Optimizing the Management of Pain and Irritability in Children with Severe Neurological Impairment: Phase I (Poster)
Lim E; Siden H; Dewan T; Gnanakumar V; Orkin J; Richardson A; Vadeboncoeur C; Holsti L; Oberlander T; Andrews G
2023
<span>Article information provided for research and reference use. It is licensed under the Creative Commons License: </span><a href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)</a>
Symptoms, adverse events, and outcomes in the use of medicinal cannabis in children and adolescents with autism spectrum disorder: a scoping review protocol
Adolescent; Autism Spectrum Disorder; Child; Delivery of Health Care; Humans; Medical Marijuana; Parents; Review Literature as Topic; Medicinal Cannabis
OBJECTIVE: The objective of this scoping review is to map and identify the symptoms, adverse events, and outcomes in the use of medicinal cannabis in children and adolescents with autism spectrum disorder. INTRODUCTION: Autism spectrum disorder is a neurodevelopmental disorder that impacts social communication and social interaction, and is associated with restrictive and repetitive behaviors and interests. Medicinal cannabis has become a potential area of interest for parents for the treatment of autism spectrum disorder symptoms in their children. There is some evidence that cannabinoids may be involved in autism spectrum disorder, laying a potential foundation for medicinal cannabis utility; however, previous reviews did not identify any clinical research on this topic. INCLUSION CRITERIA: This scoping review will consider all published and unpublished studies that investigate the use of medicinal cannabis in autism spectrum disorder, where at least 50% of the participants have a diagnosis of autism spectrum disorder and at least 50% of the study population is 0 to 18 years of age, or where pediatric data are reported separately. Studies undertaken in any context (hospital or community) and in any geographic location will be included. METHODS: We will search MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar, and the gray literature sources for studies. Two independent team members will screen titles and abstracts, review full texts for potential inclusion, and extract data for all studies. The results will be presented as a narrative synthesis and in tabular form.
Fletcher S; Pawliuk C; Ip A; Oberlander T; Siden H
JBI Evidence Synthesis
2021
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.11124/JBIES-20-00001" target="_blank" rel="noreferrer noopener">10.11124/JBIES-20-00001</a>
Pain Detectives: Optimizing the Management of Pain and Irritability of Unknown Origin in Children with Severe Neurological Impairment (Poster)
Ketchum K; Carleton B; Dewan T; Gnanakumar V; Orkin J; Richardson A; Vadeboncoeur C; Oberlander T; Siden H
2020
<span>Article information provided for research and reference use. It is licensed under the Creative Commons License: </span><a href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)</a>
Caregiver-reported nociceptive pain responses in children with significant neurological impairment (Poster)
Johnston E; Orkin J; Vadeboncoeur C; Gnanakumar V; Dewan T; Richardson A; Holsti L; Carleton B; Oberlander T; Siden H
2021
<span>Article information provided for research and reference use. It is licensed under the Creative Commons License: </span><a href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)</a>
Ensuring Equity and Inclusion in Virtual Care Best Practices for Diverse Populations of Youth with Chronic Pain
Adolescent; Canada; Chronic Pain; COVID-19; Humans; Pandemics
Poor access to care is a top patient-oriented research priority for youth with chronic pain in Canada, and the COVID-19 pandemic has exacerbated these concerns. Our patient-oriented project team engaged with marginalized and racialized youth with chronic pain (Black youth with sickle cell disease, Indigenous youth and youth with complex medical needs) and their families to ensure that best practice recommendations for virtual care are inclusive and equitable. Input provided through virtual round-table discussions improved recommendations for leveraging, implementing and selecting best platforms for virtual care for youth with chronic pain and identified new gaps for future research, practice and policy change.
Birnie KA; Killackey T; Backlin G; Gavin F; Harris C; Jordan I; Kim L;Marianayagam J; Swidrovich J; Lalonde C; Tunji-Ajayi L; Oberlander T; Kirby-Allen M; Lambert S; Siden H; Swidrovich J; Noel M; Lalloo C; Stinson J
Healthcare Quarterly (Toronto, Ontario)
2022
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.12927/hcq.2022.26778" target="_blank" rel="noreferrer noopener">10.12927/hcq.2022.26778</a>
Improving the regulation of medical cannabis in Canada to better serve pediatric patients
Canada; Cannabis; Drug regulation; Health policy; Pediatrics
Key points Children with chronic debilitating illness and pain are increasingly using cannabis for medical purposes, particularly when conventional treatment options have limited benefit or substantial adverse effects. Caregivers are becoming aware of evidence that suggests medical cannabis provides
Huntsman RJ; Kelly LE; Alcorn J; Appendino JP; Bélanger RE; Crooks B; Finkelstein Y; Gilpin A; Lewis E; Litalien C; Jacobs J; Moore-Hepburn C; Oberlander T; Rassekh SR; Repetski AE; Rieder MJ; Shackelford A; Siden H; Szafron M; ‘t Jong GW; Vaillancourt R
CMAJ
2021
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1503/cmaj.202169" target="_blank" rel="noreferrer noopener">10.1503/cmaj.202169</a>
Canadian surveillance study of complex regional pain syndrome in children
Complex Regional Pain Syndrome; Incidence; Pain Management; Pediatrics; Population Surveillance
This study describes the minimum incidence of pediatric complex regional pain syndrome (CRPS), clinical features, and treatments recommended by pediatricians and pain clinics in Canada. Participants in the Canadian Paediatric Surveillance Program (CPSP) reported new cases of CRPS aged 2-18 years monthly and completed a detailed case reporting questionnaire from September 2017 to August 2019. Descriptive analysis was completed and the annual incidence of CRPS by sex and age groupings was estimated. A total of 198 cases were reported to CPSP, 168 (84.8%) met the case definition. The minimum Canadian incidence of CRPS is estimated at 1.14/100 000 (95% CI 0.93 to 1.35/100 000) children per year. Incidence was highest among females 12 years and older (3.10, 95% CI 2.76 to 3.44/100 000). Mean age of CRPS diagnosis was 12.2 years (SD=2.4) with mean time from symptom onset to diagnosis of 5.6 months (SD=9.9) and no known inciting event for 19.6% of cases. The majority of cases had lower limb involvement (79.8%). Nonsteroidal anti-inflammatory drugs (82.7%) and acetaminophen (66.0%) were prescribed more commonly than antiepileptic drugs (52.3%) and antidepressants (32.0%). Referrals most commonly included physical therapy (83.3%) and multidisciplinary pain clinics (72.6%); a small number of patients withdrew from treatment due to pain exacerbation (5.3%). Pain education was recommended for only 65.6% of cases. Treatment variability highlights the need for empiric data to support treatment of pediatric CRPS and development of treatment consensus guidelines.
Baerg KL; Tupper SM; Chu LM; Cooke N; Dick BD; Doré-Bergeron MJ; Findlay S; Ingelmo PM; Lamontagne C; Mesaroli G; Oberlander T; Poolacherla R; Spencer AO; Stinson J; Finley GA
PAIN
2021
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/j.pain.0000000000002482" target="_blank" rel="noreferrer noopener">10.1097/j.pain.0000000000002482</a>
Physician variability in treating pain and irritability of unknown origin in children with severe neurological impairment
Article #6
BACKGROUND: <⁄span> Pain and irritability of unknown origin (PIUO) is a challenging problem for nonverbal children with severe neurological impairments. PIUO is not associated with an identifiable source of nociceptive-inflammatory or neuropathic pain. OBJECTIVE: <⁄span> To assess how physicians use pharmacotherapy to treat PIUO, and to report a pilot study of a standardized approach to investigating and treating PIUO. METHOD: <⁄span> Part 1 of the present study involved independently presenting a case vignette of a patient with PIUO to six experienced physicians who care for children with neurological impairments. They were asked for medication choices and sequences to empirically treat PIUO. Part 2 was a pilot study of a PIUO protocol. Patients followed a standard pathway for PIUO, referred to as the pathway for unknown pain (PUP). The initial drug sequence for the PUP was based on Part 1. RESULTS: <⁄span> In Part 1, physicians responding to the case vignette listed eight medications (atypical antipsychotics, benzodiazepines, gabapentin, methadone, opioids, selective serotonin reuptake inhibitors, tramadol and tricylic antidepressants) and eight empiric drug sequences. In Part 2, eight children with PIUO (six to 17 years of age; five females, three males) were enrolled in a pilot clinic. Only two had been fully evaluated for nociceptive-inflammatory pain sources before enrollment. At the end of the pilot study, four patients were clinically improved and only three required a study medication. DISCUSSION AND CONCLUSION: <⁄span> Even experienced physicians do not agree on a common approach for medical treatment of PIUO. A standardized pathway is feasible and readily implemented. The proposed PUP has the potential to address PIUO and be the basis for future intervention studies.
2013-10
Siden H; Carleton BC; Oberlander T
Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur
2013
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1155/2013/193937" target="_blank" rel="noreferrer">10.1155/2013/193937</a>
Analgesia and local anesthesia during invasive procedures in the neonate
PedPal Lit
2005
Anand KJ; Johnston CC; Oberlander T; Taddio A; Lehr VT; Walco GA
Clinical Therapeutics
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.clinthera.2005.06.018" target="_blank" rel="noreferrer">10.1016/j.clinthera.2005.06.018</a>
Summary proceedings from the neonatal pain-control group
Humans; infant; United States; Pain; Pain Measurement; Respiration; Analgesia; Research Support; U.S. Gov't; Newborn; Pain/drug therapy/etiology; Government Regulation; Anesthesia; N.I.H.; Postoperative/drug therapy; Non-P.H.S.; Extramural; General; Outcome Assessment (Health Care)/methods; Artificial/adverse effects; Clinical Trials/ethics/legislation & jurisprudence
Recent advances in neurobiology and clinical medicine have established that the fetus and newborn may experience acute, established, and chronic pain. They respond to such noxious stimuli by a series of complex biochemical, physiologic, and behavioral alterations. Studies have concluded that controlling pain experience is beneficial with respect to short-term and perhaps long-term outcomes. Yet, pain-control measures are adopted infrequently because of unresolved scientific issues and lack of appreciation for the need for control of pain and its long-term sequelae during the critical phases of neurologic maturation in the preterm and term newborn. The neonatal pain-control group, as part of the Newborn Drug Development Initiative (NDDI) Workshop I, addressed these concerns. The specific issues addressed were (1) management of pain associated with invasive procedures, (2) provision of sedation and analgesia during mechanical ventilation, and (3) mitigation of pain and stress responses during and after surgery in the newborn infant. The cross-cutting themes addressed within each category included (1) clinical-trial designs, (2) drug prioritization, (3) ethical constraints, (4) gaps in our knowledge, and (5) future research needs. This article provides a summary of the discussions and deliberations. Full-length articles on procedural pain, sedation and analgesia for ventilated infants, perioperative pain, and study designs for neonatal pain research were published in Clinical Therapeutics (June 2005).
2006
Anand KJ; Aranda JV; Berde CB; Buckman S; Capparelli EV; Carlo W; Hummel P; Johnston CC; Lantos J; Tutag-Lehr V; Lynn AM; Maxwell LG; Oberlander T; Raju TN; Soriano SG; Taddio A; Walco GA
Pediatrics
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1542/peds.2005-0620C" target="_blank" rel="noreferrer">10.1542/peds.2005-0620C</a>
Advice seeking and appropriate use of a pediatric emergency department
Child; Cross-Sectional Studies; Female; Humans; infant; Male; Questionnaires; Age Factors; Health Services Research; Severity of Illness Index; Sex Factors; Hospitals; Quebec; Emergency Service; adolescent; Hospital/utilization; Preschool; infant; Newborn; algorithms; Birth Order; Counseling/statistics & numerical data; Health Services Misuse/statistics & numerical data; Parents/education/psychology; Patient Acceptance of Health Care/statistics & numerical data; Pediatric/utilization; Teaching/utilization
OBJECTIVES: To determine whether seeking advice prior to an unscheduled visit to a pediatric emergency department (PED) influences appropriate use of this setting for minor illnesses. DESIGN: Cross-sectional questionnaire survey. SETTING: The medical emergency department of the Montreal (Quebec) Children's Hospital, a major referral and urban teaching hospital. PARTICIPANTS: Four hundred eighty-nine of 562 consecutive parents visiting the PED over two periods, one in February and the other in July 1989. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Parents of children between 0 and 18 years of age visiting the PED were asked whether they had previously sought advice from family, friends, or a physician. Other factors possibly related to the decision to seek care were also measured. Appropriateness was rated, blind to discharge diagnosis, by two pediatricians using a structured series of questions incorporating the child's age, time of the visit, clinical state, and problem at presentation. Thirty-four percent of visits among respondents were judged appropriate. In bivariate analysis, appropriate visits occurred significantly more often when a parent spoke to both a physician and a nonphysician (47%) prior to visiting the PED than when no advice was sought (29%; P < .05). In multivariate analysis, having a regular physician and being one of two children also contributed to appropriateness. CONCLUSIONS: Appropriate use of the PED was positively influenced by seeking prior advice from both a physician and family member, having a regular physician, and having prior child care experience.
1993
Oberlander T; Pless IB; Dougherty GE
American Journal Of Diseases Of Children
1993
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1001/archpedi.1993.02160320065021" target="_blank" rel="noreferrer">10.1001/archpedi.1993.02160320065021</a>
Pain in Children with Significant Neurological Impairment
Child; Humans; Pain Measurement; Communication; Nervous System Diseases/complications; RDF Project; Cerebral Palsy/complications; Analgesics/therapeutic use; Pain/complications/diagnosis/drug therapy/etiology
1999
Oberlander T; O'Donnell M; Montgomery C
Developmental And Behavioral Pediatrics
1999
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/00004703-199908000-00006" target="_blank" rel="noreferrer">10.1097/00004703-199908000-00006</a>
Beliefs about pain among professionals working with children with significant neurologic impairment
Child; Female; Humans; Male; Physician-Patient Relations; Adult; Health Care Surveys; Attitude of Health Personnel; Pain; quality of life; Nervous System Diseases/complications; caregivers; Child welfare
2001
Oberlander T; O'Donnell ME
Developmental Medicine And Child Neurology
2001
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1111/j.1469-8749.2001.tb00734.x" target="_blank" rel="noreferrer">10.1111/j.1469-8749.2001.tb00734.x</a>
Evaluating treatment outcome in an interdisciplinary pediatric pain service
Treatment Outcome; Pain; Therapeutics; Children
OBJECTIVE: To provide descriptive data evaluating outcome and treatment satisfaction among former pediatric patients and their parents seen in an interdisciplinary treatment program for complex pain syndromes. DESIGN: Retrospective telephone interview. SETTING: Pediatric academic health care centre. SUBJECTS AND METHODS: A semistructured interview designed for this study was administered by phone with 24 former patients (mean age 15.63 years) and parents, seen over the previous three years in the Complex Pain Consultation Service. Participants provided both qualitative and quantitative information about pre- and post-treatment levels of pain and functioning, achievement of treatment goals and satisfaction with the treatment program. RESULTS: Findings indicated significantly lower frequency and intensity of pain, as rated by patients, when current pain levels were compared with recalled pretreatment levels. As well, improvements were reported in strategies for managing pain and participation in regular activities of daily living. Satisfaction with the team treatment was generally very high, and most felt that their goals were partially to completely met. Child and parent ratings of outcome and satisfaction were consistent. CONCLUSIONS: These descriptive data provide preliminary support for the application of an interdisciplinary model to treating disabling complex pain syndromes in children and youths.
2000
Bennett S; Chambers C; Bellows D; Court C; Huntsman E; Montgomery C; Oberlander T; Sheriff M; Siden H
Pain Research And Management
2000
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1155/2000/767058" target="_blank" rel="noreferrer">10.1155/2000/767058</a>
Pain management for children with a developmental disability in a primary care setting
RDF Project
Siden H; Oberlander T
Pain In Children: A Practical Guide For Primary Care
2008
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Book/Book Section