Role of pediatric nurse in management of child with special needs

Children facing life with chronic illness and disability are increasing in number. There are multiple factors which are responsible for that. Most of the children survive well into adulthood with early intervention, treatment and care. Pediatric nurses may create excellent professional roles caring for children with special health care needs and their families. The main responsibility will be to provide the children medical care and developmental training so that they can handle basic daily functions and lead happy, healthy lives. The role of a pediatric nurse in this field is not fixed. They may have to carry out different kinds of responsibilities based on the type and extent of special need. Pediatric nurses are responsible for helping children adapt to a hospital setting and prepare them for medical treatment and procedures. These nurses have special training to provide expert care to the child with special needs while working with the family to address their concerns, problems and help them to understand different treatment options and services available for the child with special needs. Pediatric nurses not only focus on the child with special needs but involve themselves in the wellbeing of other family members. They have special training in caring of children, good interacting skills, good empathy, immense love for children, flexibility, having control over their own emotions and stress management skills.

Success of small-dose fractionated sodium thiosulfate in the treatment of calciphylaxis in a peritoneal dialysis patient

Background Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, fatal disorder of microvascular calcification and thrombosis that typically affects patients with end-stage renal disease (ESRD) receiving long-term dialysis. Fewer reports describe calciphylaxis in peritoneal dialysis patients than hemodialysis patients as per a literature review. To date, there are no clear guidelines for CUA diagnosis and treatment. While sodium thiosulfate (STS) has been increasingly used for treatment in recent years, there have also been reports of severe side effects. There is no uniform standard for its usage and dosage, especially for peritoneal dialysis patients. Case presentation We present a case of a 40-year-old Chinese male patient with ESRD on peritoneal dialysis who developed calciphylaxis with severe painful cutaneous ulcers on the fingers and toes that were managed successfully for 6 months with comprehensive treatment composed mainly of small-dose fractionated sodium thiosulfate. Conclusions Our experience suggests that the treatment of calciphylaxis requires timely and multi-angle intervention. Treatment with small-dose fractionated sodium thiosulfate has proven effective and tolerated in this patient.

Sarcopenia in Hepatocellular Carcinoma: Pathogenesis and Management

Background: Sarcopenia is almost constantly observed in patients with cirrhosis and hepatocellular carcinoma. Summary: Chronic liver disease represents a unique pathophysiological scenario in which sarcopenia develops and all factors involved in the pathogenesis should be taken into account for an appropriate management of the disease. No properly designed intervention studies on this topic are available and, thus, no effective strategies have been developed for clinical practice. Apart from any targeted intervention, treatment and optimization of liver disease is crucial. Key Messages: In patients with cirrhosis and hepatocellular carcinoma, nutritional support to maintain and restore nutrition status, a targeted use of branched-chain amino acids and a guided physical exercise, should all be an integral part of the multidimensional assessment and tailored interventions.

Traumatic Stress Disorders

The symptoms of posttraumatic stress disorder (PTSD) have long been recognized in medicine, history, literature, and philosophy. This chapter provides an introduction and overview to this handbook, focusing on the historical context that underlies current issues within the trauma literature. This handbook contains eight parts, focusing on classification and phenomenology; epidemiology and special populations; contributions from theory, assessment, prevention, and early intervention; treatment; and dissemination/implementation and ending with a chapter highlighting future directions. The historical underpinnings of each area are delineated, with attention to their linkage with current research. The hope for this revised edition of the Handbook of Traumatic Stress Disorders is to facilitate linkages among cross-cutting areas of study and clinical application, while providing concise, up-to-date reviews of current knowledge.

Policy innovation on environment and forestry development for supporting gender equality in Indonesia

This article discusses how policy innovation was developed for supporting gender equality in the environment and forestry development. The study focuses on how the design thinking-based policy innovation process is carried out and how social infrastructure for policy innovation is built to seek the transformation of understanding from gender-neutral to gender nature. The data were collected through focus group discussions, documentation studies, and in-depth interviews. The data were qualitatively analyzed with inductive thematic analysis method with Needs and Aspirations for a Design and Innovation process (NADI) framework and social infrastructure theory. The results show that policy innovations in environmental and forestry development based on design thinking were carried out through gender-responsive policy innovations that regulate forests to be sustainably managed for the welfare of women, men, and people with disabilities. Moreover, there were also innovative activities called GLEADS (Gender Leader Summit) and TEACH (Training for Eco-gender Activating Champions Hub) embodying National-regional Eco-forestry Hubs, which cooperated to develop innovations to improve gender equality. Multi-actor aspirations and situations in the innovation intervention process lead to a reframing of the innovation policy design process. This impacted the reframing of social infrastructure and changes in intervention treatment according to the management level.

Development of the Interactive Rehabilitation Game System for Children with Autism Based on Game Psychology

Autism is a widespread neurodevelopmental disorder. The cause of autism is still unclear. Once it occurs, it will be accompanied for life. Intervention treatment is currently recognized as an effective method. With the rise of somatosensory technology, Kinect has gradually been applied to the field of autism rehabilitation with its natural human-computer interaction and game rehabilitation psychology. Because there is a great demand for autism rehabilitation training resources in China and the existing somatosensory rehabilitation equipment has some shortcomings, this study designed a set of somatosensory rehabilitation system for autistic children based on Kinect and carried out its rehabilitation effect with experimental demonstration. The specific research work mainly includes the following contents: first, aiming at the rehabilitation needs of children with autism, this article combines mainstream intervention treatment methods, using C# programming language and Windows Presentation Foundation (WPF) development technology to develop Kinect-based somatosensory game modules. The somatosensory rehabilitation game involves the training of the language communication, behavioral movement, daily life, sensory integration, and other comprehensive abilities of children with autism, which improves the shortcomings of the previous rehabilitation training in the scope of intervention. A variety of game types and diversified game modes are designed to meet the individual needs of rehabilitation training for children with autism. Second, experiments were carried out to verify the rehabilitation effect of the system. Using the Childhood Autism Rating Scale (CARS) and Pediatric Evaluation of Disability Inventory (PEDI) scale as the rehabilitation effect evaluation tools of this system, the experimental subjects were divided into the experimental group and control group, and different comparative experiments were conducted, respectively. Through the analysis of the scoring data of the CARS, it is found that the comprehensive ability of the experimental group of children receiving somatosensory rehabilitation training is significantly improved. Through the analysis of the scoring data of the PEDI scale, it is found that the children’s language communication, behavioral activities, and daily life abilities of the experimental group have been significantly enhanced. This article focuses on the design of the somatosensory game module of the autistic somatosensory rehabilitation system and the analysis of the system’s rehabilitation effect. It satisfies the training and rehabilitation needs of children with autism and has strong practical significance.

Adapting and Testing a Brief Intervention to Reduce Maternal Anxiety During Pregnancy (ACORN): Report of a Feasibility Randomized Controlled Trial

Background. We investigated the acceptability and feasibility of a new brief intervention for maternal prenatal anxiety within maternity services. Results. 114 pregnant women attending their 12-week scan at a prenatal clinic with elevated symptoms of anxiety (GAD-7 score of ≥ 7) were randomly assigned to either the ACORN intervention + Treatment as usual (TAU) (n=57) or to usual care only (n= 57). The ACORN intervention consisted of 3 group sessions, led by a midwife and psychological therapist, for women and their partners. The intervention included psychoeducation about anxiety, strategies for problem-sovling and tolerating uncertainty during pregnancy, including communicating about these with others, and mindfulness exercises. Engagement rates with ACORN met or exceeded those in primary care services in England. In the intervention arm, 77% (n= 44) of participants attended at least one session, 51% (n=29) were adherent, defined as attending two or more sessions. Feedback was positive, and women in the ACORN treatment group demonstrated some evidence of a larger drop in their levels of anxiety than the women in the TAU-only group (Cohen’s d = 0.42). Conclusion. The ACORN intervention was acceptable to women and their partners and resulted in reductions in anxiety. With further evaluation in a larger-scale trial with child outcomes, there is significant potential for large scale public health benefit.

MARTIAL AND THE DOCTORS: OPHTHALMOLOGY AND UVULECTOMY IN EPIGRAM 10.56

This short note attempts to shed light on some of the surgical procedures referred to in Martial's epigram 10.56 by consulting pertinent Graeco-Roman medical texts. A fuller understanding of one such intervention (treatment of infected/inflamed uvula) supports Martial's text as transmitted.

Percutaneous intervention treatment of giant extrarenal aneurysm arteriovenous fistula

Objective: Anteriovenous fistula is a high-flow vascular malformation. Anteriovenous fistula is characterized by a direct connection between an artery and a vein without the presence of a nidus (network of arterial and venous channels). Renal artery aneurysm concomitant with a renal arteriovenous fistula is extremely rare. Case report: We reported the case of a 45-year-old female who has giant renal artery aneurysm combined with high-flow RAVF who presented with gross hematuria. The patient’s embolization of a giant extrarenal aneurism arteriovenous fistula was successfully treated using specialized coils and plug device. Conclusions: Renal arteriovenous fistula is a disease that can lead to serious complications. Treatment of this condition should be initiated promptly after diagnosis. Embolization endovascular is a feasible, efficient and safe method which can maximally retain normal renal function.