-
Turkish Archives of Pediatrics Nov 2023Electrocardiography (ECG) is an important diagnostic tool used in the early diagnosis and treatment of arrhythmias and conduction disorders. Pediatricians need to...
OBJECTIVE
Electrocardiography (ECG) is an important diagnostic tool used in the early diagnosis and treatment of arrhythmias and conduction disorders. Pediatricians need to interpret the ECGs correctly and be able to decide the situations that require pediatric cardiology consultation. In this study, we aimed to determine the ECG evaluation competencies of pediatricians. The obtained data will serve as a guide for the development of a training module.
MATERIALS AND METHODS
Pediatric residents and specialists were included in the study. A questionnaire was sent to the participants via Google Forms. In this questionnaire, participants were asked to evaluate whether 10 ECG samples were normal or abnormal, detect the abnormality in the ECGs, define the specific diagnosis, and indicate how confident they were in their evaluation. A total of 242 participants, 160 of whom were pediatric residents and 82 were pediatricians, were included in the study.
RESULTS
The mean knowledge level of the participants was 17 ± 4.1 out of 30 points. Electrocardiography knowledge score increased with increasing age, increasing experience after graduation from medical school, increasing seniority during residency training, and increasing self-confidence in ECG interpretation. A significant difference was found between the ECG knowledge scores of those who attended an ECG course after graduation and those who did not. The rate of correctly defining the distinction between normal and abnormal was 93.7%. The rate of detecting pathologies in ECGs accurately and correct identification of specific diagnosis was 56.7%.
CONCLUSION
The accuracy level of pediatricians in ECG evaluation is low. Electrocardiography trainings are needed to develop ECG assessment skills.
PubMed: 37915270
DOI: 10.5152/TurkArchPediatr.2023.23075 -
Archives de Pediatrie : Organe Officiel... Nov 2023Over the past decades, productivity practices at hospital resulted in staff overload and burnout. Prompted by physicians' complaints, this study assessed the level of...
Over the past decades, productivity practices at hospital resulted in staff overload and burnout. Prompted by physicians' complaints, this study assessed the level of psychosocial risk among senior pediatricians in a university hospital. The survey used the checklist of Quebec's National Institute of Public Health that comprises two six-indicator parts: "Context" and "Key Components" of the Organization. The psychosocial risk level was evaluated by a physician-psychologist duo during interviews of homogeneous groups of workers. The indicators were scored, tabulated, and discussed. The survey led to a substantial qualitative and quantitative clarification of physicians' working conditions, claims, and needs. Regarding Context, the staff reported mainly: (a) cumbersome organization and norms vs. limited human resources (lack of stability, incentives, and promotions); (b) absenteeism and presenteeism; (c) reluctance to seek care or advice for fear of discredit; (d) presence of verbal violence; (e) self-imposed harsh returns-to-work; (f) work-life conflicts and difficult mental disconnection from work. Regarding the Key Components, the staff reported mainly: (a) work overload (physical, mental, psychological, and relational/social), continuous stress, and perceived exhaustion; (b) low job satisfaction and insufficient recognition; (c) inconstant support by their superiors; (d) poor job relationships and colleagues' support; (e) occasional participation and lack of real autonomy and/or strategy sharing. The survey succeeded in underlining concerning issues that required the immediate attention of occupational physicians and managers. It proved the method feasible and valuable in the medical context despite a high diversity of staff functions and degrees.
Topics: Child; Humans; Hospitals, Pediatric; Physicians; Burnout, Professional; Pediatricians; Surveys and Questionnaires
PubMed: 37777348
DOI: 10.1016/j.arcped.2023.09.004 -
Clinical updates in inborn errors of immunity: a focus on the noninfectious clinical manifestations.Current Opinion in Pediatrics Apr 2024In the last 5 years, several new inborn errors of immunity (IEI) have been described, especially in the areas of immune dysregulation and autoinflammation. As a result,... (Review)
Review
PURPOSE OF REVIEW
In the last 5 years, several new inborn errors of immunity (IEI) have been described, especially in the areas of immune dysregulation and autoinflammation. As a result, the clinical presentation of IEIs has broadened. We review the heterogeneous presentation of IEIs and detail several of the recently described IEIs with a focus on the noninfectious manifestations commonly seen.
RECENT FINDINGS
IEIs may present with early onset and/or multiple autoimmune manifestations, increased risk for malignancy, lymphoproliferation, severe atopy, autoinflammation and/or hyperinflammation. Because of this, patients can present to a wide array of providers ranging from primary care to various pediatric subspecialists. The International Union of Immunological Societies (IUIS) expert committee has created a phenotypic classification of IEIs in order to help clinicians narrow their evaluation based on the laboratory and clinical findings.
SUMMARY
Both primary care pediatricians and pediatric subspecialists need to be aware of the common clinical features associated with IEI and recognize when to refer to allergy-immunology for further evaluation. Early diagnosis can lead to earlier treatment initiation and improve clinical outcomes for our patients.
Topics: Humans; Child; Cognition; Pediatricians
PubMed: 38299990
DOI: 10.1097/MOP.0000000000001331 -
Frontiers in Public Health 2023Breastfeeding (BF) is considered an essential component of optimal care for child health and development. In the past two decades, global data have shown improvements in...
INTRODUCTION
Breastfeeding (BF) is considered an essential component of optimal care for child health and development. In the past two decades, global data have shown improvements in some, but not all, BF indicators. Despite these positive changes sales and per capita intake of commercial milk formula (CMF) have increased globally. The CMF industry invests millions of dollars in marketing, which targets families and healthcare professionals (HCP). In Mexico, more than half of the mothers (53%) who feed their infants with CMF chose their Brand on the recommendation of HCP. Understanding the reasons behind the current recommendations for the use of CMF by HCP is important for the design of BF interventions. The primary objective of this study was to explore Mexican HCP' beliefs, attitudes, perceptions, and practices about early infant feeding practices, and reasons for recommending CMF. The secondary objective was to explore pregnant women and mother's perceptions of the infant feeding recommendations they received from HCP, and of the factors that influenced their infant feeding decisions.
METHODS
The study was based on a secondary qualitative data analysis of a WHO/UNICEF multi-country study. We analyzed focus group discussions (FGDs) and in-depth interviews (IDIs) from Mexico. Data were collected through convenience sampling in Mexico City and Guadalajara. HCP (n = 34) analysis was based on IDIs, and pregnant women or mothers of children 0-18 months ( = 74) on FGDs and IDIs.
RESULTS
Through a thematic analysis, we identified the socioecology of BF and triangulated HCP and women's accounts. HCP, pregnant women, and mothers recognized that several factors might have influenced their infant feeding decisions including healthcare facilities' policies and maternal work conditions. Although HCP believed that BF is the best way to feed newborns and young children, they routinely recommended CMF. On the other hand, pregnant women and mothers had a strong belief that BF is the best way to feed their babies. However, when women sought support from HCP, the latter often recommended switching to CMF.
DISCUSSION
This study highlights the discordance between HCP perceptions and mothers' experiences of HCP recommendations about infant feeding. Our findings support a national call for policy actions.
Topics: Animals; Female; Humans; Infant; Infant, Newborn; Pregnancy; Breast Feeding; Health Knowledge, Attitudes, Practice; Mexico; Milk; Mothers
PubMed: 38045970
DOI: 10.3389/fpubh.2023.1260222 -
European Journal of Pediatrics Nov 2023
Topics: Humans; Power, Psychological; Pediatricians
PubMed: 37589776
DOI: 10.1007/s00431-023-05158-y -
Pediatric Annals Feb 2024Despite advancements in sickle cell disease (SCD) management, individuals with SCD continue to face greater degrees of mortality, disability, and health care barriers...
Despite advancements in sickle cell disease (SCD) management, individuals with SCD continue to face greater degrees of mortality, disability, and health care barriers compared with their healthy peers. Comprehensive care includes essential elements such as newborn screening, key immunizations, penicillin prophylaxis, and consistent health screening for common complications. Pediatricians should be familiar with treatment options for SCD to offer informed education to both patients and their families. By providing guided and comprehensive care, pediatricians have the potential to enhance both the quantity and quality of life for individuals living with SCD. .
Topics: Infant, Newborn; Humans; Quality of Life; Anemia, Sickle Cell; Neonatal Screening
PubMed: 38302120
DOI: 10.3928/19382359-20231205-02 -
Journal of Clinical Immunology Dec 2023
PubMed: 38112825
DOI: 10.1007/s10875-023-01628-y -
Archives of Disease in Childhood Jun 2024Over the last century, changes in legislation, social constructs and the perceptions of what family life 'should' look like have significantly transformed the process of... (Review)
Review
Over the last century, changes in legislation, social constructs and the perceptions of what family life 'should' look like have significantly transformed the process of adoption in England. The role of adoption has shifted from providing orphaned children a stable new home to today's regulated process mainly supporting children who have suffered early physical or social adversity. This provides significant challenges to adopters, paediatricians, child psychiatrists and teachers who can only support adopted children by understanding their needs.
Topics: Humans; England; Adoption; Child; Child Welfare; History, 20th Century
PubMed: 37770117
DOI: 10.1136/archdischild-2023-325655 -
Pediatric Research Sep 2023
Topics: Humans; Surveys and Questionnaires; Pediatricians
PubMed: 37016002
DOI: 10.1038/s41390-023-02571-9 -
World Journal of Clinical Pediatrics Dec 2023Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides... (Review)
Review
Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification, highlighting essential aspects for clinical management. The article analyzed relevant studies to explore the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Results show that distal RTA (type 1) is particularly associated with nephrocalcinosis, which presents a higher risk of renal calcification. However, there are limitations to the existing literature, including a small number of studies, heterogeneity in methodologies, and potential publication bias. Longitudinal data and control groups are also lacking, which limits our understanding of long-term outcomes and optimal management strategies for children with RTA and renal calcification. Pediatricians play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated complications. In addition, alkaline therapy remains a cornerstone in the treatment of RTA, aimed at correcting the acid-base imbalance and reducing the formation of kidney stones. Therefore, early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected children. Further research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.
PubMed: 38178934
DOI: 10.5409/wjcp.v12.i5.295