Improving community-based care for children with a rare condition: The example of long-segment congenital tracheal stenosis and perceptions of health professionals, parents and teachers

xloma.fota.13 shared this article with you from Inoreader Improving community-based care for children with a rare condition: The example of long-segment congenital tracheal stenosis and perceptions of health professionals, parents and teachers Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Int J Pediatr Otorhinolaryngol. 2021 Apr;143:110651. doi: 10.1016/j.ijporl.2021.110651. Epub 2021 Feb 14. ABSTRACT BACKGROUND: Long segment congenital tracheal stenosis (LSCTS) is a rare, complex condition which is often poorly understood by community-based health professionals (HPs). Anecdotally, such HPs often lack confidence providing care for children, resulting in children being brought to the tertiary centre more frequently than necessary. We wanted to identify the information and support needs of HPs in primary and secondary care looking after a child with LSCTS, the views of those providing education to these children, and elicit parents' perceptions about community-based services, to improve overall care for children and families. METHOD: Questionnaires were sent to 175 community-based HPs and 34 teachers involved in the care of children with LSCTS. Face-to-face or telephone interviews were conducted with 12 parents of p atients with LSCTS to establish their perceptions of community-based services. RESULTS: Ninety (51%) completed questionnaires were returned from HPs and 18 (53%) from teachers. Responses indicated low levels of knowledge of LSCTS. Physical, practical and communication information needs were identified by all respondent groups, together with general and condition-specific concerns. Interviews with parents indicated that they thought the level of knowledge about LSCTS in the community was low, which had a negative impact on their willingness to consult local services. Better information provision for HPs, teachers and parents was identified as a means of improving outcomes. CONCLUSION: Professionals caring for children with LSCTS in the community and in schools have unmet information and support needs, with consequences for children, families, HCPs in both the community and tertiary hospital, and teachers. PMID:33662711 | DOI:10.1016/j.ijporl.2021.110651 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Challenges faced by parents when seeking diagnosis for children with sensorineural hearing loss

xloma.fota.13 shared this article with you from Inoreader Challenges faced by parents when seeking diagnosis for children with sensorineural hearing loss Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Int J Pediatr Otorhinolaryngol. 2021 Apr;143:110656. doi: 10.1016/j.ijporl.2021.110656. Epub 2021 Feb 19. ABSTRACT INTRODUCTION: The Joint Committee of Infant Hearing (JCIH) recommended hearing screening by one month of age, diagnosis of hearing loss by three months of age, and intervention initiated by six months of age. In Malaysia however, the age of diagnosis of hearing loss in children is relatively late. This study aimed to identify the challenges faced by parents in seeking a diagnosis of hearing loss for their children. METHOD: The study utilized a semi-structured interview with open-ended questions to obtain information about parents' experiences during the diagnosis period and their challenges when going through that process. In this study, a total of 16 parents of children who were diagnosed with moderate to profound sensorineural hearing loss and received intervention within three years at the time of the study partic ipated. Ten of the children were cochlear implant users, and six were hearing aid users. RESULTS: Thematic analysis was used to analyse themes generated from the data according to the study objective. Four main themes and 17 subthemes were identified from this study. The four main themes were 1) Parents' emotion; 2) Parental knowledge; 3) Others; 4) Profesional services. Challenges that parents faced often include emotional behaviours such as feeling guilty and devastated during the diagnosis, lack of information-sharing from healthcare givers, lack of knowledge on childhood hearing loss among parents, support from families, seek for a second opinion, worry about others' acceptance, longer time for diagnosis to confirm, late referral to other related profesionals and no priority for the appointment. CONCLUSION: Emotion is identified as the biggest challenge faced by parents in the process of diagnosis for their children with hearing loss. Hence, management of parental em otion needs to be emphasized by health profesionals as it influences the acceptance of parents towards their child's diagnosis. PMID:33662710 | DOI:10.1016/j.ijporl.2021.110656 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Persistence of choking injuries in children

xloma.fota.13 shared this article with you from Inoreader Persistence of choking injuries in children Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Int J Pediatr Otorhinolaryngol. 2021 Mar 21;144:110685. doi: 10.1016/j.ijporl.2021.110685. Online ahead of print. ABSTRACT BACKGROUND: Choking injuries are a significant cause of morbidity and mortality in children and represent a significant public health concern. Evaluating trends and the impact of interventions are essential to highlight whether progress has been made and to target public health efforts. OBJECTIVE: To investigate how rates of nonfatal and fatal choking injuries have changed before and after 2010 when policy recommendations were made by the American Academy of Pediatrics. METHODS: A descriptive study investigating unintentional nonfatal and fatal choking injuries in children aged 0-19 years using national data from 2001 to 2016 through the Centers for Disease Control and Prevention's WISQARS™ and WONDER databases, focusing on the 6 years prior and 6 years after release of the AAP's recommendations. The data was categorized by age, gender, year, and race/ethnicity for descriptive and statistical analyses. RESULTS: From 2001 to 2016, there were a total of 305,814 nonfatal injuries and 2347 choking deaths in children from 0 to 19 years. Children under five years of age accounted for 73% of nonfatal injuries and 75% of choking fatalities. There was a statistically significant increase in the nonfatal injuries rate when comparing 2005-2010 and 2011-2016 (19/100,000 versus 26/100,000, respectively). There was a decrease in the choking fatalities rate in all children (0.18/100,000 versus 0.16/100,000, respectively) but no change in fatalities rate for children under five. White and Black children experience nonfatal choking injuries at a higher rate than Hispanics. Black children had highest rates of choking fatalities over Hispanic, White, Asian, and Alaskan or American Indian ethnicities. The lowest rates of death occurred in Asians. CONCLUSIONS: Overall rate of nonfatal ch oking injuries increased, while rate of choking fatalities in children decreased after 2010. However, the choking fatalities rate in 0-4 years olds, the highest risk group, did not change. Racial gaps exist with highest rates of injury in Black children. We must continue to educate and raise awareness of choking injuries, with targeted efforts to address racial disparities. PMID:33819896 | DOI:10.1016/j.ijporl.2021.110685 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Morphologic subtypes of lobular carcinoma in situ diagnosed on core needle biopsy: clinicopathologic features and findings at follow-up excision

xloma.fota.13 shared this article with you from Inoreader Morphologic subtypes of lobular carcinoma in situ diagnosed on core needle biopsy: clinicopathologic features and findings at follow-up excision Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 06 April 2021; doi:10.1038/s41379-021-00796-9 Morphologic subtypes of lobular carcinoma in situ diagnosed on core needle biopsy: clinicopathologic features and findings at follow-up excision View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Short lingual frenulum and head-forward posture in children with the risk of obstructive sleep apnea

xloma.fota.13 shared this article with you from Inoreader Short lingual frenulum and head-forward posture in children with the risk of obstructive sleep apnea Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Int J Pediatr Otorhinolaryngol. 2021 Mar 29;144:110699. doi: 10.1016/j.ijporl.2021.110699. Online ahead of print. ABSTRACT BACKGROUND: Recent studies have shown that a short lingual frenulum is a potential risk factor for obstructive sleep apnea syndrome (OSAS) in children. A short frenulum leads to abnormal orofacial development and may consequently contribute to sleep-disordered breathing by narrowing the upper airways and increasing the risk of upper-airway collapsibility. The aim of this study was to assess the impact of a short lingual frenulum on the risk of OSAS in children. METHODS: Children from pre-, primary, secondary, and high school, aged 3-17 years, were included in the study. Parents/guardians were asked to fill in the Pediatric Sleep Questionnaire (PSQ), and then, children at risk of OSAS were enrolled in the study group. A control group was established randomly from patients with negative PSQ results. A physical examination, including measurements of head-forward posture (HFP) and length of the free tongue, inter-incisor distance and subjective high-arched palate evaluation was performed in children from both groups. RESULTS: A total of 1,500 PSQ questionnaires were distributed, and less than half (713) were returned correctly filled in. In the second part of the study, 135 children were evaluated: 67 in the study group and 68 in the control group. The mean ages were 9.4 ± 3.0 and 9.5 ± 3.1 years, respectively. Children in the study group had significantly shorter lingual frenula, higher HFP measures, and had a higher prevalence of a high-arched palate. Based on statistical analysis, a short lingual frenulum (OR 5.02 [1.58-15.94]). CONCLUSIONS: The study identified a relationship between a short lingual frenulum and the risk of OSAS in children. Detecting and addressing ankyloglossia in children is necessary before it leads to orofacial changes, malocclusion, and consequently, sleep apnea. Furthermore, OSAS was associated with higher HFP, but no relationship was found between the two parameters. PMID:33823467 | DOI:10.1016/j.ijporl.2021.110699 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Satellite habilitation centres following cochlear implantation - Are they the way ahead in improving outcomes in developing countries?

xloma.fota.13 shared this article with you from Inoreader Satellite habilitation centres following cochlear implantation - Are they the way ahead in improving outcomes in developing countries? Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Int J Pediatr Otorhinolaryngol. 2021 Jan 27;144:110606. doi: 10.1016/j.ijporl.2020.110606. Online ahead of print. ABSTRACT INTRODUCTION: Cochlear implantation is a safe surgery for restoration of hearing in profoundly deaf children. Following cochlear implantation, children undergo rehabilitation (or 'habilitation' for those without previous hearing). The device is programmed after the surgery, so that the user can hear sounds through it and through rehabilitation training, the heard sounds are made to understand. OBJECTIVE: Our study was aimed at analysing the role of satellite habilitation centres following cochlear implantation by analysing the outcomes following habilitation and comparing it with the outcomes of the main centre and correlating it with the percentage of attendance of classes. Our study also aims to compare the attendance of implant patients from outside the geographical area of the main centre before and after starting the satellite centre. MATERIALS AND METHODS: 1004 profoundly deaf children (6 years and below) who had undergone cochlear implantation and completed 12months of habilitation in our institution from July 2013 to December 2019 were retrospectively analysed. The outcomes of all the centres were assessed by comparing the baseline CAP with CAP scores at 12 months and baseline SIR with SIR scores at 12 months. The outcomes of the main centre and satellite centres were also compared. The outcomes were correlated with percentage of attendance of classes. OBSERVATION: The overall attendance in all the centres was between 75 and 80%. Both main and satellite centres showed statistically significant good outcomes and this correlates with percentage of attendance. CONCLUSION: Satellite centres for habilitation across the state has greatly helped to improve the attendance of these patients and outcomes. Reduced drop-out rates and improved speech language outcomes can b e achieved by starting satellite centres for habilitation post cochlear implantation in developing countries like India. PMID:33823468 | DOI:10.1016/j.ijporl.2020.110606 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient perspectives on how to improve education on medication side effects: cross-sectional observational study at a rheumatology clinic in The Netherlands

xlomafota.13 shared this article with you from Inoreader Patient perspectives on how to improve education on medication side effects: cross-sectional observational study at a rheumatology clinic in The Netherlands Via Latest Results for Rheumatology International Abstract Rheumatoid arthritis (RA) patients often report lacking information on medication side effects. The aims of this study were to observe how rheumatology healthcare providers deliver medication information and to determine in which specific domains information is missing. First, 12 single-blinded structured observations were performed during regular RA patient consultations. The observers noted whether and how medication and medication side effects were discussed. Second, 100 RA patients were asked to fill out an adaptation of the Satisfaction with Information about Medicines Scale (SIMS). Medication was discussed during all observed consultations. With new medication, its purpose and mode of action were explained in all cases, but possible side effects in only 33%. Overall, medication side effects were discussed in 58% of consultations. Most information delivery was verbal (92%). Response rate to the questionnaire was 61%. Overall satisfaction with medication ed ucation was mean 7.3 (± 1.9) (NRS 0–10) with a comparable high SIMS total satisfaction sum score of mean 12.3 (± 4.4). At subscale score levels, 89% were satisfied with the amount of information on the action and usage of medication, but only 47% with the information on the potential problems of medication. RA patients express overall high satisfaction with their medication education but there is still an unmet need for information on potential risks and side effects. Using the SIMS questionnaire in daily clinical practice may help focus medication education to the needs of the individual patient. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.