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关键词： Paediatric palliative care   Home hospice   Needs assessment   Screening tool   Admission  

摘要： Background While the populations of children who can benefit from paediatric palliative care (PPC) have been broadly defined, identifying individual patients to receive PPC has been problematic in practice. The Paediatric Palliative Screening scale (PaPaS) is a multi-dimensional tool that assesses palliative care needs in children and families to facilitate timely referrals. This study evaluates its use to manage new referrals and ongoing review of patients receiving home-based PPC in Singapore. Methods Using a retrospective cohort study design, 199 patients admitted to receive PPC via clinician screening were scored using PaPaS. Eighty-four patients in two groups were scored again at one of two following milestones: one-year service continuation mark or point of discharge before a year. Accuracy measures were compared against clinical assessment. Results 96.98% of patients scored 15 and above on admission (indicating need for PPC). Patients assessed at following milestones were effectively stratified;those who continued to receive service after 1 year scored significantly higher (M = 19.23) compared to those who were discharged within a year (M = 7.86). Sensitivity and specificity for PaPaS were calculated at 82.54 and 100% respectively. Overall congruence with clinician-based decisions supports the utility of PaPaS as a screening tool in PPC. Recommendations to improve the scale further are proposed. Conclusion The PaPaS is a practical screening tool that signposts PPC needs within the clinical setting. This facilitates early referrals to PPC, without having to specify individual prognoses that are often uncertain. Other benefits include optimised continuity of care and implications for resource allocation.

关键词： Sickle cell disease   Paediatric-adult care transition  

摘要： Background Thanks to advancements in medical care, a majority of patients with sickle cell disease (SCD) worldwide live beyond 18 years of age, and therefore, patients initially followed in paediatric departments are then transferred to adult departments. This paediatric-adult care transition is a period with an increased risk of discontinuity of care and subsequent morbidity and mortality. During this period, the patient will have to manage new interlocutors and places of care, and personal issues related to the period of adolescence. To take into consideration all these aspects, an interesting approach is to use the whole system approach to the patient, as presented in the biopsychosocial approach. The aim of this trial is to evaluate the impact of the proposed biopsychosocial paediatric-adult transition programme. Methods The DREPADO study is a multicentre randomised control trial comparing a control group (Arm A) to an interventional group with a paediatric-adult transition programme based on a biopsychosocial approach (Arm B). To be included, patients should have the SS, SC, or S beta form of sickle cell disease and be aged between 16 and 17 years. The randomisation in a 1:1 ratio assigns to Arm A or B. The primary outcome is the number of hospital admissions and emergencies for complications in the index hospital, in the 2 years after the first consultation in the adult department of care. Secondary outcomes consider the quality of life, but also include coping skills such as sense of self-efficacy and disease knowledge. To provide patient and parent knowledge and coping skills, the transition programme is composed of three axes: educational, psychological, and social, conducted individually and in groups. Discussion By providing self-care knowledge and coping skills related to SCD and therapeutics, helping empower patientsin relation to pain management and emotions, and facilitating the relationship to oneself, others, and care in Arm B of the DREPADO study,

关键词： Influenza   Children   Hospital admission rates   Mortality   Vaccination   Austria  

摘要： Background In Austria paediatric influenza-associated hospitalisations and deaths have never been systematically monitored. We examined the influenza season 2017/18 in terms of hospitalisation and mortality in the Austrian paediatric population and put the results into perspective of the available data from the last 15 years. Methods Cases of influenza-associated hospitalisations and deaths for season 2017/18 in children below 18 years were retrospectively collected from 12 and 33 Austrian hospitals, respectively. Hospitalisation and mortality rates for the whole Austrian paediatric population were estimated, adjusting for the population in each catchment area. Two Austrian databases were queried for hospitalisations and deaths associated with influenza during 2002-2016. Rough estimate of the vaccination coverage was calculated from a survey on 100 inpatients. Results Influenza-related paediatric hospitalisation rate in season 2017/18 was estimated as 128 (CI: 122-135) per 100,000 children, much higher than the national average of 40 per 100,000 over the years 2002-2016. There were nine reported influenza-associated deaths among children, resulting in mortality rate of 0.67 (CI: 0.32-1.21) per 100,000 children. Conclusions Reported influenza-associated hospitalisations and fatalities demonstrate a high burden of influenza in the Austrian paediatric population corresponding with very low vaccination coverage.

关键词： 呼吸道感染   儿科学   黄芪桂枝汤   玉屏风颗粒   炎症反应   免疫功能   中医药疗法   表虚证  

摘要： 目的探讨小儿反复呼吸道感染应用黄芪桂枝汤联合玉屏风颗粒的疗效。方法选择2017年6月-2018年5月儿科收治的120例小儿反复呼吸道感染患儿,随机将其分为2组,每组各60例。对照组经常规治疗干预,观察组经黄芪桂枝汤联合玉屏风颗粒治疗干预,对比2组临床疗效、炎症反应及免疫功能。结果治疗后,观察组总有效率为91.67%,高于对照组71.67%,差异有统计学意义(P<0.05);观察组肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)指标低于对照组,白介素-2(IL-2)指标高于对照组,观察组免疫球蛋白G(Ig G)、免疫球蛋白A(Ig A)及免疫球蛋白M(Ig M)指标均高于对照组,差异有统计学意义(P<0.05)。结论小儿反复呼吸道感染应用黄芪桂枝汤联合玉屏风颗粒,可有效抑制炎症反应,提高免疫功能,且临床疗效显著。

关键词： 眼底病   人民卫生出版社   罕见病例   妇幼保健人员   眼底疾病   诊治工作   眼科中心   儿科学  

摘要： 由空军军医大学王雨生教授主编的《图说小儿眼底病》一书近日由人民卫生出版社出版发行,该书系文峰教授总主编的“图说眼科疾病系列丛书”之一。小儿眼底病特殊且复杂,诊治工作十分困难,对临床医师具有极强的挑战性。本书经国内十余家关注小儿眼底病的知名眼科中心同力合作,由四十多位具有丰富经验的小儿眼底病从业人员执笔完成,是第一部中文版小儿眼底病专著。书中收集了数百例临床典型病例,精选各类精美图片近千张,图文并荗地诠释了五十余种小儿眼底疾病丰富的内涵。以创新的“图说”形式写作,每幅图附“图点评”,集专著、图谱和病例集锦等传统书藉的表达优势于一身,兼顾系统性和全面性、真实性和实用性、直观性和可读性。本书还收集了一些小儿眼底病领域罕见病例资源,将会带大家探索小儿眼底病的奥秘,也将有助于建立和丰富我国的小儿眼病资源库。愿本书能成为眼科学、儿科学或新生儿科学领域,尤其是关注小儿眼病工作的医护人员、妇幼保健人员、研究生和科研工作者的案头必备读本。该书定价228元,可从各大书店或人民卫生出版社销售网络购买。

关键词： Scopus数据库   精品科技期刊   期刊指南   核心期刊   资料管理系统   来源期刊   新乡医学院   儿科学  

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、新乡医学院承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。本刊为中国科学引文数据库(CSCD)来源期刊,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,中国精品科技期刊,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(CBMdisc)、Quick全文资料管理系统(FTME)、中文科技期刊数据库、万方数据、《中国学术期刊文摘》、Scopus数据库、美国《化学文摘》、俄罗斯《文摘杂志》、波兰《哥白尼文摘》、WH0西太平洋地区医学索引(WPRIM)、美国《乌利希斯期刊指南》等国内外数十家权威数据库收录。

关键词： 咳嗽变异性哮喘   儿科学   三子养亲汤   炎症反应   中医药疗法  

摘要： 目的探讨加味三子养亲汤治疗小儿咳嗽变异性哮喘(CVA)疗效。方法选取2017年9月-2019年7月接受治疗的CVA患儿128例,经随机数字表法将其分为对照组、观察组各64例。对照组患儿接受临床CVA常规治疗,观察组患儿在对照组基础上加入加味三子养亲汤治疗,持续治疗14 d后对比2组患儿的血清细胞因子、疗效、药物相关不良反应发生情况的差异。结果治疗后,观察组患儿血清中TNF-α、IL-10、IL-13、EOS的水平低于对照组患儿;疗效分级及总有效率均优于对照组患儿(P<0.05)。2组患儿未发生明显药物相关不良反应。结论加味三子养亲汤可提升小儿CVA的治疗效果,且治疗安全性良好。

关键词： 具身认知   PBL-CBL教学法   儿科教学   住院医师规范化培训  

摘要： 目的探讨具身认知理论联合PBL-CBL教学法在儿科学住院医师规范化培训教学中对学员医患沟通能力的培养。方法选取儿科学住院医师规范化培训学员60人,分为对照组、实验组各30人;对照组学员采用传统授课方式学习医患沟通课程;实验组予讲述具身认知理论的实施细则,并运用PBL-CBL教学法提升学员医患沟通能力。应用SEGUE量表、医学生沟通能力量表及教学满意度调查问卷测评教学结果。结果在SEGUE量表测评中,实验组各项评分均高于对照组(P<0.05);在医学生沟通能力量表测评中,实验组沟通能力显著高于对照组(P<0.05);实验组对教学满意程度较高(P<0.05)。结论具身认知理论联合PBL-CBL教学法可提高儿科学规培学员医患沟通能力,实现理论知识与体验式教学的互动结合。

关键词： 游戏教学法   幼儿科学   应用价值   应用策略  

摘要： 游戏教学法是幼儿阶段非常高效的教学方式之一,幼儿天性活动好动,游戏是他们最为喜欢的玩乐形式,如何将游戏教学法,融入到幼儿科学课堂教学中,成为幼儿教师必须要重视的问题之一。笔者结合自己多年的幼儿教育经验,从幼儿科学教育的目标出发,简要的提出了几点关于幼儿科学课堂游戏化教学的策略和方法。

关键词： 咳嗽变异性哮喘   中西医结合疗法   儿科学  

摘要： 目的观察中西医结合治疗小儿咳嗽变异性哮喘(cough variant asthma,CVA)的临床疗效。方法选取2016年1月-2017年12月就诊于我院儿科病房的小儿咳嗽变异性哮喘患者60例,随机分为2组:观察组和对照组,每组各30例。对照组患儿服用孟鲁斯特钠进行治疗,观察组在对照组基础上联合穴位贴敷治疗,观察2组的临床疗效、症状缓解时间。结果观察组患儿的临床疗效、症状缓解时间明显优于对照组,差异有统计学意义(P<0.05)。结论中西医结合治疗小儿咳嗽变异性哮喘较单纯西医治疗临床疗效更佳,值得临床推广。