Day 1 :
Keynote Forum
Heather L MacDonald
University of New Brunswick, Canada
Keynote: Respite for Parents of Children who require Complex Care
Time : 10:15-10:45
Biography:
Dr. MacDonald completed a Master’s degree in Nursing at the University of Toronto, Canada and a PhD at the University of Manchester in the UK. Currently she is a Professor in the Faculty of Nursing at the University of New Brunswick (Canada). Dr. MacDonald’s doctoral work examined respite for parents who were caring for children who required complex care. This paper comes from that work. Dr. MacDonald has three children of her own.
Abstract:
Current literature states that advances in nursing and medical care and developments in pharmaceutical and health technologies, have led to an increasing number of severely disabled children who require complex health care. These children who require complex care are being cared for in their homes by their parents. The purpose of this study was to better understand parents’ caregiving experiences and to explore the values, beliefs, and practices that influence parents’ use and satisfaction with respite services.rnAn ethnographic study involving 19 mothers, 4 fathers, and 4 grandmothers and 3 grandfathers of children between the ages of 8 and 16 years of age who required complex care and their respite providers, including 13 nurses, and 4 social workers from 3 counties in Northwest England was conducted. Data were collected through in-depth interviews, participant observation and document review.rnThe context of caring for a child with complex care needs was described and four broad themes were identified in the data. These themes include: parents caring, caring and the impact on parental identity, the nature of respite, and fair play. These themes will be discussed in the presentation.rn
Keynote Forum
Hee Yun Lee
University of Minnesota, USA
Keynote: Parents’ Health Literacy and its Link to Children’s Health and Mental Health Service Utilization and Outcomes in Asian American Immigrants: A Finding from Population-Based Survey
Time : 10:45-11:15
Biography:
Hee Yun Lee is a Professor and Director of Research at the University of Minnesota, Twin Cities, in USA. Her major research areas include cancer health disparity and health literacy among immigrant and refugee populations. She is currently conducting several RCT trials to improve cancer screening behavior and health literacy funded by the National Cancer Institute, Susan Komen for the Cure Foundation, and Department of Defense. She has published more than 47 papers in reputed medical/public health journals and has been serving as an editorial board member and currently serving as an Associate Editor for a high impact journal.
Abstract:
Health literacy is an important barrier to health service utilization and outcomes due to its impact on an individual’s ability to communicate with a service provider and ability to understand and follow health instructions. Most of the research thus far has examined its impact on physical health service utilization or outcomes, with findings generally supporting a link between parental health literacy and child physical health service utilization and outcomes. However, very little research has been done looking at the impact of parental health literacy levels on child mental health service utilization or outcomes. Due to the service gap that exists between children in need of services and those who receive services, it is important that we understand the barriers that may prevent children from receiving the mental health services they need. The present study used data from the 2007 California Health Interview Survey, with 9,399 parents included in the final sample. Multiple regression analyses were conducted to examine the impact of parental health literacy on both child mental health service utilization and mental health outcomes. The results did not support a link between parental health literacy and service utilization for children or teens, but did support a link with child mental health outcomes for Asian and African American children, but not teens. These results suggest that not only should the impact of health literacy be looked at within rather than across groups, but also that while health literacy may not be barrier to utilization of services it may impact experience and outcome of services. rn
Keynote Forum
Hideya Kodama
University of Akita, Japan
Keynote: Assessment of nocturnal sleep architecture by actigraphy and one-channel electroencephalography in early infancy
Time : 11:30-12:00
Biography:
Hideya Kodama graduated from Akita university of Medicine in 1982, and promoted to a professor of the department of maternity child nursing at Akita university graduate school of medicine and faculty of medicine in 2000. Since them, he have studied about a human circadian rhyme, including a sleep-wake cycle, a melatonin rhythm, regulation of autonomic nervous system and a body thermal rhythm, with nurses who entered his postdoctoral course. Now, he manages several research projects of the doctorial course regarding this issue, and his research subjects include early infants, pregnant women, puerperant and adolescent girls.
Abstract:
Objective: To elucidate characteristic sleep architecture of different nocturnal sleep patterns　in early infancy.　Methods: Participants were 27 infants at the same conceptional age of 3-4 months. Nocturnal sleep of　these infants was monitored at home by simultaneously using actigraphy and a one-channel portable　EEG device. According to the infants' activity for 6 hours from sleep onset, each night's sleep pattern　was classified into three categories: sleeping through the night (STN), sleeping with weak signals　(crying/fuss episodes <10 minutes or fed), and sleeping with strong signals (crying/fuss episodes≧10　minutes). Associations of sleep patterns with sleep variables (percentage of time in sleep stages,　pattern of slow-wave sleep (SWS) recurrence, etc.) were investigated.　Results： Analysis was conducted in 95 nights. STN pattern (n=36) was characterized by suppressed　body movements while EEG represented a state of wakefulness. Weak signal pattern (n=27) tended to　indicate rich and regular distributions of SWS across the night. Strong signal pattern (n=32) was　characterized by reduced sleep time, although the amount of SWS was not reduced to that degree.　Exclusively breastfed infants accounted for 78% of weak signal patterns, whereas formula-feeding　infants, 67% of STN patterns. In several nights with STN or strong signal pattern, SWS did not occur in　>50% of the sleep cycles. Multiple regression analysis showed that exclusive breastfeeding may　increase the proportion of SWS in non-REM sleep.　Conclusions: Each nocturnal sleep pattern was associated with some sleep architecture, part of which would be attributed to infant's feeding methods.
Keynote Forum
Hamish B Wallace
University of Edinburg, United Kingdom
Keynote: Female fertility in survivors of childhood malignancy
Time : 9.30 to 10.00
Biography:
Dr Hamish B Wallace is a consultant in Paediatric Oncology at the RHSC, Edinburgh since 1992. He became a Leukaemia Research Fund Research Fellow under the guidance of Professor Steve Shalet in Manchester in the late 1980s when he developed my research interest in the late endocrine effects of the treatment of childhood cancer and completed my MD thesis. His main research interest is in fertility outcome and fertility preservation for cancer patients. He is the Chair of the CCLG Hodgkin’s Lymphoma Working Group (since 2002) and President of the European Network for Paediatric Hodgkin’s Lymphoma (since 2007). Wallace is a co-author of over 130 peer-reviewed publications, and four books. Most recently he co-edited with Prof Dan Green a multi-author book on “Late effects of the treatment of Childhood Cancer†and with Prof Chris Kelnar a book on “Endocrine complications of the treatment of childhood cancerâ€. He is the the co- founder and organiser for ESLCCC, a biannual conference on the late effects of the treatment of childhood cancer. Dr Wallace was Lead Clinician for the Children’s and Young Peoples MCN for Cancer in Scotland “CATSCAN†from 2007 to 2010. He is currently the Registrar of the Royal College of Paediatrics and Child Health.
Abstract:
With 70% of young patients with cancer becoming long-term survivors the issue of fertility outcome has become an issue of great importance (Wallace et al 2012). Female fertility preservation provides significantly different challenges to that for the male (Wallace et al. 2005). Embryo freezing is now a well-established procedure in many centres, but is not available for children who do not have a partner. Cryopreservation using vitrification of mature oocytes has become increasingly successful, but requires the patient to go through a course of hormone stimulation and is therefore not appropriate for children and young girls. Ovarian tissue cryopreservation has the potential advantages of preservation of a large number of oocytes within primordial follicles, it does not require hormonal stimulation when time is short, and is appropriate for the pre-pubertal girl. Disadvantages include the need for an invasive procedure, and the uncertain risk of ovarian contamination in haematological and other malignancies. Ovarian tissue cryopreservation in adult women with later re-implantation has resulted in at least 20 live births worldwide. rnrnWe strongly recommend that all young patients with cancer have an assessment made of their fertility prognosis before they commence treatment (Wallace WH et al 2012). We have previously published guidelines for patient selection in young female patients with cancer and in this lecture I will report our practise in a single centre that has offered fertility preservation since 1996. Ovarian cryopreservation was offered to 9% of our patients, and performed in 5%. The procedure was safe and without complications. All but one of our patients who have thus far developed premature ovarian insufficiency were identified pre-treatment using our criteria. More research is required before ovarian tissue cryopreservation in young patients with cancer can be considered to be an established technique available to patients out with IRB approved studies.rn
- Pediatric Nursing
Chair
Heather L MacDonald
University of New Brunswick, Canada
Co-Chair
Hee Yun Lee
University of Minnesota, USA
Session Introduction
Arthur Engler
University of Connecticut
Title: Effectiveness of a perinatal and pediatric End-of-Life Nursing Education Consortium (ELNEC) curricula integration
Biography:
Dr. Engler completed his PhD in nursing in 1999 at the Catholic University of America in Washington DC. He has been on the faculty of the University Of Connecticut School Of Nursing in the U.S. since that time. He is the coordinator of the undergraduate pediatric nursing program and the author of numerous papers on pediatric and neonatal nursing.
Abstract:
Background: Educational practices and national guidelines for best practices of providing palliative care to children and their families have been developed and are gaining support; however, the dissemination of those practices lags behind expectations. Incorporating education for pediatric palliative care into nursing pre-licensure programs will provide guidelines for best practices with opportunities to enact them prior to graduation. Objective: To evaluate the effect of an integrated curriculum for palliative care on nursing students' knowledge. Design: Matched pretest–posttest. Setting: One private and one public university in the northeastern United States. Participants: Two groups of baccalaureate nursing students, one exposed to an integrated curriculum for palliative care and one without the same exposure. Methods: Pre-testing of the students with a 50-item multiple choice instrument prior to curriculum integration and post-testing with the same instrument at the end of the term. Results: This analysis demonstrated changes in knowledge scores among the experimental (n = 40) and control (n = 19) groups that were statistically significant by time (Wilks' Lambda = .90, F(1, 57) = 6.70, p = .012) and study group (Wilks' Lambda = .83, F(1, 57) = 11.79, p = .001). Conclusions: An integrated curriculum for pediatric and perinatal palliative and end-of-life care can demonstrate an increased knowledge in a small convenience sample of pre-licensure baccalaureate nursing students when compared to a control group not exposed to the same curriculum. Future research can examine the effect on graduates' satisfaction with program preparation for this specialty area; the role of the use of the curriculum with practice-partners to strengthen transfer of knowledge to the clinical environment; and the use of this curriculum inter professionally.
Biography:
Laurence Baldwin is a Senior Lecturer in Mental Health Nursing at Coventry University, and leads the Children and Young People’s Neurodevelopmental Team at Derbyshire Healthcare Trust. He completed his PhD at the University of Nottingham, and was previously a Consultant Nurse for Child and Adolescent Mental Health Services in Derbyshire, England. He has published several papers and chapters and been involved in multi disciplinary and community-based participatory research projects. His work for the Royal College of Nursing included representing nursing on the CAMHS Ministerial Taskforce which published the influential ‘Future In Mind’ report in March 2015.
Abstract:
Child and adolescent mental health services (CAMHS) within the UK National Health Service have often been seen as a ‘Cinderella service’ but due to increasing pressure and attention have received much more policy development in the past ten years. Important amongst this is the development of Children and Young People’s Improved Access to Psychological Therapies (CYP-IAPT) which emphasizes evidence-based approaches, and the use of routine outcome measures. Whilst it is giving nurses increased access to training in cognitive behavioural therapies, systemic therapies and parenting therapies, it does not put much emphasis on the things which young people identify as important for young people in terms of engagement, or skills which have traditionally been seen as nursing strengths. This approach, and emphasis on generic skills, has implications for the identity of CAMHS nurses, who make up 40% of the CAMHS workforce (the largest single professional group). Whilst other professional groups have been careful to protect their professional identity, nursing within this speciality has not been so quick to assert its unique identity and contribution to care, so psychologists and psychiatrists have provided the main leadership within this speciality. Mental health and paediatric nursing priviledges the relational aspects of care which are important to children and young people, and should be in a better position to qualitatively enunciate the contribution that nurses make to CAMHS. This session will explore options for CAMHS nurses to better explain and value their contribution to care.
Valliammal Shanmugam
National Institute of Mental Health and Neuroscience, India
Title: Effect Of Massage Therapy to Improve Lung Function And reduce Anxiety Among Asthmatic Children
Biography:
Dr.Valliammal Shanmugam has completed her Ph.D at the age of 35 years. Currently working in College of nursing , NIMHANS- an Institiute of National Importance. She is holding the position of Head of the Nursing Research department & Subject Teacher in Pediatric Nursing for nursing students. She has published more than 30 papers in reputed journals and she serves has an editorial board member & peer reviewer of reputed nursing journals. She has organised more than 40 national & international conferences, workshops, seminars, symposium. She is a recognized PhD Nursing examiner in reputed universities in the country.
Abstract:
Worldwide childhood asthma appears to be increasing in prevalence despite considerable improvement in management and pharmacopeia. Asthma prevalence in children is expected to be twice in 2020. The aim of the study is to assess the effectiveness of massage therapy on lung function and anxiety among asthmatic children, carried out in two different tertiary care hospitals with 238 consecutive asthmatic children who are attending the outpatient department. Institutional ethical committee approval was obtained. Children between the age group of 8 – 12 years are diagnosed as asthma within 2 years was included in the study. By using Purposive Sampling technique, 238 samples were selected and are divided as 120 in study group and 118 in control group. An informed consent was obtained from the parents. Detailed history and the findings were recorded in a predesigned patient proforma. Initially, study group and control group children were assessed for Peak Expiratory Flow Rate, Forced Expiratory volume in one second, Forced Vital Capacity, Forced Expiratory Ratio by Microplus Spirometer. Heart Rate and Respiratory Rate was assessed manually and anxiety level was assessed by using Modified Spence Children Anxiety Scale. The study group children received intervention (Massage) for 20 minutes which includes hot pack application, Deep breathing exercises, Kneading, Thumb stroke, Effleurage, Friction, Raking which performed 20 30 minutes during bed time daily for a month. The mothers of asthmatic children were asked to observe the technique of massage therapy. Education film of massage therapy (CD), booklet for massage therapy and massage practice dairy which was developed by researcher was given. Mothers were instructed to do massage to their children for 20 minutes just before the bedtime for a month and they have reinforced to attend the hospital alternate week to share their views and perform massage in front of the investigator. On 15th day and 30th day lung function and anxiety was assessed by using the same tool. The findings showed a highly statistically significant difference between pretest and posttest lung function scores PEFR (F=380.69) FEV1 (F=578.86) FVC (F=653.12) FER (F=558.43) HR (F=78.61) and RR (679.20) at p=0.001 and negative correlation between anxiety and lung function scores among asthmatic children in study group. To conclude, massage therapy combined with standard treatment is more effective in children with asthma.
Tugce Torun
Hacettepe University, Turkey
Title: Examining Burnout and Job Satisfaction of Nurses Working in Pediatric Units
Biography:
TuÄŸçe TORUN is a Research Assistant in Pediatric Nursing Department at Hacettepe University, Ankara, Turkey. She worked in Kreiskrankenhaus Lörrach State Hospital-Germany between 2011- 2012. TORUN completed her Master Thesis : Examining Burnout and Job Satisfaction of Nurses Working in Pediatric Units. She continues the PhD. Program at the Hacettepe University.
Abstract:
This study was conducted to determine the levels of burnout and job satisfaction of pediatric nurses and the relationship between them. The study sample comprised of 235 nurses who were working at least 6 months in Children’s Hospital of Hacettepe University, and Sami Ulus Maternity and Children Hospital. The data were collected by sociodemographic data form, Maslach Burnout Inventory, and Minnesota Satisfaction Questionnaire. Independent-samples t test, One-Way Analysis of Variance and the Pearson Correlation test was used. Most of the nurses were female, married, bachelor and with no children. The mean scores in the burnout inventory are 20.0±6.89 for the subscale emotional burnout, 19.7±4.43 for the subscale personal accomplishment, and 5.7±3.38 for the subscale depersonalization and the mean scores of the general satisfaction for the job satisfaction questionnaire is 2.6±0.62. There was a significant relationship between each subscales of burnout and job satisfaction (p<0.05). The levels of depersonalization in the nurses who were not married and had no children were significantly high, the scores of extrinsic satisfaction of the women were significantly lower (p<0.05). The levels of burnout and job satisfaction did not change according to the education level of the nurses (p<0.05), but it was changed significantly according to their duties in the hospital, the ability of using their autonomy and the facts of using regular leaves per week (p<0.05. It is important to investigate the levels of burnout and job satisfaction of the nurses and the factors which affect them regularly and the working conditions should be improved.
Andrea Cevasco-Trotter
University of Alabama, USA
Title: Developmental music therapy programming for extremely low and low birth weight premature infants
Biography:
Andrea Cevasco-Trotter is the Director of Music Therapy and an Associate Professor at The University of Alabama. She researches the effects of developmental music therapy interventions on premature infants’ physiological and behavioral parameters. Dr. Cevasco’s work has been published in the Journal of Music Therapy, Music Therapy Perspectives, and Pediatric Nursing; recently, she has published several textbook chapters. She serves as a member of the Editorial Committee for the Journal of Music Therapy and Music Therapy Perspectives as well as on the Board of Directors for the Certification Board for Music Therapists.
Abstract:
Premature infants in the Neonatal Intensive Care Unit (NICU) are exposed to loud noises, bright lights, and medical procedures that inhibit necessary sleep for neurological growth and development. Since the 1990s, researchers found that music assists in pacifying infants. The purpose of this presentation is two-fold: 1) to describe evidence-based music therapy protocols that are designed to meet the developmental needs of premature infants in the NICU and provide positive outcomes, and 2) to describe the outcomes of a research study involving a developmental music therapy program, based on existing protocols, to enhance and expand music therapy services for infants in the NICU. This study was especially novel in that infants as young as 25 weeks post corrected age (PCA) received live music, recorded music was utilized once infants were 30 weeks and older, and music and multimodal stimulation (MMS) was implemented for infants once they were 32 weeks and older. Infants in the experimental group went home earlier 3.6 days sooner than infants in the control group; experimental infants weighing less than 1500 gram went home 13 days earlier than those in the control group. Analysis of oxygen saturation levels and heart rate prior to, during, and post music therapy indicate positive trends. Special emphasis will be placed on how music therapist can meet the needs of very low and extremely low birth weight infants.
Elaine Uppal
The University of Manchester, UK
Title: The Human Rights of Children with reference to Child Protection
Biography:
Elaine Uppal is a Senior Lecturer in Midwifery at the University of Manchester, UK. She is currently writing up her PhD thesis: ‘Interprofessional Learning in a Community of Child Protection Practice’. She has an interest in Child Protection and has co-authored a book: Powell, J. & Uppal, E. (2012) Safeguarding babies and Young Children for Early Years Professionals. Open University Press, Buckingham, UK.
Abstract:
It is imperative to place the needs and rights of children as the central concern. This paper will set the context of safeguarding practice in terms of the universal and targeted services available to improve the well-being of children and recognise and respond to indicators of abuse. This will be set within the legislative and policy framework to achieve a sense, not only of child protection services and processes but also the supportive services and measures that can be put in place for families to prevent abuse. Rights can be defined and adhered to differently depending upon context, location, interpretation and availability. Banks (2006: 104) emphasises the broad nature of the term, referring to a range of claims, liberties, powers and relationships. Meagher and Parton (2004: 24) suggest that justice and rights are compatible and even indispensable to each other. Justice and respect are noted as key components of social care practice (Orme, 2002; Banks, 2006). However justice in terms of an individual’s rights to care for example, is often necessarily balanced against the availability of resources and number of people in need in a form of distributive justice, meaning that needs are determined by service availability that may be incompatible with principles of social care (Orme, 2002; Fairbairn and Fairbairn, 1988). Balancing the needs of various individuals within a scenario is also a dilemma for practitioners, particularly within a safeguarding context where addressing parents or carers’ needs could impact positively on the care of children; however this must not be to the point of being detrimental to the child’s well-being.
Dina Kamal
Astoon Hospital, KSA.
Title: Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR
Biography:
Dina Kamal is an Assistant Professor of Pediatric Pulmonology, Cairo University working as a Pediatric consultant, Astoon Hospital, al khobar, KSA. She was graduated in 1998 from Department of Medicine, Cairo University. She continued her post graduate studies got my master degree from Cairo University at 2003 and joined the academic work as assistant lecturer, later as a lecturer in pediatrics at Cairo University. She continued her academic work at Cairo University and got M.D. Degree of Pediatric Pulmonology in October 2007. In 2012 she was promoted as an assistant professor in the department of pediatric pulmonology, Cairo University and up to now. She is interested in studying and teaching pulmonary function in infants and did a lot of studies in the field of pulmonary function in infants by using infant plethysmography and published a lot of research papers in the past few years.
Abstract:
Introduction Acute lower respiratory tract infection in children causes significant morbidity in the developing countries. Documentation of virus infection using PCR and clinical characteristics of patients affected with viral pneumonia are reviewed in this study. Methods 51 children less than three years admitted to the Pediatric Hospital, Cairo University with viral pneumonia were included. All patients had undergone nasopharyngeal aspirate for PCR viral detection. Results A total of 51 cases were enrolled in the study, of which 7 cases were negative while 44 children were positive for viruses. The most common respiratory virus was Rhinovirus in 32 patients (72.2%), then parainfluenza virus (PIV) in 12 (27.3%), of which subtypes PIV1 were 2 (4.5%), PIV3 were 5 (11.4%) and PIV4 were 5 (11.4%) cases. The third common viruses were respiratory syncytial virus (RSV) in 9 (20.5%) cases of which 3 (6.8%) were RSVA and 6 (13.6%) were RSVB and adenovirus in 9 cases (20.5%). Boca virus was found in 8 (18.2%) patients, corona virus 2 (4.5%) patients, H1N1 2 (4.5%) patients, enterovirus 2 patients (4.5%) and human metapneumovirus in one case (2.3%). Influenza B and PIV2 were not detected. Coinfection was found in 28 (63.7%). Mortality occurred in 12 (23.5%). There was no significant relation between virus type or coinfection with disease severity. Conclusions RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.
Niang Hui Feng
National Yang-Ming University, Taiwan
Title: Evaluation of the Impact of Multi-Module Pediatric Palliative Care Training in Pediatric Clinicians
Biography:
National Yang-Ming University, Taiwan
Abstract:
A lack of knowledge of pediatric palliative care and the resulting lack of confidence in oneself may create hesitation in caring for dying children and their families. Few training programs focus specifically on pediatric palliative care and no multi-module training program in pediatric palliative care is available in Taiwan. Objectives: To examine the impact of multi-module pediatric palliative care training on pediatric clinicians. Methods: A quasi-experimental study provided educational training in pediatric palliative care to pediatric clinicians and used a pre-test and a post-test to assess outcomes. A multi-module pediatric palliative care training program was presented at a four-day training conference for clinicians in Taiwan, and all pediatricians and all pediatric nurses who completed the entire four-day training program were invited to participate. A questionnaire was used to assess different research goals. Results: Thirty-nine pediatric nurses and eleven doctors participated in this study for a response rate of 83.3%. Results showed a significant main effect (p =0.002) of training on confidence levels among pediatric clinicians in a variety of areas, including emotional support for clinicians, implementation of palliative care, ethical and legal issues, and emotional support for dying children and their families. Conclusion: Our research suggests that education program can effectively boost pediatric clinicians’ confidences regarding providing palliative care for children and their families. Further investigations are needed to evaluate the long-term effectiveness of an interdisciplinary and multifaceted training approach to pediatric palliative care training.
- Pediatric Palliative Care
Chair
Heather L MacDonald
University of New Brunswick, Canada
Co-Chair
Hee Yun Lee
University of Minnesota, USA
Session Introduction
Niang-Huei Peng
National Yang-Ming University, Taiwan
Title: Evaluation of the Impact of Multi-Module Pediatric Palliative Care Training in Pediatric Clinicians
Biography:
Dr. Niang-Huei Peng is an Assistant Professor at National Yang-Ming University, Taipei City, in Taiwan. Her professional major is pediatric nursing care, and minor major is neonatal nursing care. Her major research areas are as follows: 1.Improvement the Neonatal/ Pediatric palliative care in Taiwan 2.Exploration the Stress Responses of Preterm Infant in NICU 3.To Explore the Energy Expenditure in Preterm Infants during Periods of Environmental Stress in Neonatal Intensive Care Unit. 4.An Innovation of apparent of automatic audio and vibrotactile stimuli for interrupting apenic episodes in preterm infants She has published different research papers regarding above research topics and has been serving as an editorial board member of the Palliative Medicine & Nursing: Open Access.
Abstract:
Background: A lack of knowledge of pediatric palliative care and the resulting lack of confidence in oneself may create hesitation in caring for dying children and their families. Few training programs focus specifically on pediatric palliative care and no multi-module training program in pediatric palliative care is available in Taiwan. Objectives: To examine the impact of multi-module pediatric palliative care training on pediatric clinicians. Methods: A quasi-experimental study provided educational training in pediatric palliative care to pediatric clinicians and used a pre-test and a post-test to assess outcomes. A multi-module pediatric palliative care training program was presented at a four-day training conference for clinicians in Taiwan, and all pediatricians and all pediatric nurses who completed the entire four-day training program were invited to participate. A questionnaire was used to assess different research goals. Results: Thirty-nine pediatric nurses and eleven doctors participated in this study for a response rate of 83.3%. Results showed a significant main effect (p =0.002) of training on confidence levels among pediatric clinicians in a variety of areas, including emotional support for clinicians, implementation of palliative care, ethical and legal issues, and emotional support for dying children and their families. Conclusion: Our research suggests that education program can effectively boost pediatric clinicians’ confidences regarding providing palliative care for children and their families. Further investigations are needed to evaluate the long-term effectiveness of an interdisciplinary and multifaceted training approach to pediatric palliative care training.
Marie Wilhsson
Halmstad University, Sweden
Title: Handling demands on success †a conceptual model of adolescents’ coping with everyday life from a gender perspective
Biography:
Marie Wilhsson, Halmstad University, School of Social and Health Sciences.
Abstract:
Stress among adolescents in Western societies is becoming an issue of increasing concern and the global trend of adolescents health shows a gradual deterioration that is independent of national differences and increases with age (Currier et al, 2012). Research shows that many adolescents report high levels of stress, associated with a change in expectations about performance and an increased focus on school results (Schraman et al, 2011; Moknes et al, 2014). Purpose/methods The aim of this study was to explore the main concern of adolescents to get a deeper knowledge on how they cope with demands in everyday life. Grounded theory was used as a method to generate a model. Results The core category “striving to be successful and to succeed†explains participants main concern in their everyday lives as a continuous process aiming for success in the present and to succeed throughout their lives. The category is what the participants describe as a race against time and can be divided into the two conceptual categories “struggling with time†and “separating life into different worldsâ€, pronouncing how they struggle and cope with their main concern in order to obtain wellbeing. Our results show a difference between how girls and boys cope with their demands. Conclusions We show that girls and boys used different strategies to cope with stress in their everyday life. The results are based on adolescent’s experiences and are therefore an important contribution for initiating interventions aimed at promoting adolescents mental health from a gender perspective.
- Pediatric Emergencies
Chair
Sunil K Jatana
Melaka Manipal Medical College, Malaysia
Co-Chair
Laurence Baldwin
Coventry University, UK
Session Introduction
Carol Chamley
Coventry University, UK
Title: Leading -edge Realism Across Pedagogical Boundaries: Transforming Learning through Augmented Reality for Professional Practice in Contemporary Paediatric Orthopaedic and Trauma Care
Biography:
Currently working as Senior Lecturer /Nurse Researcher at Coventry University and a clinical background inatri paedic trauma orthopaedics, neurology and infectious diseases including caring for children with HIV and AIDS, having trained as a paediatric nurse at Great Ormond Street London. Currently being engaged in several post -doctoral research projects including Compassionate Practice Education, Disruptive Media, CAMHs, Values Exchange and Recruiting to Values having successfully worked on a collaborative service improvement project between Coventry University and University Hospitals Coventry and Warwickshire Children’s Emergency Department.
Abstract:
Paediatric orthopaedics is a highly specialized and distinctive field of paediatric practice. This contemporary module aimed to evaluate critically, evidence-based care and management associated with paediatric orthopaedic and traumatic conditions, including rehabilitation and future –focused transitional care. Developed collaboratively with senior clinicians, nurses, academics and learning technologists this innovative module sought to deliver high quality professional evidence-based education. The pedagogical strategy proposed to blend traditional teaching approaches with up-to-date and leading edge technology which actively and rapidly engaged students, whereby learning is enhanced in real-time, promptly immersing students with deeper involvement in situated learning experiences. Therefore first generation users have been introduced to ‘Augmented Reality’ during the delivery of this post registration Paediatric Orthopaedic and Trauma Module. Augmented Reality was co-constructed collaboratively as a pedagogical strategy which reflects a direct or indirect view of a physical real-world environment mediated through the use of mobile technology. Visual elements were augmented by computer, generating sensory inputs aiming to enrich learning through real-world visualization and understanding of related paediatric trauma and orthopaedic conditions such as musculo-skeletal anatomy, blood flow, fractures and images. By ‘tapping’ hot spots’ on manikin images these could be manipulated to zoom in or rotate, coupled with associated video clips, MCQ and text, all of which strengthen and deepen learning for clinical practice. In essence Augmented Reality provided rich details normally hidden in one dimensional images or text and by crafting existing images and blending new information thus reflecting ‘leading edge realism techniques’. Furthermore in-virtuo learning prepares students/practitioners for professional life whereby they can be exposed to quite complex learning and skills safely.
Biography:
Laurence Baldwin is a Senior Lecturer in Mental Health Nursing at Coventry University, and leads the Children and Young People’s Neurodevelopmental Team at Derbyshire Healthcare Trust. He completed his PhD at the University of Nottingham, and was previously a Consultant Nurse for Child and Adolescent Mental Health Services in Derbyshire, England. He has published several papers and chapters and been involved in multi disciplinary and community-based participatory research projects. His work for the Royal College of Nursing included representing nursing on the CAMHS Ministerial Taskforce which published the influential ‘Future In Mind’ report in March 2015.
Abstract:
Child and adolescent mental health services (CAMHS) within the UK National Health Service have often been seen as a ‘Cinderella service’ but due to increasing pressure and attention have received much more policy development in the past ten years. Important amongst this is the development of Children and Young People’s Improved Access to Psychological Therapies (CYP-IAPT) which emphasizes evidence-based approaches, and the use of routine outcome measures. Whilst it is giving nurses increased access to training in cognitive behavioural therapies, systemic therapies and parenting therapies, it does not put much emphasis on the things which young people identify as important for young people in terms of engagement, or skills which have traditionally been seen as nursing strengths. This approach, and emphasis on generic skills, has implications for the identity of CAMHS nurses, who make up 40% of the CAMHS workforce (the largest single professional group). Whilst other professional groups have been careful to protect their professional identity, nursing within this speciality has not been so quick to assert its unique identity and contribution to care, so psychologists and psychiatrists have provided the main leadership within this speciality. Mental health and paediatric nursing priviledges the relational aspects of care which are important to children and young people, and should be in a better position to qualitatively enunciate the contribution that nurses make to CAMHS. This session will explore options for CAMHS nurses to better explain and value their contribution to care.
Valliammal Shanmugam
National Institute of Mental Health and Neurosciences, India
Title: Effect Of Massage Therapy to Improve Lung Function And reduce Anxiety Among Asthmatic Children
Biography:
Dr.Valliammal Shanmugam has completed her Ph.D at the age of 35 years. Currently working in College of nursing , NIMHANS- an Institiute of National Importance. She is holding the position of Head of the Nursing Research department & Subject Teacher in Pediatric Nursing for nursing students. She has published more than 30 papers in reputed journals and she serves has an editorial board member & peer reviewer of reputed nursing journals. She has organised more than 40 national & international conferences, workshops, seminars, symposium. She is a recognised Ph.D Nursing examiner in reputed universities in the country.
Abstract:
Worldwide childhood asthma appears to be increasing in prevalence despite considerable improvement in management and pharmacopeia. Asthma prevalence in children is expected to be twice in 2020. The aim of the study is to assess the effectiveness of massage therapy on lung function and anxiety among asthmatic children, carried out in two different tertiary care hospitals with 238 consecutive asthmatic children who are attending the outpatient department. Institutional ethical committee approval was obtained. Children between the age group of 8 – 12 years are diagnosed as asthma within 2 years was included in the study. By using Purposive Sampling technique, 238 samples were selected and are divided as 120 in study group and 118 in control group. An informed consent was obtained from the parents. Detailed history and the findings were recorded in a predesigned patient proforma. Initially, study group and control group children were assessed for Peak Expiratory Flow Rate, Forced Expiratory volume in one second, Forced Vital Capacity, Forced Expiratory Ratio by Microplus Spirometer. Heart Rate and Respiratory Rate was assessed manually and anxiety level was assessed by using Modified Spence Children Anxiety Scale. The study group children received intervention (Massage) for 20 minutes which includes hot pack application, Deep breathing exercises, Kneading, Thumb stroke, Effleurage, Friction, Raking which performed 20 30 minutes during bed time daily for a month. The mothers of asthmatic children were asked to observe the technique of massage therapy. Education film of massage therapy (CD), booklet for massage therapy and massage practice dairy which was developed by researcher was given. Mothers were instructed to do massage to their children for 20 minutes just before the bedtime for a month and they have reinforced to attend the hospital alternate week to share their views and perform massage in front of the investigator. On 15th day and 30th day lung function and anxiety was assessed by using the same tool. The findings showed a highly statistically significant difference between pretest and posttest lung function scores PEFR (F=380.69) FEV1 (F=578.86) FVC (F=653.12) FER (F=558.43) HR (F=78.61) and RR (679.20) at p=0.001 and negative correlation between anxiety and lung function scores among asthmatic children in study group. To conclude, massage therapy combined with standard treatment is more effective in children with asthma.
Salah Thabit Al Awaidy
Ministry of Health, Oman
Title: Cost Effectiveness of a pentavalent rotavirus vaccine in Oman
Biography:
Dr Salah T. Al Awaidy is a Communicable Diseases Adviser in Health Affairs, Ministry of Health, Muscat, Oman. He is a medical doctor and holds a Master’s in Epidemiology. He is currently the adviser on Communicable Disease Surveillance, Elimination and Eradication of Communicable Diseases of Public Health Importance, EPI, vaccine supply chain system and IHR at the Ministry of Health, Oman. He was the Director of Communicable Disease Surveillance and Control at MoH, HQ, Oman between 1997-2011, IHR national focal point 2002-2013 and was a member in several of the professional committees namely: Strategic Advisory Group on Immunization (SAGE), WHO Geneva (2005-2007); Strategic Advisor Group on Vaccine and Store Management Training Courses (2005-2008), WHO Geneva; Strategic TB Advisory Board (STAG) 2007-2011 2014- till date.
Abstract:
Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman Methods: A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. Results: A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. Conclusions: Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.
Biography:
Dr Khalid Elawad has completed his MBBS at the age of 28 years from liviv medical institute in Ukraine and postgradute diploma in public health studies from Algazira University School of Medicine. After that he did his M.Sc. in applied public health (09/2009-11/ 2011) University of Wales Institute Cardiff, United Kingdom. From 2011 he is registered as fellow of the Royal Society for Public Health (RSPH) in United Kingdom. Now He is Public health consultant working as Acting manager of communicable disease control and infection prevention and control PHCC in the primary health care corporation Doha, Qatar. He has published more than 4 books in health promotion and communicable diseases prevention.
Abstract:
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is an emerging infection that causes severe illness in patients, particularly those with comorbidities; and has a high mortality rate. Healthcare associated outbreaks have been reported across the Gulf region and the Republic of Korea. While there have been cases of MERS-CoV in Qatar, no healthcare associated outbreaks have been reported. The aim of this paper is to give a description of the infection prevention and control protocol implemented by the Primary Health Care Corporation to manage suspected or probable cases of MERS-CoV in the primary health care setting. This paper focuses on Alshahania Health Centre which is considered to be a high risk area due to its proximity to the camel shelter and race track. In order to gain an understanding of how patients visiting the health center are managed. Data was collected through a visit to the Alshahania Health Centre which included discussions with staff and documentation review. Our findings show that the infection control protocol implemented at Alshahania Health Centre is very robust and ensures that staff has clearly defined responsibilities in the management of a suspected case of MERS-CoV. A dedicated Isolation Team ensures a timely risk assessment is carried out which then triggers actions that reduce the risk of exposure to both patients and staff. The experience at Alshahania Health Centre also demonstrates that good communication and leadership are important factors in order to successfully embed infection control in clinical practice and prevent healthcare associated outbreaks of MERS-CoV.
Santosh Mahindrakar
All India Institute of Medical Sciences, India
Title: Pediatric falls and trauma scores: are they associated?
Biography:
Mr. Santosh (Registered Nurse), 31 years of age is a PhD student at Department of Trauma Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi. He has completed his Master in Community Health Nursing (2010) and Masters in Public Health (2014). He has qualified for National Eligibility Test (NET) in Preventive and Social Medicine in year 2010 and DAAD Fellow in November – December 2014. He served as a research assistant in Towards Improving Trauma Care Outcome (TITCO) in India. He served as a faculty in different nursing institute in varying capacity as clinical instructor to assistant professor.
Abstract:
Unintentional injuries are the major cause of death among pediatric age group. Fall is a major contributor in unintentional injuries, a minor fall may cause a major head injury among the children. Hence this study is aimed to study the association of vital signs and trauma scores to their outcome following fall. Methodology: Data was retrieved from a prospectively maintained trauma registry at a level 1 trauma centre, New Delhi for a period of 1st October 2013 to 15th September 2015. It included all admitted multiple injury patients from emergency department and also who died between arrivals to admission. Patients with single long bone injuries and brought dead were excluded. The data were further analyzed using SPSS 23. Results: There were 4692 samples, among them 7.5% (353) were from pediatric age below 13 years and all of them were unintentional injuries. Majority (65.2%) had history of fall, followed by (27.5%) road traffic accidents. Among the fall, 67.8% were male, with mean age of 4.4±3 years and 47.8% of them were between age group of 0-3. On presentation 30% of them had GCS ≤ 8, 34.3% were intubated on arrival. In this cohort, mean values of oxygen saturation (93.9±17), respiratory rate (19.5±18 per minute), heart rate (107±29 beats/minute), and systolic blood pressure (105.8±22 mm of Hg). Among these only systolic blood pressure was statistically associated with outcome (P=.025). Mean ISS, NISS and RTS were 11.12±6.22, 16.92±8.8 and 6.7547±1.518 respectively. Among these RTS was statistically associated with outcome. Total mortality was 14.8% and was highest (25.9%) among infants followed by (19.3%) toddlers and least (6.9%) were school going age (6-12 years). Conclusion: Systolic blood pressure on arrival and RTS were statistically associated with the outcome in the group of pediatric patients arriving with fall.
Alok Kumar
Mayo University Hospital, Ireland
Title: REDUCING WAITING TIME FOR CHILDREN IN ACCIDENT AND EMERGENCY, THE LEAN WAY
Biography:
Dr Alok completed his training in Paediatrics from RCPI, Ireland. He is currently working as a General Paediatric Consultant at Mayo University Hospital, Ireland. “Reducing waiting time in accident emergency- The Lean Way” was done while Dr Alok Kumar was undergoing his training in General Paediatrics at Mayo University Hospital, Castlebar (2009-2010). He has enrolled for Specialist Diploma in Quality Management- lean healthcare system as part of my on-going training in Paediatrics and he could see there was unnecessary delay for children in Emergency Department- overcrowding, delay in getting orthopaedic, surgical teams, waiting for laboratory tests etc. He applied the Lean methodology to eliminate waste and thus improve patient flow. Dr Alok have presented this topic as Poster presentation at EBHC (Taormina- 2013), International Quality and Safety meeting – BMJ, Paris and received a good response, and other different interesting facets were discussed for reducing waiting time in Accident and Emergency.
Abstract:
BACKGROUND: Unplanned nature of patient attendance in A&E leads to unnecessary waiting time for children. This process has a clinical and operational part to it. While doing my course, I realized lean strategies could be utilized to reduce waiting time in A&E. AIMS: This project is to identify and reduce the number of non-value added steps along the patients' journey (Children of 0-14 years of age) attending emergency department at Mayo General Hospital. This is aimed to reduce the waiting time, reduce the overall time, and thus, improve the patient experience and render better patient care attending emergency department at Mayo General Hospital. METHODS: I have formed a team, which was duly approved by hospital management. The team has hardworking, experienced, dedicated and committed hospital staff. The team consisted of: - Paediatric Consultant, Registrar, senior house officer (NCHDS) - PROJECT MANAGER: Myself - Clinical Nurse Manager III- Paediatrics, A&E. - Assistant Staff Officer. - Staff nurses-Paediatric, A&E. - Other members will be co-opted as necessary - And last but the most important- the patient; children The team has been established and is already undertaking a number of activities and weekly meetings. The main steps included: - Establish clearly existing waiting times for paediatric patient. - Establish clearly the existing patient journey - Identify stakeholders to involve in the process mapping session. - Identify issues/ solutions/bottlenecks/ decision points. - Identify where value added and non-value added activity exists. - Explore options to improve the position. This should ideally include: 1. Implementation of improvement plans 2. Re-evaluation of the effectiveness of improvement plans. - And last but the most important- the patient, children. To further my lean project I formulated a document to record time taken for children in accident and emergency in the various stages of their waiting period-current visual map. This format mapped the time taken for paediatric patients at various stages that a patient generally has to undergo i.e. in medical terms, history & examination, differential diagnosis, investigation, interpret results, definitive diagnosis, determine care plan, implement and follow up review. RESULTS: Future VSM was formulated taking care of the variations /delays seen. Discussions were made with paediatric consultants, senior staff nurses, senior house officers, registrars and their observations and opinions were taken into account. We have a system already in place. To introduce improvement into it, the following current recommendations were suggested, based on current value stream map analysis. VARIABLES SUGGESTIONS: 1. >3 children waiting to be seen in A&E in Monday mornings, Friday afternoon, Bronchiolites, Gastroenterites season. The Paediatric registrar is called to assist. Team on call to use the 5S principals to organize the work and instilling the discipline. Visual display: On call team takes a look at the board- (e.g. 5 children waiting): and gets into action. 2. Interdepartmental transfer e.g. transfers between surgeons and orthopaedics Better communication and better team play will lessen waiting period. 3. Children may be kept waiting for bed once admitted- thus increasing the total waiting time. Liasion of A&E with Paediatric Ward for quicker transfer to ward. 4. One ED cubicle-causes delay if more than three children need to be seen. There should be provision for second cubicle which if not in use can be used by the Emergency department. 5. Lab, X-ray department should be contacted at appropriate time to avoid unnecessary delay, thus leading to better time management. The main idea is to holistically assess, diagnose, treat, discharge/ refer, and evaluate child care in a safe and co-ordinate way in line with the best practice, incorporating health promotion, education, and risk reduction, in the run. Thus, application of these measures: (a) Registrar led On-call Team (b) Visual display of number of waiting children, (c) Discussion and application of Lean Tools with the NCHD Team (d) Better communication with surgical and orthopaedic teams (e) Constant Consultant supervision (f) Making the new team aware of the issue of reducing waiting time in A&E during the induction meeting itself, LIMITS: Old staff resisting change, some NCHDs non -compliant. CONCLUSIONS: Reducing waiting for children in ED. Lean thinking is about team involvement. Lean thinking is about team involvement. It focuses on the process, not on individuals. This is because teams are superior to individuals at identifying and implementing improvement opportunities. I have had meetings with the medical, the surgical and the obstetric team and have persuaded them to have projects on similar lines, to discuss and be familiarized with Lean Tools (5S, Value Stream Map, Kanbans, Kaizen events, Visual Display), and formulate a Current Value Stream map. Formulating Current Value Stream Map for each individual Team will help them to 'go and see' and give them their 'waste goggles'. This will help the above team doctors to redesign care accordingly and reduce waiting time in accident & emergency for the adult patients as well, thus delivering best possible care. Our aim is to deliver the best for patients, for staff, for our community and for the taxpayer.
- Pediatric Oncology
Location: Cologne, Germany
Chair
Sunil K Jatana
Melaka Manipal Medical College, Malaysia
Co-Chair
Laurence Baldwin
Coventry University, UK
Session Introduction
Mahnaz Shoghi
Iran University of Medical Sciences, Tehran, Iran
Title: Standing together: everyday life of mothers with a leukemic child
Biography:
Mahnaz Shoghi is an Assistant Professor IRAN University of medical sciences, Tehran City, in IRAN. Her MSN is pediatric nursing care. Her professional major is pediatric nursing care, and minor major is neonatal nursing care. Her field research works are 1- nursing care in children with chronic illnesses and their family , 2- family center care in children 3- health promotion in children.
Abstract:
Aims and objectives. To gain insight into everyday living mothers of children with leukemia. The main objective of this study was trying to know the life stories of a mother dealing with leukemic child and see in its true colors. Background. When a child is being clinically diagnosed with leukemia, parents face with a real terrible shock that usually results in a huge change in their normal life. Both parents especially mothers should tackle a new life by supporting and backing their leukemic child through some activities such as home-based treatment. Method: one-time individual in-depth interview was the procedure that the researchers went through while considering grounded theory as the basis of their study. Sixteen mothers took part in this study and the interviews were carried out in two oncology ward in Tehran University Hospitals. Findings: Standing together with a leukemic child is one of the things that occur in a mother’s everyday life when she knows about her child’s severe illness. This mother gets so close to her child and she makes one with her/him. In this way, on the one hand, the mother’s quality of life suffers and in the long run it causes weariness. On the other hand, it ruins other roles of mother. It seems that those mothers who make one with their leukemic child go through all the processes of a chronic disease while being there for their child in spite of the fact that they are not a real patient.
- Pediatric Bioethics
Chair
Sunil K Jatana
Melaka Manipal Medical College, Malaysia
Co-Chair
Laurence Baldwin
Coventry University, UK
Session Introduction
Veronica Svärd
University of Gothenburg, Sweden
Title: The influence of organizational and professional factors on child maltreatment reports within children’s hospitals
Biography:
Veronica Svärd has completed her PhD in May 2016 from the University of Gothenburg. She is a hospital social worker, researcher and lecturer who works at Karolinska University Hospital and the Department of Social Work at the University of Gothenburg.
Abstract:
All health care professionals in Sweden are required to report children whom they suspect are subject to maltreatment to Social Services, but they have been shown to report less frequently than other professionals. Based on a quantitative study within the four largest children’s hospitals in Sweden the organizational and professional conditions and the professionals’ assessment and reporting experiences are explored. The findings show differences between the hospitals and the professions, and great differences between professional groups’ assessment and reporting experiences. Nurses and nurse assistants showed a lower level of awareness and knowledge of risk to children, the legal framework and the available organizational support than physicians and hospital social workers. The reporting experiences were also reflective of these conditions: while half the respondents had never made a report, there were at the same time clear differences between the professions as nine out of ten nurse assistants and more than two thirds of the nurses had never made a report. Some organizational and professional factors were found to have a significant impact on the respondents reporting experiences. Longer working experience and access to guidelines and routines were related to being a high reporter, but also related to experiences of deciding not to report. The study argues that all professional groups need to have equal access to education, with the opportunity to become more involved in the assessment and reporting process and to strengthen multidisciplinary structures. This would reduce the insecurity in assessment and the strategies of avoidance among some professionals.