教学课程资源库 更多>>

关键词： High flow nasal cannula   Paediatrics   Children   Oxygen therapy   Adjunctive therapy  

摘要： Background Heated Humidified High Flow Nasal Cannula Oxygen Therapy (HHFNC) is increasingly used on the paediatric wards and High Dependency Units (HDU) for different types of pathologies and different age groups. We aimed to describe current practice related to the use of HHFNC on the paediatric wards and HDUs, weaning practices and preferred outcome measures for future research. Methods We carried out a cross-sectional online survey of UK paediatric consultants or their delegates working on the paediatric wards. Descriptive analysis of their geographical, and organizational characteristics, their specialties, and their level of experience was investigated. Reasons for HHFNC initiation, weaning criteria, patients' characteristics and their primary pathologies were also analysed. Results Participation of 218 paediatricians from 81 hospitals (Median: 2.7, Range: 1-11) was registered. HHFNC was provided in most of the surveyed hospitals (93%, 75/81). A High Dependency Unit (HDU) was available in 47 hospitals (58%);less than a third of those have a dedicated paediatrician. Decisions around HHFNC were made solely by paediatricians in (75%) of the cases, mostly at hospitals with no HDU compared to those with dedicated HDUs (70.3% VS 36.6, 95%CI:22.6-50.4%, P < .001). HHFNC was reported by nearly two-thirds (68%) of the practitioners who used it on the wards to be as effective or superior to CPAP (Continuous Positive Airway Pressure) with fewer complications. Failure rate while on HHFNC was identified as the most important outcome measure in any future research followed by the length of need for HHFNC support (37.1, and 28% respectively). Conclusion This survey showed support for developing paediatric-specific national guidance on the use of HHFNC on the wards. Our list of defined research priorities may help guide further collaborative research efforts in this field.

关键词： Aboriginal   Torres Strait Islander   Paediatric burns   Psychosocial interventions   Pain   Anxiety   Distress   Psychological trauma  

摘要： BackgroundPaediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients' pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress, and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers;however, their degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is *** non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients' physical pain along with theirs and/or their caregiver's anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples' perspectives of *** the 3178 identified references, 17 were eligible. These include distraction based techniques (n =8), hypnosis/familiar imagery (n =2), therapeutic approaches (n =4), and patient preparation/procedural control (n =3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased 'patient control' reduced patient and caregiver anxiety;and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples' perspectives of health;and few targeted caregivers or focused on reducing their *** development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.

关键词： Neuromuscular disease   Duchenne muscular dystrophy   Spinal muscular atrophy   Charcot-Marie-tooth disease   Myopathy   Weakness   Paediatric   Gait   Functional ambulation   Assessment  

摘要： Background Weakness is the primary impairment in paediatric neuromuscular diseases, impacting gait and gait-related functional activities in ambulant children affected by these rare and often degenerative diseases. Gait speed is an indicator of health and disability, yet gait is a complex, multi-faceted activity. Using the International Classification of Function, Health and Disability (ICF) model, assessment of gait and functional ambulation should consider the impairments, activity limitations and participation restrictions due to disease, and factors related to the environment and the individual person. Methods This narrative review involved a literature search of databases including Medline, Embase and Pubmed from 1946 to October 2019. Inclusion criteria included assessments of gait, endurance and ambulatory function in paediatric (0-18 years) neuromuscular diseases. Results Fifty-two papers were identified reporting assessments of gait speed, timed function, endurance and ambulatory capacity, gait-related balance and qualitative descriptive assessments of gait function and effect of disease on gait and gait-related activities. Gait speed is an indicator of disability and children with neuromuscular disease walk slower than typically developing peers. Increasing disease severity and age were associated with slower walking in children with Duchenne muscular dystrophy and Charcot-Marie-Tooth disease. The six-minute walk test is used widely as a test of endurance and ambulatory capacity;six-minute walk distance was substantially reduced across all paediatric neuromuscular diseases. Endurance and ambulatory capacity was more limited in children with spinal muscular atrophy type 3, congenital muscular dystrophy and older boys with Duchenne muscular dystrophy. Only a few papers considered normalisation of gait parameters accounting for the effect on gait of height in heterogeneous groups of children and linear growth in longitudinal studies. Balance related to gait wa

关键词： 儿科学   儿童生长发育   预防接种   医学科学   疾病防治   健康状况   状况评估   生长曲线图  

摘要： 儿童是世界上最重要的资源,儿童的健康状况是全社会发展的基石。儿科学是一门研究促进儿童生长发育、身心健康和疾病防治的医学科学,儿童生长发育知识是儿科学发展的基石。最全面了解儿童的成长过程与健康状况即是每名儿童拥有生长曲线图、发育状况评估与预防接种的详细资料。

关键词： 中西医结合医院   重点专科建设   浙江省中医   中医儿科学   重大疾病   中医药防治   儿科   呼吸病  

摘要： 浙江省中西医结合医院儿科创建于1950年,是杭州市乃至全省具有影响力、中西医结合特色明显的小儿专科。其中中医儿科学已列入"十三五"浙江省中医药(中西医结合)重点学科建设计划和"十三五"浙江省中医药(中西医结合)重点专科建设计划。

关键词： 精品科技期刊   中华医学会系列杂志   核心期刊   资料管理系统   来源期刊   儿科学   核心学术期刊   儿科临床  

摘要： 《中华实用儿科临床杂志》(原《实用儿科临床杂志》)是由中国科学技术协会主管、中华医学会主办的中华医学会系列杂志,是以儿科临床与基础研究为主要报道内容的儿科学类核心期刊。本刊为儿科学类核心期刊、中国科技论文统计源期刊(中国科技核心期刊),RCCSE中国核心学术期刊,中国科学引文数据库(CSCD)来源期刊,中国科学技术协会精品科技期刊,被中国生物医学文献数据库(CBNWisc)、QUick全文资料管理系统(FTME).

关键词： 中医儿科学   青年教师   教学基本功  

摘要： 随着我国中医药事业的发展和对外交流的增强,中医药人才的需求逐渐增多。而中医药人才的培养需要各方面的共同努力。其中教师的培养尤其重要,而作为中医院校教学中坚力量的青年教师,他们的培养更是重中之重。在青年教师的培养过程中,基本功的培养尤为重要。其基本功包括扎实的中西医理论,如中医经典理论和现代医学理论;通过观摩教学、试讲、参加教学比赛、青年教师导师制、培训和学生反馈等;以及中医临床基本功的练习为教学提供临床素材。只有通过提高青年教师这些方面的基本功,才能让青年教师真正成长起来,为中医药事业培养更多优秀的中医药人才。

关键词： Child health services   Drug costs   Drug insurance   Paediatric pharmaceuticals   Pharmacare   Pharmaceutical economics  

摘要： Canada's drug insurance system is one of the most expensive in the world, yet millions of Canadians still struggle to access necessary medications. As a result, provincial, territorial, and federal governments are considering public pharmacare policy proposals to ensure that all Canadians can access the medications they need. Pharmacare policies offer an opportunity to prioritize children and youth, whose unique drug needs have long been neglected. Prescription drug use is common in this population, with approximately half of Canadian children and youth requiring at least one prescription in any given year. Drug use remains concentrated, however, among those with complex, chronic, and serious diseases. Children and youth rely heavily on compounded and off-label prescription drugs, which impacts safety, efficacy, palatability, and cost. Reimbursement decision-making bodies do not appropriately value the unique benefits of paediatric drugs, including child-friendly formulations, improved quality of life for children and families, and cost-savings outside the healthcare system. Regardless of the pharmacare model ultimately implemented, ensuring universal, comprehensive, and portable prescription drug coverage for all children and youth is essential. To accomplish this, paediatric drug experts should develop a national, evidence-informed formulary of paediatric drugs. Health Canada should also improve processes to make commercial paediatric drugs and child-friendly formulations more available and accessible. The federal government must also support paediatric drug research and development to this end.

关键词： 中华儿科杂志   终身教授   儿科学   编辑   博士生导师   复旦大学附属儿科医院   逝世   奠基人  

摘要： 金汉珍教授,中华儿科杂志第七、八、九届编辑委员会委员。我国著名儿科学专家、新生儿专业主要奠基人之一,第二至七届上海市政协委员,复旦大学附属儿科医院终身教授、博士生导师金汉珍教授因病医治无效,于2020年2月7日在上海逝世,享年100岁。