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Pediatric Neurology Dec 2023
Topics: Humans; Neurology; Abortion, Legal; Supreme Court Decisions; Pediatrics
PubMed: 37913564
DOI: 10.1016/j.pediatrneurol.2023.10.001 -
Pediatric Clinics of North America Feb 2024This article briefly reviews a 4-step process for implementing shared decision-making (SDM) in pediatrics. The authors address difficulties with determining whether SDM... (Review)
Review
This article briefly reviews a 4-step process for implementing shared decision-making (SDM) in pediatrics. The authors address difficulties with determining whether SDM should occur and comment on how the SDM process relates to, and may be conflated with, other decision-making models that leverage similar patient-centered and family-centered communication strategies.
Topics: Child; Humans; Communication; Decision Making; Patient Participation; Pediatrics
PubMed: 37973305
DOI: 10.1016/j.pcl.2023.08.001 -
Pediatric Neurology Jun 2024
Topics: Neurology; Awards and Prizes; Pediatrics; Humans
PubMed: 38763546
DOI: 10.1016/j.pediatrneurol.2024.04.014 -
Journal of Pain and Symptom Management Jul 2024Palliative care in the field of urology has largely been limited to adult oncologic conditions. Although there is a plethora of established literature suggesting the... (Review)
Review
Palliative care in the field of urology has largely been limited to adult oncologic conditions. Although there is a plethora of established literature suggesting the advantageous impact of palliative care, there is limited integration of palliative care in adult urology. This underutilization is further exacerbated in pediatric urology, and palliative care in pediatric urology remains an underexplored area despite the prevalence of several life-limiting conditions in this patient population. This paper highlights the potential need for palliative care intervention in a variety of urologic conditions in the pediatric population, including congenital lower urinary tract obstruction, neurogenic bladder dysfunction, exstrophy-epispadias complex, and congenital bilateral renal agenesis. Each condition poses unique challenges that can be addressed with the inclusion of a palliative care team, including decision-making spanning prenatal-neonatal-pediatric periods, acute and chronic symptom management, family relations, body image issues, risk of recurrent hospitalizations and surgeries, and potentially fatal complications. Alongside standard urologic interventions, palliative care can serve as an additional means of addressing physical and psychosocial symptoms experienced by pediatric urology patients to enhance the quality of life of patients and their families.
Topics: Humans; Palliative Care; Child; Pediatrics; Urologic Diseases; Urology
PubMed: 38521421
DOI: 10.1016/j.jpainsymman.2024.03.021 -
Pediatric Clinics of North America Feb 2024Confidentiality is a core component of adolescent health. Confidentiality is shown to be a basic human right that is in the best interest of the adolescent, addresses... (Review)
Review
Confidentiality is a core component of adolescent health. Confidentiality is shown to be a basic human right that is in the best interest of the adolescent, addresses health inequities, and supports adolescents' developing capacity. Practical aspects of confidentiality are discussed, resources provided to navigate a changing legal landscape, and threats to confidentiality addressed. Although confidentiality can be a source of conflict with parents and caregivers, pediatric providers can use confidentiality to assist parents and caregivers in shifting from making decisions for the adolescent to supporting the adolescent in making their own health decisions, thus facilitating a healthy transition to adulthood.
Topics: Adolescent; Child; Humans; Adolescent Health; Confidentiality; Parents; Primary Health Care; Pediatrics
PubMed: 37973306
DOI: 10.1016/j.pcl.2023.08.002 -
Pediatric Radiology May 2024Effective communication is an important aspect of providing quality healthcare. Radiology staff may be called upon to communicate results, even when it is difficult.... (Review)
Review
Effective communication is an important aspect of providing quality healthcare. Radiology staff may be called upon to communicate results, even when it is difficult. Simple, efficient communication models can be learned to reduce clinician distress and support patients and families through stressful times. These practical tips ensure essential communication elements are met, including assessing patient and family perspectives, clearly delivering medical information, responding with empathy, and collaborating around next steps. Models such as "Ask-Tell-Ask," "SPIKES," and "NURSE" can be used to disclose results, communicate serious news, and respond to emotion. Lastly, clinicians can also utilize "I wish… I worry… I wonder" statements to align with a patient's hopes and acknowledge a family's concerns, ultimately allowing healthcare professionals to support and guide families through challenging situations.
Topics: Humans; Communication; Pediatrics; Professional-Family Relations; Truth Disclosure; Radiology; Physician-Patient Relations; Child
PubMed: 38326566
DOI: 10.1007/s00247-024-05861-4 -
Pediatric Research Apr 2024
Topics: Humans; Pediatrics; Biomedical Research; Child
PubMed: 38233514
DOI: 10.1038/s41390-023-02983-7 -
Journal of Pediatric Urology Jun 2024
Topics: Humans; Urology; Pediatrics
PubMed: 38433080
DOI: 10.1016/j.jpurol.2024.02.019 -
Acta Paediatrica (Oslo, Norway : 1992) Aug 2023Evidence-based medicine has changed clinical practice by incorporating data from randomised controlled trials (RCTs). While some biases in RCTs are well recognised, we... (Review)
Review
Evidence-based medicine has changed clinical practice by incorporating data from randomised controlled trials (RCTs). While some biases in RCTs are well recognised, we discuss some less acknowledged. Selection bias may arise in the consent stage. Industry-funded studies more often report a positive outcome. Post-hoc changes of outcome measures and other mis-reporting lowers the reliability of outcome data. Finally, even the GRADE system retains subjectivity. CONCLUSION: Moving from "intuition" into "evidence-based" medicine involves grappling with several pitfalls. These pose challenges for authors, editors, reviewers, and readers. All require vigilance before drawing conclusions from presented data.
Topics: Humans; Neonatology; Outcome Assessment, Health Care; Bias; Evidence-Based Medicine
PubMed: 37151193
DOI: 10.1111/apa.16815 -
Journal of Perinatology : Official... Jun 2024
Topics: Humans; Infant, Newborn; Neonatology; Medical Informatics
PubMed: 38454154
DOI: 10.1038/s41372-024-01924-4