A5026188859- Palliative Care and End-of-Life Issues
- Childhood Cancer Survivors' Quality of Life
- Ethics and Legal Issues in Pediatric Healthcare
- Family and Patient Care in Intensive Care Units
- Adolescent and Pediatric Healthcare
- Ethics in medical practice
- Child and Adolescent Health
- Grief, Bereavement, and Mental Health
- Adolescent Sexual and Reproductive Health
- Child and Adolescent Psychosocial and Emotional Development
- Infant Development and Preterm Care
- Attention Deficit Hyperactivity Disorder
- Innovations in Medical Education
- Anesthesia and Pain Management
- Healthcare professionals’ stress and burnout
- Pediatric Pain Management Techniques
- Neonatal Respiratory Health Research
- Resilience and Mental Health
- Family Support in Illness
- Congenital gastrointestinal and neural anomalies
- Vaccine Coverage and Hesitancy
- Medical Education and Admissions
- Patient Dignity and Privacy
- Connective tissue disorders research
- Healthcare Decision-Making and Restraints
Children's Mercy Hospital
2014-2024
University of Kansas
2024
University of Missouri–Kansas City
2014-2024
Mercy Hospital
2019
Mercy Medical Center
2019
CHI Health Mercy Council Bluffs
2019
Cooper Green Mercy Hospital
2019
Mercy Hospital
2012-2014
Dana-Farber Cancer Institute
2012
University of Rochester Medical Center
2007-2009
Pediatric health care is practiced with the goal of promoting best interests child. Treatment generally rendered under a presumption in favor sustaining life. However, some circumstances, balance benefits and burdens to child leads an assessment that forgoing life-sustaining medical treatment (LSMT) ethically supportable or advisable. Parents are given wide latitude decision-making concerning end-of-life for their children most situations. Collaborative around LSMT improved by thorough...
The final hours, days, and weeks in the life of a child or adolescent with serious illness are stressful for families, pediatricians, other pediatric caregivers. This clinical report reviews essential elements care these patients their establishing end-of-life goals, anticipatory counseling about dying process (expected signs symptoms, code status, desired location death), engagement palliative hospice resources. also outlines postmortem tasks team, including staff debriefing bereavement.
The goals of this study were to describe the pattern voiding disorders in children our community, clinical criteria for making specific diagnoses, and comment on management. medical records 226 referred because dysfunction or urinary tract infections (UTI) evaluated. Children with normal patterns when uninfected, monosymptomatic nocturnal enuresis, known neurologic anatomic abnormalities excluded. Detrusor instability, an abnormal characterized by urgency without frequency, was diagnosis 175...
Whether death occurs in the context of a chronic illness or as sudden loss previously healthy infant, child, adolescent, child is highly stressful and traumatic event. Psychosocial support for families after embodies core medical values professional fidelity, compassion, respect human dignity, promotion best interests grieving family. The pediatrician has an important role supporting family unit through family-centered, culturally humble, trauma-informed approach. This clinical report aims...
Advances in prenatal diagnosis create a unique set of clinical ethics dilemmas. Doctors routinely obtain genetic screening, radiologic images, and biophysical profiling. These allow more accurate prognosis than has ever before been possible. However, they also reveal wider range disease manifestations were apparent when was less sophisticated. Sometimes, the best estimates turn out to be wrong. The infant's symptoms may severe or anticipated based on assessment. We present case which made...
Urban adolescents face many barriers to health care that contribute disparities in rates of sexually transmitted infections (STIs) and unintended pregnancy. Designing interventions increase access is a complex process requires understanding the perspectives adolescents. We conducted six focus groups explore attitudes beliefs about general sexual as well among urban, economically disadvantaged Participants first completed written survey assessing behaviors, utilization, demographics. The...
Although emergency department (ED) visits offer an opportunity to deliver brief behavioral interventions improve health, provision of ED-based targeting adolescent sexual health is uncommon. The objectives for this study were evaluate the feasibility and preliminary effects a novel service intervention adolescents.In cross-sectional study, sexually active patients aged 14 19 years presenting Midwestern pediatric ED recruited receive health. intervention, based on motivational interviewing...
Introduction Compassion fatigue, a product of burnout (BO), secondary traumatic stress (STS), and compassion satisfaction (CS), is reduced capacity interest in being empathetic for suffering individuals. Our objective was to determine prevalence fatigue the pediatric emergency department. Methods We administered Professional Quality Life instrument, including BO, STS, CS scales, convenience sample department staff (physicians, nurses, technicians, social workers, child life specialists)....
High-functioning palliative care teams are essential to high-quality for individuals with serious illness and their families. Such flexible adapt change. However, recent high turnover understaffing, compounded by a pandemic, challenge even the most resilient adaptable teams. An effective leader guides team through change, capitalizing on opportunities build an stronger team. leaders lack formal leadership training inadequately prepared lead such circumstances. Leaders may find caring...
Abstract Background and Objective Treatment of postoperative pain for children with severe neurologic impairment (SNI) is challenging. We describe the type, number classes, duration medications procedures common among SNI, as well variability across children's hospitals in management an emphasis on opioid prescribing. Methods This retrospective cohort study included SNI ages 0–21 years old who underwent between January 1, 2019 December 31, within 49 Pediatric Health Information System....
Diprosopus is a rare congenital malformation associated with high mortality. Here, we describe patient diprosopus, multiple life-threatening anomalies, and genetic mutations. Prenatal diagnosis counseling made beneficial impact on the family medical providers in care of this case.
Children's concept of death is influenced by experience, culture, and developmental stage. Dying children benefit from open communication about death, based on research findings clinical experience (summarized in Hurwitz, 2004). Everyone the family affected loss a loved one, even youngest members. Pediatricians can help families listening supporting them during processes bereavement.
Abstract Background Pediatric palliative care (PPC) for oncology patients improves quality of life and the likelihood goal‐concordant care. However, barriers to involvement exist. Objectives We aimed increase days between PPC consult death with refractory cancer from a baseline median 13.5 ≥30 March 2019 2020. Methods Outcome measure was death; process diagnosis consult. The project team surveyed oncologists identify barriers. Plan‐do‐study‐act cycles included establishing target diagnoses,...
Pediatric palliative care is designed to support infants and children with serious illnesses their families.
Background: The experience of starting and growing a pediatric palliative care program (PPCP) has changed over the last 10 years as rapid increases patient volume have amplified challenges related to staffing, funding, standards practice, team resilience, moral injury, burnout. These stretched new directors' leadership skills, yet, guidance in literature on identifying managing these is limited. Methods: A convenience sample 15 PPCP directors who assumed their duties within were first asked...