Pub Date : 2022-03-14DOI: 10.29011/2575-825x.100202
Hadas Katz-Dana, Ayelet Shles, Dana Schojovitzky, Nir Fridman, E. Rosenblum, Dania Takagi, Yehiam, Ofri Hayosh
Objective: This study assessed whether the use of hip Point of Care Ultrasound (POCUS), enabling bedside evaluation of hip effusion, among limping children presenting to the Pediatric Emergency Department (PED) contributed to shortening the length of stay and reduced the use of auxiliary tests. Methods: This retrospective study included children ages 1-18 years who presented to the PED in a single medical center between 2015-2019, with a chief complaint of limping and who underwent hip POCUS. The control group included children who underwent evaluation without the use of hip POCUS. The primary measurement was total length of stay in the PED and the use of imaging and blood work. Results: A total of 220 patients were included in the study group and 191 in the control group. The groups were similar in epidemiologic characteristics and clinical presentation. the ED Length of Stay in the POCUS group was significantly shorter than the control group (p<0.0001), especially among children with a diagnosis of transient synovitis. Use of auxiliary tests was also significantly reduced in the POCUS group. Conclusions: Using hip POCUS when evaluating patients presenting to the PED with a complaint of limping or limb pain reduced the length of stay and decreased the use of auxiliary tests, especially among children with a diagnosis of transient synovitis.
{"title":"Point-of-Care Ultrasound Could Streamline Workflow of Limping Children Presenting to the Pediatric Emergency Department","authors":"Hadas Katz-Dana, Ayelet Shles, Dana Schojovitzky, Nir Fridman, E. Rosenblum, Dania Takagi, Yehiam, Ofri Hayosh","doi":"10.29011/2575-825x.100202","DOIUrl":"https://doi.org/10.29011/2575-825x.100202","url":null,"abstract":"Objective: This study assessed whether the use of hip Point of Care Ultrasound (POCUS), enabling bedside evaluation of hip effusion, among limping children presenting to the Pediatric Emergency Department (PED) contributed to shortening the length of stay and reduced the use of auxiliary tests. Methods: This retrospective study included children ages 1-18 years who presented to the PED in a single medical center between 2015-2019, with a chief complaint of limping and who underwent hip POCUS. The control group included children who underwent evaluation without the use of hip POCUS. The primary measurement was total length of stay in the PED and the use of imaging and blood work. Results: A total of 220 patients were included in the study group and 191 in the control group. The groups were similar in epidemiologic characteristics and clinical presentation. the ED Length of Stay in the POCUS group was significantly shorter than the control group (p<0.0001), especially among children with a diagnosis of transient synovitis. Use of auxiliary tests was also significantly reduced in the POCUS group. Conclusions: Using hip POCUS when evaluating patients presenting to the PED with a complaint of limping or limb pain reduced the length of stay and decreased the use of auxiliary tests, especially among children with a diagnosis of transient synovitis.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81042708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.29011/2575-825x.100201
{"title":"The Impact of Overexposure to Digital Screens in the Neurodevelopment of Children and Adolescents: A Literature Review","authors":"","doi":"10.29011/2575-825x.100201","DOIUrl":"https://doi.org/10.29011/2575-825x.100201","url":null,"abstract":"","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"773 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76944413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.29011/2575-825x.100200
{"title":"Latin American Forum on Meningococcal Disease, Latin American Update: Its Prevention","authors":"","doi":"10.29011/2575-825x.100200","DOIUrl":"https://doi.org/10.29011/2575-825x.100200","url":null,"abstract":"","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78312499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-04DOI: 10.29011/2575-825x.100099
G. Bossi, G. Mussati, Ivan Fiorito, G. Vanzù, G. Luigi, Marseglia
Pseudotumoral Acute Hemicerebellitis is a very rare disease of childhood, resulting from the acute inflammation of a single cerebellar hemisphere. The clinical presentation and the neuroradiological findings strictly resembles those of posterior fossa tumors. It is regarded as a para-infectious disorder, mainly related to viral infections, albeit in almost all cases reported in the literature, the cause-effect relationship between a specific virus and this peculiar condition only relied on the recent medical history of the patient or on plasma serological tests. Molecular assays, such as Polymerase Chain Reaction has never been applied to cerebro-spinal fluid to identify the infectious agent with certainty, and among all the viruses implied, Parvovirus B19 has never been reported in the literature. Pseudotumoral Acute Hemicerebellitis requires prompt and proper medical treatment, in order to avoid the possible complications of raised intracranial pressure. Different combinations of antimicrobial agents, steroids and mannitol have been used as empirical therapy, but a very few cases of successful treatment with intravenous immunoglobulins have been reported so far. Despite usually Pseudotumoral Acute Hemicerebellitis shows a good response to therapy and a benign course, with neurological complete recovery, residual cerebellar gliosis and atrophy have been described shortly after the disease onset. Nevertheless, in all the cases reported in the literature, the clinical and neuroradiological follow-up is too short to demonstrate the long-term radiological sequelae and to establish the clinical relevance of the residual cerebellar parenchymal damage. Hereby we describe clinical presentation, diagnosis, successful treatment and long-term clinical and neuroradiological follow-up of the first pediatric case of Pseudotumoral Acute Hemicerebellitis, definitely caused by Parvovirus B19, identified in the cerebro-spinal fluid by Polymerase Chain Reaction. Citation: Bossi G, Mussati G, Fiorito I, Vanzù G, Marseglia GL (2022) Pseudotumoral Acute Hemicerebellitis Due to Parvovirus B19 Infection in a Child: Diagnostic Pitfalls, Successful Treatment with Intravenous Immunoglobulins and Long-Term Follow-Up. Arch
假性肿瘤性急性半小脑炎是一种非常罕见的儿童疾病，由单个小脑半球的急性炎症引起。临床表现和神经影像学表现与后窝肿瘤非常相似。它被认为是一种副感染性疾病，主要与病毒感染有关，尽管在文献报道的几乎所有病例中，特定病毒与这种特殊病症之间的因果关系仅依赖于患者最近的病史或血浆血清学检测。分子测定，如聚合酶链反应，从未应用于脑脊液，以确定确定的感染因子，在所有隐含的病毒中，细小病毒B19从未在文献中报道过。假性肿瘤性急性半小脑炎需要及时和适当的治疗，以避免颅内压升高可能引起的并发症。抗菌剂、类固醇和甘露醇的不同组合已被用作经验性治疗，但迄今为止，很少有静脉注射免疫球蛋白成功治疗的病例报道。尽管假性肿瘤性急性半小脑炎通常对治疗反应良好，病程为良性，神经系统完全恢复，但在发病后不久就会出现残留的小脑胶质瘤和萎缩。然而，在所有文献报道的病例中，临床和神经放射学随访时间都太短，无法证明长期的放射学后遗症，也无法确定残余小脑实质损伤的临床相关性。在此，我们描述了第一例小儿假性肿瘤性急性半小脑炎的临床表现、诊断、成功治疗以及长期的临床和神经影像学随访，该病例肯定是由细小病毒B19引起的，通过聚合酶链反应在脑脊液中发现。引用本文:Bossi G, Mussati G, Fiorito I, Vanzù G, Marseglia GL(2022)儿童由细小病毒B19感染引起的假性急性半小脑炎:诊断缺陷，静脉注射免疫球蛋白成功治疗和长期随访。拱
{"title":"Pseudotumoral Acute Hemicerebellitis Due to Parvovirus B19 Infection in a Child: Diagnostic Pitfalls, Successful Treatment with Intravenous Immunoglobulins and Long-Term Follow-Up","authors":"G. Bossi, G. Mussati, Ivan Fiorito, G. Vanzù, G. Luigi, Marseglia","doi":"10.29011/2575-825x.100099","DOIUrl":"https://doi.org/10.29011/2575-825x.100099","url":null,"abstract":"Pseudotumoral Acute Hemicerebellitis is a very rare disease of childhood, resulting from the acute inflammation of a single cerebellar hemisphere. The clinical presentation and the neuroradiological findings strictly resembles those of posterior fossa tumors. It is regarded as a para-infectious disorder, mainly related to viral infections, albeit in almost all cases reported in the literature, the cause-effect relationship between a specific virus and this peculiar condition only relied on the recent medical history of the patient or on plasma serological tests. Molecular assays, such as Polymerase Chain Reaction has never been applied to cerebro-spinal fluid to identify the infectious agent with certainty, and among all the viruses implied, Parvovirus B19 has never been reported in the literature. Pseudotumoral Acute Hemicerebellitis requires prompt and proper medical treatment, in order to avoid the possible complications of raised intracranial pressure. Different combinations of antimicrobial agents, steroids and mannitol have been used as empirical therapy, but a very few cases of successful treatment with intravenous immunoglobulins have been reported so far. Despite usually Pseudotumoral Acute Hemicerebellitis shows a good response to therapy and a benign course, with neurological complete recovery, residual cerebellar gliosis and atrophy have been described shortly after the disease onset. Nevertheless, in all the cases reported in the literature, the clinical and neuroradiological follow-up is too short to demonstrate the long-term radiological sequelae and to establish the clinical relevance of the residual cerebellar parenchymal damage. Hereby we describe clinical presentation, diagnosis, successful treatment and long-term clinical and neuroradiological follow-up of the first pediatric case of Pseudotumoral Acute Hemicerebellitis, definitely caused by Parvovirus B19, identified in the cerebro-spinal fluid by Polymerase Chain Reaction. Citation: Bossi G, Mussati G, Fiorito I, Vanzù G, Marseglia GL (2022) Pseudotumoral Acute Hemicerebellitis Due to Parvovirus B19 Infection in a Child: Diagnostic Pitfalls, Successful Treatment with Intravenous Immunoglobulins and Long-Term Follow-Up. Arch","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87586006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-24DOI: 10.29011/2575-825x.100096
Sultan Aydın, Gizem Gülten Altinkaynak
Immune Thrombocytopenic Purpura (ITP) of childhood is identified as isolated thrombocytopenia. While it can be triggered by a viral infection such as hepatitis B, hepatitis C, cytomegalovirus, Epstein-Barr, influenza, herpes, varicella-zoster, and HIV or other immune causes, the reason for ITP remains unknown in most patients. We reported a pediatric case with ITP whose COVID-19 total antibody test was positive. Despite the poor response of high dose intravenous immunoglobulin (IVIG), steroid treatment generated a good result. Our patient had an asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2, SARSCoV-2 infection (COVID-19 infection) and COVID-19 PCR was negative. Since we are in the period of the COVID-19-related pandemic, SARS-CoV-2 should be kept in mind in the etiology of ITP. This case raises awareness of both PCR and antibody screening for COVID-19 in patients with ITP, especially in the pandemic season.
{"title":"A Pediatric Case Report with Immune Thrombocytopenic Purpura Associated with COVID-19","authors":"Sultan Aydın, Gizem Gülten Altinkaynak","doi":"10.29011/2575-825x.100096","DOIUrl":"https://doi.org/10.29011/2575-825x.100096","url":null,"abstract":"Immune Thrombocytopenic Purpura (ITP) of childhood is identified as isolated thrombocytopenia. While it can be triggered by a viral infection such as hepatitis B, hepatitis C, cytomegalovirus, Epstein-Barr, influenza, herpes, varicella-zoster, and HIV or other immune causes, the reason for ITP remains unknown in most patients. We reported a pediatric case with ITP whose COVID-19 total antibody test was positive. Despite the poor response of high dose intravenous immunoglobulin (IVIG), steroid treatment generated a good result. Our patient had an asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2, SARSCoV-2 infection (COVID-19 infection) and COVID-19 PCR was negative. Since we are in the period of the COVID-19-related pandemic, SARS-CoV-2 should be kept in mind in the etiology of ITP. This case raises awareness of both PCR and antibody screening for COVID-19 in patients with ITP, especially in the pandemic season.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87986156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-22DOI: 10.29011/2575-825x.100095
P. Pires, M. Mupueleque, J. Mucufo, David, Zakus, R. Siemens, C. Belo
Background: New-born mortality is high in Africa, including in Mozambique (67.3 deaths of children less than one year of age per 1000 live births, 2017). One important factor to reduce this public health burden is ensuring the frequency and quality of newborn visits, with the availability of effectively and timely patient centred care. To reduce the new-born mortality rate in Natikiri, Nampula, teams of researchers from Lúrio University, Mozambique and the University of Saskatchewan, Canada, carried out implementation research, Alert Community for a Prepared Hospital care continuum, which included training programs for health professionals in maternal and child health care as a central component. We planned a mid-project evaluation, to assess the impact of these trainings on the quality of new-born care services at Marrere Health Centre. Methods: This was a quantitative study, applying two cross-sectional surveys about new-born visits quality at the Marrere Health Centre in Natikiri district, on the outskirts of Nampula city in Nampula province, northern Mozambique. The first survey was conducted after two health professional training sessions and the other after five more sessions. The samples of carers of infants up to 28 days of age were surveyed at the Healthy Child Service, Child at Risk Service and Emergency Room, and were calculated considering the average number of post-partum visits per month, 47 in 2018, using a margin of error of 10% and a confidence interval of 90%, and 134 in 2019, using a margin of error of 5% and a confidence interval of 95%. The surveys included a wide variety of user opinion measures of quality and used a five-point Likert scale; the responses were coded and entered REDCap digital database, and analysed to assess frequencies, percentages, mean and standard deviations. This research was approved by the bioethics committees at both Lúrio University and at the University of Saskatchewan. Results: 188 mothers were surveyed at Marrere Health Centre, about the quality of new-born services they had just received. Most areas of childcare services showed no improvement with the trainings. Positive improvements were a 48% increase in health professionals encouraging mothers to share any difficulties during the visit, and a 31% increase in encouraging mothers to have a person of their choice to accompany them during labour, almost always suggesting a traditional birth attendant (97%). Many Citation: Pires P, Mupueleque M, Mucufo JR, Zakus D, Siemens R, et al. (2021) Mothers’ Opinion About the Quality of New-Born Health Services: Implementation Research in Nampula, Mozambique. Arch Pediatr 6: 195. DOI: 10.29011/2575-825X.100095 2 Volume 6; Issue 01 Arch Pediatr, an open access journal ISSN: 2575-825X shortcomings persisted in practices of introducing themselves, communication with patients, privacy, and confidentiality. Conclusion: The quality of care at Marrere Health Centre’ new-born health services did not improve after a
{"title":"Mothers’ Opinion About the Quality of New-Born Health Services: Implementation Research in Nampula, Mozambique","authors":"P. Pires, M. Mupueleque, J. Mucufo, David, Zakus, R. Siemens, C. Belo","doi":"10.29011/2575-825x.100095","DOIUrl":"https://doi.org/10.29011/2575-825x.100095","url":null,"abstract":"Background: New-born mortality is high in Africa, including in Mozambique (67.3 deaths of children less than one year of age per 1000 live births, 2017). One important factor to reduce this public health burden is ensuring the frequency and quality of newborn visits, with the availability of effectively and timely patient centred care. To reduce the new-born mortality rate in Natikiri, Nampula, teams of researchers from Lúrio University, Mozambique and the University of Saskatchewan, Canada, carried out implementation research, Alert Community for a Prepared Hospital care continuum, which included training programs for health professionals in maternal and child health care as a central component. We planned a mid-project evaluation, to assess the impact of these trainings on the quality of new-born care services at Marrere Health Centre. Methods: This was a quantitative study, applying two cross-sectional surveys about new-born visits quality at the Marrere Health Centre in Natikiri district, on the outskirts of Nampula city in Nampula province, northern Mozambique. The first survey was conducted after two health professional training sessions and the other after five more sessions. The samples of carers of infants up to 28 days of age were surveyed at the Healthy Child Service, Child at Risk Service and Emergency Room, and were calculated considering the average number of post-partum visits per month, 47 in 2018, using a margin of error of 10% and a confidence interval of 90%, and 134 in 2019, using a margin of error of 5% and a confidence interval of 95%. The surveys included a wide variety of user opinion measures of quality and used a five-point Likert scale; the responses were coded and entered REDCap digital database, and analysed to assess frequencies, percentages, mean and standard deviations. This research was approved by the bioethics committees at both Lúrio University and at the University of Saskatchewan. Results: 188 mothers were surveyed at Marrere Health Centre, about the quality of new-born services they had just received. Most areas of childcare services showed no improvement with the trainings. Positive improvements were a 48% increase in health professionals encouraging mothers to share any difficulties during the visit, and a 31% increase in encouraging mothers to have a person of their choice to accompany them during labour, almost always suggesting a traditional birth attendant (97%). Many Citation: Pires P, Mupueleque M, Mucufo JR, Zakus D, Siemens R, et al. (2021) Mothers’ Opinion About the Quality of New-Born Health Services: Implementation Research in Nampula, Mozambique. Arch Pediatr 6: 195. DOI: 10.29011/2575-825X.100095 2 Volume 6; Issue 01 Arch Pediatr, an open access journal ISSN: 2575-825X shortcomings persisted in practices of introducing themselves, communication with patients, privacy, and confidentiality. Conclusion: The quality of care at Marrere Health Centre’ new-born health services did not improve after a","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90321857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-07DOI: 10.29011/2575-825x.100094
{"title":"Cost of Myopia Treatment for High School Students in Vietnam","authors":"","doi":"10.29011/2575-825x.100094","DOIUrl":"https://doi.org/10.29011/2575-825x.100094","url":null,"abstract":"","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87354104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/2575-825x.100193
Gouri Scheurmann, Tonya Lemonious, Jayasree Nair, R. D. D. Carpio, Haiping Qiao, B. Wrotniak, O. Gómez-Duarte
Objective: Poor Hand Hygiene Compliance (HHC) among healthcare workers is directly associated with High Hospital Acquired Infections (HAI) worldwide. In 2011, the Centers for Disease Control and Prevention (CDC) reported 721,800 HAI per year in the United States among acute care hospitals along with 75,000 associated patient deaths. The objective of this quality improvement study was to evaluate the effect of hand hygiene educational interventions on HHC among Healthcare Workers (HCW) in a Neonatal Intensive Care Unit (NICU). Methods: This was a quality improvement project for increasing HHC at a tertiary care NICU using the Plan-Do-Study-Act design. This study was exempt from IRB review as it did not involve study subjects. The HCW staff included a comprehensive team of respiratory therapists, nurse practitioners, staff nurses, attending physicians, resident physicians, fellows, radiology technicians, child life staff, social workers, discharge planners, nutrition lab technicians, housekeeping staff, among others. The study consisted of recording HHC of HCW entering and leaving patient rooms before and after the educational intervention. The data collection instrument allowed recording of type of HCW, date, and HHC during day or night shifts. The instrument was completed by non-identified observers. No personal identifiers were collected in the study. The study implemented an educational intervention to all HCW based on CDC educational tools. Results: Surveillance included a total of 762 observations, 381 were pre-intervention and 381 post-interventions. Overall, HHC significantly increased from 110 (28.9%) pre-intervention, to 227 (59.6%) post-intervention (p-value: < .001). Post intervention increase in HHC was specifically noted in subgroups of physicians, respiratory therapists and registered nurses. Conclusion: HHC educational interventions among HCW in a tertiary care NICU are associated with significant improvement in HHC and may contribute to a decrease of HAI in the NICU.
{"title":"Improving Hand Hygiene Compliance in the Neonatal Intensive Care Unit at a Regional Children’s Hospital","authors":"Gouri Scheurmann, Tonya Lemonious, Jayasree Nair, R. D. D. Carpio, Haiping Qiao, B. Wrotniak, O. Gómez-Duarte","doi":"10.29011/2575-825x.100193","DOIUrl":"https://doi.org/10.29011/2575-825x.100193","url":null,"abstract":"Objective: Poor Hand Hygiene Compliance (HHC) among healthcare workers is directly associated with High Hospital Acquired Infections (HAI) worldwide. In 2011, the Centers for Disease Control and Prevention (CDC) reported 721,800 HAI per year in the United States among acute care hospitals along with 75,000 associated patient deaths. The objective of this quality improvement study was to evaluate the effect of hand hygiene educational interventions on HHC among Healthcare Workers (HCW) in a Neonatal Intensive Care Unit (NICU). Methods: This was a quality improvement project for increasing HHC at a tertiary care NICU using the Plan-Do-Study-Act design. This study was exempt from IRB review as it did not involve study subjects. The HCW staff included a comprehensive team of respiratory therapists, nurse practitioners, staff nurses, attending physicians, resident physicians, fellows, radiology technicians, child life staff, social workers, discharge planners, nutrition lab technicians, housekeeping staff, among others. The study consisted of recording HHC of HCW entering and leaving patient rooms before and after the educational intervention. The data collection instrument allowed recording of type of HCW, date, and HHC during day or night shifts. The instrument was completed by non-identified observers. No personal identifiers were collected in the study. The study implemented an educational intervention to all HCW based on CDC educational tools. Results: Surveillance included a total of 762 observations, 381 were pre-intervention and 381 post-interventions. Overall, HHC significantly increased from 110 (28.9%) pre-intervention, to 227 (59.6%) post-intervention (p-value: < .001). Post intervention increase in HHC was specifically noted in subgroups of physicians, respiratory therapists and registered nurses. Conclusion: HHC educational interventions among HCW in a tertiary care NICU are associated with significant improvement in HHC and may contribute to a decrease of HAI in the NICU.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88003467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/2575-825x.100191
Introduction: School performance, especially in children with SLD (SLD), is adversely affected by the coexistence of a chronic physical illness, such as Type 1 Diabetes (T1DM) (previously called juvenile diabetes or insulin-dependent diabetes). Being diagnosed with a chronic illness can be overwhelming; especially at the start it can be stressful for the child and its family. We are conscious that living with T1DM can be really challenging for children and adolescents in terms of complexity of treatment and the required level of family involvement for a successful management. Aim: This article proposes a different approach to the phenomenon of learning difficulties and poor school performance in children who confront a major chronic physical condition, such as T1DM. We report the case of a 12-year-old girl who experienced SLD and school failure, while managing to adjust with T1DM. The purpose of this article is to highlight T1DM impact on psychological well-being and school performance in children and adolescents with SLD, presenting their experiences of their condition and treatment and those of their careers. Case Report: A 12-year-old girl being diagnosed with SLD and T1DM came to our hospital for examination, feeling particularly vulnerable and anxious. The Child and Adolescent Psychiatric Assessment (CAPA), which usually takes place in our medical setting, in collaboration between Outpatient State Certified Diagnostic Department for Learning Difficulties and Child Psychiatry, highlighted a range of psychological symptoms that were common in PTSD and depression. A two-year follow-up revealed the challenge of patient adherence in managing T1DM but also highlighted the disease’s impact on the psychological well-being and school performing. The main need was to shape an integrated intervention program consisting of two major areas: (1) appropriate teaching methods and curricula designed to respond to the child’s particular needs (2) an environment that creates need for structural change. Integrating these two areas and building them into a simultaneously functioning integral system ensured that the needs of our patient with SLD were met. Conclusion: Early interdisciplinary intervention is key for people with learning disorder and chronic disease. If problems are identified early, intervention can be more effective, and children can avoid going through extended problems with schoolwork and related low self-esteem. Overall, experience and research seem to indicate that the best preventive approach in T1DM patients who experience educational and psychological problems is a strong, supportive family who is able to follow health professionals’ instructions.
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Pub Date : 2020-05-28DOI: 10.29011/2575-825x.100180
E. Brownlee, C. Blore, R. Wragg, Mitul Patel, L. McCarthy
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