European military surgical teams in combat theater: A survey study on deployment preparation and experience.

Introduction: Adequate (predeployment) training of the nowadays highly specialized Western military surgical teams is vital to ensure a broad range of surgical skills to treat combat casualties. This survey study aimed to assess the self-perceived preparedness, training needs, deployment experience, and post-deployment impact of surgical teams deployed with the Danish, Dutch, or Finnish Armed Forces. Study findings may facilitate a customized predeployment training.

Self-efficacy and application of skills in the workplace after multidisciplinary trauma masterclass participation: a mixed methods survey and interview study.

Purpose: The most complex injuries are usually least often encountered by trauma team members, limiting learning opportunities at work. Identifying teaching formats that enhance trauma skills can guide future curricula. This study evaluates self-assessed technical and nontechnical trauma skills and their integration into novel work situations for multidisciplinary trauma masterclass participants.

A multicentre cross-sectional survey study on acute wound classification in the emergency department and its interobserver variability.

Annually, a vast number of patients visits the emergency department for acute wounds. Many wound classification systems exist, but often these were not originally designed for acute wounds. This study aimed to assess the most frequently used classifications for acute wounds in the Netherlands and the interobserver variability of the Gustilo Anderson wound classification (GAWC) and Red Cross wound classification (RCWC) in acute wounds.

Self-perceived preparedness and training needs of healthcare personnel on humanitarian mission: a pre- and post-deployment survey.

Background: Humanitarian healthcare workers are indispensable for treating weapon-wounded patients in armed conflict, and the international humanitarian community should ensure adequate preparedness for this task. This study aims to assess deployed humanitarian healthcare workers' self-perceived preparedness, training requirements and mental support needs.

Methods: Medical professionals deployed with the International Committee of the Red Cross (ICRC) between October 2018 and June 2020 were invited to participate in this longitudinal questionnaire.

Using the Red Cross wound classification to predict treatment needs in children with conflict-related limb injuries: a retrospective database study.

Background: The International Committee of the Red Cross (ICRC) implemented the Red Cross wound classification (RCWC) to quickly assess the severity of a wound in conflict settings. A subdivision into wound grades derived from the RCWC consists of grades 1, 2, and 3, and represents low, major, and massive energy transfer, respectively, to the injured tissue. The aim of this observational study is to assess whether the Red Cross wound grade of a pediatric patient's wound correlates with patient outcomes.

Global surgery for paediatric casualties in armed conflict.

Background: Understanding injury patterns specific for paediatric casualties of armed conflict is essential to facilitate preparations by organizations that provide medical care in conflict areas. The aim of this retrospective cohort study is to identify injury patterns and treatment requirements that are specific for paediatric patients in conflict zones.

Methods: Characteristics of children (age < 15 years) treated in medical facilities supported by the International Committee of the Red Cross (ICRC) between 1988 and 2014 in Kabul, Kao-i-Dang, Lokichogio, Kandahar, Peshawar, Quetta and Goma were analysed; patient characteristics were compared between treatment facilities and with those of adult patients (age ≥ 15 years).

Prepared for Mission? A Survey of Medical Personnel Training Needs Within the International Committee of the Red Cross.

Background: Humanitarian organizations such as the International Committee of the Red Cross (ICRC) provide worldwide protection and medical assistance for victims of disaster and conflict. It is important to gain insight into the training needs of the medical professionals who are deployed to these resource scarce areas to optimally prepare them. This is the first study of its kind to assess the self-perceived preparedness, deployment experiences, and learning needs concerning medical readiness for deployment of ICRC medical personnel.

The prehospital management of hypothermia - An up-to-date overview.

Background: Accidental hypothermia concerns a body core temperature of less than 35°C without a primary defect in the thermoregulatory system. It is a serious threat to prehospital patients and especially injured patients, since it can induce a vicious cycle of the synergistic effects of hypothermia, acidosis and coagulopathy; referred to as the trauma triad of death. To prevent or manage deterioration of a cold patient, treatment of hypothermia should ideally begin prehospital.

The role of electronic assessment of adherence in the education and counseling of children taking growth hormone: progress and challenges.

There are numerous issues surrounding adherence in children taking recombinant human growth hormone (rh-GH). New technologies capable of accurately recording/monitoring may highlight some of these issues, and have value in optimizing adherence levels through education and counseling. The intention of this review is to guide healthcare professionals (HCPs).

Growth hormone and treatment outcomes: expert review of current clinical practice.

Although there are guidelines for treatment of short stature, open questions regarding optimal management of growth hormone therapy still exist. Experts attending six international meetings agree that successful therapy results in the patient attaining mid-parental height, and relies on correct diagnosis and early intervention. Experts advocate patient followup every 3-6 months, and that growth and adherence should be monitored at each visit.

A review of biopsychosocial strategies to prevent and overcome early-recognized poor adherence in growth hormone therapy of children.

Background: Adherence to growth hormone (GH) therapy among children is variable and remains a problem, possibly affecting growth outcomes and future health, and having economic consequences.

Objective: To provide a review of the issues related to poor adherence to GH therapy in children and describe integrative strategies that may improve adherence.

Results: Poor adherence may be caused by various factors, affecting both the children and their families.

Observations of nonadherence to recombinant human growth hormone therapy in clinical practice.

Background: The effectiveness of all prescribed treatments is contingent on patient adherence. The reported levels of adherence to recombinant human growth hormone (r-hGH) therapy are highly variable, but it has been suggested that nonadherence might be as high as 36% to 49%.

Objectives: This commentary discusses the factors that affect long-term adherence to injection treatment, of which r-hGH therapy is a particular challenge.

Treatment of adductor spasticity with BTX-A in children with CP: a randomized, double-blind, placebo-controlled study.

Adductor spasticity in children with cerebral palsy (CP) impairs motor function and development. In a placebo-controlled, double-blind, randomized multicentre study, we evaluated the effects of botulinum toxin A(BTX-A) in 61 children (37 males, 24 females; mean age 6 years 1 month [SD 3y 1mo]) with CP (leg-dominated tetraparesis, n=39; tetraparesis, n=22; GMFCS level I, n=3; II, n=6; III, n=17; IV, n=29; V, n=6). Four weeks after treatment, a significant superiority of BTX-A was observed in the primary outcome measure (knee-knee distance 'fast catch', p=0.

[Achievement motivation in children with migraine and their healthy siblings].

Questions: Psychosocial variables like stress or a high achievement motivation are discussed as a possible contributory factor to an attack in migraine. The aim of our study was to examine, whether children with migraine may be at risk for impaired achievement motivation.

Patients/methods: 37 children with migraine and their 17 non-affected siblings, were examined by means of an especially developed test for achievement motivation and by the Kaufman-Assessment-Battery for Children (K-ABC).

Development of mental health dysfunction in childhood epilepsy.

A marked prevalence of mental health dysfunction in childhood epilepsy has been documented in the literature. While several individual risk factors have been identified, which are statistically associated with an impaired mental health outcome, there is a lack of knowledge on the pathways taken by these risk factors on disease development and treatment. The relevant literature of the last decade will be reviewed in this paper to provide evidence for the conceptual framework presented here.

Intraocular pressure, safety and quality of life in glaucoma patients switching to latanoprost from adjunctive and monotherapy treatments.

Purpose: To evaluate efficacy, safety and quality of life in ocular hypertensive or open-angle glaucoma patients changed to latanoprost from previous therapy.

Methods: A prospective, multicenter, active-controlled design in which qualified patients had their previous therapy substituted for latanoprost and were followed for at least three months.

Results: In 1068 patients, latanoprost was continued 92% throughout the 36-month observation period.

Risk analyses for the cognitive phenotype in Turner's syndrome: evidence of familial influence as a decisive factor.

The interindividual varying cognitive performance in female patients with Turner's syndrome has usually been attributed to the interindividual varying mosaicism with a consecutive variable loss of X-chromosome DNA or to secondary risk factors such as estrogen deficiency owing to ovarian failure. The aim of our study was to determine the specific impact of X chromosome-related features and associated risk factors, on the one hand and familial influences, on the other hand on the interindividual variation in the cognitive phenotype. One hundred and one subjects with Turner's syndrome and 53 sisters as controls for familial influences were examined by comparing the cognitive information processing abilities (Kaufmann Assessment Battery for Children [K-ABC]).

[Methodological perspectives for the assessment of adaptation in chronic diseases, exemplified by asthma bronchiale in childhood].

Background: Regarding the measurement of psychosocial adaptation due to chronic diseases in childhood and adolescence, there is a shift from a more reductionist and biomedical oriented disease-model towards a more integrated, biopsychosocial view of chronic diseases. The three paradigms in measuring psychosocial adaptation (psychopathology, coping, health related quality of life) will be discussed at the example of corresponding empirical studies in children with asthma bronchiale. The psychopathology-oriented research emphasizes the risk of the induced psychopathological comorbidity, whereas the more coping-oriented paradigm primarily includes the dynamic process of the perceived stress and the corresponding coping efforts due to a chronic disease.

[Psychosocial adaptation and compliance in chronic diseases in childhood].

A chronic disease in childhood often entails multidimensional, medical, psychosocial and financial risks which empede efficient adaptation to the disease for the whole family. Aim of this review is to describe possible strategies for effective coping with the chronic disease with the main focus on self-help-competence for the affected child and his family. Furthermore, there are proposals regarding practical handling of therapeutical noncompliance in the chronically ill infant.

[Significance of spontaneous motor activity and visual information processing for developmental diagnosis in infancy].

The neurodevelopmental examination during the first years of life is very often confronted with the problem of differentiating between normal variability and pathology of development. Recent research provides evidence about the clinical relevance of the systematic observation and examination of spontaneous movements, of postural control as well as of visual information processing in toddlers.