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The article focuses on the introduction and implementation of "Comfort Positioning" in pediatric care settings to reduce stress, anxiety, and pain during medical procedures, emphasizing the method's benefits for children, their caregivers, and healthcare providers. It discusses the development of "Mutmach-Umarmungen" (comfort hugs) and "Mutmach-Boxen" (courage boxes) by a multidisciplinary team at the University Clinic for Pediatric and Adolescent Medicine at AKH Vienna, AAustria.

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In the second half of the twentieth century, the Zurich Children’s Hospital (Kispi) developed into an internationally renowned treatment center for »intersexuality.« Children with ambiguous body-sexual characteristics were given there a clearly male or female identification by means of surgical interventions and/or hormone therapies. This study examines the question of how medical and family communication shaped the (narrated) experience of »intersex« treatments. Our analysis is based on nine oral history interviews with former Kispi patients. We show that communication in connection with the treatments was semi-tabooing and directive. We discuss the mode of communication in its social and medical-historical conditions (tabooing of the clitoris and »intersex,« paternalistic relationship between doctors and patients, concealment of »intersex« diagnoses as a doctrine), examine its biographical effects (ignorance of one’s own body, feelings of shame, stigmatization) and address individual processing strategies (breaking taboos, acquisition of knowledge). [ABSTRACT FROM AUTHOR]

Copyright of Ergoscience is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Therapeutic Pedagogy Ward assumed a central position within the Viennese welfare system soon after its opening in 1911. The minors being observed were thought to be "difficult", "neglected" or suffering from mental or physical disabilities. Some were admitted to assess their (intellectual) abilities and released with an expert report either on how to further treat or where to place them. By analysing expert opinions from 1912 to the 1970s, this paper examines the cooperation of the institutions involved in this endeavour. For that purpose, it not only studies the contents of these expert opinions but focuses on language, shedding light on acceptance, understanding and appropriation of therapeutic pedagogic concepts in related disciplines. Thus, by investigating the practice of categorizing individuality, this article highlights common forms of typing in therapeutic pedagogy and its importance beyond the narrow institutional setting. [ABSTRACT FROM AUTHOR]

Background: For the evaluation of postoperative pain therapy, nausea and vomiting (PONV), the Children's Hospital in Lucerne acts as a member of the postoperative quality improvement project QUIPSi for children. Initial results and the potential for evaluation of the postoperative pain therapy and PONV are presented here. The central questions are whether the postoperative therapy concept is sufficient and if QUIPSi serves as an ideal tool for postoperative quality improvement? Methods: Over a period of 1.5 years a total of 460 children aged between 4 to 17 years evaluated their postoperative pain, requirements for more analgesic medicine and the incidence of PONV according to a standardized questionnaire on the first postoperative day. The administration of analgesic medicine was recorded until finishing the questionnaire. Results: In this study 5 pediatric outpatient operation groups (hernia repair n = 36, bone surgery n = 23, metal removal surgery n = 31, circumcision n = 65 and soft tissue surgery n = 49) and 9 pediatric inpatient operation groups (appendectomy n = 21, bone surgery n = 78, metal removal surgery n = 24, orchidopexy n = 31, combined operation (orchidopexy + hernia repair or circumcision) n = 14, otoplasty n = 9, tonsillectomy n = 41 and pectus excavatum surgery n = 6 and soft tissue surgery n=28) could be classified. All operation groups except the inpatient and outpatient soft tissue surgery groups received regional or infiltration anesthesia. Analgesic medicine was prescribed with the maximum permitted daily dose per kg body weight (paracetamol 100 mg/kgBW, metamizole 80 mg/kgBW, diclofenac 3 mg/kgBW and ibuprofen 40 mg/kgBW; in reserve tramadol 8 mg/kgBW and nalbuphine 2.4 mg/kgBW). The following operation groups complained of persistent pain (scale according to Hicks 0-10) and/or required more pain medicine (%): pediatric outpatients circumcision 5.1/19 %, pediatric inpatients appendectomy 6.5/43 %, tonsillectomy 6.4/32 %, pectus excavatum surgery 7.7/33 %, orchidopexy 4.2/19.4 %, otoplasty 3.1/22.2 %. The reason for the elevated postoperative pain was mainly insufficient administered pain medicine despite the prescription of the maximum daily dose per kg body weight or maybe due to a late administration. Circumcision/appendectomy/tonsillectomy/pectus excavatum surgery/orchidopexy/otoplasty (% of max. daily dose): paracetamol 5/58/99/36/57/37 %, metamizole 0,4/18/8/54/4/4 %, diclofenac 44/45/3/97/51/68 % or ibuprofen 42/1/0/0/0/0 %, tramadol 0,4/0/0/0/0/0 %, nalbuphine 0,4/1/16/0/2/0 %). As the standard inhalative general anesthesia and PONV prophylaxis with tropisetron (body weight: < 20 kg 1 mg, > 20 kg: 2 mg intravenous bolus) was performed. Dexamethasone (0.15-0.5 mg/kgBW, maximum allowed dose 8 mg intravenous bolus) was administered as a back-up drug for PONV. The nausea incidence was higher in the inpatient group (14-50 %) than in the outpatient group (10-29 %). The incidence of vomiting was higher in the inpatient (0-37 %) than in the outpatient group (3-17 %). Conclusions: The quality analysis showed that especially children with the requirement for more pain medicine and a high PONV incidence (inpatient group) need further improvement in postoperative care. Because of small numbers in some operation groups this qualitative evaluation of the postoperative pain and PONV management only gives an approximate overview. The results of QUIPSi uncovered gaps in the postoperative pain management which will help improve the quality in the postoperative setting. The QUIPSi approach should be integrated as a daily tool into all pediatric surgical departments. [ABSTRACT FROM AUTHOR]

Treatment of polytraumatized children poses a challenge for all participating physicians, especially because even in pediatric trauma centers only 10-15 severely injured children are treated annually. Pediatric trauma is the number one cause of death in children, exceeding all other causes of death combined. Treatment strategies are different from adult polytraumatized patients. Caring for pediatric trauma patients requires an understanding of the distinct anatomy and pathophysiology of the pediatric population. Therefore, continuous training and the cooperation of the treatment team is pivotal to evaluate the severity of the injury and initiate appropriate, age-adapted therapeutic measures. However, the degree of recovery in polytraumatized children is often remarkable, even after apparently devastating injuries. Maximal care should, therefore, be rendered under the assumption that a complete recovery will be made. [ABSTRACT FROM AUTHOR]

For various reasons, sonography is best suited for the use in children. In pediatric practice and emergency departments, it turns out to be just as valuable for many indications, as in pediatric hospitals. As a clinical method of imaging, ultrasound is very profitable in the hands of pediatricians. Examples from daily practice illustrate this fact. Still, against this background, it is surprising, that in Switzerland -- in contrast to neighbouring countries -- pediatric sonography is largely given over to radiologists. [ABSTRACT FROM AUTHOR]

Out-of-hospital (OOH) pediatric emergencies have a relatively low prevalence. In Germany the vast majority of cases are attended by non-specialized emergency physicians (EPs) for whom these are not routine procedures. This may lead to insecurity and fear. However, it is unknown how EPs perceive and assess pediatric emergencies and how they could be better prepared for them. All active EPs (n=50) of the Department of Anaesthesiology, Emergency and Intensive Care Medicine at the University Medical Centre of Göttingen were presented with a structured questionnaire in order to evaluate their perception and assessment of OOH pediatric emergencies. The 43 participating EPs made highly detailed statements on the expected characteristics of OOH pediatric emergencies. Their confidence level grew with the children’s age (p<0.03) and with their own experience (p<0.01). The EPs felt particular deficits in the fields of cardiopulmonary resuscitation (n=18) and trauma management (n=8). The preferred educational strategies included simulator-based training (n=24) as well as more exposure to pediatric intensive care and pediatric anesthesia (n=12). Despite their own limited experience EPs can realistically assess the incidence and severity of pediatric emergencies. They felt the greatest deficits were in the care of infrequent but life-threatening emergencies. Three educational groups can be differentiated: knowledge and skills to be gained with children in hospital, clinical experience from adult care also applicable in children and rare diagnoses and interventions to be trained with manikins or simulators. [ABSTRACT FROM AUTHOR]

A review is presented of a study on stress levels of children in hospitals called "Experiences, symptoms and signs in 3-11-year-old children undergoing day surgery in the context of the perioperative dialogue," conducted by Berith Wennström at the Universität Göteburg university in Göteburg, Sweden.