B Manzanarez, K Lopez, M Lipton-Inga, C Fink, M Radzik, R Buxton, J Gonzalez, C Davis, A P Vidmar
Background: The current AAP clinical practice guidelines for the management of pediatric obesity recommend a structured, comprehensive, multi-disciplinary clinical intervention. However, there is a gap in the current literature on standardized curriculums for implementation of such programs. The objective of the present study is to adapt an evidenced-based, family- centered, weekly, weight management curriculum that addresses nutritional, physical activity and behavioral topics for a clinical care model at a tertiary care children's hospital.
Methods: The curriculum was adapted for use in six individual sessions offered monthly by a multidisciplinary team, including a health educator, physician, dietitian, physical therapist and psychologist. Each provider offered specific feedback and curriculum adaptation based on their specialty. All team members completed training with scheduled treatment fidelity monitoring during implementation. To evaluate the effectiveness of the adapted curriculum, 60 adolescents, ages 14-18 years, with overweight or obesity, and at least one family member, will complete the six month intervention. The primary outcome is mean change in zBMI and %BMIp95 at six month and 18 months. Secondary outcomes include retention, satisfaction, effect on metabolic factors and activity level.
Conclusion: There is a paucity of literature on utilizing a standard curriculum in clinical weight management programs. Drawing from evidenced-based curriculum to strengthen clinical care creates an opportunity to improve existing clinical programs and potentially increase access and implementation of the current treatment recommendations for this high risk population.
{"title":"Kids N Fitness: A Group-based Pediatric Weight Management Curriculum Adapted for a Clinical Care Model.","authors":"B Manzanarez, K Lopez, M Lipton-Inga, C Fink, M Radzik, R Buxton, J Gonzalez, C Davis, A P Vidmar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The current AAP clinical practice guidelines for the management of pediatric obesity recommend a structured, comprehensive, multi-disciplinary clinical intervention. However, there is a gap in the current literature on standardized curriculums for implementation of such programs. The objective of the present study is to adapt an evidenced-based, family- centered, weekly, weight management curriculum that addresses nutritional, physical activity and behavioral topics for a clinical care model at a tertiary care children's hospital.</p><p><strong>Methods: </strong>The curriculum was adapted for use in six individual sessions offered monthly by a multidisciplinary team, including a health educator, physician, dietitian, physical therapist and psychologist. Each provider offered specific feedback and curriculum adaptation based on their specialty. All team members completed training with scheduled treatment fidelity monitoring during implementation. To evaluate the effectiveness of the adapted curriculum, 60 adolescents, ages 14-18 years, with overweight or obesity, and at least one family member, will complete the six month intervention. The primary outcome is mean change in zBMI and %BMIp95 at six month and 18 months. Secondary outcomes include retention, satisfaction, effect on metabolic factors and activity level.</p><p><strong>Conclusion: </strong>There is a paucity of literature on utilizing a standard curriculum in clinical weight management programs. Drawing from evidenced-based curriculum to strengthen clinical care creates an opportunity to improve existing clinical programs and potentially increase access and implementation of the current treatment recommendations for this high risk population.</p>","PeriodicalId":93121,"journal":{"name":"Journal of pediatrics & child health care","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444754/pdf/nihms-1613123.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38308189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-12DOI: 10.26420/JPEDIATRCHILDHEALTHCARE.1025.2019
Sefrioui Mr
Background: Autism Spectrum Disorders (ASD) represents a developmental disorder that affect verbal and nonverbal communication, social interaction and daily activities. Aims: The purpose of this study is to identify different treatment prescribed for individuals with ASD and to evaluate the efficiency of pharmacotherapy and behavioral management in autistic patients from Morocco. Methods and Procedures: Our survey included 72 health professionals, 50 of whom were drug prescribers and 22 non- prescribers. Outcomes and Results: 68% of the prescriber professionals prescribe drugs for autism and 65% of these are off label. The most prescribed therapeutic classes are antipsychotics (76%). 56% of prescriber professionals noticed an improvement in the quality of life of children following prescription medication. Moreover, 92% of the professionals prescribe drugs for autism-associated conditions; antiepileptic drugs are the most prescribed (65%). In addition, 26% of prescribing physicians and 28% of non-prescribers associate a diet with the management of ASD. According to them, the improvement in the quality of life of children with autism following the combination of a diet is 20% and 76% respectively. On the other hand, 58% of prescribers and all non-prescriber professionals have shown that the behavioral management method is the most satisfactory method. Conclusion: These data highlight the high rate of drug prescription for autism disorder in Morocco and despite non FDA-approved uses, the improvement in the quality of life is considerable. Also, Applied Behavior Analysis (ABA) provide successful treatment and optimize outcome.
{"title":"The Therapeutic Management of Autism Spectrum Disorders: Cross-Sectional Retrospective Study of Prescriptors in Morocco","authors":"Sefrioui Mr","doi":"10.26420/JPEDIATRCHILDHEALTHCARE.1025.2019","DOIUrl":"https://doi.org/10.26420/JPEDIATRCHILDHEALTHCARE.1025.2019","url":null,"abstract":"Background: Autism Spectrum Disorders (ASD) represents a developmental disorder that affect verbal and nonverbal communication, social interaction and daily activities. Aims: The purpose of this study is to identify different treatment prescribed for individuals with ASD and to evaluate the efficiency of pharmacotherapy and behavioral management in autistic patients from Morocco. Methods and Procedures: Our survey included 72 health professionals, 50 of whom were drug prescribers and 22 non- prescribers. Outcomes and Results: 68% of the prescriber professionals prescribe drugs for autism and 65% of these are off label. The most prescribed therapeutic classes are antipsychotics (76%). 56% of prescriber professionals noticed an improvement in the quality of life of children following prescription medication. Moreover, 92% of the professionals prescribe drugs for autism-associated conditions; antiepileptic drugs are the most prescribed (65%). In addition, 26% of prescribing physicians and 28% of non-prescribers associate a diet with the management of ASD. According to them, the improvement in the quality of life of children with autism following the combination of a diet is 20% and 76% respectively. On the other hand, 58% of prescribers and all non-prescriber professionals have shown that the behavioral management method is the most satisfactory method. Conclusion: These data highlight the high rate of drug prescription for autism disorder in Morocco and despite non FDA-approved uses, the improvement in the quality of life is considerable. Also, Applied Behavior Analysis (ABA) provide successful treatment and optimize outcome.","PeriodicalId":93121,"journal":{"name":"Journal of pediatrics & child health care","volume":"175 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73650688","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 : 2018-12-30DOI: 10.13188/2380-0534.1000024
M. Alam, S. Zeidan, D. Raja, Breiche, N. Diab
A 9-year-old girl was referred for daytime wetting and nocturnal enuresis. She voids 6 times per day with good quantities but continuous dribbling was noted. There was no urgency, frequency or previous surgeries. Four years ago, urodynamic studies in another institution showed no detrusor overactivity at the filling phase, a capacity of 160 ml, low detrusor pressure and no post-void residue. CT urogram revealed normal kidneys and ureters with Urine filling the vagina (Figure 1). Her pediatric urologist taught her the correct voiding posture with opening thighs without improvement. Current examination of the external genitalia revealed a normal appearing vulva, one orifice leaking urine and an imperforate hymen (Figure 2A). Under general anesthesia, hymenectomy was performed and a hypospadic urethra was noted (Figure2B-2C). Cystovaginoscopy was within normal limits. Postoperatively, patient became continent. One year later, she is still doing well.
{"title":"A Thorough Genital Examination is the Key","authors":"M. Alam, S. Zeidan, D. Raja, Breiche, N. Diab","doi":"10.13188/2380-0534.1000024","DOIUrl":"https://doi.org/10.13188/2380-0534.1000024","url":null,"abstract":"A 9-year-old girl was referred for daytime wetting and nocturnal enuresis. She voids 6 times per day with good quantities but continuous dribbling was noted. There was no urgency, frequency or previous surgeries. Four years ago, urodynamic studies in another institution showed no detrusor overactivity at the filling phase, a capacity of 160 ml, low detrusor pressure and no post-void residue. CT urogram revealed normal kidneys and ureters with Urine filling the vagina (Figure 1). Her pediatric urologist taught her the correct voiding posture with opening thighs without improvement. Current examination of the external genitalia revealed a normal appearing vulva, one orifice leaking urine and an imperforate hymen (Figure 2A). Under general anesthesia, hymenectomy was performed and a hypospadic urethra was noted (Figure2B-2C). Cystovaginoscopy was within normal limits. Postoperatively, patient became continent. One year later, she is still doing well.","PeriodicalId":93121,"journal":{"name":"Journal of pediatrics & child health care","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78560323","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}
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