Children and Youth with Special Health Care Needs: Progress Towards More Family-Centered Systems of Care.

Children and youth with special health care needs have increasingly been included in community and society over the past 50 years. Changing definitions and programs in the education, health, and public health/Title V sectors document this greater inclusion. The most profound change was in the education system, with the passage of legislative mandates for inclusion and parental rights.

Tools used to measure the impact of comorbidities on surgical outcomes in children with complex chronic conditions: A scoping review.

Aim: To identify and describe assessment tools used to measure the impact of comorbidities on postoperative outcomes in children with complex chronic conditions (CCC).

Method: This was a scoping review using five electronic databases. The search was conducted in March 2022 by a medical librarian.

Parental Caregiver Expectations and Satisfaction Following Hip Reconstruction and Spinal Fusion in Children With Cerebral Palsy.

Children with severe (Gross Motor Function Classification System [GMFCS] IV-V) cerebral palsy (CP) exhibit profound physical and developmental impairments and require assistance for all activities of daily living. No curative treatments exist although surgical procedures to correct underlying hip and spine deformities can improve their quality of life. Despite the efficacy of these surgeries, little is known regarding parental caregivers' expectations specific to surgical outcomes and their satisfaction with surgical outcomes.

Parental caregivers' perception of their transition from hospital to home in children with cerebral palsy who have undergone orthopedic surgery.

Purpose: Evaluate parental perception of the quality of discharge teaching, readiness for discharge, and the impact of these on post discharge coping difficulty and resource utilization in children with cerebral palsy (CP) following surgery.

Design And Methods: Prospective cohort study conducted from September 2017-March 2021 at a pediatric academic medical center. Demographics were collected pre-operatively.

Determining Incidence and Risk Factors of Pressure Injury After Orthopaedic Surgery in Children and Adolescents With Neuromuscular Complex Chronic Conditions.

Background: Pressure injuries are serious yet often preventable alterations in skin integrity prevalent in orthopaedics, especially in pediatric patients with neuromuscular complex chronic conditions (NCCC). The aims of this study were to (1) estimate incidence of pressure injury in children with NCCC after orthopaedic surgery; (2) determine risk factors for pressure injury development; and (3) describe severity and location of pressure injuries.

Methods: Children and adolescents (<22 y old) with NCCC who underwent orthopaedic surgery at a single tertiary-care children's hospital between 2016 and 2020 were retrospectively identified.

Barriers to Discharge After Hip Reconstruction Surgery in Non-ambulatory Children With Neurological Complex Chronic Conditions.

Background: Hip reconstruction surgery in patients with neurological complex chronic conditions (CCC) is associated with prolonged hospitalization and extensive resource utilization. This population is vulnerable to cognitive, developmental, and medical comorbidities which can increase length of stay (LOS). The aims of this study were to characterize barriers to discharge for a cohort of children with neurological CCC undergoing hip reconstruction surgery and to identify patient risk factors for prolonged hospitalization and delayed discharge.

Pneumonia after hip surgery in children with neurological complex chronic conditions.

Aim: In children with neurological complex chronic conditions (CCC) undergoing hip surgery we aimed to: estimate the rate of postoperative pneumonia, determine the effect of pneumonia on postoperative hospital resource use, and identify predictors of postoperative pneumonia.

Method: A retrospective cohort study was conducted utilizing the Pediatric Health Information System database for 2609 children (1081 females, 1528 males) aged 4 years and older with a neurological CCC who underwent hip surgery (i.e.

Is There a Relationship Between Youth Bullying and Internet Addiction? An Integrative Review.

Youth bullying is a global public health problem; Internet addiction is on the rise globally among youths. Because the linkage between these behaviors has not been clearly explicated, this integrative review evaluated the relevant empirical evidence. A search of five electronic databases identified 2,761 original citations published between January 2000 and May 2019.

Retrospective study of patterns of vitamin D testing and status at a single institution paediatric orthopaedics and sports clinics.

Objectives: There has been a recent increase in awareness of the importance of bone health in children treated by paediatric orthopaedic and sports medicine providers. The purpose of this study was to assess our utilisation of 25 hydroxy vitamin D (25(OH)Vit D) testing in the past 10 years, and to evaluate the level of 25(OH)Vit D sufficiency in various populations of patients seen.

Design: This is a single site, retrospective medical record review study.

Health-related quality of life and caregiver burden after hip reconstruction and spinal fusion in children with spastic cerebral palsy.

Aim: To evaluate the effect of hip reconstruction or spinal fusion on health-related quality of life (HRQoL) in non-ambulatory children with spastic cerebral palsy (CP) and caregiver burden.

Method: This was a prospective, longitudinal study of changes in HRQoL and caregiver burden over the 5 years after surgical correction of hip instability or scoliosis in children with bilateral spastic CP classified in Gross Motor Function Classification levels IV or V. Serial parent proxy measures of HRQoL and caregiver burden were obtained before and 6 weeks, and 3, 6, 9, 12, 24, and 60 months after surgery using the Caregiver Priorities and Child Health Index of Life with Disabilities and the Assessment of Caregiver Experience with Neuromuscular Disease.

Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.

Aim: To assess how co-occurring conditions influence recovery after hip reconstruction surgery in children with neurological complex chronic conditions (CCCs).

Method: This was a retrospective analysis of 4058 children age 4 years or older with neurological CCCs who underwent hip reconstructive surgery between 1st January 2015 and 31st December 2018 in 49 children's hospitals. The presence of co-occurring chronic conditions was assessed using the Agency for Healthcare Research Chronic Condition Indicator system.

Hip Reconstruction in Nonambulatory Children With Cerebral Palsy: Identifying Risk Factors Associated With Postoperative Complications and Prolonged Length of Stay.

Background: The purpose of this study is to examine the relationship between preoperative comorbidities, surgical complications, and length of stay (LOS) after hip reconstruction in nonambulatory children with cerebral palsy (CP).

Methods: This single-center retrospective cohort study included 127 patients undergoing hip surgery between 2007 and 2016 who were diagnosed with CP (GMFCS IV/V). The cohort was 54% Gross Motor Function Classification System (GMFCS) V with an average age at surgery of 9 years (range, 3-19 y).

Team Approach: The Perioperative Management of Reconstructive Hip Surgery for the Non-Ambulatory Child with Cerebral Palsy and Spastic Hip Disease.

Cerebral palsy (CP) is the leading cause of physical disability in children. Although physical disability is the hallmark of CP, children with CP also often have complex medical comorbidities. Spastic hip subluxation is the second most common orthopaedic deformity in children with CP, and the incidence increases with the severity of CP.

Identifying Bullied Youth: Re-engineering the Child-Adolescent Bullying Scale into a Brief Screen.

While youth bullying is a critical public health problem, standardized exposure screening is not routinely practiced. The Child-Adolescent Bullying Scale, (CABS), a psychometrically robust 22-item tool, was designed and evaluated for this purpose using classical test theory. The goals of the present study were to examine and optimize the measurement properties of the CABS using a Rasch psychometric analysis to develop a brief screening tool appropriate for clinical use.

Building and Sustaining a Culture of Clinical Inquiry in a Pediatric Quaternary Hospital.

The Nurse Executive Committee for Research and Inquiry (NECRI) was established to align clinical inquiry with nursing clinical operations to advance nursing science and improve patient care and outcomes for patients and their families. The authors describe the development, structure, and function of NECRI, outcomes to date, and infrastructure necessary to support a sustainable model.

Item Generation and Content Validity of the Child-Adolescent Bullying Scale.

Background: Healthcare providers do not uniformly screen young patients for exposure to bullying, and no screening instruments have been developed for widespread use in clinical settings.

Objectives: The objectives of this study were to (a) generate scale items by identifying and eliciting concepts relevant to youths with potential exposure to bullying as well as to professionals who work with bullied youths and (b) assess the content validity of the new Child-Adolescent Bullying Scale (CABS) instrument.

Methods: A mixed-methods design was used to develop an initial pool of 52 items.

Intrathecal Baclofen Therapy Prior to Spinal Fusion for Patients With Gross Motor Function Classification System IV-V Cerebral Palsy.

Background: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB therapy on the postoperative course following spinal fusion in patients with GMFCS IV-V CP has not been described.

The Child Adolescent Bullying Scale (CABS): Psychometric evaluation of a new measure.

While youth bullying is a significant public health problem, healthcare providers have been limited in their ability to identify bullied youths due to the lack of a reliable, and valid instrument appropriate for use in clinical settings. We conducted a multisite study to evaluate the psychometric properties of a new 22-item instrument for assessing youths' experiences of being bullied, the Child Adolescent Bullying Scale (CABS). The 20 items summed to produce the measure's score were evaluated here.

Impact of Non-medical Out-of-pocket Expenses on Families of Children With Cerebral Palsy Following Orthopaedic Surgery.

Purpose: Limited research has been conducted on the non-medical out-of-pocket expenses (NOOPEs) incurred by families of children with chronic health conditions. The study objectives were to: 1) calculate the estimated NOOPEs incurred by families during hospitalization of their child, 2) identify predictors of high NOOPEs, and 3) assess the impact of the child's chronic health condition on the family's finances.

Design And Methods: Prospective observational study.

Noise Reduction to Reduce Patient Anxiety During Cast Removal: Can We Decrease Patient Anxiety With Cast Removal by Wearing Noise Reduction Headphones During Cast Saw Use?

Background: Noise reduction headphones decrease the sound during cast removal. Their effectiveness in decreasing anxiety has not been studied.

Purpose: Compare pediatric patients' anxiety levels during cast removal with and without utilization of noise reduction headphones combined with use of a personal electronic device.

Technology-enhanced focus groups as a component of instrument development.

Background Bullying is a critical public health problem and a screening tool for use in healthcare is needed. Focus groups are a common tool for generating qualitative data when developing an instrument and evidence suggests that technology-enhanced focus groups can be effective in simultaneously engaging participants from diverse settings. Aim To examine the use of technology-enhanced focus groups in generating an item pool to develop a youth-bullying screening tool.