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Quality of Life of Adolescents Following Heart TransplantationAnthony, Samantha J. 16 March 2011 (has links)
Despite the establishment of heart transplantation as a life-saving therapy for children and adolescents, little research has focused on the biopsychosocial impact of the transplant process. Few studies have captured the subjective experiences of young heart transplant recipients. This program of research examined how pediatric heart transplant recipients construct their worlds and the meanings they ascribe to their transplant experience. A grounded theory approach was implemented which guided data collection and analysis. A total of twenty-seven adolescents participated in semi-structured qualitative interviews. Findings illuminate pediatric heart transplantation to be a pervasive experience, with consequent impact on physical, psychological and social well-being. Participants described various biopsychosocial processes and experiences that occurred over the course of their transplant journey. Data analysis yielded themes of quality of life reflecting notions of temporality including: 1) the pre-transplant experience – a struggle to survive, 2) the transplant surgery and hospitalization – a difficult transition and 3) the post-transplant experience – an awakening and transformation. This research identifies that heart transplantation, which may contain elements of suffering and loss, may ultimately enhance young recipients’ overall quality of life. Results reveal the possibility that adolescent heart transplant recipients not only adapt to transplantation, but also potentially experience associated growth-enhancing experiences. An emergent theoretical model is presented, with implications for practice and research.
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Predictors of Caregiver Confidence in Caring for Their Hospitalized Child Following Pediatric Acquired Brain InjuryHudepohl, Margaret B. 11 July 2013 (has links)
There is a robust body of research regarding outcomes following pediatric acquired brain injury (ABI). However, these studies generally explore medium-term outcomes (i.e., 3 to 12-months postinjury), whereas functioning during acute stages following ABI is poorly understood. In particular, there is limited knowledge regarding caregiver functioning during a child’s hospitalization immediately after ABI. This study sought to identify and model caregiver and child predictors of ‘caregiver confidence’ in caring for their hospitalized child. Caregivers of 45 children with diverse types of new-onset acquired brain injuries completed self-report measures of their own psychological functioning, stress, and confidence levels, as well as their perceptions of their child’s stress and coping. Results showed that caregiver psychological functioning was negatively associated with caregiver confidence, and caregiver perceptions of child coping were positively associated with caregiver confidence. Child functional status did not serve as a significant mediator in this relationship as per the hypothesized model.
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Factors Affecting Outcome Quality of Emergency Department¡G The Example of Pediatric Asthma in a Teaching HospitalTing, Shiu-Wen 28 June 2004 (has links)
The medical quality becomes a very important issue of a scholar and the public opinion. The high quality medical service of patients center and customer direction already has been necessarily prepare conditions to get the best competition advantage of all levels hospital in Taiwan, now.¡CTherefore, all hospital manager believe that promote medical quality is the very important issue¡CThe medical service quality of Emergency Department plays the very important role in the whole hospital. The medical service quality indicator is acknowledged well trusty medical quality measurement tool. Donabedian point out that medical quality measurement is compose of structure¡Bprocess and outcome, and that the outcome quality indicator measurement is the trend¡CAsthma is one of the most common diseases among children. Because of rising morbidity, mortality and medical costs all over the world, asthma becomes a very important issue. So, The purpose of this study is to identify the key factors associated with the of outcomes quality. The example of Pediatric Asthma in a Teaching Hospital. Data take from the Teaching Hospital¡¦s TQIP database through 2003. There are 534 Pediatric asthma patients who are research samples and care take by 25 physicians.
The research analyze patient¡¦s and physician¡¦s characteristic to described data, Correlation and Regression with SPSS software. Look for the characteristic what influence the outcome quality of Emergency Department. The outcome quality include that patient¡¦s state after the treatment, patient¡¦s stay time and unscheduled revisit to Emergency Department.¡CRegression analysis showed that. 1.patient¡¦s state after the treatment trend to be inpatient who care by experienced physician, younger, illness serious and reach on day shift. 2.patient¡¦s stay time longer who care by experienced physician, so that the consultations effectiveness should promote to reduce .patient¡¦s stay time¡C3.patient¡¦s stay time longer who younger, so that the staff take care more careful and pay attention to patient¡¦s condition change frequently¡Ato reduce uneasy of long-term stay in Emergency Department. 4.unscheduled revisit ratio in the study is 4.7%¡Abut not discover the correlation factor¡C
Integrate above-mentioned¡Athe study find that ¡Aphysician¡¦s and patient¡¦s characteristic will influence medical outcome quality. The project hospital should with different influence factor to draw quality manage policy and stratagem, and improve Emergency Department quality will raise the satisfied degree.
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The effects of training children to cope with stress a comparison of procedures for preparing children to control stress responses during a dental examination /Nielsen, Earl S. January 1979 (has links)
Thesis (Ph. D.)--University of Nevada, Reno, 1979. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (p. 97-110).
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Attitudes of nursing students toward mental retardation before and after curricular experience with mentally retarded childrenBaker, Amanda Sirmon, January 1974 (has links)
Thesis--University of Florida. / Description based on print version record. Typescript. Vita. Bibliography: leaves 117-120.
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Predictive factors of Post-Traumatic Stress Disorder in pediatric medical trauma patients : the influence of cognitive development on appraisal factors / Influence of cognitive development on appraisal factorsMetz, Kristina Lynne 24 February 2012 (has links)
This report will provide an overview of the literature on predictive factors of the development of Post-Traumatic Stress Disorder in pediatric medical trauma patients as well as discuss the influence of cognitive development on the validity of such predictive factors. The report will propose that the validity of current predictive factors, including trauma memory, parental influence, and appraisals of the trauma and its sequelae, may alter across child development due to differences in cognitive abilities. In particular, the report proposes examining the following questions for pediatric patients (5 to 17 years of age) who have endured a medical trauma: 1) Are appraisal predictive values of PTSD moderated by age; 2) Is data-driven processing‟s predictive value of PTSD moderated by parental attitude of avoidance. The report additionally outlines hypotheses as well as proposes the methodology and statistics to examine the proposed hypotheses. Limitations as well as the importance of this study are discussed. / text
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Emotional trauma and children’s executive functioning : is there a connection?Holder, Christen Marie 25 October 2012 (has links)
The purpose of this dissertation was to examine the connection between emotional trauma and executive function ability in children and adolescents. Trauma is defined as an overwhelming event that is beyond the realm of what might be an expectable occurrence for the average person. A serious outcome, occurring in around 14% of those children who experience trauma, is the development of Post Traumatic Stress Disorder, which is classified as an anxiety disorder occurring after exposure to a traumatic event, in which symptoms of re-experiencing, avoidance, and arousal are present. In addition to the numerous physical, emotional, and social effects of trauma, neuropsychological and imaging research has confirmed that children’s neuroanatomy and cognitive functioning are often affected. It has been proposed that intrusive thoughts occurring immediately after the trauma event may modify the neural network function, setting the stage for neurobiological dysregulation. One of the most common neural anatomic areas of concern following trauma is the prefrontal cortex, a structure that continues to develop until the third decade of life, and that has been implicated as the home of executive function, an idea conceptualized in a number of ways, but that is most often considered an umbrella term describing essential functions of the mind, such as planning, inhibition, attention, and working memory. The scope of literature addressing the effect of trauma on executive function is minimal. It is the hypothesis of this study that early trauma may disrupt the normal development of the PFC and subsequently result in decreased executive functioning abilities. In order to explore this hypothesis, a set of neuropsychological measures were selected as representative of executive functioning, based on previous research. An initial factor analysis was conducted in order to determine if, as suspected, all subtests chosen load on a common factor of executive function. Multiple linear regression was used to determine whether children who experienced trauma have impaired executive functioning abilities, if there was a significant gender difference, and what, if any, differences there were between children who developed PTSD and children who did not. / text
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Processing speed and executive function in pediatric acute lymphoblastic leukemia survivorsGarrison, Daniel Alexander 05 November 2013 (has links)
This study examined processing speed and executive function late effects in survivors of pediatric ALL (hereafter referred to as Survivors). Late effects are long-term, treatment-related health problems associated with the neurotoxic side-effect of cancer treatment on brain development. Processing speed —mental and motor speed with which a person can solve nonverbal problems — was estimated via an composite of processing speed attained from several measures of processing speed. Executive function — a collection of processes orchestrated in the performance of purposeful, goal-directed behavior — was measured using the Parent and Teacher forms of the Behavior Rating Inventory of Executive Function (BRIEF). This study also explored the effect of previously identified risk factors for processing speed and executive function late effects. Finally, executive function late effects were further explored via the use of performance-based measures, including the Tower and Trail Making (Condition 4) tests of the Delis-Kaplan Executive Function System (D-KEFS).
Hypotheses included (1) Survivors would demonstrate significantly poorer processing speed; (2) late effects risk factor variables (i.e., greater elapsed time since completion of treatment, lower age at diagnosis, and higher intensity of treatment) would predict poorer processing speed; (3) female gender would predict poorer processing speed; (4) parents and teachers would demonstrate both low interrater agreement (Hypothesis 4a) and differ significantly in the severity (Hypothesis 4b) of their ratings of Survivor executive function; (5) parent and teacher ratings of executive function would indicate significantly poorer Survivor metacognition (Hypothesis 5a), whereas Survivor behavioral regulation would not differ significantly (Hypothesis 5b); (6) risk factor variables would predict poorer Parent and Teacher ratings of Survivor metacognition; (7) female gender would predict poorer Parent and Teacher ratings of Survivor metacognition; (8) survivor processing speed and Parent and Teacher ratings of executive function would exhibit a positive relationship; and (9) poorer Survivor processing speed would predict poorer parent and teacher ratings of executive function. Results provided support for hypothesis 1 and 5a. Partial support was obtained for hypotheses 4a, 4b, and 7. Hypotheses 2, 3, 5b, 6, 8, and 9 were not supported. / text
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Mia Alessandra : life with Juvenile Idiopathic ArthritisSherry, Grace Carolyn 11 December 2013 (has links)
Mia Alessandra Nieto is an 8-year old living with Juvenile Idiopathic Arthritis (JIA) in Austin, Texas. When she was diagnosed at 10 months, she was the youngest child ever diagnosed with JIA in the state of Texas. However, it took 37 days to confirm her condition because there is an immense lack on knowledge in the field of pediatric rheumatology among general practitioners despite the fact that JIA is the most prevalent chronic condition in children in the United States with over 300,000 diagnosed. This is an overview of Mia’s story, along with information regarding the lack of knowledge on the condition not only in the general population but mainly and more importantly among the medical professionals in the United States. / text
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What the neuropsychologist said to the neuroradiologist : two methods of lateralization of landuage in pre-surgical assessment of children with intractable epilepsyPotvin, Deborah Claire 19 December 2013 (has links)
For children with intractable epilepsy, surgery provides significant reduction in seizure frequency, with no significant declines in intellectual or behavioral functioning (Datta, et al., 2011). Prior to surgery, children must undergo a thorough assessment to determine the location of the seizure-focus and to evaluate risks of post-operative impairment (Lee, 2010). Currently, fMRI offers one of the most reliable and least invasive means of localizing language prior to surgery (McDonald, Saykin, William & Assaf, 2006).
Dichotic listening, a behavioral task in which subjects are asked to listen to two competing stimuli simultaneously, offers a possible alternative for children who cannot complete fMRI studies. Previous studies have relied on research-based listening tasks and the type of quantitative analysis of the fMRI rarely available in the clinical setting. Instead, this study examined how well dichotic listening results predict language lateralization from fMRI within a clinical setting.
Data were gathered through a records review of 13 children with intractable epilepsy referred to Austin Neuropsychology through the epilepsy treatment team at Dell Children’s Medical Center. Overall, children classified as atypical language dominance on the fMRI studies showed lower levels of right ear advantage on the dichotic listening measure. Despite this trend, a discriminant analysis using the dichotic listening results to predict fMRI classification showed no significant improvement over chance classification. A secondary analysis examined factors related to a child’s ability to complete an fMRI language study, comparing 12 children from the original sample with 6 children referred through the same process and over the same time period who could not obtain a successful fMRI determination of language lateralization. Overall, children who successfully completed the fMRI language studies showed a trend of lower levels of difficulty with behavioral regulation and higher levels of intelligence.
Although the non-significant results highlight the limitations of dichotic listening as a clinical tool, the failure rate within the total sample, along with the information about the roles of intelligence and behavioral regulation, may help spur the development of alternative methods of language lateralization. / text
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