The Experience of Parental Caregiving for Children With Medical Complexity.

Children with medical complexity (CMC) have complex chronic conditions with significant functional impairment, contributing to high caregiving demand. This study seeks to explore impacts of parental caregiving for CMC. Fifteen caregivers of CMC followed at a tertiary care hospital participated in semi-structured interviews.

Comparison of pan-ethnic and ethnic-based carrier screening panels for individuals of Ashkenazi Jewish descent.

The intent of carrier screening is to identify individuals at risk for having a child with a genetic disorder. American College of Medical Genetics and Genomics (ACMG) guidelines currently recommend that individuals of Ashkenazi Jewish (AJ) descent be screened for carrier status for nine disorders. However, a joint statement from five professional organizations acknowledges benefits of expanded carrier screening and this is becoming common practice.

Patient Experience in Health Professions Curriculum Development.

Unlabelled: To enhance student learning, many health profession programs are embracing involvement of patients in their curricula, yet little is known about the impact of such an experience on patients.

Objective: To understand the experiences of patients who contributed to the creation of a Verbatim Reader's Theater used in health professions curriculum.

Methods: A semi-structured interview was conducted with a focus group of 3 patients who participated in curriculum development.

Understanding Partnerships With Patients/Clients in a Team Context Through Verbatim Theater.

Introduction: Patient partnership has come to the forefront in health care practice and education, influencing professional programs and interprofessional education curricula. While students conceptually understand the idea of partnering with the patient, the practice of doing so is more challenging. Innovative ways to teach this health care approach may be effective in enabling students to apply their learning and promote enhanced patient partnerships.

Prevalence and instability of fragile X alleles: implications for offering fragile X prenatal diagnosis.

Objective: To document fragile X allele frequencies in a national referral population and evaluate CGG repeat expansion in mother-offspring transmissions.

Methods: Fragile X DNA analysis by Southern blot and polymerase chain reaction was completed for 14,675 women, aged 18 years or older, and 238 mother-offspring pairs between January 1999 and June 2004. Carrier frequencies were compared between groups referred for different clinical indications.

Sensitivity of objective parameters in the diagnosis of pediatric septic hips.

This study examines the sensitivity of temperature, leukocyte count, and erythrocyte sedimentation rate in the diagnosis of pediatric septic arthritis of the hip by retrospective case analysis of 26 children, aged 0 to 6 years, in hospitals of central Brooklyn. The average presenting temperature was 38.4 degrees C, with 65% of the patients having had a temperature higher than 38 degrees C.

Completely nonsurgical management of ectopic pregnancies.

Twelve cases of presumed ectopic pregnancies were successfully treated with intramuscular methotrexate. Importantly, these patients were managed with no surgical intervention and without hospitalization. Criteria for selecting such patients is described, as well as treatment and follow-up protocol.

Luxatio erecta: persistent displacement of the greater tuberosity after reduction.

The case of a 36-year-old man who sustained a luxatio erecta dislocation of his shoulder is reported. He had persistent displacement of a fracture of the greater tuberosity after closed reduction of the shoulder. The two-part fracture required operative treatment.

Training community-based paraprofessionals as behavior therapists with families of alcohol-abusing adolescents.

To combat the increase in chronic alcohol use among adolescents in a large metropolitan area, community-based paraprofessionals were trained in behavior therapy and treated these adolescents and their families in the home. Preliminary evaluation of the program revealed encouraging results. This training supplied structure for the paraprofessionals' interventions with families and provided them with skills they are continuing to use in their community work.

Psychological aspects of cystic fibrosis in children and adolescents.

Medical care of children with cystic fibrosis has been so greatly improved in recent years that many are now reaching adolescence and early adulthood. Traversing adolescence is a trying task for any chronically ill child, but even more difficult for the cystic fibrosis patient. Clinicians report that many of these adolescents have problems for which the patients, the family, and the practitioners need help.

The practitioner and school age child problems.

The extraordinary plasticity of the growing child offers the general practitioner an unusual opportunity to intervene either in a preventative or therapeutic manner. Such intervention, properly the task of any informed physician dealing with families, can alter unhealthy growth to healthier development. The whole child is just as important as his medical illnesses; the whole family usually needs help when there is an emotional disturbance in any child.

Group psychotherapy with adolescents.

In working in a large general hospital with groups of disturbed adolescent patients from economically and emotionally deprived walks of life, therapists worked out a plan of outpatient group therapy that in general has had good results as measured by effective living and functioning in school, at home and with peers. Groups were limited to eight patients and meetings were held once a week with two co-therapists of different sexes. Therapists usually did not try to turn discussions in one direction or another.