-
The Clinical Teacher Aug 2020Paediatric patients (PPs) often feel that they are not involved in care and treatment decisions. Although training clinicians may help, there is a lack of evaluated...
BACKGROUND
Paediatric patients (PPs) often feel that they are not involved in care and treatment decisions. Although training clinicians may help, there is a lack of evaluated training programmes specifically for work with PPs. The aim of this article is to evaluate 'Me first', a training programme aimed at improving clinicians' attitudes and communication skills when working with PPs.
METHODS
A total of 69 clinicians attended 'Me first' training and completed questionnaires across three time points: (1) prior to attending the training; (2) at the end of the training; and (3) 4-6 weeks later. This included 14 medical staff, 29 nursing staff and 26 allied health staff. Attitude was measured using the Leeds Attitudes to Concordance II (LATCon II) scale, and communication skills were measured using the Effective Listening and Interactive Communication Scale (ELICS).
RESULTS
Overall, clinicians reported that their attitude and communication skills improved after attending 'Me first'. This was maintained 4-6 weeks later. Subgroup analysis showed that allied health staff did not maintain the improved attitude at the follow-up conducted 4-6 weeks later. Subgroup analysis showed that allied health staff did not maintain the improved attitude at the follow-up conducted 4-6 weeks later CONCLUSIONS: Findings suggest that 'Me first' may be helpful in improving clinician attitudes and communication skills with PPs. Further research should examine whether PPs report higher levels of communication and decision making with clinicians who have attended training.
Topics: Attitude of Health Personnel; Child; Communication; Humans; Patient-Centered Care; Pediatrics; Surveys and Questionnaires
PubMed: 31710178
DOI: 10.1111/tct.13100 -
BMJ Paediatrics Open 2021Around the world, one in four children live in a country affected by conflict, political insecurity and disaster. Healthcare in humanitarian and fragile settings is... (Review)
Review
Around the world, one in four children live in a country affected by conflict, political insecurity and disaster. Healthcare in humanitarian and fragile settings is challenging and complex to provide, particularly for children. Furthermore, there is a distinct lack of medical literature from humanitarian settings to guide best practice in such specific and resource-limited contexts. In light of these challenges, Médecins Sans Frontières (MSF), an international medical humanitarian organisation, created the MSF Paediatric Days with the aim of uniting field staff, policymakers and academia to exchange ideas, align efforts, inspire and share frontline research and experiences to advance humanitarian paediatric and neonatal care. This 2-day event takes place regularly since 2016. The fourth edition of the MSF Paediatric Days in April 2021 covered five main topics: essential newborn care, community-based models of care, paediatric tuberculosis, antimicrobial resistance in neonatal and paediatric care and the collateral damage of COVID-19 on child health. In addition, eight virtual stands from internal MSF initiatives and external MSF collaborating partners were available, and 49 poster communications and five inspiring short talks referred to as 'PAEDTalks' were presented. In conclusion, the MSF Paediatric Days serves as a unique forum to advance knowledge on humanitarian paediatrics and creates opportunities for individual and collective learning, as well as networking spaces for interaction and exchange of ideas.
Topics: COVID-19; Child; Delivery of Health Care; Humans; Infant, Newborn; Medical Missions; Pediatrics; SARS-CoV-2
PubMed: 34632107
DOI: 10.1136/bmjpo-2021-001156 -
Journal of Clinical Research in... Sep 2020Long-term growth management can be challenging for patients, families and healthcare professionals (HCP). Personalised optimal responses to growth hormone (GH) therapy... (Review)
Review
Long-term growth management can be challenging for patients, families and healthcare professionals (HCP). Personalised optimal responses to growth hormone (GH) therapy depend on the creation of a good working relationship between the patient and family and the HCPs responsible for care. Current unmet needs in growth management will be discussed, focusing on the likelihood of a poor growth response and its identification and management with emphasis on the importance of good adherence to GH therapy. Digital tools are now available to record injections and communicate accurate adherence data to the HCP and patient. Psychological barriers to good adherence will be covered, with techniques identified to change behaviour and improve outcome. Motivational interviewing is a valuable skill in this respect and should be taught to both medical and nursing HCPs to enhance the quality of the relationship with the patient and family. Key messages are, firstly, the importance of personalised care with the HCP using acquired psychological skills to prevent and manage poor adherence. Secondly, a human-eHealth partnership is necessary to maximise the benefit of new digital tools to aid in successful growth management.
Topics: Child; Child Development; Delivery of Health Care, Integrated; Growth Disorders; Humans; Inventions; Pediatrics; Precision Medicine
PubMed: 31744271
DOI: 10.4274/jcrpe.galenos.2019.2019.0153 -
British Journal of Haematology Nov 2020Paediatric haematology began to establish itself as a speciality in the UK just over 60 years ago. In that time, clinical trials involving all the specialist centres in... (Review)
Review
Paediatric haematology began to establish itself as a speciality in the UK just over 60 years ago. In that time, clinical trials involving all the specialist centres in the country, and based on scientific advances, have dramatically improved the outlook for children with a range of malignant and non-malignant disorders, but particularly acute leukaemia. As in many specialties, multidisciplinary teams have played a major role in delivering these advances. With these structures in place at a national level, perhaps, of all specialities, paediatric haematology is poised to benefit from the new developments in precision medicine, gene editing and immunotherapy.
Topics: Adolescent; Child; Child, Preschool; Hematology; Humans; Infant; Infant, Newborn; Pediatrics; United Kingdom
PubMed: 33190251
DOI: 10.1111/bjh.17163 -
Pediatric Surgery International Jan 2021The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the... (Review)
Review
The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.
Topics: Child; Child, Preschool; Extracorporeal Membrane Oxygenation; Humans; Infant; Infant, Newborn; Pediatrics
PubMed: 33386443
DOI: 10.1007/s00383-020-04800-2 -
Indian Pediatrics Dec 2019
Topics: Humans; India; Pediatrics; Periodicals as Topic
PubMed: 31884424
DOI: No ID Found -
Pediatrics Dec 2019Pediatric surveillance of young children depends on providers' assessment of developmental milestones, yet normative data are sparse. Our objectives were to develop new...
BACKGROUND AND OBJECTIVES
Pediatric surveillance of young children depends on providers' assessment of developmental milestones, yet normative data are sparse. Our objectives were to develop new norms for common milestones to aid in clinical interpretation of milestone attainment.
METHODS
We analyzed responses to the developmental screening form of the Survey of Well-being of Young Children from 41 465 screens across 3 states. Associations between developmental status and a range of child characteristics were analyzed, and norms for individual questions were compared to guidelines regarding attainment of critical milestones from the Centers for Disease Control and Prevention (CDC).
RESULTS
A contemporary resource of normative data for developmental milestone attainment was established. Lower developmental status was associated with child age in the presence of positive behavioral screening scores ( < .01), social determinants of health ( < .01), Medicaid ( < .01), male sex ( < .01), and child race ( < .01). Comparisons between Survey of Well-being of Young Children developmental questions and CDC guidelines reveal that a high percentage of children are reported to pass milestones by the age at which the CDC states that "most children pass" and that an even higher percentage of children are reported to pass milestones by the age at which the CDC states that parents should "act early." An interactive data visualization tool that can assist clinicians in real-time developmental screening and surveillance interpretation is also provided.
CONCLUSIONS
Detailed normative data on individual developmental milestones can help clinicians guide caregivers' expectations for milestone attainment, thereby offering greater specificity to CDC guidelines.
Topics: Child; Child Development; Child, Preschool; Female; Humans; Male; Pediatrics; Physician's Role; Practice Guidelines as Topic; Surveys and Questionnaires; United States
PubMed: 31727860
DOI: 10.1542/peds.2019-0374 -
Cancer Metastasis Reviews Mar 2020Survival for childhood cancers has improved significantly over the last decades. However, patient outcomes have plateaued over the last decade for difficult-to-treat... (Review)
Review
Survival for childhood cancers has improved significantly over the last decades. However, patient outcomes have plateaued over the last decade for difficult-to-treat diseases. With high cure rates, decreasing long-term toxicities and sequelae remains crucial. Since many advances in childhood cancer research come from the adult oncology world, one of the key areas is improving the adaptation of tools that are essential for clinical trial conduct that were developed for adults into pediatrics. These include tools to evaluate toxicity, quality of life, radiological response, statistical methodology, or indicators of cancer care quality. In this review, we present ongoing international efforts to validate and adapt these tools for children and adolescents and discuss remaining challenges. These efforts will hopefully accelerate and improve the quality of pediatric oncology research in the upcoming years.
Topics: Age Factors; Child; Clinical Trials as Topic; Humans; Medical Oncology; Neoplasms; Pediatrics; Randomized Controlled Trials as Topic
PubMed: 31939050
DOI: 10.1007/s10555-020-09856-z -
AJR. American Journal of Roentgenology Aug 2021Pancreatitis is as common in children as it is in adults, though causes and accepted imaging strategies differ in children. In this narrative review we discuss the... (Review)
Review
Pancreatitis is as common in children as it is in adults, though causes and accepted imaging strategies differ in children. In this narrative review we discuss the epidemiology of childhood pancreatitis and key imaging features for pediatric acute, acute recurrent, and chronic pancreatitis. We rely heavily on our collective experience in discussing advantages and disadvantages of different imaging modalities; practical tips for optimization of ultrasound, CT, and MRI with MRCP in children; and image interpretation pearls. Challenges and considerations unique to imaging pediatric pancreatitis are discussed, including timing of imaging, role of secretin-enhanced MRCP, utility of urgent MRI, severity prediction, autoimmune pancreatitis, and best methods for serial imaging. We suggest a methodical approach to pancreatic MRI interpretation in children and have included a sample structured report, and we provide consensus statements according to our experience imaging children with pancreatitis.
Topics: Child; Diagnostic Imaging; Humans; Pancreas; Pancreatitis; Pediatrics; Periodicals as Topic
PubMed: 33728974
DOI: 10.2214/AJR.21.25508 -
Critical Care (London, England) Sep 2020Peripheral vascular catheterization (PVC) in pediatric patients is technically challenging. Ultrasound guidance has gained the most interest in perioperative and... (Review)
Review
Peripheral vascular catheterization (PVC) in pediatric patients is technically challenging. Ultrasound guidance has gained the most interest in perioperative and intensive care fields because it visualizes the exact location of small target vessels and is less invasive than other techniques. There have been a growing number of studies related to ultrasound guidance for PVC with or without difficult access in pediatric patients, and most findings have demonstrated its superiority to other techniques. There are various ultrasound guidance approaches, and a comprehensive understanding of the basics, operator experience, and selection of appropriate techniques is required for the successful utilization of this technique. This narrative review summarizes the literature regarding ultrasound-guided PVC principles, approaches, and pitfalls to improve its clinical performance in pediatric settings.
Topics: Catheterization, Peripheral; Child; Humans; Pediatrics; Ultrasonography, Interventional
PubMed: 32998762
DOI: 10.1186/s13054-020-03305-7