Features Associated With the Presence of Specific Bacterial Strains in Pediatric Tracheostomy.

Background: Tracheostomy bypasses physical barriers that decrease microbial access to the lower airway, which can lead to changes to the lung microbiota. Patients often become chronically colonized with potential pathogens. This study described the incidence and prevalence of specific organisms in a 5-y cohort of children with tracheostomy.

Parents' experiences of their children's medical journeys with tracheostomies: A Focus Group Study.

Objectives: Children living with a tracheostomy have among the most complex medical care needs in Canada. The focus of this study was to gain a contemporary understanding of key aspects of these children's medical journeys.

Methods: We conducted a qualitative constructivist grounded theory study using semi-structured focus groups with parents whose children are living in the community with a tracheostomy.

Tracheostomies in term and preterm infants: A single-center Canadian retrospective cohort.

Objective: To examine patient characteristics, hospital course, and medical outcomes of neonatal tracheostomy at a single center.

Design: Retrospective cohort study.

Setting: Level III neonatal intensive care units (NICUs) in Edmonton, Canada.

Recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling.

Background: Stakeholders can provide valuable input to improve scheduling paediatric ambulatory clinic appointments, a complex process that requires effective planning and communication between parents, administrative staff and clinicians. The purpose of our study was to characterize recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling.

Methods: Conducted between February 2018 and January 2019, this qualitative study was guided by qualitative description.

Pediatric ambulatory appointment scheduling: a qualitative study of stakeholders' perceptions and experiences.

Objective: Scheduling ambulatory clinic appointments includes a complex set of factors and diverse stakeholders. Families, administrative staff and clinicians may have varied experiences with scheduling clinic appointments. The objective of our study was to understand stakeholders' perceptions and experiences with scheduling pediatric ambulatory clinic appointments.

Dysphagia in healthy children: Characteristics and management of a consecutive cohort at a tertiary centre.

Objective: Whereas the literature is replete with reports on complex children with dysphagia (DP), the parameters characterizing non-neurologically impaired (NNI) children have been underreported, leaving a substantial knowledge gap. We set to characterize a consecutive cohort of NNI children, their management, and outcomes.

Methods: We undertook a retrospective case series.

Workshop Report: Aerosol Delivery to Spontaneously Breathing Tracheostomized Patients.

The number of pediatric and adult patients requiring tracheostomy has increased. Many of them require aerosol therapy as part of their treatment. Practitioners have little guidance on how to optimize drug delivery in this population.

Changes to a pediatric sleep disordered breathing clinic improve wait-times and clinic efficiency.

Background: Recognition of the impact of sleep disordered breathing (SDB) on health has increased referrals in pediatric respiratory medicine with a concomitant increase in wait-times.

Methods: To reduce wait-time (primary outcome), we developed a rapid SDB clinic (RSC) to identify, diagnose, and treat patients with few to no comorbidities (uncomplicated) and presumed SDB based on the referral letter. The RSC uses 1) parent-report questionnaires to capture the patients' medical history and 2) sleep testing (e.

Dry Powder Inhaler Delivery of Tobramycin in In Vitro Models of Tracheostomized Children.

Background: Pediatric tracheostomies are not uncommon and aerosols allow for targeted lung therapy. However, there is little literature that quantifies aerosol delivery through tracheostomies. Nebulizers are commonly used in delivering tobramycin, but there are drawbacks, for example, time burden.

Prevalence and risk factors of asthma in First Nations children living on reserves in Canada.

Objectives: To explore the prevalence and determine the risk factors of asthma in First Nations children aged 0 to 11 years living on reserves in Canada.

Methods: In this cross-sectional study, we considered the data collected as part of the First Nations Regional Health Survey involving 6,657 children living in 238 First Nations communities in the 10 Canadian provinces, the Northwest Territories and the Yukon.

Results: The overall prevalence of asthma that has lasted or is expected to last at least six months (ever-asthma) among children living on reserves was 14.

Cyclin-dependent kinase 5 regulates degranulation in human eosinophils.

Degranulation from eosinophils in response to secretagogue stimulation is a regulated process that involves exocytosis of granule proteins through specific signalling pathways. One potential pathway is dependent on cyclin-dependent kinase 5 (Cdk5) and its effector molecules, p35 and p39, which play a central role in neuronal cell exocytosis by phosphorylating Munc18, a regulator of SNARE binding. Emerging evidence suggests a role for Cdk5 in exocytosis in immune cells, although its role in eosinophils is not known.

Physician specialty influences important aspects of pediatric asthma management.

Background: Physician training influences patient care.

Objective: To compare asthma management and change in the percentage predicted FEV1 among pediatric physician specialties.

Methods: A retrospective cohort of children 6 years of age or older, seen in a multidisciplinary asthma clinic between 2009 and 2010, and followed to 2012, was completed to examine differences in asthma outcomes by specialty (2 pediatricians, 3 pediatric allergists, 5 pediatric respirologists).

A pilot trial on the treatment of gastroesophageal reflux-related cough in infants.

Background: Diagnosing asthma in infancy is largely made on the basis of the symptoms of cough and wheeze. A similar presentation can be seen in neurologically normal infants with excessive gastroesophageal reflux (GER). There are no randomized placebo controlled studies in infants using proton pump inhibitors (PPI) alone or in addition to prokinetic agents.

[A pilot trial on the treatment of gastroesophageal reflux-related cough in infants].

Objective: Diagnosing asthma in infancy is largely made on the basis of the symptoms of cough and wheezing. A similar presentation can be seen in neurologically normal infants with excessive gastroesophageal reflux (GER). There are no randomized placebo controlled studies in infants using proton pump inhibitors (PPI) alone or in addition to prokinetic agents.

A children's asthma education program: Roaring Adventures of Puff (RAP), improves quality of life.

Background: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.

Objective: To assess the feasibility and impact of 'Roaring Adventures of Puff' (RAP), a six-week childhood asthma education program administered by health professionals in schools.

Methods: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group).

Early life factors associated with incidence of physician-diagnosed asthma in preschool children: results from the Canadian Early Childhood Development cohort study.

Background. Asthma is a common childhood illness. The objective of this study is to determine the incidence of physician-diagnosed asthma in preschool years and its relationship to host, prenatal and postnatal factors, early childhood factors, parental factors, household factors and demographic factors.

A child's asthma quality of life rating does not significantly influence management of their asthma.

Background: Children of parents who perceive their children have increased asthma severity use more medical services and reliever medication.

Methods: A randomized control trial of the Roaring Adventures of Puff (RAP) education program was completed among 287 grade 2-5 children with asthma. Parents and children completed a quality of life (QOL) questionnaire pre-intervention, 6 and 12 months post-intervention.

Prevalence of asthma and risk factors for asthma-like symptoms in Aboriginal and non-Aboriginal children in the northern territories of Canada.

Background: Few studies have investigated the prevalence and risk factors of asthma in Canadian Aboriginal children.

Objective: To determine the prevalence of asthma and asthma-like symptoms, as well as the risk factors for asthma-like symptoms, in Aboriginal and non-Aboriginal children living in the northern territories of Canada.

Methods: Data on 2404 children, aged between 0 and 11 years, who participated in the North component of the National Longitudinal Survey of Children and Youth were used in the present study.

Predictors for wheezing phenotypes in the first decade of life.

Background And Objective: This study examined prenatal, perinatal and early childhood predictors of wheezing phenotypes in the first decade of life.

Methods: Information on current wheezing, was collected prospectively from five surveys conducted every 2 years over the first decade of life. Five wheezing phenotypes were defined: non-wheezers, preschool, primary-school, intermittent and persistent wheezers.

Reduced risk of physician-diagnosed asthma among children dwelling in a farming environment.

Background And Objective: Living in a farm environment has been reported to be associated with lower prevalence of asthma, based on the results of cross-sectional studies. The objective of this longitudinal study was to determine whether living in a farm environment is associated with lower incidence of asthma among children.

Methods: A total of 13 524 asthma-free children aged 0-11 years were drawn from the Cycle 1 (1994/1995) of the Canadian National Longitudinal Survey of Children and Youth (NLSCY).

Clinical correlations and pulmonary function at 8 years of age after severe neonatal respiratory failure.

Objectives: The aim of this study was to determine the pulmonary sequelae of severe neonatal respiratory failure.

Study Design: This was a multicenter, prospective study. Fifty-four survivors of neonatal respiratory failure (oxygenation indices >25 on two occasions), completed pulmonary function testing at 8 years of age.

Beyond randomized controlled trials: a "real life" experience of respiratory syncytial virus infection prevention in infancy with and without palivizumab.

A population-based study of the impact of palivizumab on confirmed Respiratory Syncytial Virus (RSV) hospitalizations over a 7-year period within and between two similar health regions . Clinicians in Calgary implemented palivizumab prophylaxis for high-risk infants during the last four RSV seasons; clinicians in Edmonton did not. The two cities are part of a unified health care system and similar sociodemographics.

Internet-based asthma education - a novel approach to compliance: a case report.

Asthma costs Canadians over 1.2 billion dollars per annum and, despite advances, many asthmatic patients still have poor control. An action plan, symptom diary and measurement of peak expiratory flow have been shown to improve clinical outcomes.

The Pediatric Investigators Collaborative Network on Infections in Canada study of predictors of hospitalization for respiratory syncytial virus infection for infants born at 33 through 35 completed weeks of gestation.

Background: Infants born at 33 through 35 completed weeks of gestation (33-35GA) are at risk for severe respiratory syncytial virus (RSV) infection, and palivizumab prophylaxis lowers hospitalizations for RSV infection by as much as 80%. The 33-35GA cohort comprises 3-5% of annual births; thus expert panels recommend limiting prophylaxis to situations in which frequency or health care impact of RSV infection is high. This study sought to identify independent risk factors for hospitalization for RSV infection.