Disordered sleep affects 20-40% of children and adolescents. Such disorders can result in academic difficulties, emotional regulation difficulties, and decreased immune system functioning. Behavioral treatments are the empirically supported treatment for pediatric sleep problems. With most children getting yearly well-child visits, pediatric medical professionals are in an optimal position to identify sleep difficulties and refer children for treatment. However, research suggests that medical professionals receive limited formal education in disordered sleep, and they more frequently recommend medication over behavioral interventions. Therefore, referrals to psychologists for behavioral treatments may often be warranted. The factors that influence medical professionals’ referral decisions have not been investigated. The current study investigated factors implicated in referral behaviors including pediatric medical professionals’ knowledge, screening patterns, treatment preferences, and referral patterns in the area of pediatric behavioral disordered sleep. A total of 65 medical professionals were recruited to complete an online survey to investigate these factors. Results indicated that participants in the current study demonstrated significantly higher sleep knowledge and rates of screening than what was found in a previous study. Regarding predictors of sleep knowledge, taken together, specialty, years in practice, and screening behaviors significantly predicted sleep knowledge scores. Additionally, sleep knowledge of participants who indicated that a referral was necessary when presented with a hypothetical case example of a child presenting with disordered sleep was significantly lower than the sleep knowledge of those who did not refer. Further, rates of referral were significantly lower than reported in previous research. Confidence in managing sleep problems and rates of providing behavioral recommendations were also explored. Overall, results of the current study indicate that pediatric medical professionals may benefit from additional training in the area of pediatric behavioral sleep and increased awareness of appropriate referral sources. Further exploration into the influence of screening behaviors and treatment preferences on referral behavior is necessary.

Implementation of an Evidence-Based Childhood Obesity Toolkit in a Rural Pediatric Clinic in Cookeville, TN: A Quality Improvement Project Dawn G. Johnson, MSN, APRN, FNP-BC Tennessee Technological University Nursing 6802 – DNP Project Development Dr. Victoria Pope & Dr. Candice Short March 23, 2022 Author Note Dawn G. Johnson https://orcid.org/0000-0002-7090-8036 College of Nursing, Tennessee Technological University There are no conflicts of interest to disclose. Correspondence concerning this manuscript should be addressed to Dawn G. Johnson, Tennessee Technological University, 248 Haven Lane, Algood, TN 38506 Email: djohnson@tntech.edu Abstract Purpose: The purpose of this quality improvement project is to increase the early identification of overweight or obese children in the primary care setting and provide education through the implementation of an evidence-based childhood obesity toolkit. Aims: This project aims to implement the Healthy Care for Healthy Kids Physical Activity and Nutrition Survey Management Plan to educate patients and parents about childhood obesity. The Healthy Care for Healthy Kids Physical Activity and Nutrition Survey Management Plan is an evidence-based questionnaire and action plan used by healthcare providers in the prevention and treatment of childhood obesity. Processes: Nurses will provide the toolkit to children ages 5-18 who present to the clinic for well-child examinations and have a BMI classified as overweight or obese. Providers will then review the screening toolkit with the patient and family and make a corrective plan of action. The screening tool will then be signed by the patient, caregiver, and provider and placed in the child’s electronic medical record. Results: To be determined after project implementation is complete. Results are anticipated to be that more overweight and obese children are identified by the clinic and proper education is provided to the patient and family. Limitations: The study is limited to one location and only available to the providers who perform well-child examinations. Conclusions: Implementation of an evidence-based childhood obesity toolkit in the pediatric setting with increase the early identification of overweight and obese children. Keywords: childhood obesity, pediatric obesity, toolkit, obesity, overweight

No description available.

This study aimed to establish a better candidacy protocol for pediatric heart transplant patients at the University of Arizona Medical Center through a retrospective chart review of pediatric heart transplants held there between the years of 2004 -2009. Sequential patterns related to noncompliance investigated included patient and guardian demographics and past medical, familial, social and psychiatric history. Trends between gender and noncompliance were found as 5/5 noncompliant rejectors were male. Four out of the 5 were between the ages of 16.5 and 21 years old. Seventy percent of medication changes due to medication intolerance were associated with noncompliance. Patients with family members currently or previously suffering from life-threatening illnesses (7/16) had a greater likelihood of having subtherapeutic immunosuppressive trough levels. Of noncompliant rejectors, 4/5 (80%) had a duration of illness prior to transplant > than 6 months. Also, 4/4 patients with pre-transplant depression experienced rejection and 2/4 were noncompliant rejectors.

Purpose: The purpose of this study is to assess what training and motivational factors dental providers report in providing dental care to PSHCN (patients with special healthcare needs. Materials and Methods: An electronic questionnaire was sent to n=104 fourth year dental students, n=147 general dentists with a specific continuing education course pertaining to PSCHN, and n=140 pediatric dentists in Virginia. The questionnaire consisted of four sections including Demographics, Professional Attitudes, Special Needs Patients and Motivational Factors, and PSCHN Cases. Results: The overall response rate for our study was 21%. The response rates of dental students, general dentists, and pediatric dentists were 30%, 10%, and 25%, respectively. A statistically significant difference was found for 10 out 12 motivational factors. Conclusions: There is a difference in motivational factors among the three different types of dental providers.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University