Search

Objective: Children and youth with special health care needs (CYSHCN) require additional considerations for staying safe in emergencies. Our team of clinicians and preparedness professionals developed and tested a virtual home preparedness intervention (VHPI) in families with CYSHCN receiving care in a statewide medical home network., Methods: The VHPI comprised 1) a pre/post interview covering fire safety, emergency evacuation, sheltering in place, and informing emergency responders of the child/youth's care needs; 2) a resource packet containing emergency planning templates and information on local supports; and 3) individualized referrals coordinated through the medical home/community partners. Eligible CYSHCN had medical technology reliance, physical/mobility needs, communication/intellectual challenges, and/or vision/hearing loss. Preparedness was measured as pre/post affirmed rates of 19 items from the interview and as mean composite scores of these items; associations were evaluated using generalized estimating equations-based regression for repeated measures., Results: The pre and post-VHPI interviews were completed by 170 and 148 participants, respectively. Significant individual-item gains included having a current Emergency Information Form for the child/youth (31% [pre] to 47% [post] affirmed) and assembling an evacuation kit (50% to 68%). The mean preparedness score was 13.33/19 items affirmed at baseline and increased to 14.96 post-VHPI (P < .01). In the adjusted regression model, the post-intervention preparedness score remained significantly higher than pre-VHPI, with mean increases of 1.22 preparedness steps affirmed for homeowners and 1.85 for renters., Conclusions: Preparedness scores improved post-VHPI in families with CYSHCN. Future work should address incorporating the VHPI into care visits in the medical home., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: R Turchi: Centers for Disease Control and Prevention (CDC) funding and contract for this study, continuing medical education (CME) funding from St. Christopher's Hospital for Children to attend academic meetings, and leadership roles in the American Academy of Pediatrics, Health Resources & Services Administration Maternal and Child Health Bureau (HRSA MCHB), and Academic Pediatric Association. All other authors have no disclosure to share., (Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

A palladium-catalyzed synthesis of 2-SF 5 -indenols has been developed by reacting commercially available boronic acid derivatives and readily accessible SF 5 -alkynes. The present methodology is fully regioselective thanks to the intrinsic polarization of SF 5 -alkynes. A selection of downstream functionalizations has been performed to highlight the versatility of 2-SF 5 -indenols and indenones as platforms for the design of more complex SF 5 -containing molecules., (© 2023 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

The chloropentafluorosulfanylation of alkynes is a delicate but crucial operation for accessing SF 5 -alkynes that serve as substrates in numerous transformations. Dolbier's procedure using Et 3 B/O 2 was the most efficient approach, while recent efforts make use of other initiators and light activation. We found that THF, as a single stimulus, is sufficient to trigger the reaction of SF 5 Cl with alkynes. We determined the configuration of Cl/SF 5 products and clarified the structure of side-products.

Pyrazines are reactive 4π partners in intermolecular Diels-Alder cycloaddition with exceptionally activated dienophiles or in an intermolecular version at elevated temperatures. Herein, it is shown that an intramolecular cascade could occur even at room temperature, delivering a collection of 6- or 7-aza-indazoles. An interesting substituent effect of the cycloaddition precursor on the product distribution was uncovered, and in situ NMR studies were conducted to gain insights into this unexpected selectivity.

Herein is described a fully regio- and stereoselective hydroelementation reaction of SF 5 -alkynes with N, O and S-nucleophiles and further functionalization of the corresponding Z-(hetero)vinyl-SF 5 intermediates, a suitable platform to access α-SF 5 ketones and esters, β-SF 5 amines and alcohols under mild reaction conditions. Experimental and computational comparative studies between SF 5 - and CF 3 -alkynes have been performed to highlight and explain the difference of reactivity and selectivity observed between these two fluorinated motifs., (© 2023 Wiley-VCH GmbH.)

Children and youth with special healthcare needs (CYSHCN) are at disproportionate risk of harm from widespread disasters and from life-safety emergencies. These risks may be mitigated by providing preparedness training and support to family caregivers. We conducted a scoping review to identify and map the scholarly literature on home-focused preparedness of families with CYSHCN. Our search strategy yielded 22 relevant articles; 13 pertained to life-safety emergencies, 5 centered on widespread disasters, and 4 addressed preparedness on multiple scales. Approaches to measure or attempt to improve emergency preparedness levels in CYSHCN and their families were diverse and included interviews and focus groups; didactic, video-based, or side-by-side instruction; simulated medical crises; and provisioning of emergency kits. For the studies that involved an intervention (n=15, 68%), several proxy indicators of preparedness were used, including caregiver knowledge, skill, or comfort level with managing emergencies that could affect their CYSHCN; completion of preparedness tasks; and reduction in adverse clinical outcomes. Despite the varied methodologies, prevailing themes in the studies were that family caregivers of CYSHCN felt underprepared for emergencies and disasters, desired training to improve their preparedness at home, and benefited from such trainings, at least in the short term, across domains of self-efficacy, skill, and health outcomes of their CYSHCN. Although more research is needed to compare preparedness interventions and evaluate the durability of these interventions in larger, more diverse samples of CYSHCN and their families, our findings support incorporating preparedness training into preventive care encounters and the hospital-to-home transition.

Children and youth with special healthcare needs are at risk for severe consequences during infectious disease emergencies. Messages for parents and caregivers from trusted sources, via preferred channels, that contain the information they need, may improve health outcomes for this population. In this mixed methods study, we conducted a survey (N = 297) and 80 semistructured interviews, with 70 caregivers of children and youth and 10 young adults with special healthcare needs, between April 2018 and June 2019 in Pennsylvania. The survey presented 3 scenarios (ie, storm, disease outbreak, radiation event); the interviews included questions about storms and an outbreak. This article addresses only the disease outbreak data from each set. Participants were recruited through convenience samples from an urban tertiary care children's hospital and practices in a statewide medical home network. In this article, we summarize the preferred information sources, channels, and content needs of caregivers of children and youth with special healthcare needs during an infectious disease emergency. Nearly 84% of caregivers reported that they believe their child's doctor is the best source of information. Other preferred sources include medical experts (31%); the US Centers for Disease Control and Prevention (30%); friends, family, and neighbors (21%); and local or state health and emergency management (17%). Pediatric healthcare providers play an important role in providing information to parents and caregivers of children and youth with special healthcare needs during an infectious disease emergency. Public health agencies can establish health communication plans that integrate medical practices and other reliable sources to promote the dissemination of accurate information from trusted messengers.

Purpose of Review: Postpartum depression (PPD) negatively impacts caregivers, infants, siblings, and entire families. Mothers with infants admitted to the neonatal intensive care unit (NICU) face additional risk for PPD, coupled with risk factors extending beyond a NICU admision. The novelty of this review is the focus on maternal PPD for mothers with infants admitted to the NICU. Interventions aimed at limiting and preventing PPD in this population include: prenatal and postpartum depression screening, PPD symptom awareness and monitoring, and trauma-informed care., Recent Findings: PPD, the most frequent complication of childbirth, affects approximately 10-15% of mothers worldwide. Prevalence rates increase to 40% for mothers whose infant is admitted to the NICU. PPD can affect maternal and child health across the life course and predispose future generations to a myriad of developmental, psychosocial, and physical challenges. Prevalence rates are higher for racial and ethnic minorities, immigrant and refugee populations, and mothers in rural locations. Trauma-informed care is suggested at individual and organizational levels, leading to better care for those with and without previous trauma exposure., Summary: Increasing PPD symptom awareness, screening for PPD, and connections with resources should begin during prenatal visits. Care teams should discuss barriers to resources for mothers, children, and families to improve access and support., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Numerous studies confirm efficacy of psychiatric treatment as well as psychiatric placebo. The aim of the current study was the assessment of improvement rate and factors associated with treatment response in naturalistic group of adolescent inpatients., Methods: Eighty two consecutive adolescent inpatients were recruited. Each patient at the admission and discharge was assessed with brief psychiatric rating scale (BPRS), eating attitude test (EAT-26), clinical global impression scale (CGI-S) and children global assessment scale (CGAS). Individual and family history was assessed by semi-structured interview. Patients, who improved in at least two interviewer-based scales (IMP, n = 67) were compared to the rest (N-IMP, n = 15). For statistical analysis STATISTICA package was used., Results: The main difference between groups was ICD-10 diagnosis distribution: in the IMP group more anxiety-related disorders (F4), in the N-IMP group more personality disorders (F6). Other differences include history of paediatric hospitalisations and surgery (more in the N-IMP group). Most of the analysed factors did not differ between groups., Conclusions: The inpatient treatment seems to be most effective in severe mental states and in anxiety-related disorders and least effective in personality disorders. Due to limited inpatient treatment efficacy we believe outpatients services are crucial in adolescent psychiatry.

The case of monozygotic female twins simultaneously concordant for anorexia nervosa is reported. The mechanisms of interaction between psychological factors and genetic predisposition playing a role in the onset and the course of disease in twin sisters are discussed.

Separation and individuation process ceases to be physiological when the family does not furnish the child with a feeling of security. Very often it becomes the main reason for the development of fears, including separation fear. The described study of the child suffering from separation fear testifies to a strong interrelation between the attitude of the parents, their volatile feeling of security, an the fear developed by the child. It also demonstrates the influence of the generic families on the current family situation. All these factors prove that there should be a strong relation between the child therapy and the family therapy. All the described forms of therapy account for work with the child in the conditions of the day ward according to the Good-Start Method, V. Sherborne, group therapy and system family therapy. The interesting point is the stage at which the family decides to undergo the therapy and consequently break it up.