Parents' experiences receiving an antenatal versus postnatal diagnosis of complex congenital heart disease were explored. Key findings include:
1) Parents who received an antenatal diagnosis had more time to prepare but still experienced significant emotional distress, similar to those receiving a postnatal diagnosis.
2) Factors like who delivers the diagnosis and how well it is explained can impact parents' understanding and emotional status, regardless of diagnosis timing.
3) Support needs vary between families and should be individually assessed to ensure parents receive sensitive and well-timed support.
Australian Clinical Consensus Guideline: The diagnosis and acute management o...Carmenlahiffjenkins
This document presents guidelines for the diagnosis and acute management of childhood stroke in Australia. It was developed by an expert panel and is based on a systematic review of evidence from 2007-2017. The guidelines provide over 60 evidence-based recommendations to help clinicians rapidly identify, diagnose, determine the cause of, and treat childhood strokes. Key recommendations include rapid neuroimaging to confirm diagnosis, investigations to identify the cause, treatments like intravenous thrombolysis to restore blood flow to the brain, and management of conditions like raised intracranial pressure. Implementing the guidelines would help minimize delays in care, improve access to treatments, and allow for benchmarking outcomes of childhood strokes in Australia.
This document discusses a proposed study on the effect of infant congenital heart disease (CHD) on motor and cognitive development. The study aims to determine if infants with CHD have motor deficits and if motor deficits are associated with cognitive deficits. The hypothesis is that infants with more severe CHD will have more severe motor delays and those with motor delays will show cognitive delays. The proposed study would assess 900 infants with no CHD, mild CHD, or severe CHD at 6, 12, and 15 months using the Bayley Scales of Infant Development to measure motor and cognitive development. The results are predicted to show delayed motor development in infants with mild and severe CHD and cognitive deficits associated with motor deficits.
This study aimed to compare the ability of serial cranial ultrasounds (CUS) and early MRI scans in detecting preterm brain injuries. The study found that CUS allowed for more scans due to better feasibility in the NICU, and was better at detecting grade I-II intraventricular hemorrhages and perforator strokes. MRI was superior for identifying smaller cerebellar hemorrhages and provided more quantitative data. Overall, the combination of serial CUS and MRI provided the highest sensitivity for detecting common preterm brain injuries, though MRI could not be performed in the sickest infants.
A 2 year multidomain intervention of diet, exercise, cognitive training, and ...Nutricia
A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
An approach to mulitmorbidity in frail older adultsCamilla Wong
Ms. A is a 72-year-old woman with multiple chronic conditions including COPD, CAD, CHF, diabetes, and CKD. She has multimorbidity, with some conditions being concordant due to similar pathophysiology and management plans. Her diabetes may be considered the dominant condition. Over 10 years, her condition progresses with the addition of colon cancer and mild dementia. In her last year of life, she is frail and in the terminal phase of her multimorbidity. Interventions shift to advanced care planning, symptom management, and liaison with palliative care.
Study of Neonatal Outcome with Low Apgar Score in Term Neonatesiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes the challenges of communicating risk in prenatal screening tests. It discusses how:
1) Prenatal screening tests have a high rate of false positives, leading many women with healthy pregnancies to undergo invasive follow-up tests that carry risks of miscarriage. For example, a first trimester screening test with a 5% false positive rate could lead to around 50 unnecessary miscarriages among 100,000 screened women.
2) Calculating and understanding the positive predictive value of screening tests, which is needed for informed decision making, requires Bayesian reasoning that most people struggle with. As a result, risks are often underestimated.
3) While research has identified effective ways to communicate Bayesian concepts
Australian Clinical Consensus Guideline: The diagnosis and acute management o...Carmenlahiffjenkins
This document presents guidelines for the diagnosis and acute management of childhood stroke in Australia. It was developed by an expert panel and is based on a systematic review of evidence from 2007-2017. The guidelines provide over 60 evidence-based recommendations to help clinicians rapidly identify, diagnose, determine the cause of, and treat childhood strokes. Key recommendations include rapid neuroimaging to confirm diagnosis, investigations to identify the cause, treatments like intravenous thrombolysis to restore blood flow to the brain, and management of conditions like raised intracranial pressure. Implementing the guidelines would help minimize delays in care, improve access to treatments, and allow for benchmarking outcomes of childhood strokes in Australia.
This document discusses a proposed study on the effect of infant congenital heart disease (CHD) on motor and cognitive development. The study aims to determine if infants with CHD have motor deficits and if motor deficits are associated with cognitive deficits. The hypothesis is that infants with more severe CHD will have more severe motor delays and those with motor delays will show cognitive delays. The proposed study would assess 900 infants with no CHD, mild CHD, or severe CHD at 6, 12, and 15 months using the Bayley Scales of Infant Development to measure motor and cognitive development. The results are predicted to show delayed motor development in infants with mild and severe CHD and cognitive deficits associated with motor deficits.
This study aimed to compare the ability of serial cranial ultrasounds (CUS) and early MRI scans in detecting preterm brain injuries. The study found that CUS allowed for more scans due to better feasibility in the NICU, and was better at detecting grade I-II intraventricular hemorrhages and perforator strokes. MRI was superior for identifying smaller cerebellar hemorrhages and provided more quantitative data. Overall, the combination of serial CUS and MRI provided the highest sensitivity for detecting common preterm brain injuries, though MRI could not be performed in the sickest infants.
A 2 year multidomain intervention of diet, exercise, cognitive training, and ...Nutricia
A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
An approach to mulitmorbidity in frail older adultsCamilla Wong
Ms. A is a 72-year-old woman with multiple chronic conditions including COPD, CAD, CHF, diabetes, and CKD. She has multimorbidity, with some conditions being concordant due to similar pathophysiology and management plans. Her diabetes may be considered the dominant condition. Over 10 years, her condition progresses with the addition of colon cancer and mild dementia. In her last year of life, she is frail and in the terminal phase of her multimorbidity. Interventions shift to advanced care planning, symptom management, and liaison with palliative care.
Study of Neonatal Outcome with Low Apgar Score in Term Neonatesiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes the challenges of communicating risk in prenatal screening tests. It discusses how:
1) Prenatal screening tests have a high rate of false positives, leading many women with healthy pregnancies to undergo invasive follow-up tests that carry risks of miscarriage. For example, a first trimester screening test with a 5% false positive rate could lead to around 50 unnecessary miscarriages among 100,000 screened women.
2) Calculating and understanding the positive predictive value of screening tests, which is needed for informed decision making, requires Bayesian reasoning that most people struggle with. As a result, risks are often underestimated.
3) While research has identified effective ways to communicate Bayesian concepts
This document outlines the elements and benefits of a proactive geriatric trauma consultation service. It discusses how such a service was established at St. Michael's Hospital in Toronto through collaboration between geriatrics and trauma specialists. The service utilizes comprehensive geriatric assessments and focuses on common geriatric issues for injured older patients. Evaluation of the service found benefits including reduced delirium, nursing home discharges, other consultations, and length of stay. The 10 essential elements of collaborative care models are presented, which were followed to achieve measured improved outcomes. The service has expanded to other hospitals and continues to demonstrate sustained volumes and adherence to guidelines.
Clinical, ethical and legal considerations in the treatment of newborns 2008Dominique Gross
Non-ketotic hyperglycinaemia (NKH) is a devastating neurometabolic disorder leading, in its classical form, to early death or severe disability and poor quality of life in survivors. Affected neonates may need ventilatory support during a short period of respiratory depression. The transient dependence on ventilation dictates urgency in decision-making regarding withdrawal of therapy.
The occurrence of patients with apparent transient forms of the disease, albeit rare, adds uncertainty to the prediction of clinical outcome and dictates that the current practice of withholding or withdrawing therapy in these neonates be reviewed. Both bioethics and law take the view that treatment decisions should be based on the best interests of the patient.
The medical-ethics approach is based on the principles of non-maleficence, beneficence, autonomy and justice. The law relating to withholding or withdrawing life-sustaining treatment is complex and varies between jurisdictions. Physicians treating newborns with NKH need to provide families with accurate and complete information regarding the disease and the relative probability of possible outcomes of the neonatal presentation and to explore the extent to which family members are willing to take part in the decision making process. Cultural and religious attitudes, which may potentially clash with bioethical and juridical principles, need to be considered.
2008 Elsevier Inc
PRA Insights Report: Alzheimer's Disease ResearchEmma Whieldon
(1) The document summarizes the results of a survey conducted at the 2017 Alzheimer's Association International Conference to gather insights on Alzheimer's disease research. (2) Over half of respondents believed the foremost challenge in neuroscience drug development is target identification. (3) The amyloid hypothesis was seen as the most promising research area, though tau protein and inflammation were also viewed as important. (4) Pre-screening subjects in the community was believed to have the biggest positive impact on recruiting prodromal Alzheimer's patients.
This document summarizes a presentation about developing a risk stratification tool to identify type 2 diabetes patients at high risk for hypoglycemia-related hospitalization or emergency department visits. The tool was developed using electronic health record data from over 200,000 patients. It stratifies patients into high (>5%), intermediate (1-5%), and low (<1%) risk categories based on 6 factors. The tool demonstrated good performance in external validations and predicting real-world hypoglycemia outcomes. The goal is to help target higher risk patients for interventions to prevent hypoglycemic events.
This document discusses issues with care for the elderly and terminally ill in hospice facilities. It notes that doctors often have high patient loads in these facilities, which can lead to overmedication of patients due to lack of communication between doctors. The document also discusses how Americans often want a quick medical fix, which can negatively impact elderly patients if they mix over-the-counter drugs with prescription medications or overdose on medications. Overall, the document examines some of the challenges around quality of care for vulnerable patient populations in end-of-life care facilities.
The study assessed the reproductive education needs of infertile clients undergoing assisted reproduction treatment in Iran. A questionnaire was used to evaluate the knowledge and attitudes of 154 clients regarding fertility, infertility, and infertility treatment. Results showed the highest knowledge scores related to factors affecting pregnancy, while the lowest scores related to the natural reproductive cycle and genital anatomy. Males had higher knowledge than females for some topics. Education level also impacted knowledge, with those having less than a diploma scoring lower. Most clients believed education programs should address treatment types and procedures. The study concluded it is important to educate infertile clients on infertility causes and treatments to enable informed decision making.
Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data
V. Berghella, M. Palacio, A. Ness, Z. Alfirevic, K. H. Nicolaides and G. Saccone
Volume 49, Issue 3, Date: March (pages 322–329)
Slides prepared by Dr Shireen Meher (UOG Editors-for-Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.17388/full
Perinatal and long-term outcomes in fetuses diagnosed with isolated unilateral ventriculomegaly: systemic review and meta-analysis
C. Scala, A. Familiari, A. Pinas, A.T. Papageorghiou, A. Bhide, B. Thilaganathan, A. Khalil
Volume 49, Issue 4, Date: April (pages 450–459)
Slides prepared by Dr Yael Raz (UOG Editor-for-Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.15943/full
Genetic counseling is a process that provides patients information about inherited disorders and risks. It involves interpreting family histories, educating about genetic testing options, and counseling to promote informed decision making. Genetic counselors have advanced degrees and provide non-directive support and advice to help patients understand genetic conditions, risks, and make decisions. Common reasons for genetic counseling include family histories of conditions, advanced parental age, abnormal test results, and ethnic backgrounds with increased risks. Counseling sessions provide information to help patients decide whether to undergo further screening or diagnostic testing during pregnancy.
This document discusses a proposed study to introduce a national autism screening program for toddlers aged 21-24 months in New Zealand. The study would screen 50,000 toddlers over 12 months using a two-stage screening process conducted by trained Plunket nurses. Results would be analyzed to determine the number of children diagnosed with autism and related to other factors like gender. The implications are that early diagnosis leads to better outcomes for children and families. The research aims to determine if such a screening program should be implemented nationally.
This document discusses strategies for optimizing patient recruitment in clinical trials, especially for rare diseases. It notes that patient recruitment is critical for drug and device approval but can be challenging for rare diseases where patients are spread out globally. New technologies like social media and mobile devices have helped increase awareness of studies. Trial designs are evolving to be more accessible and reduce patient burden, such as through multi-site trials. Collaboration between clinical research organizations, sites, and patient groups can also enhance recruitment. The future of recruitment looks encouraging as awareness and access continue to improve through technological advances.
Journal of perinatology fetal cardiology changing the definition of critica...gisa_legal
1) The document discusses different classification systems for critical congenital heart disease (CHD) in fetuses and newborns that require urgent intervention within the first 24 hours of life.
2) It describes the most common types of critical CHD, including hypoplastic left heart syndrome (HLHS) with a restricted or closed atrial septum, total anomalous pulmonary venous return with obstruction, and transposition of the great arteries with a restrictive atrial septum.
3) For HLHS, certain Doppler ultrasound parameters measured late in pregnancy, such as a pulmonary vein flow velocity time integral ratio below 3, can help identify fetuses needing emergency intervention immediately after birth to improve survival rates.
West West Auckland Integrated Care Project - Locality and Cluster AnalysisJonathan Simon onzm
This document provides a summary of health data and population characteristics for the West Auckland locality and three clusters within it - Henderson, Massey, and New Lynn. Some key findings include:
1) The West Auckland locality has a growing and increasingly diverse population, with higher deprivation than the overall Waitemata DHB region.
2) Life expectancy is lower in West Auckland compared to the overall DHB region, and varies between ethnic groups.
3) Both primary and secondary health care utilization is higher in West Auckland compared to the DHB as a whole. Rates of long-term conditions and hospital admissions are also generally higher.
4) There is variation in health indicators within the three clusters, with the
Physician burnout is a significant problem, with nearly half of physicians experiencing at least one symptom of burnout. Primary care physicians, especially those in family medicine, internal medicine, and emergency medicine, have the highest rates of burnout. However, physicians spend less than half (45%) of their time in direct patient care activities, with the rest spent on tasks like documentation, care coordination, and follow up for patients not present. New models are needed that leverage technology, protocols, and team-based care to automate tasks and delegate work to reduce burdens on physicians in order to address burnout and make primary care sustainable.
Risky Business: Risk communicat ion in the provider-patient encounterZackary Berger
Communicating risk is part of nearly every patient-provider encounter. I present some evidence-based strategies to improve patients\' and doctors\' risk perception.
000 2015 qualitativo parent's experiences of counselling andgisa_legal
The document discusses a qualitative study that explored parents' experiences after receiving a prenatal diagnosis of congenital heart disease in their child. The study found that parents greatly valued:
1) Receiving clear and straightforward information from specialists shortly after diagnosis to help them understand the condition and make decisions.
2) Having continued support from healthcare professionals, like a pediatric nurse, throughout their pregnancy to help manage stress and anxiety.
3) Accessing additional information sources like written materials, online resources, and connecting with other parents who could share their experiences.
Screening Tool for Developmental Disorders in ChildrenApollo Hospitals
Developmental problems are a diverse group of conditions that affect and limit children and their life-chances. A ready reference for a Paediatrician would be the first six chapters of the latest edition (18th) of the Nelson Textbook of Pediatrics (The Field of Pediatrics, Growth & Development, Psychological Disorders, Social Issues, Children with Special Health Needs and Nutrition and Human Genetics and Metabolic Diseases).
This document outlines the elements and benefits of a proactive geriatric trauma consultation service. It discusses how such a service was established at St. Michael's Hospital in Toronto through collaboration between geriatrics and trauma specialists. The service utilizes comprehensive geriatric assessments and focuses on common geriatric issues for injured older patients. Evaluation of the service found benefits including reduced delirium, nursing home discharges, other consultations, and length of stay. The 10 essential elements of collaborative care models are presented, which were followed to achieve measured improved outcomes. The service has expanded to other hospitals and continues to demonstrate sustained volumes and adherence to guidelines.
Clinical, ethical and legal considerations in the treatment of newborns 2008Dominique Gross
Non-ketotic hyperglycinaemia (NKH) is a devastating neurometabolic disorder leading, in its classical form, to early death or severe disability and poor quality of life in survivors. Affected neonates may need ventilatory support during a short period of respiratory depression. The transient dependence on ventilation dictates urgency in decision-making regarding withdrawal of therapy.
The occurrence of patients with apparent transient forms of the disease, albeit rare, adds uncertainty to the prediction of clinical outcome and dictates that the current practice of withholding or withdrawing therapy in these neonates be reviewed. Both bioethics and law take the view that treatment decisions should be based on the best interests of the patient.
The medical-ethics approach is based on the principles of non-maleficence, beneficence, autonomy and justice. The law relating to withholding or withdrawing life-sustaining treatment is complex and varies between jurisdictions. Physicians treating newborns with NKH need to provide families with accurate and complete information regarding the disease and the relative probability of possible outcomes of the neonatal presentation and to explore the extent to which family members are willing to take part in the decision making process. Cultural and religious attitudes, which may potentially clash with bioethical and juridical principles, need to be considered.
2008 Elsevier Inc
PRA Insights Report: Alzheimer's Disease ResearchEmma Whieldon
(1) The document summarizes the results of a survey conducted at the 2017 Alzheimer's Association International Conference to gather insights on Alzheimer's disease research. (2) Over half of respondents believed the foremost challenge in neuroscience drug development is target identification. (3) The amyloid hypothesis was seen as the most promising research area, though tau protein and inflammation were also viewed as important. (4) Pre-screening subjects in the community was believed to have the biggest positive impact on recruiting prodromal Alzheimer's patients.
This document summarizes a presentation about developing a risk stratification tool to identify type 2 diabetes patients at high risk for hypoglycemia-related hospitalization or emergency department visits. The tool was developed using electronic health record data from over 200,000 patients. It stratifies patients into high (>5%), intermediate (1-5%), and low (<1%) risk categories based on 6 factors. The tool demonstrated good performance in external validations and predicting real-world hypoglycemia outcomes. The goal is to help target higher risk patients for interventions to prevent hypoglycemic events.
This document discusses issues with care for the elderly and terminally ill in hospice facilities. It notes that doctors often have high patient loads in these facilities, which can lead to overmedication of patients due to lack of communication between doctors. The document also discusses how Americans often want a quick medical fix, which can negatively impact elderly patients if they mix over-the-counter drugs with prescription medications or overdose on medications. Overall, the document examines some of the challenges around quality of care for vulnerable patient populations in end-of-life care facilities.
The study assessed the reproductive education needs of infertile clients undergoing assisted reproduction treatment in Iran. A questionnaire was used to evaluate the knowledge and attitudes of 154 clients regarding fertility, infertility, and infertility treatment. Results showed the highest knowledge scores related to factors affecting pregnancy, while the lowest scores related to the natural reproductive cycle and genital anatomy. Males had higher knowledge than females for some topics. Education level also impacted knowledge, with those having less than a diploma scoring lower. Most clients believed education programs should address treatment types and procedures. The study concluded it is important to educate infertile clients on infertility causes and treatments to enable informed decision making.
Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data
V. Berghella, M. Palacio, A. Ness, Z. Alfirevic, K. H. Nicolaides and G. Saccone
Volume 49, Issue 3, Date: March (pages 322–329)
Slides prepared by Dr Shireen Meher (UOG Editors-for-Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.17388/full
Perinatal and long-term outcomes in fetuses diagnosed with isolated unilateral ventriculomegaly: systemic review and meta-analysis
C. Scala, A. Familiari, A. Pinas, A.T. Papageorghiou, A. Bhide, B. Thilaganathan, A. Khalil
Volume 49, Issue 4, Date: April (pages 450–459)
Slides prepared by Dr Yael Raz (UOG Editor-for-Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.15943/full
Genetic counseling is a process that provides patients information about inherited disorders and risks. It involves interpreting family histories, educating about genetic testing options, and counseling to promote informed decision making. Genetic counselors have advanced degrees and provide non-directive support and advice to help patients understand genetic conditions, risks, and make decisions. Common reasons for genetic counseling include family histories of conditions, advanced parental age, abnormal test results, and ethnic backgrounds with increased risks. Counseling sessions provide information to help patients decide whether to undergo further screening or diagnostic testing during pregnancy.
This document discusses a proposed study to introduce a national autism screening program for toddlers aged 21-24 months in New Zealand. The study would screen 50,000 toddlers over 12 months using a two-stage screening process conducted by trained Plunket nurses. Results would be analyzed to determine the number of children diagnosed with autism and related to other factors like gender. The implications are that early diagnosis leads to better outcomes for children and families. The research aims to determine if such a screening program should be implemented nationally.
This document discusses strategies for optimizing patient recruitment in clinical trials, especially for rare diseases. It notes that patient recruitment is critical for drug and device approval but can be challenging for rare diseases where patients are spread out globally. New technologies like social media and mobile devices have helped increase awareness of studies. Trial designs are evolving to be more accessible and reduce patient burden, such as through multi-site trials. Collaboration between clinical research organizations, sites, and patient groups can also enhance recruitment. The future of recruitment looks encouraging as awareness and access continue to improve through technological advances.
Journal of perinatology fetal cardiology changing the definition of critica...gisa_legal
1) The document discusses different classification systems for critical congenital heart disease (CHD) in fetuses and newborns that require urgent intervention within the first 24 hours of life.
2) It describes the most common types of critical CHD, including hypoplastic left heart syndrome (HLHS) with a restricted or closed atrial septum, total anomalous pulmonary venous return with obstruction, and transposition of the great arteries with a restrictive atrial septum.
3) For HLHS, certain Doppler ultrasound parameters measured late in pregnancy, such as a pulmonary vein flow velocity time integral ratio below 3, can help identify fetuses needing emergency intervention immediately after birth to improve survival rates.
West West Auckland Integrated Care Project - Locality and Cluster AnalysisJonathan Simon onzm
This document provides a summary of health data and population characteristics for the West Auckland locality and three clusters within it - Henderson, Massey, and New Lynn. Some key findings include:
1) The West Auckland locality has a growing and increasingly diverse population, with higher deprivation than the overall Waitemata DHB region.
2) Life expectancy is lower in West Auckland compared to the overall DHB region, and varies between ethnic groups.
3) Both primary and secondary health care utilization is higher in West Auckland compared to the DHB as a whole. Rates of long-term conditions and hospital admissions are also generally higher.
4) There is variation in health indicators within the three clusters, with the
Physician burnout is a significant problem, with nearly half of physicians experiencing at least one symptom of burnout. Primary care physicians, especially those in family medicine, internal medicine, and emergency medicine, have the highest rates of burnout. However, physicians spend less than half (45%) of their time in direct patient care activities, with the rest spent on tasks like documentation, care coordination, and follow up for patients not present. New models are needed that leverage technology, protocols, and team-based care to automate tasks and delegate work to reduce burdens on physicians in order to address burnout and make primary care sustainable.
Risky Business: Risk communicat ion in the provider-patient encounterZackary Berger
Communicating risk is part of nearly every patient-provider encounter. I present some evidence-based strategies to improve patients\' and doctors\' risk perception.
000 2015 qualitativo parent's experiences of counselling andgisa_legal
The document discusses a qualitative study that explored parents' experiences after receiving a prenatal diagnosis of congenital heart disease in their child. The study found that parents greatly valued:
1) Receiving clear and straightforward information from specialists shortly after diagnosis to help them understand the condition and make decisions.
2) Having continued support from healthcare professionals, like a pediatric nurse, throughout their pregnancy to help manage stress and anxiety.
3) Accessing additional information sources like written materials, online resources, and connecting with other parents who could share their experiences.
Screening Tool for Developmental Disorders in ChildrenApollo Hospitals
Developmental problems are a diverse group of conditions that affect and limit children and their life-chances. A ready reference for a Paediatrician would be the first six chapters of the latest edition (18th) of the Nelson Textbook of Pediatrics (The Field of Pediatrics, Growth & Development, Psychological Disorders, Social Issues, Children with Special Health Needs and Nutrition and Human Genetics and Metabolic Diseases).
Parental alcohol consumption and the risk of congenital heart diseases in off...BARRY STANLEY 2 fasd
Conclusions: Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, our review indicates that parental alcohol exposures are significantly associated with the risk of CHDs in offspring, which highlights the necessity of improving health awareness to prevent alcohol exposure during preconception and conception periods.
07 construção e validação de questionário fatores de risco cv em criançasgisa_legal
The document describes the development and validation of a questionnaire (CARDIOKID) to assess knowledge of healthy habits and cardiovascular disease risk factors in schoolchildren aged 7-11 years old. Researchers developed questions about nutrition, physical activity, obesity, and other risk factors based on literature review and expert input. The questionnaire was tested on 145 children and showed good reliability (Cronbach's alpha 0.91-0.93) and validity (two identifiable dimensions). Test-retest analysis found no significant differences, demonstrating reproducibility. The CARDIOKID questionnaire was found to be a valid and reliable tool for measuring cardiovascular health knowledge in children.
Running head CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS.docxtodd271
Running head: CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
5
CRITIQUE OF QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
Critiquing Quantitative, Qualitative, or Mixed Methods Studies
Adenike George
Walden University
NURS 6052: Essentials of Evidence-Based Practice
April 11, 2019
Critique of Quantitative, Qualitative, or Mixed Method Design
Both quantitative and qualitative methods play a pivotal role in nursing research. Qualitative research helps nurses and other healthcare workers to understand the experiences of the patients on health and illness. Quantitative data allows researchers to use an accurate approach in data collection and analysis. When using quantitative techniques, data can be analyzed using either descriptive statistics or inferential statistics which allows the researchers to derive important facts like demographics, preference trends, and differences between the groups. The paper comprehensively critiques quantitative and quantitative techniques of research. Furthermore, the author will also give reasons as to why qualitative methods should be regarded as scientific.
The overall value of quantitative and Qualitative Research
Quantitative studies allow the researchers to present data in terms of numbers. Since data is in numeric form, researchers can apply statistical techniques in analyzing it. These include descriptive statistics like mean, mode, median, standard deviation and inferential statistics such as ANOVA, t-tests, correlation and regression analysis. Statistical analysis allows us to derive important facts from data such as preference trends, demographics, and differences between groups. For instance, by conducting a mixed methods study to determine the feeding experiences of infants among teen mothers in North Carolina, Tucker and colleagues were able to compare breastfeeding trends among various population groups. The multiple groups compared were likely to initiate breastfeeding as follows: Hispanic teens 89%, Black American teens 41%, and White teens 52% (Tucker et al., 2011).
The high strength of quantitative analysis lies in providing data that is descriptive. The descriptive statistics helps us to capture a snapshot of the population. When analyzed appropriate, the descriptive data enables us to make general conclusions concerning the population. For instance, through detailed data analysis, Tucker and co-researchers were able to observe that there were a large number of adolescents who ceased breastfeeding within the first month drawing the need for nurses to conduct individualized follow-ups the early days after hospital discharge. These follow-ups would significantly assist in addressing the conventional technical problems and offer support in managing back to school transition (Tucker et al., 2011).
Qualitative research allows researchers to determine the client’s perspective on healthcare. It enables researchers to observe certain behaviors and experiences amo.
A systematic review of prevention interventions to reduce prenatal alcohol ex...BARRY STANLEY 2 fasd
Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol
exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention
interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates
the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work.
Madridge Journal of AIDS (ISSN: 2638-1958); As a result of the increased availability of antiretroviral treatment, children infected with HIV can expect to live to adulthood and even to have long, productive lives.
The document summarizes the findings of a study that expanded newborn screening in the UK from testing for phenylketonuria to five additional inherited metabolic disorders. Key findings after one year of screening over 438,000 babies include acceptable laboratory performance, reliable diagnostic testing within target timeframes, manageable workload for clinical and dietetic services, low decline rates, and prevalence and positive predictive values generally in line with predictions. Health economic analysis found screening for four of the five conditions to be potentially cost-effective. Based on these results, four of the five conditions were recommended to be added to the national newborn screening program in the UK. Follow-up after two years found sustained acceptable performance. Future work includes longitudinal tracking of outcomes
Prenatal diagnosis of critical congenital heart disease reduces risk of death...gisa_legal
This meta-analysis examined outcomes for newborns with critical congenital heart disease who received prenatal vs postnatal diagnoses. It analyzed data from 8 studies including 1,373 total patients. When excluding patients who were high risk or received comfort care, newborns with prenatal diagnoses were significantly less likely to die before planned cardiac surgery than those with postnatal diagnoses (pooled odds ratio 0.26). Specifically, of the 1,316 cases deemed standard risk and planned for surgery, preoperative death occurred in 0.7% with prenatal diagnosis vs 3.0% with postnatal diagnosis. The study concludes that for newborns most likely to benefit from treatment, prenatal diagnosis can reduce the risk of death prior to
Prenatal diagnosis of critical congenital heart disease reduces risk of death...gisa_legal
This meta-analysis examined outcomes for newborns with critical congenital heart disease who received prenatal vs postnatal diagnoses. It analyzed data from 8 studies including 1,373 total patients. When excluding patients who were high risk or received comfort care, newborns with prenatal diagnoses were significantly less likely to die before planned cardiac surgery than those with postnatal diagnoses (pooled odds ratio 0.26). Specifically, of the 1,316 cases deemed standard risk and planned for surgery, preoperative death occurred in 0.7% with prenatal diagnosis vs 3.0% with postnatal diagnosis. The study concludes that for newborns most likely to benefit from treatment, prenatal diagnosis can reduce the risk of death prior to
Lipid Screening in Childhood for Detection of Multifactorial DyslipidemiaGlobal Medical Cures™
Lipid Screening in Childhood for Detection of Multifactorial Dyslipidemia
IMPORTANT NOTE TO USERS OF WEBSITE & DOCUMENTS POSTED ON SLIDESHARE- Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
www.globalmedicalcures.com
This study examined the impact of prenatal diagnosis via fetal echocardiography on outcomes for neonates with critical congenital heart defects (CHD) requiring intervention within the first month of life. The study compared outcomes between neonates who were diagnosed prenatally (n=29) versus postnatally (n=71). Key findings included that neonates diagnosed prenatally presented at birth in better condition, with a mean age of presentation of 0 days compared to 10 days for those diagnosed postnatally. Prenatal diagnosis also facilitated delivery at a tertiary care center for 34.5% of cases and improved preoperative stabilization. However, there were no significant differences found in postoperative outcomes between the two groups.
Ann pediatrcard eco fetal no diag precocegisa_legal
This study examined the impact of prenatal diagnosis via fetal echocardiography on neonatal outcomes for critical congenital heart defects. The study compared outcomes for 29 neonates diagnosed prenatally via fetal echocardiography to 71 diagnosed postnatally. Prenatal diagnosis resulted in planned deliveries at tertiary care centers for 10/29 babies and allowed for prompt postnatal stabilization. Prenatal diagnosis was associated with shorter time to presentation, better preoperative stabilization including use of prostaglandin, and improved pH and mortality rates compared to postnatal diagnosis. Fetal echocardiography facilitated improved counseling and management planning, leading to reduced morbidity and mortality.
Perioperative Management of the Pediatric Organ Donorasclepiuspdfs
Introduction: For bereaved families, organ donation does not take away from the pain and loss of death, but it does give some meaning at the time and a great deal of comfort later. Each and every family whose child has suffered brain stem death should be offered the chance to donate. When a diagnosis of brain death has been made in a child, it may be possible for organ donation to occur, but it requires optimization of the donor and meticulous planning. There are a number of medical, nursing, ethical, psychological, and administrative issues which must be addressed in the perioperative period to facilitate the procurement of organs in good condition. Aim: This review aims to provide up to date information and provides the clinical pathway used in our tertiary level, university-affiliated children’s hospital for the management of the child in the critical care unit before organ donation, and intraoperative anaesthetic management. Method: This review was prepared using literature and clinical guidelines which were obtained from Medline and EMBASE databases, using the following search terms: Organ donation; intensive care management of organ donor; paediatric; neonatal; transplant outcome; and graft outcome. The focused literature search was carried out in 2017 by the five authors involved in the project. Results: The Society of Critical Care Medicine published consensus based guidelines for donor management in adult patients in 2015. Many of the core critical care principles in this document are similar in infants and children; although there are different considerations with respect to the diagnosis of brain death, consent, and pharmacological management. Full-text papers were employed by the project group to update our clinical pathway for the perioperative management of the infant or child who is a potential organ donor. Providing critical care medical and nursing staff with a pathway may improve communication, confidence, and delivery of care to the deceased child, their family and the graft recipients in this challenging situation.
The document discusses public health surveillance of rare childhood conditions conducted by the Public Health Agency of Canada. It provides examples of three national surveillance systems - the Canadian Congenital Anomalies Surveillance System, Cancer in Young People in Canada surveillance system, and Canadian Paediatric Surveillance Program. These systems monitor trends in rare childhood diseases and conditions to support public health policies and programs.
11. Identifying the Elements of the Limitations & ImplicationsGo tBenitoSumpter862
11. Identifying the Elements of the Limitations & Implications
Go to the Limitations/Implications section(s) and identify the limitations of the study and how those limitations impacted the whole study.
12. Identifying the Elements of the Conclusion Section
Go to the Conclusion section and identify the conclusive statements of the study and the recommendations made for future research.
POST # 1 EDITHA
When assessing an adolescent with bipolar disorder, what are some of the diagnostic and treatment challenges the clinician might face?
Bipolar disorder is a serious mental health disorder that is often first diagnosed during young adulthood or adolescence. Symptoms of the illness, however, also can appear in early childhood. Although once thought rare in children, diagnosis of bipolar disorder in children has significantly increased over the last decade (Papolos & Bronsteen, 2018). Despite the increased diagnosis of bipolar disorder in children, assessment and diagnosis remain challenging and controversial. This is, in part, because of the lack of research on this disorder in children and adolescents and the growing recognition that the disease can present differently in children from how it presents in adults (AACAP, 2019). Over the years, more attention has focused on the unique presentation of bipolar disorder in the young that has introduced new ways of looking at this disease and assessing it in children.
The importance of identifying the presence of bipolar disease at an early age is highlighted by data showing that adults in whom bipolar disease started at an early age have a more severe course of the illness compared with adult-onset disease. Early-onset disease is associated with a higher risk of suicide; severe mood lability and polarity; lower quality of life and greater functional impairment; higher rates of comorbidity; and a higher risk of substance use disorders compared with adult-onset disease (Papolos & Bronsteen, 2018). Although some children meet the criteria established for adults categorized in the DSM-5, many children fall outside these classical categories, and diagnosis in these children is particularly challenging and difficult (APA, 2013). For these children, additional information beyond what is provided in the DSM may help make an accurate diagnosis which causes increased challenges in assessment and diagnosis.
References
Papolos, D, & Bronsteen A. (2018) bipolar disorder in children: assessment in general pediatric practice. Curr Opin Pediatr, 25(3):419-426.
American Academy of Child and Adolescent Psychiatry (AACAP). (2019) bipolar disorder: Parents’ Medication Guide for Bipolar Disorder in Children & Adolescents.
American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Washington, DC: American Psychiatric Association.
RESEARCH ARTICLE
Association of suicidal behavior with exposure
to suicide and suicide attempt: A systematic
...
11. Identifying the Elements of the Limitations & ImplicationsGo tSantosConleyha
11. Identifying the Elements of the Limitations & Implications
Go to the Limitations/Implications section(s) and identify the limitations of the study and how those limitations impacted the whole study.
12. Identifying the Elements of the Conclusion Section
Go to the Conclusion section and identify the conclusive statements of the study and the recommendations made for future research.
POST # 1 EDITHA
When assessing an adolescent with bipolar disorder, what are some of the diagnostic and treatment challenges the clinician might face?
Bipolar disorder is a serious mental health disorder that is often first diagnosed during young adulthood or adolescence. Symptoms of the illness, however, also can appear in early childhood. Although once thought rare in children, diagnosis of bipolar disorder in children has significantly increased over the last decade (Papolos & Bronsteen, 2018). Despite the increased diagnosis of bipolar disorder in children, assessment and diagnosis remain challenging and controversial. This is, in part, because of the lack of research on this disorder in children and adolescents and the growing recognition that the disease can present differently in children from how it presents in adults (AACAP, 2019). Over the years, more attention has focused on the unique presentation of bipolar disorder in the young that has introduced new ways of looking at this disease and assessing it in children.
The importance of identifying the presence of bipolar disease at an early age is highlighted by data showing that adults in whom bipolar disease started at an early age have a more severe course of the illness compared with adult-onset disease. Early-onset disease is associated with a higher risk of suicide; severe mood lability and polarity; lower quality of life and greater functional impairment; higher rates of comorbidity; and a higher risk of substance use disorders compared with adult-onset disease (Papolos & Bronsteen, 2018). Although some children meet the criteria established for adults categorized in the DSM-5, many children fall outside these classical categories, and diagnosis in these children is particularly challenging and difficult (APA, 2013). For these children, additional information beyond what is provided in the DSM may help make an accurate diagnosis which causes increased challenges in assessment and diagnosis.
References
Papolos, D, & Bronsteen A. (2018) bipolar disorder in children: assessment in general pediatric practice. Curr Opin Pediatr, 25(3):419-426.
American Academy of Child and Adolescent Psychiatry (AACAP). (2019) bipolar disorder: Parents’ Medication Guide for Bipolar Disorder in Children & Adolescents.
American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Washington, DC: American Psychiatric Association.
RESEARCH ARTICLE
Association of suicidal behavior with exposure
to suicide and suicide attempt: A systematic
...
The document provides a literature review and methodology for a study examining the non-medical information needs of parents with newly diagnosed sick children. The literature review identifies key challenges faced by parental caregivers like stress, informational barriers, and needs. A quantitative survey was conducted with parents in oncology and haematology units to understand their awareness and satisfaction with supportive information provided. The results found that length of care, timing of information, and availability of financial support information most impacted parental satisfaction.
This document discusses palliative care in the pediatric setting. It begins by outlining the epidemiology of childhood death, noting that over 55,000 children under 19 die annually in the US from a diverse set of causes including injuries, cancer, and complex chronic conditions. The goals and focus of palliative care are then described, emphasizing active total care to improve quality of life for patients and their families. Five principles of pediatric palliative care are discussed, including respect for patients/families, access to compassionate care, family support, advancement through research/education, and overlapping curative and comfort-focused care. Common symptoms experienced by children at end of life like pain, fatigue and dyspnea are also reviewed.
Similar to Percepcao dos pais diag pre e pos natal de cc (20)
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
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