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Open Access Emergency Medicine : OAEM 2024The objective of this review was to explore parents' experiences and information needs regarding management of their child with an intellectual and/or developmental... (Review)
Review
Seeking Care for Children with Intellectual and/or Developmental Disabilities in the Emergency Department: A Mixed Methods Systematic Review of Parents' Experiences and Information Needs.
The objective of this review was to explore parents' experiences and information needs regarding management of their child with an intellectual and/or developmental disability (IDD) in the emergency department (ED). We searched six electronic databases and grey literature to identify primary studies in English published since 2000. We synthesized quantitative and qualitative outcome data simultaneously using a convergent integrated approach and used a Mixed Methods Appraisal Tool (MMAT) to assess methodological quality of the included studies. Nine articles derived from seven studies were included (3 qualitative, 3 quantitative, 1 mixed method). Four main themes related to parents' self-reported experiences were identified: 1) appropriateness of the ED to manage and support their child; 2) acknowledgement/recognition of their child's IDD and incorporation of those considerations into overall care and management; 3) managing and navigating the ED environment; and 4) decision to disclose their child's condition when visiting the ED. Two articles provided data relevant to information needs, highlighting parents' desire to have resources supporting ED orientation and access to services within and outside of the ED setting. From the limited number of studies, it was evident that parents wanted better communication with healthcare providers and a greater understanding by ED staff around physical space settings needed to support their child. Resources supporting ED staff and parents to communicate effectively and work together can ensure that children with IDDs care needs are met. Further research into understanding parents' experiences and information needs related to managing a child with an IDD in the ED is needed to guide the development of effective resources.
PubMed: 38912093
DOI: 10.2147/OAEM.S450191 -
Frontiers in Pediatrics 2024Traffic accidents, particularly blunt impacts, cause serious injuries in children. We aimed to assess inflammatory and injury responses in infant rabbits subjected to...
BACKGROUND
Traffic accidents, particularly blunt impacts, cause serious injuries in children. We aimed to assess inflammatory and injury responses in infant rabbits subjected to acute lung injury resulting from blunt impact, with the goal of identifying potential circulatory injury markers.
METHODS
Forty 4-week-old infant rabbits were subjected to a right chest impact using a Hopkinson bar with 2,600 g. Computed tomography was employed to assess injury severity. Pathological changes were observed using hematoxylin and eosin staining in the control, 0, 24, and 72 h groups, post-injury. Immunohistochemistry was used to examine surfactant protein A (SP-A) changes in right lung tissues and upper main bronchi. Serum levels of interleukin-6 (IL-6), IL-8, and SP-A were measured using ELISA within 24 h post-injury in the control, 0 h, and 24 h groups.
RESULTS
Following blunt injury, significant increases were observed in blood white blood cell count ( = 101.556, < 0.01) and neutrophil percentage ( = 104.228, < 0.01), which gradually decreased after 24 and 72 h. The lung wet/dry weight ratio indicated significant edema ( = 79.677, < 0.01), corroborated by hematoxylin and eosin staining showing edema, exudation, and marked granulocyte infiltration in the control, 0 h, 24 h and 72 h groups. SP-A levels decreased rapidly at 0 h, and recovered between 24 and 72 h in the right lung tissues ( = 6.7, < 0.05), left lung ( = 15.825, < 0.05) and upper main bronchi ( = 59.552, < 0.01). The ELISA results showed increasing trends for the control and 0 h groups, while decreasing trends were observed in 24 h group for IL-6 ( = 58.328, < 0.01) and IL-8 ( = 41.802, < 0.01). Conversely, SP-A exhibited a decreasing trend in the control and 0 h groups but increased in the serum of 24 h group ( = 52.629, < 0.01).
DISCUSSION
In cases of direct chest trauma in infant rabbits, particularly mild injuries without rib fractures. SP-A levels correlated with pathological changes across all groups and may serve as biomarkers for pediatric blunt lung impact.
PubMed: 38910959
DOI: 10.3389/fped.2024.1354531 -
Research Involvement and Engagement Jun 2024Discharge communication is essential to convey information regarding the care provided and follow-up plans after a visit to a hospital emergency department (ED), but it...
BACKGROUND
Discharge communication is essential to convey information regarding the care provided and follow-up plans after a visit to a hospital emergency department (ED), but it can be lacking for visits for pediatric mental health crises. Our objective was to co-design and conduct usability testing of new discharge communication interventions to improve pediatric mental health discharge communication.
METHODS
The study was conducted in two phases using experience-based co-design (EBCD). In phase 1 (Sep 2021 to Jan 2022), five meetings were conducted with a team of six parents and two clinicians to co-design new ED discharge communication interventions for pediatric mental health care. Thematic analysis was used to identify patterns in team discussions and participant feedback related to discharge communication improvement and the Capability, Opportunity, Motivation, Behavior (COM-B) model was used to identify strategies to support the delivery of the new interventions. After meeting five, team members completed the Public and Patient Engagement Evaluation Tool (PPEET) to evaluate the co-design experience. In phase 2 (Apr to Jul 2022), intervention usability and satisfaction were evaluated by a new group of parents, youth aged 16-24 years, ED physicians, and nurses (n = 2 of each). Thematic analysis was used to identify usability issues and a validated 5-point Likert survey was used to evaluate user satisfaction. Evaluation results were used by the co-design team to finalize the interventions and delivery strategies.
RESULTS
Two discharge communication interventions were created: a brochure for families and clinicians to use during the ED visit, and a text-messaging system for families after the visit. There was high satisfaction with engagement in phase 1 (overall mean PPEET score, 4.5/5). In phase 2, user satisfaction was high (mean clinician score, 4.4/5; mean caregiver/youth score, 4.1/5) with both interventions. Usability feedback included in the final intervention versions included instructions on intervention use and ensuring the text-messaging system activates within 12-24 h of discharge.
CONCLUSIONS
The interventions produced by this co-design initiative have the potential to address gaps in current discharge practices. Future testing is required to evaluate the impact on patients, caregivers, and health care system use after the ED visit.
PubMed: 38907328
DOI: 10.1186/s40900-024-00594-y -
PloS One 2024Reducing the risk of infection transmission by getting emergency care for pediatric patients is a challenging task.
BACKGROUND
Reducing the risk of infection transmission by getting emergency care for pediatric patients is a challenging task.
AIM
The study aim was to assess emergency nurses' readiness to provide care for pediatric patients with infectious diseases.
METHOD
Two hundred Jordanian emergency department nurses were surveyed using a descriptive design.
RESULTS
The study revealed that insufficient safety and infection control procedures were put into place, starting with family support to allow nurses to work 145 (78%), family care plans intended to assist caregivers 139 (74.7%), the availability of respiratory protection and a backup plan for standard precautions, training requirements, and equipment 131 (70.4%), create a unit pandemic safety strategy 124 (66.7%), have a plan for emergencies for at-risk staff 116 (62.4%), have a hospital pandemic safety plan 113 (60.8%), manage inventory 102 (54.8%), use reuse guidelines if there will be severe shortages 99 (53.2%), create a strategy for nurses' access to healthcare for themselves and their families 96 (51.6%), and end with any required system updates for new policies 88 (47.3%). Staff nurses made up a large proportion of participants (145; 78%; 115; 62.8%) who said they lacked experience with care for pediatric patients with infectious illnesses who were critically sick. A 62.8% of nurses reported they did not have training in infectious disease emergency prevention and control for pediatric patients. What nurses prioritize it was determined that the concept of crisis standards of care (34.9%) was the most important educational topic for training emergency room nurses to care for pediatric patients who are critically ill with infectious infections, while the clarity of communication pathways was ranked lowest.
CONCLUSION
More training and support are needed for emergency room nurses to properly care for children's patients with infectious illnesses.
Topics: Humans; Emergency Service, Hospital; Female; Male; Child; Jordan; Adult; Infection Control; Surveys and Questionnaires; Evidence-Based Practice; Middle Aged; Patient Care
PubMed: 38905253
DOI: 10.1371/journal.pone.0305001 -
PloS One 2024The aim of the study was to assess the success of an adaption of the Students' Attitudes Towards Addressing Sexual Health Extended Questionnaire (SA-SH-Ext) in meeting...
Nursing and midwifery students' attitudes towards addressing patient sexual health in their future profession: Polish adaptation and validation of the students' attitudes towards addressing sexual health extended questionnaire (SA-SH-Ext).
The aim of the study was to assess the success of an adaption of the Students' Attitudes Towards Addressing Sexual Health Extended Questionnaire (SA-SH-Ext) in meeting Polish linguistic and cultural norms, as well as to ascertain the nursing and midwifery students' attitudes towards addressing sexual health using the SA-SH-Ext questionnaire. The sample size of the cross-sectional validation study consisted of 570 Polish nursing and midwifery students. The collected data was used to examine the internal consistency reliability and construct validity using exploratory factor analysis (EFA). Internal consistency reliability showed a Cronbach's alpha value of 0.91, and construct validity measured by exploratory factor analysis (EFA) demonstrated good results. The Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) was high and amounted to 0.923, and the Bartlett's test of sphericity was significant (p = 0.000). The analysis of construct validity demonstrated five major factors: "Present feelings of comfortableness" (Factor 1), "Future working environment" (Factor 2), "Fear of negative influence on future patient relation" (Factor 3), "Educational needs-Awareness of knowledge gap" (Factor 4), "Educational needs-Awareness of the needs for competences" (Factor 5). The SA-SH-Ext v.PL questionnaire is a reliable and valuable instrument for assessing the level of perceived preparedness among nursing and midwifery students in addressing patient sexual health, a field often neglected in health and holistic care.
Topics: Humans; Students, Nursing; Surveys and Questionnaires; Female; Poland; Sexual Health; Male; Cross-Sectional Studies; Midwifery; Adult; Attitude of Health Personnel; Young Adult; Reproducibility of Results
PubMed: 38905205
DOI: 10.1371/journal.pone.0300515 -
Alternative Therapies in Health and... Jun 2024Pediatric purulent tonsillitis is a common infectious disease in children and can be difficult to cure and can recur with irritation of the throat. To improve treatment...
CONTEXT
Pediatric purulent tonsillitis is a common infectious disease in children and can be difficult to cure and can recur with irritation of the throat. To improve treatment outcomes, alleviate symptoms, and promote recovery, an effective clinical-nursing intervention is often necessary.
OBJECTIVE
The study aimed to explore the specific measures of the comprehensive nursing model for pediatric patients with purulent tonsillitis and to analyze its practical value in improving patients' treatment outcomes and quality of life (QoL) in clinical application, to provide feasible references and guidance for medical practice.
DESIGN
The research team conducted a randomized controlled trial.
SETTING
The study took place at Mengcheng County First People's Hospital.
PARTICIPANTS
Participants were 80 pediatric patients who had received a diagnosis of purulent tonsillitis at the hospital between December 2020 and March 2022.
INTERVENTIONS
The research team randomly divided participants into two groups, with 40 participants in each group: (1) the intervention group, who received comprehensive nursing care in addition to routine nursing care, and (2) the control group, who received routine nursing care only.
OUTCOME MEASURES
The research team: (1) evaluated times to relief of throat pain and to improvement of hoarseness, (2) assessed times to recovery of body temperature, white blood cells, and tonsillar signs, (3) measured treatment compliance, and (4) conducted a health knowledge survey with the children' family members at baseline and postintervention using a visual analogue scale (VAS).
RESULTS
Compared to control group, the intervention group's (1) times to relief of throat pain and improvement time of hoarseness were significantly shorter (both P < .05); (2) times to recovery of temperature (P = .002), white blood cells (P = .006), and tonsillar signs (P = .024) were significantly shorter; (3) treatment compliance was significantly higher (P = .021); and (4) level of health knowledge of family members was significantly higher (P < .001).
CONCLUSIONS
The comprehensive nursing model for pediatric purulent tonsillitis can effectively improve pediatric patients' treatment outcomes, shorten their recovery times, enhance the health knowledge of family members, and provide a better focus on the overall health of pediatric patients. The model has a positive significance for pediatric patients' rehabilitation and is worth promoting.
PubMed: 38904631
DOI: No ID Found -
PloS One 2024Children living with HIV/AIDS are particularly vulnerable to under-nutrition. Under-nutrition associated with HIV/AIDS infection increases the rate of morbidity and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Children living with HIV/AIDS are particularly vulnerable to under-nutrition. Under-nutrition associated with HIV/AIDS infection increases the rate of morbidity and mortality in children. To reaffirm a future objective, there needs to be evidence regarding the current national burden of under-nutrition and related factors among children infected with HIV. Hence, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in Ethiopia.
METHODS
We searched Ethiopian universities' online libraries, Google, Google Scholar, PubMed, CINAHL, Cochrane Library, and Scopus to find the primary studies for this review. Publication bias was checked through Egger's regression test. Heterogeneity among the included studies was assessed using the I2 test. The data were extracted using Microsoft Excel and exported to STATA Version 14 statistical software. A random effect meta-analysis model was performed to estimate the pooled prevalence of Under-nutrition.
RESULTS
After reviewing 1449 primary studies, 16 articles met the inclusion criteria and were included in the final meta-analysis. The estimated pooled prevalence of stunting, underweight, and wasting among children living with HIV/AIDS was 32.98% (95% CI: 22.47, 43.50), 29.76% (95% CI: 21.87, 37.66), and 21.16% (95% CI: 14.96, 27.35) respectively.
CONCLUSIONS
This study showed that under-nutrition among HIV-infected children in Ethiopia was significantly high. Under-nutrition is more common among HIV-infected children with opportunistic infections, child feeding problems, do not adhere to dietary recommendations, and have diarrhea. The national policies and strategies for ART service- provider centers should maximize their emphasis on reducing under-nutrition among HIV-infected children. Based on this finding, we recommend HIV intervention programs to address nutritional assessment and interventions for HIV-infected children.
PROTOCOL REGISTRATION
The protocol has been registered in the PROSPERO database with a registration number of CRD-394170.
Topics: Ethiopia; Humans; Prevalence; Child; HIV Infections; Child, Preschool; Malnutrition; Thinness
PubMed: 38900809
DOI: 10.1371/journal.pone.0303292 -
Cureus May 2024Mycoplasma pneumoniae commonly causes respiratory tract infections but can also involve the skin and mucosal surfaces. Reactive infectious mucocutaneous eruption (RIME)...
Mycoplasma pneumoniae commonly causes respiratory tract infections but can also involve the skin and mucosal surfaces. Reactive infectious mucocutaneous eruption (RIME) secondary to mycoplasma infection is uncommon in adults but is an important clinical entity. We present the case of a 26-year-old male who experienced recurrent episodes of erythematous and painful oral ulcers without any prodromal or respiratory symptoms. Serological testing confirmed a recent mycoplasma infection. The patient was successfully treated with oral steroids and supportive therapy. This case underscores the challenges of diagnosing RIME, particularly in the absence of typical respiratory symptoms. Moreover, oral steroid therapy with supportive treatment may suffice to manage RIME if the patient lacks an ongoing infection or other underlying pathologies.
PubMed: 38894801
DOI: 10.7759/cureus.60603 -
Journal of Clinical Medicine Jun 2024: HIV is a severe and incurable disease that has a devastating impact worldwide. It affects the immune system and negatively affects the nervous system, leading to... (Review)
Review
: HIV is a severe and incurable disease that has a devastating impact worldwide. It affects the immune system and negatively affects the nervous system, leading to various cognitive and behavioral problems. Scientists are actively exploring different therapeutic approaches to combat these issues. One promising method is transcranial direct current stimulation (tDCS), a non-invasive technique that stimulates the brain. : This review aims to examine how tDCS can help HIV patients. Searches were conducted in the Pubmed/Medline, Research Gate, and Cochrane databases. : The literature search resulted in six articles focusing on the effects of tDCS on cognitive and behavioral measures in people with HIV. In some cases, tDCS showed positive improvements in the measures assessed, improving executive functions, depression, attention, reaction time, psychomotor speed, speed of processing, verbal learning and memory, and cognitive functioning. Furthermore, the stimulation was safe with no severe side effects. However, the included studies were of low quality, had small sample sizes, and did not use any relevant biomarkers that would help to understand the mechanisms of action of tDCS in HIV. : tDCS may help patients with HIV; however, due to the limited number of studies and the diversity of protocols used, caution should be exercised when recommending this treatment option in clinical settings. More high-quality research, preferably involving neurophysiological and neuroimaging measurements, is necessary to better understand how tDCS works in individuals with HIV.
PubMed: 38892999
DOI: 10.3390/jcm13113288 -
Nutrients May 2024Obesity is an emerging threat and a current challenge for children and adolescents worldwide. The aim of the present work was to evaluate the relationship between the...
Obesity is an emerging threat and a current challenge for children and adolescents worldwide. The aim of the present work was to evaluate the relationship between the Dietary Antioxidant Index (DAI) and the weight status of students in early adolescence. A sample of 1580 students aged 10-12 years from 47 primary schools in Greece were enrolled. Anthropometric characteristics were assessed, and calculation of the Body Mass Index (BMI) was used to categorize students into two weight-status groups. Dietary habits and physical activity were evaluated using a self-completed questionnaire, and the DAI was calculated through derived micronutrients' content, along with energy, macro-, and micro-nutrient intake. Crude and adjusted regression analysis showed a significant inverse association of the DAI and body weight status (Odds Ratio (OR): 0.719, 95% Confidence Interval (CI): 0.576; 0.897, and adjusted Odds Ration (aOR): 0.667, 95% CI: 0.489; 0.907). An antioxidant diet seems to play a protective role against increased body weight among students in early adolescence. Thus, dietary patterns rich in antioxidants should be promoted to facilitate healthy habits early in life, and to fight the obesity threat.
Topics: Humans; Male; Child; Female; Antioxidants; Greece; Students; Body Mass Index; Diet; Body Weight; Feeding Behavior; Schools; Pediatric Obesity; Exercise; Cross-Sectional Studies; Surveys and Questionnaires
PubMed: 38892600
DOI: 10.3390/nu16111667