Articles: child.
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Journal of medical ethics · Feb 2014
Multicenter StudyA study of consent for participation in a non-therapeutic study in the pediatric intensive care population.
To document the legal guardian-related barriers to consent procurement, and their stated reasons for non-participation in a paediatric critical care research study. ⋯ Barriers to consent procurement in a non-therapeutic paediatric critical care study appear to occur at many levels with lack of availability of legal guardians, and legal guardians feeling overwhelmed, being the most commonly recorded reasons. Further research into the impact of these findings on the validity and generalisability of the results of such studies is necessary prior to the development and study of future consent models.
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Am. J. Respir. Crit. Care Med. · Jan 2014
Multicenter Study Comparative StudyClinical and Epidemiologic Phenotypes of Childhood Asthma.
Clinical and epidemiologic approaches have identified two distinct sets of classifications for asthma and wheeze phenotypes. ⋯ Clinical phenotypes were well supported by LCA analysis. The hypothesis-free LCA phenotypes were a useful reference for comparing clinical phenotypes. Thereby, we identified children with clinically conspicuous but undiagnosed disease. Because of their high area under the curve values, clinical phenotypes such as (recurrent) unremitting wheeze emerged as promising alternative asthma definitions for epidemiologic studies.
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Multicenter Study
Pain in Hospitalized Children: Effect of a Multidimensional Knowledge Translation Strategy on Pain Process and Clinical Outcomes.
Hospitalized children frequently receive inadequate pain assessment and management despite substantial evidence to support effective pediatric pain practices. The objective of this study was to determine the effect of a multidimensional knowledge translation intervention, Evidence-based Practice for Improving Quality (EPIQ), on procedural pain practices and clinical outcomes for children hospitalized in medical, surgical and critical care units. A prospective cohort study compared 16 interventions using EPIQ and 16 standard care (SC) units in 8 Canadian pediatric hospitals. ⋯ Comparisons of moderate (4-6/10) and severe (7-10/10) pain, controlling for child and unit level factors, indicated that the odds of having severe pain were 51% less for children in the EPIQ group (adjusted OR: 0.49, 95% CI: 0.26-0.83; P=0.009). EPIQ was effective in improving practice and clinical outcomes for hospitalized children. Additional exploration of the influence of contextual factors on research use in hospital settings is required to explain the variability in pain processes and clinical outcomes.
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Randomized Controlled Trial Multicenter Study
Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.
This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals. ⋯ Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.
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Pediatric emergency care · Jan 2014
Multicenter StudyInterhospital Pediatric Patient Transfers-Factors Influencing Rapid Disposition After Transfer.
The objective of this study was to determine the incidence, demographics, and clinical course of pediatric patients rapidly discharged after transfer from outlying emergency departments (EDs) to a tertiary care pediatric ED (PED) with no additional diagnostic or therapeutic actions. ⋯ Pediatric patients transferred from outlying community EDs to a PED frequently required little or no additional care. Referring hospital ED type and physician training type are associated with the need for additional workup at the pediatric emergency room.