1
40
6
-
Text
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Citation List Month
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URL Address
<a href="http://doi.org/10.1111/j.1440-1754.2008.01353.x" target="_blank" rel="noreferrer">http://doi.org/10.1111/j.1440-1754.2008.01353.x</a>
Dublin Core
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Title
A name given to the resource
Withdrawal and limitation of life-sustaining treatments in a paediatric intensive care unit and review of the literature.
Publisher
An entity responsible for making the resource available
Journal Of Paediatrics And Child Health
Date
A point or period of time associated with an event in the lifecycle of the resource
2008
Subject
The topic of the resource
Child; Humans; Intensive Care Units; New South Wales; Hospital Mortality; Hospitals; adolescent; Preschool; infant; retrospective studies; Withholding Treatment/statistics & numerical data; Terminal Care; Pediatric/statistics & numerical data; Medical Audit; Medical Futility; Physician's Practice Patterns/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Moore P; Kerridge I; Gillis J; Jacobe S; Isaacs D
Description
An account of the resource
OBJECTIVES: To examine withdrawal and limitation of life-sustaining treatment (WLST) in an Australian paediatric intensive care unit (PICU) and to compare this experience with published data from other countries. DESIGN: Retrospective chart review and literature review. SOURCE OF DATA: Review of 12 months of patient records from a tertiary Australian children's teaching hospital. Medline search using relevant key words focusing on death and PICU. RESULTS: Twenty of 27 deaths (74%) followed either WLST (n = 16) or Do Not Resuscitate (DNR) orders (n = 4); five children failed cardiopulmonary resuscitation (CPR); and two children were brain-dead. Meetings between the medical team and family were documented for 15 of 16 children (93.8%) before treatment was withdrawn. The average time between withdrawal of life support and death was 13 min. A review of the English-language literature revealed that 18-65% occurring in PICUs worldwide follow WLST and/or institution of DNR orders. Rates were higher (30-65%) in North America and Europe than elsewhere. Most PICU deaths occurred within 3 days of admission. North American and British parents appear to be involved in decisions regarding withdrawal and limitation of treatment more often than parents in other countries. CONCLUSIONS: Withdrawal and limitation of life-sustaining treatment was more common in an Australian children's hospital ICU than has been reported from other countries. Details of discussion with parents, including the basis for any decision to WLST, were almost always documented in the patient's medical record.
2008-08
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1440-1754.2008.01353.x" target="_blank" rel="noreferrer">10.1111/j.1440-1754.2008.01353.x</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2008
Adolescent
Backlog
Child
Gillis J
Hospital Mortality
Hospitals
Humans
Infant
Intensive Care Units
Isaacs D
Jacobe S
Journal Article
Journal of Paediatrics and Child Health
Kerridge I
Medical Audit
Medical Futility
Moore P
New South Wales
Pediatric/statistics & Numerical Data
Physician's Practice Patterns/statistics & numerical data
Preschool
Retrospective Studies
Terminal Care
Withholding Treatment/statistics & Numerical Data
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2008-1159" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2008-1159</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Neuroimaging-use trends in nonacute pediatric headache before and after clinical practice parameters
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2008
Subject
The topic of the resource
Child; Cross-Sectional Studies; Female; Humans; Male; adolescent; Preschool; Physician's Practice Patterns/statistics & numerical data; retrospective studies; Tomography; Headache/diagnosis; Magnetic Resonance Imaging/utilization; X-Ray Computed/utilization
Creator
An entity primarily responsible for making the resource
Graf WD; Kayyali HR; Alexander JJ; Simon SD; Morriss MC
Description
An account of the resource
OBJECTIVES: The objective of this study was to determine trends in diagnostic neuroimaging-use rates in nonacute pediatric headache before and after publication of clinical practice guidelines. METHODS: Retrospective, cross-sectional analysis was conducted of neuroimaging rates for 725 children and adolescents who were aged 3 to 18 years with nonacute headache and normal neurologic examination and were evaluated in a single pediatric neurology clinic during study years 1992, 1996, 2000, and 2004. Following recommendations of current practice parameters, patients with conditions that justify consideration for neuroimaging (eg, progressive headache, abnormal neurologic examination) were excluded from this analysis. We recorded the origin of any neuroimaging request at the time of the clinic visit and any abnormal neuroimaging findings that led to major clinical consequences. RESULTS: Overall, the mean rate of neuroimaging for patients with nonacute headache was 45%. Use rates remained steady during the 13-year study period (range: 41%-47%). The majority of neuroimaging studies were ordered originally by primary care providers. The proportion of neuroimaging studies that were ordered by primary care providers increased significantly from 1992 to 2004. CONCLUSIONS: In the evaluation of patients who had nonacute pediatric headache and were referred to a child neurology clinic, neuroimaging-use rates remained stable during the past decade. An increasing proportion of neuroimaging studies are ordered by primary care providers. The influence of evidence-based medicine on medical decision-making may be partly responsible for curbing increases in neuroimaging overuse. The perceived value of neuroimaging by physicians and consumers deserves ongoing study.
2008
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2008-1159" target="_blank" rel="noreferrer">10.1542/peds.2008-1159</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2008
Adolescent
Alexander JJ
Backlog
Child
Cross-sectional Studies
Female
Graf WD
Headache/diagnosis
Humans
Journal Article
Kayyali HR
Magnetic Resonance Imaging/utilization
Male
Morriss MC
Pediatrics
Physician's Practice Patterns/statistics & numerical data
Preschool
Retrospective Studies
Simon SD
Tomography
X-Ray Computed/utilization
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/j.jpainsymman.2004.05.004" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2004.05.004</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Status quo of palliative care in pediatric oncology-a nationwide survey in Germany
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Child; Female; Humans; infant; Male; Data Collection; Treatment Outcome; adolescent; Preschool; Non-U.S. Gov't; Research Support; infant; Physician's Practice Patterns/statistics & numerical data; Pediatrics/methods/trends; Newborn; location of death; Germany/epidemiology; Home Care Services/statistics & numerical data/trends; Medical Oncology/methods/trends; Neoplasms/mortality/therapy; Palliative Care/methods/statistics & numerical data/trends
Creator
An entity primarily responsible for making the resource
Friedrichsdorf SJ; Menke A; Brun S; Wamsler C; Zernikow B
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jpainsymman.2004.05.004" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2004.05.004</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
Cancer is the leading cause of death among the pediatric population with life-limiting conditions. The provision of palliative care at home and on the children's cancer unit has not been surveyed previously on a national scale. A survey of 71 (of 73) German pediatric oncology units (response rate 97%) provided information on the timing of breaking bad news, place of death, orchestrating palliative care at home and on the ward, integration of services and staff, funding of palliative care, bereavement services for siblings and parents, educational needs, level of self-satisfaction, and designated integrated palliative care services for children with cancer. More than 60% of children with malignancies died as inpatients in 2000, fewer than 40% at home. Twenty-nine pediatric cancer departments were able to provide comprehensive medical palliative home care, and nine units incorporate a designated palliative care team or person. Only half of the departments provide bereavement services for siblings. Many health professionals working on pediatric cancer units in Germany provide palliative home care in their free time without any payment. They predominantly use their private vehicles and often are unclear about the legal background and insurance arrangements covering their provision of care. The data suggest an important need for education about palliative and end-of-life care. The majority of children dying from cancer in Germany do not have access to comprehensive palliative care services at home. Our study highlights the necessity of incorporating the palliative paradigm into the care of children with cancer. Barriers to its implementation must be identified and overcome.
2005
Adolescent
Backlog
Brun S
Child
Data Collection
Female
Friedrichsdorf SJ
Germany/epidemiology
Home Care Services/statistics & numerical data/trends
Humans
Infant
Journal Article
Journal of Pain and Symptom Management
Location Of Death
Male
Medical Oncology/methods/trends
Menke A
Neoplasms/mortality/therapy
Newborn
Non-U.S. Gov't
Palliative Care/methods/statistics & numerical data/trends
Pediatrics/methods/trends
Physician's Practice Patterns/statistics & numerical data
Preschool
Research Support
Treatment Outcome
Wamsler C
Zernikow B
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/j.jpainsymman.2004.01.013" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2004.01.013</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Frequency and perceived competence in providing palliative care to terminally ill patients: a survey of primary care physicians
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Humans; Physician-Patient Relations; Data Collection; Physician's Practice Patterns/statistics & numerical data; United States/epidemiology; Palliative Care/statistics & numerical data; Terminally Ill/statistics & numerical data; Quality Assurance; Professional Competence/statistics & numerical data; Health Care/methods; Primary Health Care/statistics & numerical data; Terminal Care/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Farber NJ; Urban SY; Collier VU; Metzger M; Weiner J; Boyer EG
Description
An account of the resource
We surveyed primary care physicians about their involvement and perceived skills in palliative care. A survey instrument asked how frequently internal medicine and family practice physicians performed 10 palliative care items. Subjects rated their skills in each area. A majority of physicians always or frequently performed all 10 palliative care items, but fewer than 50% of respondents adequately attended to the spiritual needs and economic problems of patients. Interest in palliative care was associated with an increased frequency in performing palliative care items (P = 0.036), while training in palliative care was associated with better perceived performance (P = 0.05). Only 36% of respondents had received training in palliative care. Internists and family practitioners provide palliative care to patients, but feel their skills are lacking in certain areas. Training may improve care to patients at the end of life.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jpainsymman.2004.01.013" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2004.01.013</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2004
Backlog
Boyer EG
Collier VU
Data Collection
Farber NJ
Health Care/methods
Humans
Journal Article
Journal of Pain and Symptom Management
Metzger M
Palliative Care/statistics & Numerical Data
Physician-patient Relations
Physician's Practice Patterns/statistics & numerical data
Primary Health Care/statistics & numerical data
Professional Competence/statistics & numerical data
Quality Assurance
Terminal Care/statistics & Numerical Data
Terminally Ill/statistics & numerical data
United States/epidemiology
Urban SY
Weiner J
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1001/archpedi.154.2.173" target="_blank" rel="noreferrer">http://doi.org/10.1001/archpedi.154.2.173</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Preventive services in a health maintenance organization: how well do pediatricians screen and educate adolescent patients?
Publisher
An entity responsible for making the resource available
Archives Of Pediatrics & Adolescent Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Humans; Data Collection; California; Adolescent Behavior; adolescent; Adolescent Transitions; Risk-Taking; Adolescent Health Services/statistics & numerical data; Health Maintenance Organizations; Patient Education as Topic/statistics & numerical data; Pediatrics/statistics & numerical data; Physician's Practice Patterns/statistics & numerical data; Preventive Health Services/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Halpern-Felsher BL; Ozer EM; Millstein SG; Wibbelsman CJ; Fuster CD; Elster AB; Irwin CE
Description
An account of the resource
OBJECTIVE: To determine whether pediatricians in managed care settings adhere to national guidelines concerning the provision of clinical preventive services. DESIGN: Surveys were mailed between September 1996 and April 1997 to all pediatricians practicing in a California group-model health maintenance organization. The survey asked pediatricians about their screening and education practices on 34 recommended services and the actions taken with adolescent patients who have engaged in risk behavior. RESULTS: The response rate was 66.2% (N = 366). Pediatricians, on average, screened 92% of their adolescent patients for immunization status and blood pressure; 85% for school performance; 60% to 80% for obesity, sexual intercourse, cigarette use, alcohol use, drug use, and seat belt and helmet use; 30% to 47% for access to handguns, suicide, eating disorders, depression, and driving after drinking alcohol; fewer than 20% for use of smokeless tobacco, sexual orientation, sexual and physical abuse, and riding a bike or swimming after drinking alcohol; and 26% to 41% for close friends' engagement in risk behavior. Pediatricians' assessment and education with adolescent patients who screened positive for risk behavior was particularly low. Female physicians, physicians who saw a greater proportion of older adolescents, and recent medical school graduates were more likely to provide preventive services. CONCLUSIONS: Pediatricians in this health maintenance organization provide preventive services to adolescent patients at rates below recommendations but at rates greater than physicians in other practice settings. Improvement is especially needed in the areas that contribute most to adolescent mortality and for patients who screen positive for a risk behavior.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/archpedi.154.2.173" target="_blank" rel="noreferrer">10.1001/archpedi.154.2.173</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2000
Adolescent
Adolescent Behavior
Adolescent Health Services/statistics & numerical data
Adolescent Transitions
Archives Of Pediatrics & Adolescent Medicine
Backlog
California
Data Collection
Elster AB
Fuster CD
Halpern-Felsher BL
Health Maintenance Organizations
Humans
Irwin CE
Journal Article
Millstein SG
Ozer EM
Patient Education as Topic/statistics & numerical data
Pediatrics/statistics & numerical data
Physician's Practice Patterns/statistics & numerical data
Preventive Health Services/statistics & numerical data
Risk-Taking
Wibbelsman CJ
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1001/jama.2011.370" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.2011.370</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Association between opioid prescribing patterns and opioid overdose-related deaths
Publisher
An entity responsible for making the resource available
Jama
Date
A point or period of time associated with an event in the lifecycle of the resource
2011
Subject
The topic of the resource
Female; Humans; Male; Young Adult; Cohort Studies; Adult; Analgesics; Aged; Middle Aged; Risk; Acute Disease; Case-Control Studies; adolescent; Physician's Practice Patterns/statistics & numerical data; Chronic disease; United States/epidemiology; Drug Prescriptions/statistics & numerical data; Opioid/administration & dosage/poisoning; Overdose/epidemiology; Pain/drug therapy; Veterans/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Bohnert AS; Valenstein M; Bair MJ; Ganoczy D; McCarthy JF; Ilgen MA; Blow FC
Description
An account of the resource
CONTEXT: The rate of prescription opioid-related overdose death increased substantially in the United States over the past decade. Patterns of opioid prescribing may be related to risk of overdose mortality. OBJECTIVE: To examine the association of maximum prescribed daily opioid dose and dosing schedule ("as needed," regularly scheduled, or both) with risk of opioid overdose death among patients with cancer, chronic pain, acute pain, and substance use disorders. DESIGN: Case-cohort study. SETTING: Veterans Health Administration (VHA), 2004 through 2008. PARTICIPANTS: All unintentional prescription opioid overdose decedents (n = 750) and a random sample of patients (n = 154,684) among those individuals who used medical services in 2004 or 2005 and received opioid therapy for pain. Main Outcome Measure Associations of opioid regimens (dose and schedule) with death by unintentional prescription opioid overdose in subgroups defined by clinical diagnoses, adjusting for age group, sex, race, ethnicity, and comorbid conditions. RESULTS: The frequency of fatal overdose over the study period among individuals treated with opioids was estimated to be 0.04%.The risk of overdose death was directly related to the maximum prescribed daily dose of opioid medication. The adjusted hazard ratios (HRs) associated with a maximum prescribed dose of 100 mg/d or more, compared with the dose category 1 mg/d to less than 20 mg/d, were as follows: among those with substance use disorders, adjusted HR = 4.54 (95% confidence interval [CI], 2.46-8.37; absolute risk difference approximation [ARDA] = 0.14%); among those with chronic pain, adjusted HR = 7.18 (95% CI, 4.85-10.65; ARDA = 0.25%); among those with acute pain, adjusted HR = 6.64 (95% CI, 3.31-13.31; ARDA = 0.23%); and among those with cancer, adjusted HR = 11.99 (95% CI, 4.42-32.56; ARDA = 0.45%). Receiving both as-needed and regularly scheduled doses was not associated with overdose risk after adjustment. CONCLUSION: Among patients receiving opioid prescriptions for pain, higher opioid doses were associated with increased risk of opioid overdose death.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/jama.2011.370" target="_blank" rel="noreferrer">10.1001/jama.2011.370</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2011
Acute Disease
Adolescent
Adult
Aged
Analgesics
Backlog
Bair MJ
Blow FC
Bohnert AS
Case-Control Studies
Chronic Disease
Cohort Studies
Drug Prescriptions/statistics & numerical data
Female
Ganoczy D
Humans
Ilgen MA
JAMA
Journal Article
Male
McCarthy JF
Middle Aged
Opioid/administration & dosage/poisoning
Overdose/epidemiology
Pain/drug Therapy
Physician's Practice Patterns/statistics & numerical data
Risk
United States/epidemiology
Valenstein M
Veterans/statistics & numerical data
Young Adult