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Seminars in Pediatric Neurology Apr 2023
Topics: Child; Humans; Neurosciences; Pediatrics
PubMed: 37003630
DOI: 10.1016/j.spen.2023.101038 -
Pediatrics Jun 2020
Review
Topics: Acute Disease; Child; Female; Home Care Services; Hospitalization; Humans; Male; Patient Discharge; Pediatrics
PubMed: 32467093
DOI: 10.1542/peds.2019-0074 -
Journal of Advanced Nursing Mar 2024To provide an analysis of legacy and legacy-oriented interventions in paediatric healthcare. (Review)
Review
AIM
To provide an analysis of legacy and legacy-oriented interventions in paediatric healthcare.
DESIGN
Walker and Avant's method of concept analysis.
METHODS
Using Walker and Avant's method, three defining attributes of the concept were determined, followed by antecedents, consequences, and empirical referents of legacy.
RESULTS
In paediatrics, legacy is co-authored in relationships, has the capability to outlive the person or event it represents, and elicits the essence of a person or experience. Receiving legacy-oriented interventions are not a prerequisite for having a legacy, nor is death.
CONCLUSION
Engaging in purposeful, individualized legacy-oriented interventions can improve coping in paediatric patients, families, and providers. By understanding the concept of legacy, providers are better equipped to provide care honouring the unique personhood, relationships, and strengths of children and families in even the most dire circumstances.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE
Understanding the scope and purpose of legacy in paediatrics assists providers in improving patient- and family-centred outcomes by designing interventions that facilitate long-term coping in patients facing a loss of or significant change in health, normalcy, or life.
IMPACT
Legacy-oriented interventions are provided at most children's hospitals in the United States, yet no widespread consensus on foundation or scope has been determined. This concept analysis provides evidence-based guidelines for policy and practice in creating legacy for and with children, providing opportunities to improve quality of care for young patients and their families around the world.
REPORTING METHOD
N/A.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contribution.
Topics: Child; Humans; United States; Pediatrics; Delivery of Health Care
PubMed: 37921200
DOI: 10.1111/jan.15922 -
Pediatric Annals Jun 2024
Topics: Humans; Pediatrics; Hospitals, Pediatric; Child; Hospital Medicine; Patient Safety
PubMed: 38852081
DOI: 10.3928/19382359-20240407-03 -
Current Opinion in Clinical Nutrition... May 2020There is ongoing interest in nutritional screening tools in pediatrics to facilitate the identification of children at risk for malnutrition who need further assessment... (Review)
Review
PURPOSE OF REVIEW
There is ongoing interest in nutritional screening tools in pediatrics to facilitate the identification of children at risk for malnutrition who need further assessment and possible nutritional intervention. The choice for a specific tool depends on various factors. This review aims to provide an overview of recent progress in pediatric nutritional screening methods.
RECENT FINDINGS
We present recent studies about newly developed or adjusted tools, the applicability of nutritional screening tools in specific populations, and how to implement screening in the overall process of improving nutritional care in the pediatric hospital setting.
SUMMARY
Three new screening tools have been developed for use on admission to hospital: two for the mixed pediatric hospitalized population and one for infants. A simple weekly rescreening tool to identify hospital-acquired nutritional deterioration was developed for use in children with prolonged hospital stay. Different from most previous studies that only assessed the relationship between the nutritional risk score and anthropometric parameters of malnutrition, new studies in children with cancer, burns, and biliary atresia show significant associations between high nutritional risk and short-term outcome measures such as increased complication rate and weight loss. For implementation of a nutritional care process incorporating nutritional screening in daily practice, simplicity seems to be of great importance.
Topics: Child; Child Nutrition Disorders; Child, Preschool; Female; Humans; Infant; Male; Mass Screening; Nutrition Assessment; Pediatrics; Risk Assessment
PubMed: 32068547
DOI: 10.1097/MCO.0000000000000644 -
Developmental Medicine and Child... May 2020Currently, coaching is increasingly applied to foster the involvement of families with an infant or young child with special needs in early intervention and paediatric... (Review)
Review
Currently, coaching is increasingly applied to foster the involvement of families with an infant or young child with special needs in early intervention and paediatric rehabilitation. Coaching practices are included in many forms of intervention and are regarded as essential to reach beneficial outcomes for the child and family. There are, however, many ambiguities that blur the concept of coaching and hamper its understanding and integration as an evidence-based approach in early intervention and paediatric rehabilitation: lack of differentiation between coaching and training of families, for example. Challenges to incorporate coaching into professional practice relate to adult learning processes and knowledge acquisition, and transformation of attitudes, beliefs, and treatment habits. In this paper, we review the barriers encountered and the possibilities available to promote successful implementation of coaching in early childhood interventions. WHAT THIS PAPER ADDS: Literature defines coaching ambiguously, which hampers its implementation in early intervention. The term 'coaching' should be reserved for relationship-directed, family-centred intervention.
Topics: Child; Early Intervention, Educational; Family Practice; Humans; Mentoring; Parent-Child Relations; Pediatrics; Professional-Family Relations; Rehabilitation
PubMed: 32065385
DOI: 10.1111/dmcn.14493 -
BMJ Supportive & Palliative Care Jun 2020To review literature relating to evidence, context and facilitation to describe knowledge translation in paediatric palliative care. Paediatric palliative care requires...
OBJECTIVES
To review literature relating to evidence, context and facilitation to describe knowledge translation in paediatric palliative care. Paediatric palliative care requires competences including both paediatric specialists as well as services that are developed for this purpose, and there is a need to facilitate paediatric palliative care knowledge translation. Promoting Action on Research Implementation in the Health Services (PARiHS) is a framework for knowledge translation, which highlights the relationships between evidence, context and facilitation. PARiHS framework has been revised and updated in a new version called i-PARiHS.
METHODS
The electronic databases AgeLine, CINAHL, The Cochrane Library, PsycINFO, PubMed and Scopus were searched. Papers included were limited to English and Swedish publications and restricted to publications dated between 1993 and August 2019. All types of observational and experimental studies using any research design were included.
RESULTS AND CONCLUSIONS
Thirty-eight articles were included and there was a common vision about how and when palliative care should be offered to children. The i-PARiHS was used as a lens to describe the knowledge translation in paediatric palliative care. Symptom relief was the most commonly described evidence-based strategy, and the hospital environment was the most commonly described context. Different types of education were the most commonly used strategies to facilitate knowledge translation. The results mainly focused on increasing knowledge of palliative care in paediatric care. To sum up, the results report strategies to achieve knowledge translation of paediatric palliative care, and these can be interpreted as a guideline for how this process can be facilitated.
TRIAL REGISTRATION NUMBER
CRD42018100663.
Topics: Child; Female; Health Services Research; Humans; Male; Palliative Care; Pediatrics; Translational Research, Biomedical
PubMed: 31836595
DOI: 10.1136/bmjspcare-2019-001934 -
Pediatrics Jul 2021Screening and surveillance are integral aspects of child health promotion and disease prevention. The American Academy of Pediatrics recommends that primary care... (Review)
Review
Screening and surveillance are integral aspects of child health promotion and disease prevention. The American Academy of Pediatrics recommends that primary care clinicians screen children and adolescents for a broad array of conditions, conduct surveillance of growth and development, identify social determinants of health, and identify protective and risk factors that might impact health over time. However, access to and outcomes of preventive services vary based on features of children’s social ecology, including family and community contexts. The proposed five-stage socio-ecological model considers multiple contextual dimensions of pediatric screening: (1) individual, (2) interpersonal, (3) organizational, (4) community/population, and (5) public policy. Incorporating this model into routine care might improve outcomes at the individual and population level. Future endeavors should focus on integration of this model with validated risk screening tools as part of a supportive electronic health record, culture, and incentive structure. Further research assessing the contributors and outcomes of differences in beliefs, resources, practices, and opportunities among individuals, families, providers, primary care organizations, communities, health systems, and policy partners will be essential in advancing knowledge and policies to improve preventive services delivery.
Topics: Adolescent; Child; Delivery of Health Care; Education; Humans; Pediatrics; Preventive Medicine; Social Environment
PubMed: 34210842
DOI: 10.1542/peds.2021-050693D -
International Journal of Pharmaceutics Mar 2022The total number of paediatric formulations available only account for a small proportion of the full therapeutic plethora required to effectively treat paediatrics and,... (Review)
Review
The total number of paediatric formulations available only account for a small proportion of the full therapeutic plethora required to effectively treat paediatrics and, therefore, the availability of high quality medicines designed specifically for children remains an ongoing challenge. Currently, the World Health Organisation (WHO) report that around 50% of medication issued for long-term conditions are not taken as advised, whilst it has also been established that, in general practice, around one tenth of medicines prescribed for children are either off-label or unlicensed. Such off-label and unlicensed use is owing to the considerable anatomical and physiological differences observed between paediatric subsets. Identifying such differences, is essential for better informing paediatric drug development and assisting regulatory reviews, whilst ensuring safe and effective therapeutic concentrations of pharmacological substances. Points covered: The review discusses factors affecting the safety, toxicity and efficacy of paediatric drug delivery systems. The research highlights features of the gastrointestinal tract and reports anatomical and physiological differences between paediatrics and adults. Additionally, differences observed in paediatric pharmacokinetic profiles (absorption, distribution, metabolism and elimination) due to physiological differences are also discussed. Furthermore, this review considers the advantages and limitations of current paediatric specific dosage forms available and assesses the acceptability of innovative small flexible solid oral dosage forms. Lastly, this review highlights factors affecting paediatric medicine adherence and acceptability and discusses the techniques available to overcome barriers associated with non-adherence.
Topics: Adult; Child; Dosage Forms; Humans; Off-Label Use; Pediatrics; Pharmaceutical Preparations
PubMed: 35092832
DOI: 10.1016/j.ijpharm.2022.121501 -
Irish Medical Journal Jul 2020Aim Compare the opinion of paediatric consultants to paediatric Senior House Officers (SHOs) with regards their perceived level of preparedness for starting work in...
Aim Compare the opinion of paediatric consultants to paediatric Senior House Officers (SHOs) with regards their perceived level of preparedness for starting work in paediatrics. Methods A 5-point Likert scale questionnaire was administered to paediatric consultants and SHOs investigating how well they considered the SHO was performing and how well prepared the SHO perceived themselves for work in clinical paediatrics, respectively. Questions related to procedures, clinical examination, teamwork, history taking and OPD related activity. Results 50 Consultants and 75 SHOs completed the questionnaire. Using a Mann-Whitney U test, both groups answered similarly to questions relating to clinical examination and history taking (p=0.51 and p=0.15). However, there were significant differences in their responses to questions relating to procedures, teamwork and OPD related activity (p<0.05). Conclusion There is a significant disparity between consultant opinion of ability and SHOs perception of preparedness for some of the same skills. More work, focusing on these specific aspects of undergraduate paediatric education needs to be carried out to improve graduate preparedness for this role.
Topics: Clinical Competence; Consultants; Education, Medical, Graduate; Education, Medical, Undergraduate; Humans; Medical History Taking; Pediatrics; Surveys and Questionnaires; Training Support
PubMed: 32846081
DOI: No ID Found