Pediatrics
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This study investigates how pediatricians define palliative care and their preferences regarding the timing of referrals for children with life-limiting diseases. ⋯ Despite recommendations to refer children to palliative care early in the course of illness, most pediatricians define palliative care as similar to hospice care and refer patients once curative therapy is no longer an option. Creating a more-practical definition of care, one that emphasizes an array of services throughout the course of an illness, as opposed to hospice care, may increase earlier palliative care referrals for children with life-limiting illnesses.
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The objective of this study was to determine the impact of family-centered multidisciplinary rounds on an inpatient pediatric ward. We hoped to (1) gain a better understanding of the patient and family experience with family-centered multidisciplinary rounds, (2) measure hospital staff satisfaction with family-centered multidisciplinary rounds compared with conventional rounds, and (3) understand the time commitment for family-centered multidisciplinary rounds and conventional rounds. ⋯ Family-centered multidisciplinary rounds is a method of conducting inpatient hospital rounds that fosters teamwork and empowers hospital staff. The patient and family are engaged in and are the focal point of the rounds. Staff members are able to hear everyone's perspective and give input. The impact on staff satisfaction and the family's ability to participate in their care is significant.
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Prenatal stress has been linked to several adverse neurobehavioral outcomes, which may share a common pathophysiology with autism. We aimed to examine whether prenatal stress exposure after maternal bereavement is associated with an increased risk of autism later in life. ⋯ This is the first population-based cohort study to examine the effect of prenatal stress on autism in childhood. Our data do not support any strong association between prenatal stress after maternal bereavement and the risk of autism.
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Multicenter Study Comparative Study
Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.
The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. ⋯ By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must establish the importance of this topic in the pediatric education of residents of all specialties.
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Our goal was to investigate the risk factors for sudden infant death syndrome in the infants' sleep environment for a population in which few infants sleep prone as a result of education campaigns. ⋯ This study has clarified the risk factors for sudden infant death syndrome in a population where few infants sleep prone. This study supports the current recommendations of the American Academy of Pediatrics. This study has identified several novel risk factors for sudden infant death syndrome: an increased risk if the infants sleeps outside the parental home, death in the living room, and the high risk when sleeping prone on a sheepskin; however, because the numbers of cases in these groups are small, additional studies are needed to confirm these findings.