatar

Science.gov (United States)

Al-Hadad, Nawal Khalil

2010-01-01

Family-professional partnership has been considered a recommended practice in Early Intervention/Early Childhood Special Education (EI/ECSE) programs for young children with disabilities and their families for the past two decades. The importance of establishing successful partnerships between families and professionals in educational planning has…

Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996–2001)

International Nuclear Information System (INIS)

Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Mejía-Aranguré, Juan Manuel; Rendón-Macías, Mario Enrique; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

2004-01-01

The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996–2001. The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found. Of the children, the stage of

The Production of Professional School Counselors in Alabama: Graduation Rates of CACREP and Non-CACREP Programs

Science.gov (United States)

Boes, Susan R.; Snow, Brent M.; Chibbaro, Julie S.

2009-01-01

Today's professional school counselors have many roles and tasks within the schools. As more children depend on the services of school counselors, well-trained counselors are needed to meet the demands. Data presented in this paper provide support for the production of professional school counselors in Alabama and the immediate southeastern area…

Differentiating therapy-induced leukoencephalopathy from unmyelinated white matter in children treated for acute lymphoblastic leukemia (ALL)

Science.gov (United States)

Reddick, Wilburn E.; Glass, John O.; Pui, Ching-Hon

2003-05-01

Reliably detecting subtle therapy-induced leukoencephalopathy in children treated for cancer is a challenging task due to its nearly identical MR properties and location with unmyelinated white matter. T1, T2, PD, and FLAIR images were collected for 44 children aged 1.7-18.7 (median 5.9) years near the start of therapy for ALL. The ICBM atlas and corresponding apriori maps were spatially normalized to each patient and resliced using SPM99 software. A combined imaging set consisting of MR images and WM, GM and CSF apriori maps were then analyzed with a Kohonen Self-Organizing Map. Vectors from hyperintense regions were compared to normal appearing genu vectors from the same patient. Analysis of the distributions of the differences, calculated on T2 and FLAIR images, revealed two distinct groups. The first large group, assumed normal unmyelinated white matter, consisted of 37 patients with changes in FLAIR ranging from 80 to 147 (mean 117-/+17) and T2 ranging from 92 to 217 (mean 144-/+28). The second group, assumed leukoencephalopathy, consisted of seven patients with changes in FLAIR ranging from 154 to 196 (mean 171-/+19) and T2 ranging from 190 to 287 (mean 216-/+33). A threshold was established for both FLAIR (change > 150) and T2 (change > 180).

Head trauma in female professional wrestlers

International Nuclear Information System (INIS)

Nomoto, Jun; Seiki, Yoshikatsu; Nemoto, Masaaki

2007-01-01

The clinical characteristics of head trauma were evaluated in 18 wrestlers belonging to a female professional wrestling organization, 13 regular members and five trainees aged 15-34 years. Medical examinations for head trauma were performed in all wrestlers, and wrestlers treated at our emergency outpatient department were clinically evaluated. In addition, the relationships of head trauma with duration of the wrestling career of 1-16 years (mean 8 years) in the regular members, and less than 1 year in the five trainees, and body mass index (BMI) of 21.0-32.0 in the 16 subjects, excluding two trainees, was evaluated. Chronic symptoms were noted in four of the 18 wrestlers with long wrestling careers (16 years in 1, 13 years in 1, and 5 years in 2). Three wrestlers with symptoms immediately after head trauma showed recurrent retrograde amnesia and had low BMI (21.6, 21.6, and 23.1). Five wrestlers were treated at our emergency outpatient clinic, three required hospitalization and two showed intracranial traumatic changes on computed tomography (acute subdural hematoma in 1 and diffuse brain swelling in 1). Head trauma in female professional wrestlers is associated with longer wrestling career and low BMI. Periodic medical examinations are recommended to monitor for signs of head trauma. (author)

Reversible audiometric threshold changes in children with uncomplicated malaria

DEFF Research Database (Denmark)

Adjei, George O; Goka, Bamenla Q; Kitcher, Emmanuel

2013-01-01

Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs) with hearing...... is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n = 37), artemether-lumefantrine (n = 35), or amodiaquine (n = 8) in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared...... evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels...

[Anxiety in the parents of children treated in pediatric emergency services in Andalusia and its association with aspects of family functioning].