Using simulators to teach pediatric airway procedures in an international setting

2018 ◽  
Vol 104 ◽  
pp. 178-181 ◽  
Author(s):  
Marissa A. Schwartz ◽  
Katherine R. Kavanagh ◽  
Steven J. Frampton ◽  
Iain A. Bruce ◽  
Tulio A. Valdez
Keyword(s):  
Pediatric Airway ◽  
International Setting

A Quality Improvement Plan for Implementing an Innovative Organization System for Pediatric Airway Patients

2020 ◽  
Author(s):  
Aileen Kerns ◽  
Rebecca Mahoney ◽  
Kathryn Deeds ◽  
Keshia Boone-Edwards ◽  
Mary Ross ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Comprehensive Care ◽  
Pediatric Airway ◽  
Improvement Plan ◽  
Hospital To Home ◽  
Type Feedback

AbstractRisks of pediatric tracheostomy are well known. The objectives of this quality improvement study were to organize tracheostomy supplies into a comprehensive care kit and demonstrate that the kits improved nursing and parental comfort in providing tracheostomy care routinely and emergently. Kits were assembled using roll-up toiletry style bags and organized in a uniform fashion with necessary supplies. Nurses and parents were surveyed using a 5-point Likert-type. Feedback was overall very positive; the kits were found to ease the transition of caring for a child with a new tracheostomy from hospital to home. This intervention can easily be adapted at other pediatric institutions.

Brokering Peace in Nuclear Environments

2018 ◽  
Author(s):  
Moeed Yusuf
Keyword(s):  
Cold War ◽  
Third Party ◽  
Bargaining Theory ◽  
The Third ◽  
China And India ◽  
International Setting ◽  
Multiple Audiences ◽  
Crisis Behavior ◽  
The Cold War ◽  
Shed Light

This book is the first to theorize third party mediation in crises between regional nuclear powers. Its relevance flows from two of the most significant international developments since the end of the Cold War: the emergence of regional nuclear rivalries; and the shift from the Cold War’s bipolar context to today’s unipolar international setting. Moving away from the traditional bilateral deterrence models, the book conceptualizes crisis behavior as “brokered bargaining”: a three-way bargaining framework where the regional rivals and the ‘third party’ seek to influence each other to behave in line with their crisis objectives and in so doing, affect each other’s crisis behavior. The book tests brokered bargaining theory by examining U.S.-led crisis management in South Asia, analyzing three major crises between India and Pakistan: the Kargil conflict, 1999; the 2001-02 nuclear standoff; and the Mumbai crisis, 2008. The case studies find strong evidence of behavior predicted by the brokered bargaining framework. They also shed light on several risks of misperceptions and inadvertence due to the challenges inherent in signaling to multiple audiences simultaneously. Traditional explanations rooted in bilateral deterrence models do not account for these, leaving a void with serious practical consequences, which the introduction of brokered bargaining seeks to fill. The book’s findings also offer lessons for crises on the Korean peninsula, between China and India, and between potential nuclear rivals in the Middle East.

Tracheocutaneous Fistula After Pediatric Open Airway Reconstruction

2021 ◽  
pp. 000348942098742
Author(s):  
Stephen R. Chorney ◽  
Joanne Stow ◽  
Luv R. Javia ◽  
Karen B. Zur ◽  
Ian N. Jacobs ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Case Series ◽  
Primary Objective ◽  
Multivariable Logistic Regression Analysis ◽  
Pediatric Airway ◽  
Surgical Closure ◽  
Laryngotracheal Reconstruction ◽  
Airway Reconstruction ◽  
Tracheocutaneous Fistula

Objectives: Tracheocutaneous fistula (TCF) is a common occurrence after pediatric tracheostomy decannulation. However, the persistence of TCF after staged reconstruction of the pediatric airway is not well-described. The primary objective was to determine the rate of persistent TCF after successful decannulation in children with staged open airway reconstruction. Methods: A case series with chart review of children who underwent decannulation after double-stage laryngotracheal reconstruction between 2017 and 2019. Results: A total of 26 children were included. The most common open airway procedure was anterior and posterior costal cartilage grafting (84.6%, 22/26). Median age at decannulation was 3.4 years (IQR: 2.8-4.3) and occurred 7.0 months (IQR: 4.3-10.4) after airway reconstruction. TCF persisted in 84.6% (22/26) of children while 15.4% (4/26) of stomas closed spontaneously. All closures were identified by the one-month follow-up visit. There was no difference in age at tracheostomy ( P = .86), age at decannulation ( P = .97), duration of tracheostomy ( P = .43), or gestational age ( P = .23) between stomas that persisted or closed. Median diameter of stent used at reconstruction was larger in TCFs that persisted (7.0 mm vs 6.5 mm, P = .03). Tracheostomy tube diameter ( P = .02) and stent size ( P < .01) correlated with persistence of TCF on multivariable logistic regression analysis. There were 16 surgical closure procedures, which occurred at a median of 14.4 months (IQR: 11.4-15.4) after decannulation. Techniques included 56.3% (9/16) by primary closure, 18.8% (3/16) by secondary intention and 25% (4/16) by cartilage tracheoplasty. The overall success of closure was 93.8% (15/16) at latest follow-up. Conclusions: Persistent TCF occurs in 85% of children who are successfully decannulated after staged open airway reconstruction. Spontaneous closure could be identified by 1 month after decannulation and was more likely when smaller stents and tracheostomy tubes were utilized. Surgeons should counsel families on the frequency of TCF and the potential for additional procedures needed for closure.

scholarly journals Anti-meningococcal B vaccination in Italian adolescents: a cost-effective health opportunity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Panatto ◽  
P Landa ◽  
D Amicizia ◽  
P L Lai ◽  
E Lecini ◽  
...  
Keyword(s):  
Large Scale ◽  
Public Health Problem ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Dose Schedule ◽  
Developed Countries ◽  
Invasive Disease ◽  
International Setting ◽  
The Impact

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.

Catheter‐Guided Basket Removal of a Difficult‐to‐Reach Pediatric Airway Foreign Body

2021 ◽  
Author(s):  
Alexander Gabinet‐Equihua ◽  
Sharon L. Cushing ◽  
Evan J. Propst ◽  
Nan Gai ◽  
Nikolaus E. Wolter
Keyword(s):  
Foreign Body ◽  
Pediatric Airway ◽  
Airway Foreign Body

scholarly journals Safe Space, Dangerous Territory: Young People’s Views on Preventing Radicalization through Education—Perspectives for Pre-Service Teacher Education

2021 ◽  
Vol 11 (5) ◽  
pp. 205
Author(s):  
Saija Benjamin ◽  
Visajaani Salonen ◽  
Liam Gearon ◽  
Pia Koirikivi ◽  
Arniika Kuusisto
Keyword(s):  
Teacher Education ◽  
Online Survey ◽  
Educational Institutions ◽  
Growing Up ◽  
Safe Spaces ◽  
Violent Extremism ◽  
International Setting ◽  
Pre Service Teacher ◽  
And Training

Initiatives for preventing radicalization and violent extremism through education (PVE-E) have become a feature of global educational policy and educational institutions across all phases, from early childhood to universities, also in Finland. If schools may be regarded as safe spaces here for identity and worldview construction and experiences of belonging, the specific subject matter of PVE-E is also dangerous territory. Not least because of PVE-E’s focus on radicalization, but above all because of perceptions of schools being used as an adjunct of governmental counter-terrorism policy. We argue that understanding young people’s views on issues related to radicalization and violent extremism is critical in order to develop ethical, sustainable, contextualized, and pedagogical approaches to prevent hostilities and foster peaceful co-existence. After providing some critical framing of the Finnish educational context in a broader international setting, we thus examine young people’s views (n = 3617) in relation to the safe spaces through online survey data gathered as a part of our larger 4-year research project Growing up radical? The role of educational institutions in guiding young people’s worldview construction. Specifically focused on Finland but with potentially wider international implications, more understanding about the topic of PVE-E is needed to inform teacher education and training, to which our empirical data makes some innovative contribution.

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