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Background There has been growing support for the adoption of telehealth (TH) services in pediatric populations. Children on chronic peritoneal dialysis (PD) represent a vulnerable population that could benefit from increased use of TH. The COVID-19 pandemic prompted rapid adoption of TH services in the population among pediatric centers participating in The Children's Hospital Association's Standardizing Care to Improve Outcomes in Pediatric ESKD (SCOPE) Collaborative. Methods We developed a survey to explore the experience of both pediatric PD providers and caregivers of patients receiving PD care at home and using TH services during the COVID-19 pandemic. Results We obtained responses from 27 out of 53 (50.9%) SCOPE centers that included 175 completed surveys from providers and caregivers. Major challenges identified by providers included inadequate/lack of physical exam, inability to visit with the patient/family in-person, and inadequate/lack of PD catheter exit site exam. Only 51% of caregivers desired future TH visits; however, major benefits of TH for caregivers included no travel, visit takes less time, easier to care for other children, more comfortable for patient, and no time off from work. Providers and caregivers agreed that PD TH visits are family centered (p = 0.296), with the lack of a physical exam (p < 0.001) and the inability to meet in-person (p = 0.002) deemed particularly important to caregivers and providers, respectively. Conclusions TH is a productive and viable visit option for children on PD; however, making this a successful, permanent part of routine care will require an individualized approach with standardization of core elements. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information., Author(s): Stephanie L. Clark [sup.1] , Brandy Begin [sup.2] , Heidi G. De Souza [sup.3] , Kathleen Mallett [sup.4] , Melisha G. Hanna [sup.5] , Troy Richardson [sup.3] , Megan [...]

Background Self-reported physical activity (PA) and screen time exposure in adolescents with chronic kidney disease (CKD) has not been evaluated. Methods We performed a cross-sectional analysis of PA and screen time in 224 adolescents at entry into the Chronic Kidney Disease in Children (CKiD) cohort. We compared proportions of CKiD vs. healthy 2012 National Health and Nutrition Examination Survey (NHANES) participants reporting the recommended 60 min of PA 7 days/week or [less than or equal to] 2 h/day of entertainment screen time (binomial probability test). Within CKiD, we assessed correlates of PA and screen time using multivariable logistic and linear regression and examined longitudinal data for 136 participants. Results Median age of CKiD participants was 15 years, and 60 % were male. Median estimated glomerular filtration rate (eGFR) was 41.3 (IQR 30.8, 52.3) ml/min/1.73 m.sup.2. Only 13 % of CKiD participants met recommendations for PA vs. 25 % of NHANES (p < 0.001), while 98 % in CKiD exceeded the recommended screen time vs. 73 % in NHANES (p < 0.001). Within CKiD, obesity (p = 0.04) and lower eGFR (p = 0.02) were independently associated with greater screen time. Conclusions Adolescents with CKD engage in significantly less PA and greater screen time than healthy youth in the United States, and this may worsen over time., Author(s): Stephanie L. Clark[sup.1] [sup.2] , Michelle R. Denburg[sup.1] [sup.2] , Susan L. Furth[sup.1] [sup.2] Author Affiliations: (1) Division of Nephrology, The Children's Hospital of Philadelphia, 34th Street and Civic [...]

The author talks about the association between venous thromboembolism (VTE) and air travel by referring to the rise of commercial aviation and a reduction in fare prices. Topics discussed include an advisory issued by Great Britain's National Institute for Health and Care Excellence to all moderate or high-risk long-haul travelers for VTE, the risk of developing thrombosis in travelers with factor V Leiden mutation and obesity, and the association between VTE risk and pregnancy.

Over the past 10 years, electronic music technologies have developed and become more accessible to music therapists and their clients. Music therapists are changing their clinical practices to incorporate these expanding technologies, which may include music software, electronic instruments, MP3 players, music-based video games, and a myriad of other options. These devices are growing popular in the music therapy field; however, a review of the literature results in little information about the indications and counterindications for the use of electronic music technologies in a medical setting. This article presents guidelines for the use of electronic music technologies in music therapy practice in pediatric medical settings. Clinical interventions and counterindications for using electronic music technology are examined. [ABSTRACT FROM PUBLISHER]