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Pediatrics Jun 2024
Topics: Humans; Child; Pediatrics
PubMed: 38804060
DOI: 10.1542/peds.2023-065014 -
Fetal and Pediatric Pathology Dec 2023Costs for sendout genetic testing on in-patients are billed to the hospital. Turnaround times are several weeks, often extending past the inpatient hospitalization. We...
Costs for sendout genetic testing on in-patients are billed to the hospital. Turnaround times are several weeks, often extending past the inpatient hospitalization. We concurrently reviewed all sendout genetic in-patient test requests over an 18-month period, deferring those that could be obtained as an outpatient, directing the tests to less expensive laboratories with complementary testing profiles, and identifying no-charge sponsored tests. Of 121 test requests, 25 were deferred, alternative less expensive laboratories were identified for 8, 16 requests were directed to sponsored tests, for a 42.3% cost saving. Of the 96 tests sent, 18 (18.8%) identified an explanatory genetic abnormality. Approximately 40% of the sendout genetic testing costs were reduced with prior test review. Deferment, alternative laboratories, and sponsored tests contributed to cost savings. Efficiency of diagnostic inpatient genetic testing was approximately 20%.
Topics: Child; Humans; Genetic Testing; Hospitalization; Laboratories; Pathologists; Pediatrics; Inpatients
PubMed: 37787107
DOI: 10.1080/15513815.2023.2263790 -
Current Opinion in Pediatrics Jun 2024Over the past four decades, pediatric emergency Medicine (PEM) has witnessed significant global development, with a notable increase in training programs and official... (Review)
Review
PURPOSE OF REVIEW
Over the past four decades, pediatric emergency Medicine (PEM) has witnessed significant global development, with a notable increase in training programs and official recognition by regulatory bodies. However, disparities persist in the recognition of PEM as an independent subspecialty, availability of training programs on a global scale, academic recognition, and the ability to provide high-quality care to children worldwide. There is paucity of published literature regarding development of PEM globally. This review explores the current trends and challenges in international pediatric emergency medicine.
RECENT FINDINGS
Current trends in international pediatric emergency medicine encompass the provision of training in pediatric-focused emergency and acute care, increased propagation of evidence-based guidelines specific to the care of children, the growth of collaborative research networks and interest groups within national and international societies. Simultaneously, the field continues to face challenges such as the lack of recognition, inequities in access, and a lack of dissemination of global PEM initiatives.
SUMMARY
While recent advancements have significantly enhanced the state of international pediatric emergency medicine, including pediatric specific research networks and training programs, barriers still hinder its overall quality. Many of these obstacles are not unique to pediatric emergency medicine but are directly affected by financial disparities and lack of governmental and public recognition of the essential role of pediatric emergency care.
Topics: Humans; Pediatric Emergency Medicine; Child; Global Health; Internationality; International Cooperation; Emergency Medicine
PubMed: 38655809
DOI: 10.1097/MOP.0000000000001355 -
Archives de Pediatrie : Organe Officiel... Aug 2023
Topics: Child; Humans; Diagnostic Equipment; Meta-Analysis as Topic; Pediatrics; Systematic Reviews as Topic; Guidelines as Topic
PubMed: 37244773
DOI: 10.1016/j.arcped.2023.04.001 -
Journal of Perinatology : Official... Jan 2024Artificial intelligence (AI) offers tremendous potential to transform neonatology through improved diagnostics, personalized treatments, and earlier prevention of... (Review)
Review
Artificial intelligence (AI) offers tremendous potential to transform neonatology through improved diagnostics, personalized treatments, and earlier prevention of complications. However, there are many challenges to address before AI is ready for clinical practice. This review defines key AI concepts and discusses ethical considerations and implicit biases associated with AI. Next we will review literature examples of AI already being explored in neonatology research and we will suggest future potentials for AI work. Examples discussed in this article include predicting outcomes such as sepsis, optimizing oxygen therapy, and image analysis to detect brain injury and retinopathy of prematurity. Realizing AI's potential necessitates collaboration between diverse stakeholders across the entire process of incorporating AI tools in the NICU to address testability, usability, bias, and transparency. With multi-center and multi-disciplinary collaboration, AI holds tremendous potential to transform the future of neonatology.
Topics: Infant, Newborn; Humans; Artificial Intelligence; Brain Injuries; Neonatology; Oxygen Inhalation Therapy; Sepsis
PubMed: 38097685
DOI: 10.1038/s41372-023-01848-5 -
Paediatric Anaesthesia Aug 2023Patient blood management is a patient-centered evidence-based approach to improve patient outcomes by harnessing the patient's own hematopoietic system to optimize blood... (Review)
Review
Patient blood management is a patient-centered evidence-based approach to improve patient outcomes by harnessing the patient's own hematopoietic system to optimize blood health while promoting patient safety and empowerment. Perioperative patient blood management is a standard of care in adult medicine, yet it is not commonly accepted in pediatrics. Raising awareness may be the first step in improving perioperative care for the anemic and/or bleeding child. This article highlights five preventable perioperative blood conservation error traps for children. The goal is to provide practical clinical guidance to improve preoperative diagnosis and treatment of anemia, facilitate recognition and treatment of massive hemorrhage, reduce unnecessary allogeneic blood transfusions, and decrease associated complications of anemia and blood component transfusions utilizing a patient/family-centered informed consent and shared decision-making approach.
Topics: Child; Humans; Anemia; Blood Transfusion; Hemorrhage; Perioperative Period; Pediatrics
PubMed: 37144721
DOI: 10.1111/pan.14683 -
Current Problems in Pediatric and... Dec 2023
Topics: Animals; Child; Humans; Pediatrics; Animal Assisted Therapy
PubMed: 38044174
DOI: 10.1016/j.cppeds.2023.101505 -
The European Respiratory Journal Jun 2024https://bit.ly/3TMm6bi
https://bit.ly/3TMm6bi
Topics: Humans; Hypertension, Pulmonary; Child; Pediatrics
PubMed: 38575157
DOI: 10.1183/13993003.01518-2023 -
Anales de Pediatria Sep 2023
Topics: Humans; Pediatrics; Biomedical Research
PubMed: 37598073
DOI: 10.1016/j.anpede.2023.06.017 -
Journal of Pediatric Psychology Jul 2023Pediatric psychologists have unique expertise to contribute to the care of youth with serious illnesses yet are not routinely integrated into pediatric palliative care...
OBJECTIVE
Pediatric psychologists have unique expertise to contribute to the care of youth with serious illnesses yet are not routinely integrated into pediatric palliative care (PPC) teams. To better define the role and unique skillset of psychologists practicing in PPC, support their systematic inclusion as part of PPC teams, and advance trainee knowledge of PPC principles and skills, the PPC Psychology Working Group sought to develop core competencies for psychologists in this subspecialty.
METHODS
A Working Group of pediatric psychologists with expertise in PPC met monthly to review literature and existing competencies in pediatrics, pediatric and subspecialty psychology, adult palliative care, and PPC subspecialties. Using the modified competency cube framework, the Working Group drafted core competencies for PPC psychologists. Interdisciplinary review was conducted by a diverse group of PPC professionals and parent advocates, and competencies were revised accordingly.
RESULTS
The six competency clusters include Science, Application, Education, Interpersonal, Professionalism, and Systems. Each cluster includes essential competencies (i.e., knowledge, skills, attitudes, roles) and behavioral anchors (i.e., examples of concrete application). Reviewer feedback highlighted clarity and thoroughness of competencies and suggested additional consideration of siblings and caregivers, spirituality, and psychologists' own positionality.
CONCLUSIONS
Newly developed competencies for PPC psychologists highlight unique contributions to PPC patient care and research and provide a framework for highlighting psychology's value in this emerging subspecialty. Competencies help to advocate for inclusion of psychologists as routine members of PPC teams, standardize best practices among the PPC workforce, and provide optimal care for youth with serious illness and their families.
Topics: Child; Humans; Palliative Care; Practice, Psychological; Psychology, Child; Pediatrics
PubMed: 37141582
DOI: 10.1093/jpepsy/jsad007