Previous works have shown that effective communication between parental caregivers and child patients has many benefits to the children, such as providing emotional support and coping skills for ...health management. Drawing on semi-structured interviews, we have identified the challenges parental caregivers face when communicating with their children about health-related information in daily illness management. Three salient challenges that the parental caregivers encountered include: (i) acknowledging different perceptions and approaches to being a cancer patient, (ii) choosing an appropriate communication method, and (iii) understanding their child's uncommunicated emotions. Based on these challenges, we recognize distinctive, yet implicit, needs that children develop during the illness trajectory, affecting the parent-child dyadic relationship. We discuss design opportunities for a collaborative system that enhances the parent-child dyadic communication by supporting the child's implicit and dynamically changing needs throughout the illness trajectory and beyond.
Abstract We administered a 7-question survey on drooling to PD patients and age-matched controls. Each subject was assigned a drooling severity score and categorized as a “drooler” or a ...“non-drooler”. The age, disease duration, motor scores, quality of life (PDQ-39), and levodopa equivalent daily dosage (LEDD) were compared between PD droolers vs. PD non-droolers. 58 PD patients and 51 age-matched controls participated. In PD patients, the mean: disease duration was 10.96 years (SD 8.66) and UPDRS on motor score was 30.76 (SD 10.57). The drooling severity score was significantly different between patients vs. controls (3.41 vs. .58; p < .01). 14% of controls vs. 59% of patients were droolers ( p < .01). PD droolers scored worse on the ADL subscale of the PDQ-39 ( p = .031). Furthermore, PD droolers had significant difficulty speaking (7.27% vs. 0%; p < .01); eating (3.64% vs. 0%; p = .01); and socially interacting (12.73% vs. 0%; p < .01) compared to PD non-droolers. Interestingly, the hallucination component of the UPDRS Part I was significantly correlated with being a drooler ( p = .016). None of the other variables have significant effect on drooling severity scores. There is a high prevalence of drooling among PD patients compared to controls. PD droolers had worse quality of life and had more difficulty speaking, eating and socially interacting compared to PD non-droolers. Experiencing hallucinations was the only factor that correlated with being a drooler and it may be confounded by medications.
Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association ...of Medical Colleges‐affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.
In sum, teaching in all three subjects combined comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics.
Effective patient-provider communication is critical to promote patient satisfaction, encourage patient involvement in care, and improve health outcomes. Although prior HCI works aim to enhance the ...dyadic communication by improving patients’ communication skills, little is known about healthcare providers’ communication work to facilitate effective communication with their child patients. Through semi-structured interviews with 10 healthcare providers and clinic observations, our study identified four strategies that providers used in their communication with patients: building rapport, developing familiarity with care settings, respecting patients’ communication modes and preferences, and delegating small decision-making and directing questions to patients. Based on these strategies, we discuss three key elements that providers value and work toward to achieve effective communication in pediatric care practice. Our study also uncovers the detailed process of how the providers develop their strategies to tailor their communication to the patients’ specific needs and preferences, and we describe design opportunities for communication technology.
PurposeTo report a case of recurrent retinoblastoma following transpupillary thermotherapy (TTT) with development of scleral ectasia, as well as their successful treatment with intra-arterial ...chemotherapy.ObservationsA 15-month-old girl with bilateral retinoblastoma presented with recurrent retinoblastoma and associated scleral ectasia with concern for extraocular extension after receiving multiple round of systemic chemotherapy and TTT. Given her negative systemic evaluation, decision was made to pursue intra-arterial chemotherapy. After completion of six rounds of 3-agent intra-arterial chemotherapy, the recurrent retinoblastoma had completely regressed and the scleral ectasia had improved and fibrosed.Conclusions and importanceThe sclera is classically viewed as hyperthermy-resistant to TTT. Here, we describe scleral ectasia due to aggressive TTT with recurrence of the retinoblastoma. Our treatment with intra-arterial chemotherapy not only caused complete regression of the recurrent retinoblastoma, but it also contributed to the stabilization and improvement of the weakened scleral.
Clinical trials for children with cancer are important Clinical trials work in four phases, each meant to further assess the safety, optimal dose and effectiveness of the drug or treatment regimen. ...The goal of phase III clinical trials is to improve survival and/or decrease side effects when compared to previous treatment regimens.
Objectives Rapid diagnostic tests (RDTs) are promoted for the diagnosis of malaria in many countries. The question arises whether laboratories where the current method of diagnosis is microscopy ...should also switch to RDT. This problem was studied in Kassala, Sudan where the issue of switching to RDT is under discussion. Methods Two hundred and three blood samples were collected from febrile patients suspected of having malaria. These were subsequently analysed with microscopy, RDT (SD Bioline P.f/P.v) and PCR for the detection and identification of Plasmodium parasites. Results Malaria parasites were detected in 36 blood samples when examined microscopically, 54 (26.6%) samples were found positive for malaria parasites by RDT, and 44 samples were positive by PCR. Further analysis showed that the RDT used in our study resulted in a relatively high number of false positive samples. When microscopy was compared with PCR, an agreement of 96.1% and k = 0.88 (sensitivity 85.7% and specificity 100%) was found. However, when RDT was compared with PCR, an agreement of only 81.2 and k = 0.48 (sensitivity 69% and specificity 84%) was found. Conclusion PCR has proven to be one of the most specific and sensitive diagnostic methods, particularly for malaria cases with low parasitaemia. However, this technique has limitations in its routine use under resource‐limited conditions, such as our study location. At present, based on these results, microscopy remains the best option for routine diagnosis of malaria in Kassala, eastern Sudan.
Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general ...examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.
Author information Affiliations 1. Faculty of Medicine, Kassala University, Kassala, Sudan * Mamoun MM Osman * & Mohamed F Sedig 2. Faculty of Medical Laboratory Sciences, University of Gezira, Wad ...Medani, Sudan * Mamoun MM Osman * , Bakri YM Nour * , Adil M Babikir * & Ahmed A Mohamedani 3. Blue Nile Institute for Communicable Diseases, University of Gezira, Wad Medani, Sudan * Bakri YM Nour * , Adil M Babikir * & Ahmed A Mohamedani 4. Royal Tropical Institutes (KIT), Biomedical Research, Amsterdam, The Netherlands * Laura de Bes * & Petra F Mens Authors 1. Search for Mamoun MM Osman in: * PubMed • * Google Scholar 2. Search for Bakri YM Nour in: * PubMed • * Google Scholar 3. Search for Mohamed F Sedig in: * PubMed • * Google Scholar 4. Search for Laura de Bes in: * PubMed • * Google Scholar 5. Search for Adil M Babikir in: * PubMed • * Google Scholar 6. Search for Ahmed A Mohamedani in: * PubMed • * Google Scholar 7. Search for Petra F Mens in: * PubMed • * Google Scholar Corresponding author Correspondence to Bakri YM Nour.
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