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关键词： Paediatric care   Patient handover   Teamwork   Stress   Operating room   Intensive care unit  

摘要： Postsurgical handover of paediatric patients from operating rooms to intensive care units is a critical moment. This process is susceptible to errors and inefficiencies particularly if poor teamwork in this multidisciplinary and ad hoc collaboration occurs. Through combining provider- and observer-rated team performance, we aimed to determine agreement levels on team performance and associations with mental demands, disruptions, and stress. An observational and multisource study of provider and concomitant expert-observer ratings was established. In an Academic Paediatric Hospital, we conducted standardized observations of postsurgical handovers to PICU. We applied established observational and self-reported teamwork tools. Nested fixed and mixed models were established to estimate agreement within teams, between providers' and observer's ratings, as well as for estimations between team performance and mental demands, disruptions, and stress outcomes. Thirty-one postsurgical patient handovers were included with overall 109 ratings of involved providers. Provider-perceived team performance was rated high. Within the receiving sub-team, situation awareness was perceived lower compared to the handoff sub-team [F(df = 1) = 4.41, p = .04]. Inter-provider agreement on handover team performance was low for the overall team yet higher within handover sub-teams. We observed that high level of distractions during the handover was associated with inferior team performance rated by observers (B = - 0.72, 95% CI = - 1.44, - 0.01). Conclusion: We observed substantial disagreements on how involved professionals as well as observers rated teamwork during patient transfers. Investigations into paediatric teamwork and particular team-based handovers should carefully consider if concurrent provider and observer assessments are a valid and reliable way to evaluate teamwork in paediatric care. Common handover language should be established and mandatory before jointly evaluating this pr

关键词： Australia   Buruli ulcer   paediatrics   paradoxical reaction  

摘要： Aim This study describes an Australian cohort of paediatric Buruli ulcer (BU) patients and compares them with adult BU patients. Methods Analysis of a prospective cohort of all BU cases managed at Barwon Health, Victoria, from 1 January 1998 to 31 May 2018 was performed. Children were defined as <= 15 years of age. Results A total of 565 patients were included: 52 (9.2%) children, 289 (51.2%) adults aged 16-64 years and 224 (39.6%) adults aged >= 65 years. Among children, half were female and the median age was 8.0 years (interquartile range 4.8-12.3 years). Six (11.5%) cases were diagnosed from 2001 to 2006, 14 (26.9%) from 2007 to 2012 and 32 (61.5%) from 2013 to 2018. Compared to adults, children had a significantly higher proportion of non-ulcerative lesions (32.7%, P < 0.001) and a higher proportion of severe lesions (26.9%, P < 0.01). The median duration of symptoms prior to diagnosis was shorter for children compared with adults aged 16-64 years (42 vs. 56 days, P = 0.04). Children were significantly less likely to experience antibiotic complications (6.1%) compared with adults (20.6%, P < 0.001), but had a significantly higher rate of paradoxical reactions (38.8%) compared with adults aged 16-64 (19.2%) (P < 0.001). Paradoxical reactions in children occurred significantly earlier than in adults (median 17 vs. 56 days, P < 0.01). Cure rates were similarly high for children compared to adults treated with antibiotics alone or with antibiotics and surgery. Conclusions Paediatric BU cases in Australia are increasing and represent an important but stable proportion of Australian BU cohorts. Compared with adults, there are significant differences in clinical presentation and treatment outcomes.

关键词： Bibliometrics   Citation analysis   Paediatric dentistry   Altmetric   Dimensions  

摘要： Purpose To perform a bibliometric analysis on the 100 most-cited articles to provide a historical perspective in the scientific advancement of research, and to identify the areas of more intense research. To determine the correlation of the Altmetric Attention Score (AAS) with the number of citations. Methods The articles were identified through a search of the Web Of Science (WOS) database. The information relative to the articles was collected. Descriptive statistics was used to describe the articles and the journals. The Pearson's correlation analysis was used to explore the relationship among WOS citations, AAS and dimensions. Results The most-cited articles were published between 1967 and 2013. The articles were published in 18 different journals and cited from 69 to 305 times. The authors belonged to institutions in 20 different countries. The most common study design was observational followed by literature reviews. Conclusions The journals with a special interest in paediatric dentistry published the majority of the 100 most-cited articles. The most frequent field of study was caries and EEC. MIH and OHRQL displayed a high number of citations per year. A poor correlation exists between the citation count in the WOS and the AAS. Dimension citation count has a strong correlation with the WOS one.

关键词： Children   Contrast agents   Contrast-enhanced   Intracavitary   Ultrasound  

摘要： Contrast-enhanced ultrasonography (US) has become an important supplementary tool in many clinical applications in children. Contrast-enhanced voiding urosonography and intravenous US contrast agents have proved useful in routine clinical practice. Other applications of intracavitary contrast-enhanced US, particularly in children, have not been widely investigated but could serve as a practical and radiation-free problem-solver in several clinical settings. Intracavitary contrast-enhanced US is a real-time imaging modality similar to fluoroscopy with iodinated contrast agent. The US contrast agent solution is administered into physiological or non-physiological body cavities. There is no definitive list of established indications for intracavitary US contrast agent application. However, intracavitary contrast-enhanced US can be used for many clinical applications. It offers excellent real-time spatial resolution and allows for a more accurate delineation of the cavity anatomy, including the internal architecture of complex collections and possible communications within the cavity or with the surrounding structures through fistulous tracts. It can provide valuable information related to the insertion of catheters and tubes, and identify related complications such as confirming the position and patency of a catheter and identifying causes for drainage dysfunction or leakage. Patency of the ureter and biliary ducts can be evaluated, too. US contrast agent solution can be administered orally or a via nasogastric tube, or as an enema to evaluate the gastrointestinal tract. In this review we present potential clinical applications and procedural and dose recommendations regarding intracavitary contrast-enhanced ultrasonography.

关键词： Child physical abuse   paediatric dentists   dental trauma  

摘要： Objectives Numerous studies have shown that the education of health professionals is essential to effectively respond to child abuse. The present study aimed to evaluate Turkish paediatric dentists' knowledge, experiences and attitudes regarding child physical abuse. Materials and methods An electronic questionnaire was e-mailed to 518 paediatric dentists. Participants' knowledge of diagnostic indicators of child physical abuse, and their past experiences, attitudes and self-assessment of educational needs were evaluated. Results The response rate was 40.9% (n = 212). Participants who completed their undergraduate education before 1997 received significantly less education on child physical abuse than participants who completed their education more recently (P < 0.001). Although statistically insignificant, participants who completed their doctorate/specialty training after 2012 received increased education on child physical abuse (P = 0.06). Of the participants, 43.9% suspected physical abuse;however, only 12.7% reported it. 'I did not know where and how to report' was the most common reason for not reporting physical abuse. The rate of suspicion was higher among dentists from state hospitals or oral health centres (P < 0.05). Of the participants, 70.3% did not know about the legal sanctions for delay in or not reporting suspected cases. Only 15.6% assessed themselves as competent to diagnose and report physical abuse. Almost all of them acknowledged their need for more education on this topic. Conclusion Turkish paediatric dentists' educational needs for diagnosing and reporting of child physical abuse cases should be met.

关键词： Chlamydophila pneumoniae   lower respiratory tract infections   Mycoplasma pneumoniae   polymerase chain reaction   serology  

摘要： Purpose: Mycoplasma pneumoniae (M. pneumoniae) and Chlamydophila pneumoniae (C. pneumoniae) play a significant role in children of all ages with lower respiratory tract infections (LRTIs). This study was conducted to detect M. pneumoniae and C. pneumoniae in children with community-acquired LRTIs employing serology, polymerase chain reaction (PCR) and nested PCR analysis. Material and Methods: This study included 75 children with acute LRTIs for detection of M. pneumoniae and C. pneumoniae. Blood was obtained for M. pneumoniae and C. pneumoniae antibodies and nasopharyngeal aspirates for M. pneumoniae PCR and C. pneumoniae nested PCR. Results: M. pneumoniae infection was positive in 9 (64.21%) children aged 2-6 months and in 5 (35.79%) aged 7 months-12 years, and this difference was statistically significant (P = 0.002). C. pneumoniae infection was comparable within the age group and statistically insignificant (P = 0.43). Clinical and radiological profiles of M. pneumoniae- and C. pneumoniae-positive and negative patients were numerically comparable. Serology and PCR together detected M. pneumoniae infection in 14 (18.6%) children. The sensitivity, specificity and positive and negative predictive values of serology were 77.78%, 92.42%, 58.33% and 96.83%, respectively. C. pneumoniae infection was positive in 11 (14.6%) children by serology and nested PCR with 50% sensitivity, 87.67% specificity, 10% positive predictive value and 98.46% negative predictive value. Conclusions: Our study confirms that M. pneumoniae and C. pneumoniae play a significant role in community-acquired LRTIs and a combination of serology and nested PCR is useful for its diagnosis.

关键词： OCD   Family accommodation   Emotion regulation   Externalising symptoms  

摘要： Paediatric Obsessive-Compulsive Disorder (OCD) is associated with significant family accommodation (FA), which frequently results in heightened parental distress, increased OCD severity and impairment. Examining factors which might drive FA is an important focus for the field. This study aimed to examine parents' report of children's emotion regulation (ER) and associations with OCD severity, externalising symptoms, and FA. Participants were 76 youth (7 to 17 years) with a primary diagnosis of OCD and one of their parents. Following child diagnostic and OCD symptom interviews, parents completed study questionnaires. Results indicated that parent-report of children's emotional Lability/Negativity was significantly and positively correlated with child externalising symptoms and FA, whereas children's adaptive ER was significantly and negatively correlated with externalising symptoms only. Furthermore, children's emotional Lability/Negativity predicted externalising symptoms, even when accounting for OCD severity. Lability/Negativity did not predict FA after controlling for OCD severity and externalising symptoms, however it was a significant moderator of the relationship between OCD severity and FA. These findings extend the growing body of literature on ER and OCD in youth and highlight the importance for clinicians to specifically address such deficits in ER as a part of OCD treatment.

关键词： Child   preschool   Parents   Dentists   Acute pain   Pain   procedural  

摘要： Purpose Parents/carers' and dentists' evaluations are important when assessing young children's pain. However, there is little evidence on agreement regarding children's pain according to proxy reports. The aims of this cross-sectional study were to investigate the agreement among paediatric dentists and parents/carers about children's pain during treatment and the association between the reporting of pain and child behaviour. Methods Participants were 81 parents/carers of uncooperative children undergoing restorative treatment, and five paediatric dentists. Pain during dental treatment was assessed after dental procedures using the Visual Analogue Scale (0-4 mm: no pain;5-44 mm: mild pain;45-74 mm: moderate pain;75-100 mm: severe pain). Child behaviour was assessed by calibrated researchers using the Ohio State University Behavioural Scale. The agreement between respondents about a child's pain was evaluated using the weighted kappa test. The association between the pain report and child behaviour was verified using the Kruskal-Wallis and Mann-Whitney tests. Results Parents/carers (36, 44.4%) and paediatric dentists (40, 49.4%) reported that children felt mild pain in all sessions. The parents/carers reported that the children experienced higher pain intensities compared to paediatric dentists. The agreement between respondents was slight (weighted Kappa < 0.20). Higher pain intensities were more frequent when the children's behaviour was uncooperative. Conclusion Parents/carers and paediatric dentists showed slight agreement regarding the pain felt by children in dental treatment. Pain proxy reporting in children is influenced by the children's behaviour.

关键词： Liver diseases   Transplantation  

摘要： In a new study, cryopreserved human hepatocytes retrieved from livers deemed unsuitable for transplantation were thawed and encapsulated into alginate microbeads and then infused into the peritoneal cavity of a group of children with acute liver failure who were awaiting liver transplantation.

关键词： Transition   Liver disease   Adolescent   Young adults   Liver transplantation  

摘要： Transition describes a progressive and highly coordinated process encompassing the transfer of a young patient from paediatric care to the adult-care system. Transfer of medical care for an adolescent to adult services is a complex and challenging task requiring close collaboration of both the paediatric and adult-care providers. It must take into account the medical, psychosocial and educational needs of the young adult. The Transition Working Group of the French Network for Rare Liver Diseases (FILFOIE) proposes recommendations and tools designed to optimise the transition process of adolescents and young adults with chronic liver disease from child-based to adult-based healthcare services, focusing on three key time points: preparation before the transfer, the transfer process to the adult service, and finally reception and follow-up within the adult-care service. (C) 2019 Published by Elsevier Masson SAS.