Values of Retinoblastoma Survivors and Parents Regarding Treatment Outcomes: A Qualitative Study

PURPOSE: Retinoblastoma is an aggressive pediatric eye cancer. Patient-reported outcome measures reveal important insights into how patients perceive their own health. Currently, there is no widely used or validated measure for assessment of retinoblastoma outcomes. The purpose of this research was to uncover which treatment outcomes that retinoblastoma survivors and their parents value, to inform the development of a future measure. METHODS: This qualitative, cross-sectional study included retinoblastoma survivors age 6 years and older and parents of retinoblastoma survivors. Participants who did not demonstrate fluency in English were excluded. Study participants participated in semistructured interviews or focus groups, either in person at The Hospital for Sick Children, Toronto, Canada, or through secure videoconference, between March 3, 2019, and January 25, 2020. Iterative rounds of opening coding, codebook development, and coresearcher analysis were used to identify key emergent themes and subthemes. RESULTS: Seventeen adults participated in six focus groups. Nine pediatric survivors participated in individual interviews. Four common themes emerged from all participant groups: (1) definition of treatment success, (2) enucleation—acceptance and challenges, (3) treatment outcomes to measure, and (4) need for outcome reporting. An additional, unique theme was identified in all pediatric discussions: worries and coping mechanisms. Treatment outcomes deemed valuable were related to the following domains: psychosocial outcomes, daily functioning, functional vision, retinoblastoma education, cosmetic outcomes, and secondary eye conditions. CONCLUSION: This study represents the first stage in the development of a retinoblastoma-specific patient-reported outcome measure. The findings reveal insight into what outcomes are valued by survivors after treatment and offer promise to improve outcomes assessment for retinoblastoma.

Antibiotic use in Moshi Urban: A cross-sectional Study of Knowledge and Practices among Caretakers of Children in Kilimanjaro Tanzania

IntroductionAntibiotics are commonly accessed and used for the management of illness in children without a prescription. We investigated the caretaker’s knowledge and practices on antibiotics and antibiotics use to their children.MethodThis was the hospital-based cross-sectional study conducted from April to July 2017 in three facilities located in Moshi Municipality. A convenience sampling was employed to select for caretakers with their sick children at KCMC, Mawenzi hospital, and Longuo dispensary. Face-to-face interviews were conducted with 224 caretakers who had visited health facilities with their children seeking health care.ResultsThe majority (87.9%, 197/224) of all interviewed caretakers had good knowledge of the use of antibiotics. Irrespective of knowing that it is not safe to self-medicate a child with any antibiotics (95.1%, 213/224), most (61.6%, 138/224) caretakers practiced self-medication with the medicines. Having two children (aOR = 7.75, 95% CI: 1.89-31.67) and having three children (aOR=7.23, 95%CI: 1.08-48.51) were significantly associated with good knowledge of antibiotics.ConclusionThis study has revealed that caretakers in Moshi had a good knowledge of antibiotic use. However, despite such good knowledge, malpractices were observed. We call upon the use of media campaigns to advocate for the importance of the rational use of antibiotics and its effect on human health and the risk of antimicrobial resistance development.Rwanda J Med Health Sci 2021;4(3):347-356

Laboratory finding of CSF analysis in patients with meningitis at Elamin Hamid Pediatrics Hospital in Khartoum, Sudan

Bacterial meningitis in infants and children is a serious clinical entity with signs and symptoms that commonly do not allow distinguishing the diagnosis and the causative agents. The only method to determine if meningitis is the cause of these symptoms is a lumbar puncture. Lumbar puncture is the gold standard for the diagnosis and should be done in all suspected cases of meningitis unless contraindicated. Objectives: The purpose of this study is to identify the importance of the microbiological study of cerebrospinal fluid (CSF) in patients suspected to have acute meningitis. Despite the availability of all other investigations and Imaging for diagnosis of meningitis but CSF analysis remains the most available, accurate, and cheaper for diagnosis of meningitis in children. Methodology and result: This is a prospective study. 71 patients were included. All patients were clinically suspected to have acute meningitis. A lumbar puncture for CSF analysis was done for all patients. The data was collected and analysed. CSF culture was done. The culture was negative In 58 patients (81.7%) and positive in 13 patients (18.3%). Streptococcus was found in 3 patients (4.2 %), staphylococcus epidermidis in 2 patients (2.8%), E Coli in 2 patients (2.8%), klebsiella in 2 patients (2.8%), pneumococci in 2 patient (2.8%), salmonella in 1 patient (1,4%) and Bacilli in 1 patient (1.4 %). Recommendation: Lumbar Puncture (LP) remains the easiest, cheapest and accurate investigation for diagnosis of meningitis in children mainly in rural areas in Sudan and other developing countries. It’s mandatory to offer training for doctors and medical staff for doing lumber punctures safely and accurately and to offer well-equipped laboratories for such essential investigations. It’s not only the role of doctors and medical staff but is a governmental obligation as well. This can save a lot of sick children and prevent mortality and morbidity of acute meningitis in children.

COVID-19 Testing in Schools: Perspectives of School Administrators, Teachers, Parents, and Students in Southern California

Background School-based COVID-19 testing is a potential strategy to facilitate the safe reopening of schools that have been closed due to the pandemic. This qualitative study assessed attitudes toward this strategy among four groups of stakeholders: school administrators, teachers, parents, and high school students. Methods Focus groups and interviews were conducted in Los Angeles from December 2020 to January 2021 when schools were closed due to the high level of COVID transmission in the community. Results Findings indicated similarities and differences in attitudes toward in-school COVID-19 testing. All groups agreed that frequent in-school COVID-19 testing could increase the actual safety and perceived safety of the school environment. School administrators expressed pessimism about the financial cost and logistics of implementing a testing program. Parents supported frequent testing but expressed concerns about physical discomfort and stigma for students who test positive. Teachers and parents noted that testing would prevent parents from sending sick children to school. Students were in favor of testing because it would allow them to return to in-person school after a difficult year of online learning. Conclusion In-school COVID-19 testing could be a useful component of school reopening plans and will be accepted by stakeholders if logistical and financial barriers can be surmounted and stigma from positive results can be minimized.

Disease prevention: childcare practices of caregivers in day-cares/pre-schools in Ibadan, Nigeria

Background: Childhood Disease prevention practices (DPP) by day-care/preschools caregivers are essential to the wellbeing of enrolled children. We assessed DPP such as hand hygiene, feeding, nutrition, handling sick children and pre-employment medical screening in day-cares /pre-schools and the factors associated with DPP.Methods: The cross-sectional study involved 799 pre-school caregivers (teachers and minders/nannies). Ten settlements were selected from five randomly selected metropolitan Local Government Areas in Oyo state, Nigeria. Data collected on DPP was mainly graduated on 3-point Likert like scale: ‘always responses’- allotted 2 points; ‘sometimes’- 1 point; and ‘never’- zero. Using a significance level (p value) set at 5% and higher R-squared values, associations between DPPs and explanatory variables were tested).Results: Mean age of respondents was 33.7±9.5 years. Majority, 594 (74.3%) did not have pre-employment childcare training. Self-reported hand hygiene was highest for stool moments. Most 456 (56.3%) reported formula feeds for 1-6 months and mainly staples for older children. Aggregated DPP score (80) was dichotomized using mean childcare DPP score of 24±4.5. Slightly more than half of the respondents, 453 (56.7%) had inadequate DPP. Formal childcare training p<0.001, current job specification p=0.02 and knowledge of VPD p=0.004 were associated with DPP index. Some predictors of adequate childcare DPP include facility registration status (OR=2.19, 95%CI=1.05-4.56); respondents who had childcare training (OR=1.52, 95%CI=1.083-2.144); affiliation with health (OR=2.0, 95%CI=1.227-3.262).Conclusions: This study highlights childcare DPP within the day-cares/pre-schools and provides evidence for tailored training interventions and monitoring of the facilities.

CHARITABLE ACTIVITY OF LYUBOVE IVANOVNA KURIS (1852-1935)

The article examines the life and charitable activities of the famous Kuris family representative in the South of Ukraine – Lyubov Ivanovna Kuris. Based on the primary sources study, archival documentation and publications of the Lyubov I. Kuris' life period, Lybov Ivanivna's activity in Odesa region charitable societies, in her own noble estate in her homeland and in Kurisovo-Pokrovsky is covered.Particular attention is paid to Kuris family charity tracing and continuing charitable work from generation to generation. Research of the charitable activity basis and types in the south of Ukraine.It is established that Lyubov I. Kuris continued to carry out charitable activities after her husband's mother, Lyubov Stanislavivna Kuris, who worked fruitfully for the benefit of the Odessa Women's Charitable Society until her death.Among the Lyubov Ivanovna main merits is the construction and maintenance of educational institutions, churches, patronage, assistance to sick children and the needy. Lyubov Ivanivna Kuris was fascinated by the idea of public education spreading. As a trustee of Kurisovo-Pokrovsky, she did a lot for the village school and school garden. In 1862, her father Ivan Alexandrovich Gizhitsky founded the first local school in Ryasnopil, which he maintained at his own expense until 1869. Later, Lyubov I. Kuris tried to continue his work.However, the greatest cause in the field of charity Lyubov I. Kuris was her participation in the work of the Odessa Society for the Sick Children Care. She devoted almost 30 years of her life to this activity, having done many good deeds and invested in it her Christian love, charity and unquenchable energy.Lyubov I. Kuris' activity as the chairman of the society allowed to establish contacts and involve many famous and influential people of the city. The main achievement of the Society was the medical station for children and a children's kitchen "Drop of Milk" construction. By 1901, more than 1,500 children had undergone a treatment full course at the sanitary station. Lyubov I. Kuris was also a member of the Odessa Society of History and Antiquities, was a philanthropist, passing part of her husband's collection, antique exhibits, the museum for the benefit of society.

Evaluation of Computed Tomography Scan of Brain in Pediatric Patients

Objective: To determine the effectiveness of computed tomography in pediatric patients referred to radiology department for computed tomography scan brain Study Design: Cross sectional study Place and Duration of Study: Radiology Department, Sandmen Provincial Hospital Quetta form 1st January 2018 to 30th March 2018. Methodology: Sixty pediatric patients included in the study who referred from Pediatric OPD for computed tomography scan of brain. Patients with trauma were excluded while all other patient’s age between 1 month to 4 years were included. Findings were divided with normal and abnormal findings. Results: Twenty five (41.7%) were boys and 35 (58.3%) were girls. Only 25% were negative and 75% were positive and showed significant pathology. Major complaint was fits accompanied with fever and unconsciousness was also one of the reasons. Conclusion: Computed tomography scan is quick and now-a-days with easy access it is an effective diagnostic method in sick children with cases of neurological disease in spite of its radiation exposure child. Key word: Computed tomography (CT), Effectiveness, Children

PEDAGOGICAL CARE IN HOSPITAL ENVIRONMENT

Pedagogical assistance in a hospital environment aims to continue the schooling of children who are hospitalized. In addition, it aims to develop activities that help in training and that help with school tasks during hospitalization. This article aims to publicize the hospital class as an inclusive teaching modality aimed at assisting children and adolescents while they are undergoing health treatment during the period of hospitalization. The bibliographical research presents a scenario about the hospital educational service in Brazil and in the state of Mato Grosso do Sul, showing a growing percentage, however, insufficient of hospital classes to guarantee the right to education of sick children and adolescents.

Medications Reconciled at Discharge Versus Admission Among Inpatients at a Children’s Hospital

BACKGROUND AND OBJECTIVES Discharge prescription practices may contribute to medication overuse and polypharmacy. We aimed to estimate changes in the number and types of medications reported at inpatient discharge (versus admission) at a tertiary care pediatric hospital. METHODS Electronic medication reconciliation data were extracted for inpatient admissions at The Hospital for Sick Children from January 1, 2016, to December 31, 2017 (n = 22 058). Relative changes in the number of medications and relative risks (RRs) of specific types and subclasses of medications at discharge (versus admission) were estimated overall and stratified by the following: sex, age group, diagnosis of a complex chronic condition, surgery, or ICU (PICU) admission. Micronutrient supplements, nonopioid analgesics, cathartics, laxatives, and antibiotics were excluded in primary analyses. RESULTS Medication counts at discharge were 1.27-fold (95% confidence interval [CI]: 1.25–1.29) greater than admission. The change in medications at discharge (versus admission) was increased by younger age, absence of a complex chronic condition, surgery, PICU admission, and discharge from a surgical service. The most common drug subclasses at discharge were opioids (22% of discharges), proton pump inhibitors (18%), bronchodilators (10%), antiemetics (9%), and corticosteroids (9%). Postsurgical patients had higher RRs of opioid prescriptions at discharge (versus admission; RR: 13.3 [95% CI: 11.5–15.3]) compared with nonsurgical patients (RR: 2.38 [95% CI: 2.22–2.56]). CONCLUSIONS Pediatric inpatients were discharged from the hospital with more medications than admission, frequently with drugs that may be discretionary rather than essential. The high frequency of opioid prescriptions in postsurgical patients is a priority target for educational and clinical decision support interventions.