Qualitative study exploring the perspectives of emerging adults with type 1 diabetes after transfer to adult care from a paediatric diabetes centre in Montreal, Canada.

Introduction: Among youth living with type 1 diabetes (T1D), the increasing demands to diabetes self-care and medical follow-up during the transition from paediatric to adult care has been associated with greater morbidity and mortality. Inadequate healthcare support for youth during the transition care period could exacerbate psychosocial risks and difficulties that are common during emerging adulthood. The current investigation sought to explore the post-transfer perceptions of emerging adults living with T1D relating to their transition to adult care.

Diabetes duration, perceived comfort with self-management and glycaemic control in adolescents with type 1 diabetes: A cross-sectional study.

Aims: Evidence is lacking on whether diabetes duration is associated with type 1 diabetes (T1D) self-management during late adolescence before transfer from paediatric to adult care. We examined associations of diabetes duration with dimensions of perceived comfort with diabetes self-management (self-efficacy, transition readiness, diabetes distress) and glycaemic control in late adolescence.

Methods: Using a cross-sectional design, we conducted a secondary analysis of baseline data of adolescents (ages 16-17 years) with T1D followed at paediatric diabetes academic hospitals in Montreal and enrolled in the Group Education Trial to Improve Transition (GET-IT-T1D).

Association of stigma, diabetes distress and self-efficacy with quality of life in adolescents with type 1 diabetes preparing to transition to adult care.

Aims: In type 1 diabetes (T1D), psychosocial factors may impact quality of life (QOL) and clinical outcomes, but remain understudied, particularly during late adolescence. Our aim was to determine whether stigma, diabetes distress and self-efficacy are associated with QOL in adolescents with T1D as they are preparing to transition to adult care.

Methods: We conducted a cross-sectional study of adolescents (ages 16-17 years) with T1D participating in the Group Education Trial to Improve Transition (GET-IT) in Montreal, Canada.

Associations of Diabetes-related and Health-related Quality of Life With Glycemic Levels in Adolescents With Type 1 Diabetes Preparing to Transition to Adult Care.

Objectives: As adolescents with type 1 diabetes (T1D) progress to adulthood, they assume responsibility for diabetes self-management while dealing with competing life demands, decreasing parental support, and the transfer to adult care. Lower perceived quality of life (QOL) may hamper diabetes management, which is associated with suboptimal glycemic levels. Our objective was to determine associations of diabetes- and health-related QOL with glycemic management (glycated hemoglobin [A1C]) in adolescents with T1D before their transfer to adult care.

Text message-based intervention, Keeping in Touch (KiT), to support youth as they transition to adult type 1 diabetes care: a protocol for a multisite randomised controlled superiority trial.

Introduction: Transition from paediatric to adult care can be challenging for youth living with type 1 diabetes (T1D), as many youth feel unprepared to transfer to adult care and are at high risk for deterioration of glycaemic management and acute complications. Existing strategies to improve transition experience and outcomes are limited by cost, scalability, generalisability and youth engagement. Text messaging is an acceptable, accessible and cost-effective way of engaging youth.

Association of accelerometry-derived social jetlag and sleep with temperament in children less than 6 years of age.

Study Objectives: Social jetlag (SJL) measures the discrepancy between circadian and social clocks. Using accelerometry-derived data, our objective was to assess the prevalence of SJL in young healthy children and determine the association of SJL and sleep with temperament.

Methods: Of 117 children participating in TARGet Kids!, a Canadian cohort of healthy preschool-aged children, 78 children (39 girls; 50%; mean age [SD]: 35.

Increasing Incidence of Type 1 and Type 2 Diabetes Among Canadian Children.

Background: Diabetes mellitus is one of the most common pediatric chronic illnesses. Although a rising incidence of childhood type 1 diabetes (T1D) has frequently been documented, an almost 400-fold variation in incidence has been seen worldwide. We aimed to describe the trends in incidence of diabetes (type 1, type 2, all types) among children and adolescents living in the Greater Montréal area of Québec, Canada.

Association of Self-Efficacy, Transition Readiness and Diabetes Distress With Glycemic Control in Adolescents With Type 1 Diabetes Preparing to Transition to Adult Care.

Objectives: Adolescence and emerging adulthood are associated with inadequate medical follow up, suboptimal glycemic control and higher risk for adverse outcomes. Our aim in this study was to determine whether self-efficacy, transition readiness or diabetes distress is associated with glycemic control (glycated hemoglobin [A1C]) among adolescents with type 1 diabetes (T1D) preparing to transition to adult care.

Methods: We conducted a cross-sectional study of adolescents (age 17 years) with T1D followed at the Montreal Children's Hospital Diabetes Clinic 1 year before transferring to adult care.

A systematic review and meta-analysis of the prevalence of sleep problems in children with cerebral palsy: how do children with cerebral palsy differ from each other and from typically developing children?

Background: Up to 85% of children with neurodevelopmental disorders have sleep problems, compared with 25% of typically developing children. Children with cerebral palsy (CP)may have risk factors (brain injury, physical disability, and comorbidities) that make them more likely to have sleep problems compared with typically developing children.

Objective: To determine prevalence of sleep problems in children with CP.

Group education for adolescents with type 1 diabetes during transition from paediatric to adult care: study protocol for a multisite, randomised controlled, superiority trial (GET-IT-T1D).

Introduction: Transition from paediatric to adult care is challenging for adolescents and emerging adults (ages 18 to 30 years) with type 1 diabetes (T1D). This transition is characterised by a deterioration in glycaemic control (haemoglobin A1c (HbA1c)), decreased clinical attendance, poor self-management and increased acute T1D-related complications. However, evidence to guide delivery of transition care is lacking.

Behavioral difficulties, sleep problems, and nighttime pain in children with cerebral palsy.

Background: Children with cerebral palsy (CP) may be at risk of behavioral difficulties.

Aims: 1) Determine the prevalence of behavioral difficulties in preschool- and school-aged children with CP and 2) Assess the association between behavioral difficulties and a) sleep problems, b) nighttime pain and c) child characteristics (age, CP phenotype, comorbidities).

Methods And Procedures: Caregivers of 113 children with CP aged 4-12 years [mean (SD) age = 7.

Health-related quality of life in Canadian children with cerebral palsy: what role does sleep play?

Objective: To evaluate, in Canadian children with cerebral palsy (CP): (1) health-related quality of life (HRQoL) as well as (2) associations between HRQoL and (a) sleep problems, (b) nighttime pain, and (c) child characteristics (eg, age, CP phenotype, comorbidities).

Methods: Children aged 3-12 years were recruited from neurology clinics and a provincial CP registry. Caregivers completed the Pediatric Quality of Life Inventory (PedsQL) Generic Core and CP Modules as well as the Sleep Disturbance Scale for Children (SDSC) to assess HRQoL and sleep, respectively.

Prevalence of sleep problems and sleep-related characteristics in preschool- and school-aged children with cerebral palsy.

Objectives: To determine, in preschool- and school-aged children with cerebral palsy (CP): (i) the prevalence of sleep disorders, including disorders of initiation and maintenance of sleep, and (ii) the association between child characteristics and sleep disorders.

Methods: Children with CP aged 3-12 years were recruited from neurology clinics and a provincial CP registry. Caregivers completed the Sleep Disturbance Scale for Children (SDSC) and a questionnaire on sleep-related characteristics.

Sleep and quality of life of patients with glycogen storage disease on standard and modified uncooked cornstarch.

Background: Glycemic control in hepatic glycogen storage diseases (GSDs) relies on specific nutritional recommendations, including strict avoidance of a fasting period. Uncooked cornstarch (UCCS) is an important therapeutic component. A new modified UCCS, Glycosade™, was created with the objective of prolonging euglycemia.

Point-of-care lung ultrasound in young children with respiratory tract infections and wheeze.

Objective: Characterise lung ultrasound (LUS) findings, diagnostic accuracy and agreement between novice and expert interpretations in young children with respiratory tract infections and wheeze.

Methods: Prospective cross-sectional study in a paediatric ED. Patients ≤2 years with a respiratory tract infection and wheeze at triage were recruited unless in severe respiratory distress.

Point tenderness at 1 of 5 locations and limited elbow extension identify significant injury in children with acute elbow trauma: a study of diagnostic accuracy.

Objective: Our goal was to determine whether the combination of tenderness at 1 of 5 commonly fractured sites and elbow extension accurately predicts the presence of acute elbow fractures or isolated effusions in children.

Methods: A prospective cohort study was performed using a convenience sample of patients. Children 0 to 18 years old with acute elbow injuries without elbow deformities or radial head subluxations were prospectively enrolled.

Attitudes and knowledge regarding health care policy and systems: a survey of medical students in Ontario and California.

Background: Canada and the United States have similar medical education systems, but different health care systems. We surveyed medical students in Ontario and California to assess their knowledge and views about health care policy and systems, with an emphasis on attitudes toward universal care.

Methods: A web-based survey was administered during the 2010-2011 academic year to students in 5 medical schools in Ontario and 4 in California.

Accuracy of ultrasonography for determining successful realignment of pediatric forearm fractures.

Study Objective: The primary objective of this study is to assess the accuracy of point-of-care ultrasonography compared with blinded orthopedic assessment of fluoroscopy in determining successful realignment of pediatric forearm fractures. The secondary objective is to determine the rate of agreement of ultrasonography and fluoroscopy in real-time by the treating physician.

Methods: A cross-sectional study was conducted in children younger than 18 years and presenting to an academic emergency department with forearm fractures requiring realignment of a single bone.

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation.

Objective: To evaluate the efficacy and safety of a simple linear midazolam-based protocol for the management of impending status epilepticus in children up to 18 years of age.

Methods: This is a descriptive, quality assessment, retrospective chart review of children presenting with the chief complaint of seizure disorder in the emergency department (ED) of a tertiary care pediatric hospital and a triage category of resuscitation or urgent from April 1, 2009, to August 31, 2011. In children with at least one seizure episode in the ED treated according to the linear protocol, three main outcomes were assessed: compliance, effectiveness, and complications.

Effect of glutamine on glucose metabolism in children with Duchenne muscular dystrophy.

Background & Aims: Glutamine is a potent gluconeogenic precursor and stimulates insulin secretion. Glutamine's effect on glucose metabolism in Duchenne muscular dystrophy (DMD) has never been studied. To determine plasma glucose and insulin concentrations measured during and after glutamine administration in DMD boys.

Visibility of the urethral meatus and risk of urinary tract infections in uncircumcised boys.

Background: Uncircumcised boys are at higher risk for urinary tract infections than circumcised boys. Whether this risk varies with the visibility of the urethral meatus is not known. Our aim was to determine whether there is a hierarchy of risk among uncircumcised boys whose urethral meatuses are visible to differing degrees.

Glutamine supplementation in sick children: is it beneficial?

The purpose of this review is to provide a critical appraisal of the literature on Glutamine (Gln) supplementation in various conditions or illnesses that affect children, from neonates to adolescents. First, a general overview of the proposed mechanisms for the beneficial effects of Gln is provided, and subsequently clinical studies are discussed. Despite safety, studies are conflicting, partly due to different effects of enteral and parenteral Gln supplementation.

Utility assessment of body contouring after massive weight loss.

Background: The number of surgical procedures performed for obesity and massive weight loss (MWL) is increasing. The authors set out to quantify the health state utility assessment of living with MWL that can occur after such procedures.

Methods: Utility assessments using the visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG) were used to obtain utilities for MWL, monocular blindness, and binocular blindness from a sample of the general population and medical students.