Articles: adolescent.
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World J. Gastroenterol. · Oct 2013
ReviewQuality improvement in pediatric inflammatory bowel disease: moving forward to improve outcomes.
In recent years, pediatric health care has embraced the concept of quality improvement to improve patient outcomes. As quality improvement efforts are implemented, network collaboration (where multiple centers and practices implement standardized programs) is a popular option. In a collaborative network, improvement in the conduct of structural, process and outcome quality measures can lead to improvements in overall health, and benchmarks can be used to assess and compare progress. ⋯ We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care, and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance. We aimed to assess current quality improvement efforts in pediatric IBD and other diseases, such as childhood asthma, childhood arthritis, and neonatal health. By doing so, we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Review Case Reports[In Process Citation].
Patients with univentricular congenital heart disease are treated with Fontan-procedure for more than 40 years resulting in mainly good life-quality for pediatric and now more and more adult patients. Due to prolonged life expectation and adequate physical state, adolescent and adult Fontan-patients participate in normal life activities like the main population. Mass events like open-air concerts and sport events belong to these activities. ⋯ Visitors with minor or major health problems are treated by emergency response services like the German Red Cross, the German St Johns Ambulance and the German Order of Malta. The article refers to the special pathophysiology and management of Fontan-patients in emergency and anaesthesiologic settings based on a case report from the Southside Festival. Due to increasing "fontanpopulation" profound education of attending physicians and paramedics is inevitable to provide good quality in prehospital and innerhospital care.
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Review
The effects of abused drugs on adolescent development of corticolimbic circuitry and behavior.
Adolescence is a period of significant neurobiological change that occurs as individuals transition from childhood to adulthood. Because the nervous system is in a relatively labile state during this stage of development, it may be especially sensitive to experience-induced plasticity. ⋯ Whenever possible, our focus is on studies that use comparison groups of adolescent- and adult-exposed subjects as this is a more direct test of the hypothesis that adolescence represents a period of enhanced vulnerability to the effects of drug-induced plasticity. Lastly, we suggest areas of future investigation that are needed and methodological concerns that should be addressed.
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The genetic, biological, and environmental backgrounds of an organism fundamentally influence the balance between risk and resilience to stress. Sex, age, and environment transact with responses to trauma in ways that can mitigate or exacerbate the likelihood that post-traumatic stress disorder will develop. Translational approaches to modeling affective disorders in animals will ultimately provide novel treatments and a better understanding of the neurobiological underpinnings behind these debilitating disorders. ⋯ Animal models of stress have differing effects on behavior and endocrine pathways; however, complete models replicating clinical characteristics of risk and resilience have not been rigorously studied. This review discusses a four-factor model that considers the importance of studying both risk and resilience in understanding the developmental response to trauma/stress. Consideration of the multifactorial nature of clinical populations in the design of preclinical models and the application of preclinical findings to clinical treatment approaches comprise the core of translational reciprocity, which is discussed in the context of the four-factor model.
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During the past 30 years, there has been an increase in the incidence of cancer in adolescents. While recent studies have illustrated remarkable resilience in youth living with cancer, they can also face daunting acute and chronic adjustment struggles, cognitive and school problems, family and peer relational difficulties, depression, post-traumatic stress symptoms, and other anxiety disorders. ⋯ The authors also explore ways that the particular psychological problems often faced by teen cancer patients, including anxiety about the future, may be especially well suited to mindfulness approaches such as learning to observe physical sensations, thoughts, and emotions, as well as cultivating compassion towards themselves and others. The paper concludes with an exploration of unanswered and potential research questions regarding the future use of MBIs with adolescents with cancer, and potentially with teenagers with other chronic diseases.