A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Purpose: Acupuncture at point P6 has proven efficacious in alleviating postoperative nausea and vomiting (PONV). Evidence supporting its use in pediatric patients is not nearly as conclusive. Furthermore, acupuncture’s effects when combined with antiemetics needs to be further elucidated. We conducted a double-blinded, randomized controlled trial to investigate the effects of P6 acupuncture combined with antiemetics on pediatric patients undergoing tonsillectomy. Methods: A total of 109 patients between the ages of 3 – 9 years old were randomly assigned to one of two treatment groups prior to surgery. Each group received standard antiemetic medications while only one group received acupuncture intraoperatively. PONV was assessed via usual protocol while the patients remained at the post-anesthesia care unit (PACU) and Day Stay Unit. A follow-up phone call 24 hours following surgery was conducted to assess for overnight symptoms. Results: 106 patients completed the study with 58 randomly assigned to the Treatment Group, whom receive acupuncture and antiemetic therapy, and 48 to the Control Group, receiving only antiemetic therapy. When comparing baseline characteristics and possible confounding factors for each group, no statistical differences between the groups could be found. For primary outcomes, the only significant difference between the two groups occurred with the incidence of nausea in the PACU following the surgery (P = 0.02), but nausea in the Day Stay Unit trended toward significance (P = 0.06). Retching and vomiting incidence did not occur frequently enough in the hospital to be analyzed. No differences between the Treatment Group and Control group were seen in the 24 hours after the patients were discharged from the hospital. Discussion: With no adverse events from its use and with statistically significant efficacy, P6 acupuncture embodies a useful prophylactic treatment for postoperative nausea in children.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.

Color has a large impact on our psychological and physiological responses. This study examines the value of color as a component in a healing environment for pediatric patient rooms by measuring color preferences among healthy children, pediatric patients, and design professionals. Environmental satisfaction is a significant mediator between the physical environment and children’s health. Previous color preference studies have typically been done with small color chips or papers, which are very different from seeing a color applied on wall surfaces. A simulation method allowed for investigating the value of color in real contexts and controlling confounding variables. The findings of this study demonstrated that blue and green are the most preferred, and white the least preferred color, by both children and design professionals. Children’s gender differences were found in that boys prefer red and purple less than girls. Pediatric patients reported lower preference scores for yellow than did healthy children. These findings lead to color application guidelines for designers to understand color more and eventually to create better environments for children and their families.

Color has a large impact on our psychological and physiological responses. This study examines the value of color as a component in a healing environment for pediatric patient rooms by measuring color preferences among healthy children, pediatric patients, and design professionals. Environmental satisfaction is a significant mediator between the physical environment and children’s health. Previous color preference studies have typically been done with small color chips or papers, which are very different from seeing a color applied on wall surfaces. A simulation method allowed for investigating the value of color in real contexts and controlling confounding variables. The findings of this study demonstrated that blue and green are the most preferred, and white the least preferred color, by both children and design professionals. Children’s gender differences were found in that boys prefer red and purple less than girls. Pediatric patients reported lower preference scores for yellow than did healthy children. These findings lead to color application guidelines for designers to understand color more and eventually to create better environments for children and their families.

Revisión por pares

Resumo: O objetivo deste trabalho foi investigar de que forma a educação musical poderia auxiliar o paciente pediátrico em sua interação com a realidade, dialogando com as necessidades e dificuldades resultantes do processo de hospitalização Para atingir esse objetivo, propostas de atividades envolvendo som/música e criatividde foram apresentadas a crianças e adolescentes hospitalizados no Instituto de Infectologia Emilio Ribas (SP). Os instrumentos adotados para apreensão dos processos desenvolvidos durante o tabalho de campo foram: gravação de áudio de episódios significativos de cada encontro, depoimentos dos participantes, relatórios de observação e entrevistas semi-estruturadas e estruturadas com os profissionais da saúde e voluntários envolvidos no projeto. Tanto a fundamentação teórica como o método empregado basearam-se nas proposições do psiclógogo russo L.S. Vigotski e nos autores em eduçação musical que valorizam a prática musical criativa, e sua contribuição para o desenvolvimento integral do ser hlumano, Acredita-se que a presença de processos criativos em educação musical na instituição hospitalar tenha contribuído ao processo de humanização deste contexto, promovendo saúde segundo a definição da abordagem sócio-histórica e instrumentalizando o paciente pediátrico ao enfrentamento de sua internação. / Abstract: The aim of this study was to investigate how music education could assist the pediatric patient in his interaction with the reality, dialoging with the necessities and difficulties resultant of the hospitalization process. To reach this objective, proposals of activities involving sound/music and creativity were presented to children and teenagers hospitalized in the Instituto de Infectologia Emilio Ribas (SP) (Institute of Infectology "Emilio Ribas"). The instruments adopted for the grasp of the processes developed during the field work were: recordings in tape of significant episodes of each meeting, participants testimonies observation reports, semi-structured and stuctured interviews with the health professionals and volunteers involved in the project. Both the theoretical basis and the method employed were based on the proposals of Russian psychologist L.S. Vigotski and the music education authors who value the creative music pactice, and its contribution for the integral development of the human being. It is believed that the presence of creative processes in music education in the hospital institution has contributed to the humanization process of this context, promoting health according to the definition of socio-historical approach and helping the patient to face the hospitalization. / Orientador: Marisa Trench de Oliveira Fonterrada / Coorientador: Marisa Irene Siqueira Castanho / Banca: Ilka Zenker Leme Joly / Banca: Yara Borges Casnók / Mestre

Cat scratch's disease caused by Bartonella henselae, is known to be a self-limited benign process in immunocompetent children. The association with neurologic manifestations is very uncommon especially in patient with no immunologic defects and in cases without specific treatment. A 7 years old male patient, without any immunocompromised defect, presented an atypic presentation of the cat scratch disease. The patient came to the hospital in two opportunities in a status epilepticus, in both cases the diagnosis was encephalitis by Bartonella henselae and the evolution with treatment was monitored with PCR (polymerase chain reaction) in cerebrospinal fluid and blood, as well as IFI (IgM, IgG) serology (indirect immunofluorescence). The patient had a favorable clinical and laboratory evolution for 6 months showing no recurrence of the disease. / This work has been partially supported by the Programa Nacional de Innovacion para la Competitividad y Productividad ´ (Innovate Per ´ u), under the contract 116-PNICP-PIAP-2015.

Made available in DSpace on 2014-06-11T19:27:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2007Bitstream added on 2014-06-13T18:31:38Z : No. of bitstreams: 1 caldeira_za_me_ia.pdf: 1436682 bytes, checksum: 95ab2146f7b65182d4696c6e2e0ce927 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo deste trabalho foi investigar de que forma a educação musical poderia auxiliar o paciente pediátrico em sua interação com a realidade, dialogando com as necessidades e dificuldades resultantes do processo de hospitalização Para atingir esse objetivo, propostas de atividades envolvendo som/música e criatividde foram apresentadas a crianças e adolescentes hospitalizados no Instituto de Infectologia Emilio Ribas (SP). Os instrumentos adotados para apreensão dos processos desenvolvidos durante o tabalho de campo foram: gravação de áudio de episódios significativos de cada encontro, depoimentos dos participantes, relatórios de observação e entrevistas semi-estruturadas e estruturadas com os profissionais da saúde e voluntários envolvidos no projeto. Tanto a fundamentação teórica como o método empregado basearam-se nas proposições do psiclógogo russo L.S. Vigotski e nos autores em eduçação musical que valorizam a prática musical criativa, e sua contribuição para o desenvolvimento integral do ser hlumano, Acredita-se que a presença de processos criativos em educação musical na instituição hospitalar tenha contribuído ao processo de humanização deste contexto, promovendo saúde segundo a definição da abordagem sócio-histórica e instrumentalizando o paciente pediátrico ao enfrentamento de sua internação. / The aim of this study was to investigate how music education could assist the pediatric patient in his interaction with the reality, dialoging with the necessities and difficulties resultant of the hospitalization process. To reach this objective, proposals of activities involving sound/music and creativity were presented to children and teenagers hospitalized in the Instituto de Infectologia Emilio Ribas (SP) (Institute of Infectology Emilio Ribas). The instruments adopted for the grasp of the processes developed during the field work were: recordings in tape of significant episodes of each meeting, participants testimonies observation reports, semi-structured and stuctured interviews with the health professionals and volunteers involved in the project. Both the theoretical basis and the method employed were based on the proposals of Russian psychologist L.S. Vigotski and the music education authors who value the creative music pactice, and its contribution for the integral development of the human being. It is believed that the presence of creative processes in music education in the hospital institution has contributed to the humanization process of this context, promoting health according to the definition of socio-historical approach and helping the patient to face the hospitalization.

The aim of this diploma thesis is to present psychosocial aspects of acute phase treatment of childhood cancer. The literary briefing section is divided into four chapters. The first chapter presents the general medical characteristics of childhood malignancies and the principles of treating pediatric oncology diseases. The second chapter captures key findings of developmental psychology to ontogenesis in childhood and adolescence. The third chapter focuses on the psychosocial aspects of oncological treatment and psychological interventions applied during this treatment. The fourth chapter deals with palliative care in pediatric oncology and the psychological context of the child's death and family bereavement. Qualitative research consists of a set of four descriptive case reports of patients and their parents who are in the acute phase of cancer treatment or are shortly after its completion. The case reports present the experience of these patients and parents. Keywords Pediatric oncology, pediatric hematooncology, pediatric oncopsychology, pediatric patient, adolescent patient.

The topic of my diploma thesis is the issue of nursing care in pediatric pati- ents before consumption of organs at the resuscitation department. I consider this topic socially very topical because the number of transplant candidates on transplantation lists is constantly increasing. Since child transplant can- didates are the most vulnerable group, I have focused on child organ donors. The theoretical part criticizes the concept of death and threat, including examination methods that lead to brain death. I present the activities of the Coordination Center of the Transplant and Coordinated Coordinator in a donor program that seeks to proliferate the transplant program. An important component is legal legislation and ethical aspects, which are an integral part of the donor system in the Czech Republic. Study materials I searched in the databases NLK, SVKKL, Medvik, Embase, PubMed, Wiley Online Library, Medscape. The research was conducted from the National Medical Library and from the Central Bohemian Library in Kladno. I got statistical data from web sources, especially from KST. Methodology: The choice of the case study best fulfills the requirements necessary to map the key moments of nursing care, which may play a role in the timely indication of a potential organ donor, as well as in considering...