Tesi sul tema "Children's Hospital at Westmead"
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1
Alcaino, Eduardo A. "The demand for dental general anaesthesia in children at Westmead Hospital, Sydney, Australia". Thesis, The University of Sydney, 1998. http://hdl.handle.net/2123/4752.
Testo completo
2
Alcaino, Eduardo A. "The Demand For Dental General Anaesthesia In Children At Westmead Hospital, Sydney, Australia". Thesis, Faculty of Dentistry, 1998. http://hdl.handle.net/2123/4426.
Testo completo
3
Bush, Paul. "General Anaesthesia For Child Dental Patients At Westmead Hospital". Thesis, Faculty of Dentistry, 1995. http://hdl.handle.net/2123/5042.
Testo completo
4
Ogawa, Hiroshi. "General Anaesthesia For Handicapped Patients Of The Community Dental Health Unit At Westmead Hospital 1986-1995". Thesis, Faculty of Dentistry, 1996. http://hdl.handle.net/2123/5043.
Testo completo
5
Mathiasen, Lis. "Children's attitudes to a hospital familiarisation programme". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1326.
Testo completoAbstract (sommario):
Many young children are admitted to the emergency departments of our childrens hospitals without the opportunity to receive any preparation in terms of what to expect and what to do or not to do (Health Department of W A, 2000). Surrounded by strange people, environment, smells, sounds and medical equipment, and confronted with possibly painful and invasive procedures, many young children become stressed and anxious. Negative psychological effects may have immediate and/or long lasting psychological consequences (Zuckerberg, 1994; 0 Byrne, Peterson & Saldana, 1997). It is important to protect young childrens rights and to minimise upset and trauma whenever possible. To meet the needs of children who may experience unplanned hospitalisation, preventative measures have been taken by the Association for the Welfare of Children in Hospital (AWCH). One of these preventative measures is a Hospital Familiarisation Programme (HFP) designed to prepare healthy young children for possible hospitalisation. This study investigated the effect of the HFP on 5 years olds understanding of common items of medical equipment and procedures, using a Medical Equipment and Procedures Test (MEPT). In addition, their feelings towards possible hospitalisation and medical intervention were obtained by the use of a Hospital Intervention Footings Index (HIFI). A Solomon Four Group design (Salkind, 1997) was employed with a total sample of 84 five-year-olds drawn from 4 pre-primary centres in a large metropolitan ' primary school. The treatment consisted of a Hospital Familiarisation Session conducted by a presenter from the Association for the Welfare of Children iii Hospital, W.A. An analysis of variance revealed th8t there was a significant increase in the childrens understanding of medical equipment and procedures, as well as an increase in positive feelings towards medical intervention as a result of the Hospital Familiarisation Programme. On the basis of these results and from a review of the research literature and an analysis of developmental theories, some modifications to the presentation of the HFP were suggested to maximise its effectiveness. Further recommendations were also made for current practice and future research investigation.
6
Meyer, Sarah. "Children's preferences for color schematics of hospital rooms". Connect to resource, 2007. http://hdl.handle.net/1811/28522.
Testo completoAbstract (sommario):
Thesis (Honors)--Ohio State University, 2007.Title from first page of PDF file. Document formatted into pages: contains 29 p. Includes bibliographical references (p. 27-29). Available online via Ohio State University's Knowledge Bank.
7
Sutton, Kathleen Rose Creagh. "A study of the Mater Children's Hospital tile project". Thesis, Australian Catholic University, 2005. https://acuresearchbank.acu.edu.au/download/3303ce53026ee5b25d4b9999cab5113e699008ff8e72b1e1b6287d695968da0c/9528867/65102_downloaded_stream_327.pdf.
Testo completoAbstract (sommario):
This thesis examined the relationship between children's visual art and hospital contexts. It specifically focused on children's art in the Tile Project within the Mater Children's Hospital, Brisbane, Queensland, Australia. This ethnographic study consisted of interviews with the creators of the Tile Project as well as interviews and a survey with parents, staff, and children within the Mater Children's Hospital. The interviews were informed by a review of literature in the areas of art in health settings. The study made observations of the community interacting with the tiles and collected images of the tiles used in the hospital and employed the framework of Bourdieu's (1993) fields of cultural production and Abbs's (1987) aesthetic field and dimensions, as well as the aesthetic dimensions of Beardsley (1982), Eisner (1985), and Csikszentmihalyi (1990). The study investigated the aesthetic characteristics of the tiles and their health outcomes in relation to the hospital community. This study is significant because the Mater Children's Hospital Tile Project was a project that reflected art in healthcare settings involving Community Arts, art in design, and art in public buildings. The research identified the unique nature of the Tile Project which saw the hospital as a children's space with artworks for children by children. The study reflected on the value of the tiles in having a healing and distracting quality for parents and children alike and that engagement with the tiles through touch, imagination, and playful games improved the atmosphere of the hospital.
8
Livesley, Joan. "Children's experiences as hospital in-patients : voice, competence and work". Thesis, University of Salford, 2010. http://usir.salford.ac.uk/26780/.
Testo completoAbstract (sommario):
There is growing evidence that children's subjective interpretations of events may differ significantly from those of adults; yet children's voices and children's knowledge regarding hospital care remain largely unexplored. This study was undertaken to determine what counted as voice in work with hospitalised children, and explore children's subjective interpretations and knowledge as in-patients. Influenced by critical ethnographic methods, the study was undertaken in two phases with children who had been in-patients in one English tertiary referral children's ward. Phase one involved reconnaissance with 6 children to explore what mattered most to them regarding their in-patient experience. Phase two involved field work undertaken over six months, on a nephro-urology ward, and included in-depth work with nine children. Voice became manifest in what the children said but also through the non-verbal mechanisms of resisting and being silent. In this study, the children chose which voice to present when they participated in the study and that voice was accepted without question. Inductive analysis revealed that the children shared the experience of being in trouble. While they were in-patients, recognition of their competence was fluid=and contingent on structural and material factors. When their competence was denied, some of the children fought hard to re-establish their claim as authentic and knowledgeable individuals. However, while all of the children who participated in this study, regardless of ability, were capable commentators on their experiences, their capacity to work in their own best interests was sometimes challenged. During these episodes, they relied heavily on supportive adults. In the absence of supportive adults they often became marooned and subject to routinised care.
9
Muhina, Ibrahim Ali, e Issa Asal. "Microbiological research in neonatal ICU (Sumy region children's clinical hospital)". Thesis, Sumy State University, 2016. http://essuir.sumdu.edu.ua/handle/123456789/48138.
Testo completoAbstract (sommario):
Newborns with very low and extremely low body weight at birth (VLBW and ELBW) are
the most complicated category of patients in a Department of resuscitation and intensive therapy of newborns (ICU). Objective: to determine of colonization by opportunistic microorganisms and fungi, as well as their sensitivity in newborns in ICU.
10
Davidson, Alan. "Wilms' tumour outcomes at Red Cross Children's Hospital 1979-2003". Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/14308.
Testo completoAbstract (sommario):
Includes bibliographical references (leaves 78-96).BACKGROUND: In Africa Wilms' tumour frequently presents with advanced disease. This study reports our results over 25 years using the National Wilms' Tumor Study Group approach of primary surgery, in the form of nephrectomy, followed by chemotherapy. A small number of these tumours are bilateral and here surgery has evolved from simple nephrectomy into the use of nephron-sparing techniques. METHODS: A retrospective analysis was performed on all patients diagnosed with Wilms' tumour between January 1979 and December 2003. Treatment was according to National Wilms' Tumor Study Group protocols. For unilateral Wilms' tumour primary surgery, where possible, was followed by adjuvant chemotherapy with vincristine and dactinomycin. Doxorubicin was added for stage III and IV tumours. Other drugs were used for unfavourable histology, and radiotherapy was reserved for local stage III tumours and pulmonary metastases. Patients with bilateral Wilms' tumours underwent initial bilateral biopsy, neoadjuvant chemotherapy and tumourectomy. Where indicated, nephrectomy (partial or complete) involved using ice dam topical cooling and vascular control, and in one case bench surgery and extensive renal reconstruction with orthotopic autotransplantation. Revision tumourectomy was utilized on three occasions for recurrence in areas of nephroblastomatosis. Radiotherapy was reserved for pulmonary metastases and palliation. RESULTS: There were 188 children with unilateral Wilms' tumour and 20 with bilateral Wilms' tumour. Among those with unilateral Wilms' tumour fifty seven (30.3%) were stage I, 33 (17.6%) were stage II, 60 (31.9%) were stage III and 38 (20.2%) were stage IV. Twenty-four patients (12.8%) had unfavourable histology. Fifteen of the bilateral Wilms' tumours had a synchronous presentation, one with liver metastases at diagnosis, and five were metachronous. Nephroblastomatosis was identified in 18 of the 20 patients (90%) with bilateral Wilms' tumour. One hundred and forty five patients are alive and disease free, 23 to 318 months from diagnosis. The estimated 5-year overall survival for all unilateral Wilms' tumours was 78.3%; 82.8% for favourable histology and 47.3% for unfavourable histology. Among those with favourable histology, estimated 5-year overall survival was 94.6% for stage I, 96.2% for stage II, 78.4% for stage III and 54.2% for stage IV. There was no difference in overall survival between those favourable histology stage III tumours that were operable and those deemed inoperable. Intra-operative spillage was uncommon (8%), and did not increase local relapse rate. Survival of stage IV disease has not improved over the last decade. mong those with bilateral Wilms' tumours, 11 are alive free of disease one to fifteen years after completing treatment, all with well-preserved renal function. Nine have died (two of unrelated disease), including six of the seven with spread outside the kidney. All three with unfavourable histology are alive, as are four of the five with a metachronous presentation. Survival for bilateral Wilms' tumour has improved markedly in the last decade. CONCLUSIONS AND RECOMMENDATIONS" National Wilms' Tumor Study Group protocols employed in a South African setting with highly competent and experienced surgical care, produced results for non-metastatic favourable histology unilateral Wilms' tumour comparable to those of the National Wilms' Tumor Study Group. For bilateral Wilms' tumours appropriate chemotherapy together with conservative (nephron-sparing) and innovative surgery produced good results with preservation of adequate renal function in nearly all cases. We can seek to improve outcomes via better risk stratification with molecular markers, new adjuvant chemotherapy regimes for high risk tumours and novel surgical approaches to improve nephron-sparing in bilateral Wilms' tumour. Improving results in Stage IV patients may depend as much on earlier diagnosis, as on advances in therapeutics.
11
Moore, David Paul. "Aspect of tuberculosis case management at Red Cross Children's Hospital". Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/10863.
Testo completoAbstract (sommario):
Includes abstract.Includes bibliographical references (leaves 151-165).
Aim: To describe the spectrum of tuberculosis in children <15 years of age attending Red Cross War Memorial Children's Hospital between January 2006 and December 2008. Methods: A retrospective review of a paper-based Notifications Register and a database of culture-confirmed tuberculosis were undertaken. Laboratory and clinical data were analysed. Results: 1,314 episodes of tuberculosis were identified amongst 1,300 children. 433 (33%) of all cases were culture-confirmed; however, 120 (27.7%) of all culture-confirmed cases were not recorded in the paper-based Notifications Register. Conclusions: To improve the clinical service, detection of HIV co-infection in children undergoing evaluation for tuberculosis should be enhanced and strategies adopted to ensure that all children with culture- confirmed disease are notified and access antituberculosis therapy.
12
Lachman, Peter Irwin. "Referral patterns to the Red Cross War Memorial Children's Hospital". Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/26634.
Testo completoAbstract (sommario):
This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.
13
Bishop, Katherine G. "From their perspectives: Children and young people's experience of a paediatric hospital environment and its relationship to their feeling of well-being". Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3962.
Testo completoAbstract (sommario):
This study was conducted to increase our understanding of children and young people’s experience of a hospital environment and to identify the salient attributes of the physical environment in their experience. There were three specific aims: to describe children and young people’s experience of a hospital environment and identify what constitutes a supportive paediatric environment; to examine the role of the physical environment in patients’ feeling of well-being; and to highlight the capacity of participatory research with children and young people to inform evidence-based paediatric design. At this stage, there has been very little healthcare design research carried out with populations of children and young people. Well-being research with children and young people in paediatric environments that identifies the potential supportive attributes in this environment is also very limited. Historically research on children’s health and well-being has been dominated by a focus on the prevalence of disorders, problems and disabilities. More recently, in response to the change to health promotion, positive attributes have been included in well-being and satisfaction measures. At this stage, there are still many fewer positive measures. Within the body of literature that exists in healthcare, healthcare design research, and well-being research, there are only a small number of participatory studies that focus on children and young people’s experience of hospitalisation, and an even smaller number that include children and young people’s experience of hospital environments. The picture that is created by the research that exists is patchy. There is a need for a more holistic understanding of children and young people’s experience of hospitalisation and of hospital environments from their own perspectives. Based on these gaps in current knowledge, two research questions were developed. The first was concerned with describing children and young people’s experience of the sociophysical environment of a paediatric hospital. The second question was concerned with understanding the role of the physical environment in children and young people’s feeling of well-being in a hospital environment. In addressing these questions, the intention was to identify attributes within the hospital setting which collectively comprise a supportive environment for children and young people and which contribute to children and young people’s feeling of well-being in a paediatric setting. The current study was conducted as an exploratory qualitative case study and carried out at the Children’s Hospital at Westmead, in Sydney, Australia. Using participatory research techniques, the sequence of the study included two pilot studies and the main study. The focus was on understanding the experiences of longer-term patients of a paediatric hospital environment. In the main study 25 children and young people, aged between 9-18 years, who had been in hospital for at least a week completed semi-structured interviews in which they talked about their response to the environment of the hospital and their experience of hospitalisation. Data analysis was completed using a combination of concept mapping and thematic analysis techniques. Preliminary findings were used as the basis of a further member-checking task carried out with a further six children and young people before conclusions were reached. The findings reveal that children and young people’s experience of a paediatric setting involves a number of major areas of influence including their personal situation, their social experience, their interaction with the physical environment, opportunities and characteristics of the organisation, and the effect of time. The findings also reveal that children’s feeling of well-being within this experience is linked to their ability to feel comfortable in the environment, to maintain a positive state of mind, and to remain positively engaged with the experience and the environment. This research reveals a dynamic relationship between children and young people and a paediatric environment that children and young people actively manage and shape. It reveals some of the key considerations in children and young people’s experience of hospitalisation. It also reveals why these considerations are important and what role they play in patients’ experience and feeling of well-being. These findings provide the basis for further research and they have implications for future design and research practice in paediatric healthcare settings.
14
Bishop, Katherine G. "From their perspectives children and young people's experience of a paediatric hospital environment and its relationship to their feeling of well-being /". University of Sydney, 2008. http://hdl.handle.net/2123/3962.
Testo completoAbstract (sommario):
Doctor of Philosophy (PhD)This study was conducted to increase our understanding of children and young people’s experience of a hospital environment and to identify the salient attributes of the physical environment in their experience. There were three specific aims: to describe children and young people’s experience of a hospital environment and identify what constitutes a supportive paediatric environment; to examine the role of the physical environment in patients’ feeling of well-being; and to highlight the capacity of participatory research with children and young people to inform evidence-based paediatric design. At this stage, there has been very little healthcare design research carried out with populations of children and young people. Well-being research with children and young people in paediatric environments that identifies the potential supportive attributes in this environment is also very limited. Historically research on children’s health and well-being has been dominated by a focus on the prevalence of disorders, problems and disabilities. More recently, in response to the change to health promotion, positive attributes have been included in well-being and satisfaction measures. At this stage, there are still many fewer positive measures. Within the body of literature that exists in healthcare, healthcare design research, and well-being research, there are only a small number of participatory studies that focus on children and young people’s experience of hospitalisation, and an even smaller number that include children and young people’s experience of hospital environments. The picture that is created by the research that exists is patchy. There is a need for a more holistic understanding of children and young people’s experience of hospitalisation and of hospital environments from their own perspectives. Based on these gaps in current knowledge, two research questions were developed. The first was concerned with describing children and young people’s experience of the sociophysical environment of a paediatric hospital. The second question was concerned with understanding the role of the physical environment in children and young people’s feeling of well-being in a hospital environment. In addressing these questions, the intention was to identify attributes within the hospital setting which collectively comprise a supportive environment for children and young people and which contribute to children and young people’s feeling of well-being in a paediatric setting. The current study was conducted as an exploratory qualitative case study and carried out at the Children’s Hospital at Westmead, in Sydney, Australia. Using participatory research techniques, the sequence of the study included two pilot studies and the main study. The focus was on understanding the experiences of longer-term patients of a paediatric hospital environment. In the main study 25 children and young people, aged between 9-18 years, who had been in hospital for at least a week completed semi-structured interviews in which they talked about their response to the environment of the hospital and their experience of hospitalisation. Data analysis was completed using a combination of concept mapping and thematic analysis techniques. Preliminary findings were used as the basis of a further member-checking task carried out with a further six children and young people before conclusions were reached. The findings reveal that children and young people’s experience of a paediatric setting involves a number of major areas of influence including their personal situation, their social experience, their interaction with the physical environment, opportunities and characteristics of the organisation, and the effect of time. The findings also reveal that children’s feeling of well-being within this experience is linked to their ability to feel comfortable in the environment, to maintain a positive state of mind, and to remain positively engaged with the experience and the environment. This research reveals a dynamic relationship between children and young people and a paediatric environment that children and young people actively manage and shape. It reveals some of the key considerations in children and young people’s experience of hospitalisation. It also reveals why these considerations are important and what role they play in patients’ experience and feeling of well-being. These findings provide the basis for further research and they have implications for future design and research practice in paediatric healthcare settings.
15
Park, Jennifer Channa. "An analysis of dental emergency cases managed at BC Children's Hospital". Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/54501.
Testo completoAbstract (sommario):
Objective: To explore factors contributing to a reported increase in emergencies presenting to the Department of Dentistry at BCCH over recent years by investigating the “who, what, when and why” of their hospital management. Methods: A two-phase study incorporated quantitative (retrospective chart review) and qualitative (personal interview) elements. Phase 1- Records of 300 emergencies from 2009 to 2013 were systematically selected and reviewed. Patient demographics; source of referral; time/day of visit; nature, scope and management of emergency; and follow-up care were analyzed (Pearson’s Chi-squared Tests and Odds Ratios). Phase 2 - Twenty-five interviews with parents of children who recently experienced dental emergencies were recorded and analyzed for common themes in reported factors/circumstances. Results: Emergencies included dentoalveolar trauma (56.7%), pain of dental origin (20%), swelling from advanced dental disease (13.3%), and ‘other’, unrelated to trauma or caries (10%). Common patient characteristics were: healthy, male, young age (<7 years old), proximity of residence to the hospital and low socioeconomic status. Primary source of referral was the emergency department; emergencies presented equally throughout the week. No immediate intervention was necessary for the majority of cases and follow-up with a community dentist was advised. Factors contributing to a parent’s decision to seek emergent dental care in a hospital setting included: perception of urgency; concern for their child’s well being; desire for reliable care by a reputable institution; limited understanding of dental disease and consequences of poor oral care; and financial and access to care barriers. Conclusion: Dentoalveolar trauma and untreated advanced dental caries compel families to seek hospital-based dental emergency services. More aggressive efforts to improve awareness of the importance of early dental visits; development of curricula emphasizing management of anxious children and exposure to pediatric emergencies; and reinforcing the ethical responsibility of dentists to provide after-hours emergency care may help to reduce burden on hospital resources.Dentistry, Faculty of
Graduate
16
Higham, Sue. "Protecting, providing and participating : fathers and their children's unplanned hospital admission". Thesis, Swansea University, 2011. https://cronfa.swan.ac.uk/Record/cronfa42988.
Testo completoAbstract (sommario):
Fathers are being encouraged to be more involved with all aspects of their children's lives and patterns of responsibility for earning income and childcare within families are changing. Yet fathers have been overlooked in previous nursing research into the experiences of the parents of sick children in hospital, leaving nurses wishing to practice family-centred care without an evidence base for their practice with fathers. In this thesis an investigation is presented into the experiences of fathers of children admitted to general children's wards in a District General Hospital following acute illness or injury. A critical realist ethnographic approach was adopted in a study design incorporating participant observation, interviews with nurses and post-discharge interviews with fathers. Data were analysed through a process of content analysis and interpretation. Interpretation was guided by domain theory, reflecting the understanding that the social world is multidimensional. This enabled the complexity of fathers' experiences and the factors which influence them to be identified. Whilst fathers were often seen by health care professionals to be marginal to the child's illness, the study showed that many fathers played significant roles in the families' experiences of hospitalisation of a child for acute illness. Fathers could face barriers to involvement in the child's care which mothers did not. Such barriers arose from their own understandings and circumstances, but also from mothers' and nurses' behaviour in addition to institutional processes and routines. Nurses had received no training or education on working with fathers and therefore based their practice on experiential knowledge. The study indicates the need for changes in nurse education to better prepare nurses to practice family-centred care with 21st century families. It also demonstrates the need for practitioners, institutions and policy makers to take both mothers and fathers into account in the planning and delivery of children's acute in-patient care.
17
Huggins, Leslie Jane. "Immunization Status of NICU Graduates at a Tertiary Care Children's Hospital". BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6333.
Testo completoAbstract (sommario):
The objectives of this study were to determine the current rates of immunization and identify variables associated with immunizations of NICU graduates who were 60 days of age or older at time of discharge. This is a descriptive pilot study utilizing retrospective paper chart review. The relationships between immunization status and study variables were examined using logistic regression. Of 43 infants discharged at least 60 days of age or older from the NICU, 74.4% were up to date for immunizations in accordance with AAP recommendations. Additional variables were not significant. Immunization needs to be a priority in order to give NICU infants every advantage regarding their future health status.
18
Betts, Paul David. "Children's Oncology Group Hospital Membership and Survival of Pediatric Lymphoblastic Leukemia". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3862.
Testo completoAbstract (sommario):
Acute lymphoblastic leukemia (ALL) predominates in children ages 0-14 years and has an excellent prognosis for cure with 5-year survival exceeding 90% in the United States. However, not all children experience such positive outcomes. The purpose of this quantitative, retrospective cohort study was to evaluate differences in survival of ALL among children who reside in the 32-county Texas-Mexico border region. While factors such as poverty and health insurance have been strongly associated with poorer cancer outcomes, additional factors such as geographic isolation and treatment disparities are not as well-documented in children. This study examined the association between use of Texas Children's Oncology Group (COG) pediatric research facilities and survival among children in Texas diagnosed with ALL. This study used cancer incidence data 1995-2009 from the Texas Cancer Registry. Differences in survival and use of COG facilities were investigated between children who reside within the 32-county Texas-Mexico border region and the combined remaining 222 Texas counties. Chi-square was used to analyze area of residence, gender, race/ethnicity, and poverty status between COG and non-COG reported cases. Logistic regression was used to examine ALL survival differences between COG and non-COG facilities controlling for multiple variables. COG affiliation alone was not a significant predictor of survival. An interaction between race/ethnicity, region, poverty status, and COG facility affiliation was observed as a significant predictor of poorer survival. The results of this study have the potential to promote positive social change by implementing interventions addressing access to equivalent pediatric cancer care in the 32-county Texas-Mexico border area.
19
Givan, Veronica L. "Parent/Patient Satisfaction and Physician/Nurse Interaction at a Children's Hospital". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7800.
Testo completoAbstract (sommario):
Walden University
College of Health Sciences
This is to certify that the doctoral dissertation by
Veronica Laviece Givan
has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.
Review Committee
Dr. Diana Naser, Committee Chairperson, Health Services Faculty
Dr. Nicoletta Alexander, Committee Member, Health Services Faculty
Dr. Michael Brunet, University Reviewer, Health Services Faculty
The Office of the Provost
Walden University
2019
Parent/patient satisfaction surveys are important tools used to measure quality of health care provided by physicians, nurses, and hospitals. Research has been conducted on patient satisfaction in adult settings; however, a gap exists in the research about pediatric patient satisfaction in relationship to nurse interactions and interactions with physicians in various clinical settings. The purpose of this descriptive quantitative study was to determine whether a significant difference exists in overall parent/patient satisfaction scores and interaction of patients with nurses, and physicians, as well as interaction with anesthesiologists in terms of pain management in the pediatric surgical service in comparison to the medical inpatient unit and intensive care unit. Watson's caring science theory served as the framework for this study. Research questions evaluated parent/patient satisfaction scores and tested interactions between the parent/patient and the physicians, nurses, and anesthesiologists in a children's hospital. A total of 675 parent/patient satisfaction surveys from a children's hospital were analyzed using an independent samples t test, Levene's test, and regression analysis. The data analysis revealed a significant difference between overall parent/patient satisfaction scores (p = .021) in the pediatric surgical service as compared with the medical unit and for the parent/patient satisfaction survey responses (p = .004) for the interaction with nurses and physicians in the pediatric surgical service as compared with intensive care units. The potential social change that could result from this study is that health care organizations should record patient experiences to facilitate and improve the quality of care, interactions with physicians and nurses, and clinical outcomes
20
Stewart, Moira Connell. "An examination of the factors associated with the presentation of children at the Royal Belfast Hospital for Sick Children and of the hospital resources used in their management". Thesis, Queen's University Belfast, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.357511.
Testo completo
21
Aniruth, Sunildutt. "Maxillofacial fractures in children attending the Red Cross War Memorial Children's Hospital". Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
Testo completoAbstract (sommario):
The literature shows that maxillofacial fractures in children are uncommon. Although the Department of Oral and Maxillofacial Surgery of the Faculty of Dentistry, of the University of the Western Cape, has been providing a service to the Red Cross Children&rsquos Hospital (RXH) for the past twenty years, no study had been undertaken to determine the age, gender, number of patients per year, aetiology, patterns, and management of maxillofacial fractures at this institution. A retrospective records based study was undertaken to determine these features. This study accessed the records of patients seen at the trauma unit at RXH, from 1994 to 2003 inclusive, and referred for maxillofacial attention.
One-hundred-and-five patient records were obtained and analyzed using the SPSS statistic package. One-hundred-and-twenty-seven fractures were recorded in one hundred and five patients. The age of the patients ranged from one to thirteen. Sixty-five male and forty female patients were seen. Dentoalveolar fractures were the most common fracture seen in both the midface and mandible. Midface fractures were more common than mandibular fractures. Falls, followed by motor vehicle accidents, were the most common cause of facial fractures. Most fractures were successfully managed by closed procedures. At this institution, nasal and frontal fractures have surprisingly little or no input from the Department of Oral and Maxillofacial Surgery.
22
Andriychuk, D. R. "Optimization of the work of "Weight management school" in children's endocrinological hospital". Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18832.
Testo completo
23
Gurria, Juan P. "Thrombocytosis Following Pancreatectomy with Islet Autotransplantation in Children: Cincinnati Children's Hospital Experience". University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1521191336859138.
Testo completo
24
Pottinger, Heidi Lee, e Heidi Lee Pottinger. "Integrative Wellness Sessions In A Pediatric Hospital Setting: A Feasibility Study to Assess Evaluation of the Hospital Heroes Program at Banner's Diamond Children's Hospital". Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625669.
Testo completoAbstract (sommario):
BACKGROUND: Evidence suggests complementary and alternative medicine (CAM) therapies can be effective in treating certain chronic, recurrent, and incurable conditions. Use of CAM in pediatric populations is increasing considerably and uptake is especially evident among hospitalized children. Further, burnout among healthcare providers is increasing, affecting both their wellbeing and patient outcomes. At Banner Children's Diamond Children's Hospital, patients, families, and staff can receive CAM through the Integrative Touch for Kids™ (ITK) Hospital Heroes (HH) program. SIGNIFICANCE: Further study to evaluate HH is vital to understanding the quality of care delivered and recommendations for improvement. OBJECTIVES: Assess feasibility of evaluation of HH by Aim 1: Describing the vision and programmatic structure of the HH program. Aim 2: Achieving therapist consensus on referral, care coordination, and debriefing processes; Aim 3: Evaluating session impact on pain, fear/distress/anxiety, global/overall well-being, and satisfaction. Describe retrospective case studies to highlight valuable outcomes otherwise not represented. FRAMEWORKS & METHODS: The Centers for Disease Control & Prevention Framework for Program Evaluation in Public Health, elements from the Ethnographic Assessment of Evaluation Systems, and elements from Donabedian's Quality Framework were used to create a novel, theory-based, whole practice, program evaluation framework to evaluate HH via the following aims. Aim 1: Structure- Key- informant ethnographic interviews with ITK management (N=2) and self-completed questionnaires by HH therapists (N=4) were used to describe the program vision and structural elements. Interviews were transcribed and all data was de-identified, described, and summarized. Transcripts were converted into culturally-appropriate word clouds validated by participants. Univariate and descriptive statistics were used to assess questionnaire items related to human resources and quality rankings were assigned based on ITK standards. Aim 2: Process- The Delphi method was used by administering self-administered ethnographic questionnaires (N=3) to all HH therapists (N=4) to generate consensus on referrals, care coordination, and debriefing processes. Concept Maps were created for each element and validated by participants. Aim 3: Outcomes- Evaluation instruments were developed and piloted in collaboration with ITK stakeholders and data was collected over a two-month period representing nearly 50% of sessions administered by the HH therapists, from Aims 1 and 2, for 2017. Session and recipient characteristics for all sessions (N=95), regardless of recipient ability to report, were summarized. Pre/post changes were calculated using validated scales for pain, fear/distress/anxiety, global/ overall well-being, and likelihood to recommend the hospital. Session satisfaction rankings were collected post-session. Wilcoxon matched-pair signed-rank tests were done to calculate significant differences between median changes pre/post session for recipients able to respond and stratified by recipient type. Retrospective case studies (N=4) were described from data in the electronic health record and/or ITK records, as well as interviews with HH therapists. RESULTS: The program structure was described and quality of human resources met or exceeded criteria for most indicators of quality. Expert consensus on therapist interactions related to referrals, care-coordination, and debriefing was achieved. Evaluation of the HH program was determined feasible and in alignment with the program model and short-term vision. Strong evidence to support decreases in pain and fear/distress/anxiety, as well as increases in global overall well-being were observed in recipients able to report. High levels of satisfaction (mean≥9.0) and top-box rankings for likelihood to recommend the hospital overall, were reported. Retrospective case studies (N=4) highlighted additional outcomes from multiple perspectives. CONCLUSION: These results help to support ethnographic evaluation of the HH program, a holistic and integrative model of care, as ITK continues expanding and replicating the HH program within and beyond the current setting. Knowledge reported provides a new theory-based, whole practice, program evaluation model and expands existing evidence on CAM use in hospitalized pediatric patients.
25
McKerrow, Neil Hugh. "Childhood sexual abuse : the Red Cross War Memorial Children's Hospital experience, 1986-1988". Master's thesis, University of Cape Town, 1990. http://hdl.handle.net/11427/27189.
Testo completoAbstract (sommario):
This retrospective descriptive study reviews sexually abused children who presented to the Child Abuse Team at the Red Cross War Memorial Children's Hospital (RCWMCH) between 1 January 1986 and 31 June 1988. During this period 365 children were referred to the Child Abuse Team, of whom 357 were entered into this study. 297 of these were cases of confirmed sexual abuse. There were 48 male children and 123 children under 6 years of age. Most children were victims of a single episode of sexual abuse with only 13, 7% presenting following repeated abuse. More serious forms of sexual abuse, rape or sodomy, were common, accounting for 60% of the cases. Over 70% of the children had physical signs to substantiate their claims of having been sexually abused. Sexually transmitted disease was a common finding, being present in 15,6 % at presentation. All children were accompanied to hospital by an adult, usually a parent. 60% of the children presented directly to RCWMCH. A delay between abuse and presentation was common, only 42% of the children presenting within 48 hours of having been abused. Physical problems frequently required management. Very few children received more than crisis intervention for their emotional state and only 20% needed any form of intervention to ensure their safety. Only 1% of cases involved a female abuser. In general, the age of the abuser was older than previously reported with 18, 6% being under 20 years of age. The relationship between abused and abuser was similar to that described in the literature, as was the reaction of the family against the abuser. 27,4% were prosecuted and of those that appeared in court 7 4, 5% were convicted. Further comparison of the following sub-groups of abused children are presented: male and female, young and old, intrafamilial and extrafamilial abuse, a single episode of abuse and repeated abuse.
26
Henley, Lesley D. "End of life decision making in a children's hospital : ethical and practice implications". Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/26589.
Testo completoAbstract (sommario):
Aims: To evaluate end of life practices among hospitalised children who died of HIV/AIDS. Design: Retrospective chart review. Setting: A public, secondary and tertiary children's teaching hospital in a developing country. Patients: A consecutive series of in-patient deaths among HIV-infected children. Main Outcome Measures: Identification of patients as dying, presence of do not resuscitate (DNR) orders, documentation of comfort care plans, whether end of life decisions were discussed with parents or caretakers, nature of diagnostic and therapeutic interventions in the last 24 hours of life, and presence of pain and distress in the last 48 hours of life. Results: 165 out of 167 in-patient deaths were reviewed. 79% of patients died in the general wards. The median age of patients was 4 months. The median length of hospitalisation was 6 days. 30% of patients fell in Category B. Patients with shorter lengths of stay were more likely to fall in Category B (median 4 days versus 7 days, P=0.0000). About 1 quarter of patients had a median length of stay of 25 days. 84% of patients had a DNR order, with a median of 4 days between admission and documentation of the order. DNR orders appeared simultaneously in only 41 % of medical and nursing entries. 39% and 63% respectively of doctors did not document their justification for the DNR order or whether it had been discussed with parents. 50% of patients were identified as dying. Terminology such as 'TLC' and 'keep comfortable' designated 44% of patients to receive comfort care only. The median time between admission and identifying a patient as dying and documenting a comfort plan was 5 days and 7 days respectively. In 44% of folders there was no indication of whether the comfort plan had been discussed with parents. 73% and 62% respectively of patients with comfort plans received IV fluids and IV antibiotics in their last 24 hours of life. 55% of patients who died in general wards experienced pain and distress in the last 48 hours of life. Respiratory symptomatology and oral and oesophageal candidiasis accounted for most discomfort. 2 in 5 patients with a comfort plan failed to receive analgesia, despite pain and distress. Conclusions: Despite extreme diagnostic and prognostic uncertainty, doctors made key end of life decisions. Doctors' practices often failed to meet procedural and ethical requirements in professional guidelines. Failure to discuss DNR orders or comfort plans with parents ignores their role as principal decision makers for their children. The low rate of comfort plans, compared to DNR orders, suggests doctors had difficulty making the transition from curative to palliative care. Many comfort plans were incoherent and included interventions neither meant for, nor likely to promote patients' comfort. Whilst fear of hastening death may explain doctors' reluctance to prescribe adequate analgesia, undertreating pain and distress in a dying child is of more concern morally and medically than the risk of suppressing respiratory effort. To achieve better end of life care for HIV-infected children, it will be necessary to improve practice patterns. A structured medical treatment plan that focuses on goals of care is proposed to manage transitions from life-sustaining treatment to palliation.
27
Ngcobo, Richard Sibongiseni. "Nursing staff absenteeism at the Red Cross Children's Hospital and it's financial implications". Master's thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/9336.
Testo completoAbstract (sommario):
Includes bibliographical references (leaves 58-60).Absenteeism is a problem affecting the Public and the Private sector institutions alike. Anecdotal evidence from monthly absenteeism statistics and managers' comments suggest that it is also a problem for Red Cross Children's Hospital (RCCH). This dissertation describes the investigation into absenteeism among nurses at RCCH that was conducted by the writer in the year 2004. The writer reviewed attendance records for the year 2003. The main findings from the investigation and recommendations on management of absenteeism are then presented. The overall objective of the study was to establish the determinants of absenteeism among nursing personnel of RCCH and financial implications thereof. This involved establishing the extent of absenteeism among the nursing personnel, identifying major causes, estimating the financial burden and making recommendations on how to manage this problem. The study followed a descriptive as well as analytic methodology in presentation and discussion of results. The methodology included a review of the literature on absenteeism, motivation and migration of health personnel. The study has a qualitative and a quantitative aspect. Focus groups and in-depth interviews were conducted for collection of primary data from nurses. Two questionnaires were used as interview guides. Secondary data was collected from PERSAL database using the data capture sheet. Attendance records of all nurses were reviewed for the quantitative aspect of the study. A major finding of the study was that absenteeism among nursing personnel at RCCH was above what most writers on the subject regard as acceptable level. Staff turnover was found to be high in the nursing department with staff leaving the service and posts remaining vacant. It was felt that there is difficulty in recruiting nurses especially from the outskirts of the Western Cape and other provinces because of lack of accommodation. It was suggested that Staff Residence policy be enforced to address this problem since it confers power of granting or refusing accommodation to management. Stress was identified as the major cause of absenteeism by all interviewees. The source of stress was identified as both personal and work related problems. The financial burden of nurses' absenteeism was estimated at more than one million rands for the year 2003. Important recommendations that emerged from the study were that absenteeism control should be included in the job descriptions of supervisory positions. Development of institutional absenteeism policy was also recommended. it was also recommended that mechanisms be developed to recognize staff members with good attendance records.
28
Antonenko, I., C. O. Okonkwo, O. Lito, Аліна В`ячеславівна Гончарова, Алина Вячеславовна Гончарова e Alina Viacheslavivna Honcharova. "Structure poisoning in childhood and treatment algorithms at present in Sumy City Children's Hospital". Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/60791.
Testo completo
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Okonkwo, C. O., I. Antonenko, O. Lito e A. Goncharova. "Structure poisoning in childhood and treatment algorithms at present in Sumy City Children's Hospital". Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/60777.
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30
Isaacs, Yumnah. "Admission trends at Red Cross War Memorial Children's Hospital, Cape Town: 2004 to 2013". Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/24505.
Testo completoAbstract (sommario):
Background: Hospital database research has the potential to provide useful insights into health systems functioning, population health, clinical conditions and epidemiological trends thereof. This type of research is routinely done in countries that have large national hospital databases where results are usually extrapolated to the national population. South Africa does not have a national hospital database, but individual healthcare institutions, such as the Red Cross War Memorial Children's Hospital (RCCH) in Cape Town, collects routine patient data in a computerised database that if tapped should yield valuable information about child health of the catchment population as well as of the functioning of that health institution. Methods: Selected data from the RCCH database were converted into spreadsheet format and then exported into a statistical programme, Stata. Variables included patient demographic details, ICD-10 diagnostic codes, length of hospital stay and outcomes at discharge. Stata was used to clean and code the data and perform basic descriptive analyses of contained variables. Medians and interquartile ranges described numerical variables. Frequencies, proportions and percentages described categorical variables. Appropriate tests of statistical significance were performed where applicable. Admission and mortality trends were analysed across a decade and common conditions were explored. Findings and Conclusions: Overall admissions to RCCH increased by 9.3% across a decade while the number of new patients decreased by 8.6%, indicating an increase in readmissions. In-patient mortality decreased consistently across a decade despite an increase in admissions, which suggests an improvement in quality of care. The median ages of admissions and deaths increased across the decade, which correlates with less HIV and improved management thereof. Infections remain the commonest causes of in-hospital mortality. Admissions and mortality for diarrhoea and pneumonia displayed a consistent decline across 6 years corresponding with the introduction of new vaccines; however, diarrhoea and lower respiratory tract illness remained the commonest causes of medical admission. Injuries were the commonest reason for surgical admissions. Computerised hospital databases contain useful information for healthcare research.
31
Smith, Lara. "Neurocognitive outcome of HIV-infected children on antiretroviral therapy at Red Cross Children's Hospital". Master's thesis, University of Cape Town, 2004. http://hdl.handle.net/11427/11190.
Testo completoAbstract (sommario):
Includes bibliographical references (leaves 54-59).Central nervous system involvement contributes significantly to the morbidity and mortality of paediatric HIV infection. The spectrum of CNS morbidity varies from minor developmental disabilities to severe, progressive encephalopathy. Therefore regular developmental evaluation should be regarded as an essential component of the overall care of HIV-infected children. Antiretroviral therapy may arrest or even reverse neurocognitive and motor deficits associated with HIV infection.
32
Stowers, Louisa Lockhart Lau Tin-Man. "An approach to improve children's hospital facilities by incorporating a play system with stimuli that allows for imaginative play to aid in children's development". Auburn, Ala, 2009. http://hdl.handle.net/10415/1744.
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33
Omarjee, Zakiyya. "An audit of endocrine dysfunction in children with craniopharyngiomas at Red Cross Children's Hospital and Groote Schuur Hospital from 1976 to 2004". Master's thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/26765.
Testo completoAbstract (sommario):
Background: Craniopharyngiomas account for 6-10% of childhood brain tumours and are the third most common intracranial tumours of childhood. Despite their benign histological appearance, they are often associated with a poor outcome and have significant associated morbidity. Aim: To analyse the data of children with craniopharyngiomas at Red Cross Children's Hospital and Groote Schuur Hospital from 1976 to 2004 with respect to age at presentation, presenting symptoms and preoperative and post-operative endocrine dysfunction. Patients and methods: The records of 45 children aged between 9 months and 13 years were reviewed. The majority of children in the study were aged between 5 and 10 years. There was a considerable delay in the diagnosis in most cases especially in areas outside of Cape Town. Pre-operative tests prior to 2000 were incomplete but have improved since then. Twenty nine percent of our patients had a near total excision of the craniopharyngioma and 29% had partial excisions necessitating adjuvant radiotherapy. The endocrinological, neuro imaging and presenting symptoms were analysed and post-operative tests were reviewed. Where possible neuropsychiatric assessments were accessed as well in order to assess long term neurocognitive deficits Results: The age of presentation of craniopharyngiomas in our group of patients was much younger than in other studies with the largest group of affected children being between 5 and 10 years of age. The most common presenting symptoms in this group were headaches (62%) and visual disturbances (57%). Sixty four percent of the children had preoperative endocrine testing for pituitary dysfunction of which 59% were ACTH and TSH deficient and only 38% were growth hormone deficient. After surgery multiple endocrinopathies were universal with 56% of children having pan hypopituitarism at follow up. There was no reversal of pre-existing hormone deficits after surgery. The management of craniopharyngiomas remains controversial. Twenty nine percent of our patients had a near total excision and 29 % had a partial excision combined with radiotherapy with a further 6 patients receiving intratumoral bleomycin for recurrences. Post operatively the majority of children were on replacement therapy but only 6 patients (14%) received human growth hormone or are receiving human growth hormone currently due to a lack of funds to provide human growth hormone for children with growth hormone deficiency. Seventy percent of the children had central diabetes insipidus post operatively reflecting posterior pituitary damage. Our overall survival rate from 1976 to 2004 was 91 % with a mortality rate of 13%. Most of the deaths were attributed to recurrences of the craniopharyngioma and the complications of bleomycin treatment. Conclusion: Craniopharyngiomas remain tumours associated with significant morbidity. Total excision of the tumour remains a favourable option but the proximity of the craniopharyngioma to the pituitary gland and optic tracts results in devastating sequelae. Although the medical and surgical management of craniopharyngiomas has improved, a significant number of patients had endocrine sequelae. The management of craniopharyngiomas in an African context compares favourably internationally but with limited resources especially with regard to growth hormone replacement, a large proportion of our children are not receiving optimal treatment.
34
Norris, Elizabeth C. "Managing change and measuring success in the relocation of staff to a new children's hospital". Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2009. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=58980.
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35
Sfandyari, Fard E. "An investigation into the consideration of children and young peoples' preferences in children's hospital design". Thesis, University of Salford, 2013. http://usir.salford.ac.uk/30693/.
Testo completoAbstract (sommario):
This study was conducted to increase the understanding of the involvement of children in the design process of the children's hospitals environment from their perspectives. It was aimed to build rich picture of the process, methods, benefits and problems associated with engaging children during the design process of children’s hospital. It also provides a set of guidelines to apply for the process of involvement, which can be applied in future design projects conducted with children. This study was conducted to increase the understanding of the involvement of children in the design process of the children's hospitals environment from their perspectives. It was aimed to build rich picture of the process, methods, benefits and problems associated with engaging children during the design process of children’s hospital. It also provides a set of guidelines to apply for the process of involvement, which can be applied in future design projects conducted with children. The research methodology employed a case study approach, including two case studies: Royal Alexandra children’s Hospital and Royal Manchester Children’s Hospital. The process of identifying children’s preferences and considering them into the different stages of the design process is described. Different research techniques have been applied, including literature review and synthesis, interviews and content analysis. The contribution of this research is to address the gap identified in the literature and practice between the hospital design process and the needs of its users, i.e. children. It is intended to addresses the role of user perspective, the empowerment of the users, and the quality of the final outcome. These issues are examined from the points of view of hospital staff, designer, PFI. As a result, a better understanding of children and young people’s participation during the design process of hospital was achieved. The research has produced a set of guidelines for the process of involvement, which can be applied in future design projects to support project teams to define the process and tools for children’s participation.
36
Edwards, Maria E. B. "Children's and young people's experiences of being in hospital : disruption, uncertainty, powerlessness and restoring equilibrium". Thesis, University of Central Lancashire, 2009. http://clok.uclan.ac.uk/7815/.
Testo completoAbstract (sommario):
Whilst the Government has made explicit its stance towards identifying and taking into account the views of children and young people as service users it appears, within some hospital settings, that few openings are available to many children and young people, particularly those with learning or physical disabilities and acute illnesses. This qualitative study used an ethnographic approach to explore 46 children and young people's experiences of being in hospital. Data were collected within the hospital setting through unstructured participatory observation and semi-structured interviews alongside a variety of methods and activity based techniques. The data were collected and analysed concurrently in order to explore emerging themes in the analysis. The children and young people were diverse in terms of age ranges, experience of being in hospital and illness, with some being acutely ill and others having long term chronic illness. The findings revealed that children and young people experienced disruption due to being in hospital. This was experienced as a complex variety of factors, situations and people impacting upon their experiences. Interwoven within this disruption were feelings of powerlessness and uncertainty. Children and young people described experiencing disruption, uncertainty and powerlessness in terms of being in hospital, being ill and undergoing treatment and experiences of care and caring. In order to reduce these experiences children and young people undertook a range of strategies and actions in an attempt to restore equilibrium including "influencing", "accepting", "acting" and "positivity". Within this study I bring together for the first time the ways in which being in hospital creates disruption for children and young people and their agency and capacity in mediating their resultant experiences of powerlessness and uncertainty. I also provide an explanation for the ways in which children and young people experience disruption and restore equilibrium by drawing on Bronfenbrenner's work. The findings have implications for children's nursing in terms of quality and delivery of care for children and young people in hospital.
37
Le, Roux David Martin. "Impact of measles epidemic at Red Cross Children's Hospital, 2009-2010 : a retrospective record review". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/3062.
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Naidoo, Reené. "Epidemiology of Staphylococcus aureus bacteraemia at a tertiary children's hospital in Cape Town, South Africa". Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/3064.
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Spies, Anri. "Audit of transfusion practice during burns surgery at the Red Cross War Memorial Children's Hospital". Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27015.
Testo completoAbstract (sommario):
Rationale: Major burn surgery can be associated with significant blood loss, often requiring transfusion of blood products. In an effort to decrease aforementioned blood loss, various blood conservation strategies have been developed, rendering older formulae to predict intraoperative blood loss ineffective and outdated. Currently there are no clear guidelines on when to transfuse burn victims but, the trend is towards employing a more conservative transfusion practice in an attempt to reduce transfusion related complications. The predicament has become one of containing cost by not ordering blood unnecessarily and/or excessively, versus putting a patient at risk by not having blood available when he or she needs it. A guideline, based on haemoglobin and extent of surgery, was drawn up at the Red Cross War Memorial Children's Hospital in an effort to rationalise preoperative blood ordering. The aim of this audit was to assess how well the implemented guideline was adhered to, and how accurately the guideline predicted the need to have blood products available in theatre during burns surgeries of varying extent. Methods: After a guideline, based on expert opinion, had been drawn up and implemented, a prospective audit of practice was done from April 2014 to June 2015. Two hundred separate burn surgeries were audited. Data collected included haemoglobin levels, extent of surgery, pre-and intra-operative instructions to blood bank, and whether patients were transfused. Pre-operative instructions were compared to the guideline to test adherence, and to the ultimate need for blood to test accuracy. Additional data recorded were the adherence to surgical plan (extent of surgery). Results: Five of the 200 cases were excluded due to incomplete data, leaving 195 cases. Blood was ordered according to the guideline in 131 (67.2%) cases. There were two groups where adherence was particularly poor. In these patients the guideline suggested that only a group and screen was necessary - a category for which it would also be difficult to assess how accurately the guideline predicts the need for blood. After excluding these two groups, the preoperative instructions to the blood bank were appropriate in 119 (94.4%) of the 126 cases where the guideline was followed. Blood was ordered preoperatively in 83 of the 195 cases, but only used in 50 cases (60.2%). Of the 33 cases where blood was not used, 23 cases were not in keeping with the guideline. In 50 (83%) of the 60 cases where blood was ordered according to the guideline, it was appropriate. The performed surgery proceeded as planned in 162 (83.1%) cases. Discussion: Blood transfusion exposes the recipient to transfusion-related risks and is expensive. In an attempt to avoid these risks there has been a trend towards conservative transfusion practices. It has been shown to be cost effective and safe to employ a restrictive transfusion practice during major paediatric burn surgery. During our study period one unit of blood cost R1096,00 and a group and screen R172,00. Significant savings could therefore be incurred if blood is ordered according to the proposed guideline. Conclusion: This audit confirmed that the guideline is an appropriate one to use for preoperative ordering of blood products for burns surgery at the Red Cross War Memorial Children's Hospital.
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Mvalo, Tisungane Knox Titus. "Blood stream infections in oncology patients at Red Cross War Memorial Children's Hospital, Cape Town". Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27377.
Testo completoAbstract (sommario):
Background: Infections cause significant morbidity and mortality in children with cancer, which may be related to the cancer or treatment received. There is paucity of data on the epidemiology of bloodstream infection (BSI) in sub-Saharan Africa. To address this knowledge gap, the present study was conducted at Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town, South Africa. Methods: Structured literature review: From 1 April 2016 to 31 May 2016 a PubMed search was undertaken on BSI in Paediatric Oncology. The search string used was (bacteraemia OR blood stream infection) AND (paediatric OR pediatric) AND (oncology). Studies that did not describe infection patterns, risk factors for infection, morbidity/mortality, articles not in English and those exclusively describing neonatal or ICU patients were excluded from full review. Retrospective cohort study: A retrospective cohort study was conducted at the haematology-oncology unit of RCWMCH. All positive blood cultures from RCWMCH oncology patients taken between 1 January 2012 and 31 December 2014 were retrieved to identify patients who had BSI. Results: Structured literature review: 508 abstracts / articles were initially retrieved and screened. 478 studies were excluded as per the literature review exclusion criteria. Thus, 30 articles were included in full analysis, 17 retrospective studies, 4 prospective multicentre studies, 6 prospective single centre studies, 2 systematic reviews and 1 case report. All were observational studies. This literature review showed that BSI is a frequent and important cause of morbidity and mortality in paediatric oncology. Gram-positive bacteria was noted to be the leading type of pathogen causing BSI. Increased risk of BSI may be from the cancer itself, chemotherapy, hospitalisation, central venous catheter insertion, and oncology patients were at risk of multi-drug resistant infection. Research gaps noted included paucity of studies from Sub-Saharan Africa, limited analysis of the antimicrobial susceptibility of causative microorganisms and limited description of fungal BSI in oncology patients. Retrospective cohort study: From 436 positive blood culture results, 150 BSI episodes were identified amongst 89 patients; 49.1% of the culture isolates were Gram-positive bacteria, 41.6 were Gram-negative bacteria and 9.3% were fungal. Coagulase Negative Staphylococcus and Viridans Group Streptococcus were the most common Gram-positive isolates, and Escherichia coli and Klebsiella species the commonest Gram-negative isolates. The majority of BSI episodes occurred in patients with haematological malignancies (74%), in the presence of severe neutropaenia (76.4%) and whilst on or following chemotherapy (88%). Complications occurred in 14% of the BSI episodes. Fungal infections had the highest prevalence of complications (21.4%). Three children died during BSI as a result of multidrug resistant isolates, giving a case-fatality rate of 2%. Conclusion: The findings of our cohort study show that BSI are mainly caused by Gram-positive bacteria and associated with a low case-fatality rate. The results of this study are consistent with worldwide experience of BSI in paediatric oncology patients. This study provides an understanding of the spectrum of organisms causing BSI and the outcome of BSI in a sub-Saharan African context.
41
Dix-Peek, Stewart. "Pelvic osteotomies for exstrophy : a review of techniques and outcomes at Red Cross Children's Hospital". Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/2838.
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Alexander, Diane Elizabeth. "Technical Communication, Medical Writing and I.T. Converge: An Internship at Cincinnati Children's Hospital Medical Center". Miami University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=miami1292436407.
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Chen, Ying. "Epidemiological analysis of inpatient cases of rotavirus diarrhea in a children's hospital in Guangzhou, China". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994056.
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Toman, Peter. "Parental factors influencing the use of emergency medical services at the Women's and Children's Hospital, Adelaide /". Title page, table of contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09ARPS/09arpst655.pdf.
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45
Igwe, Oluchi. "Structure of bronchopulmonary among children according to infectious department № 2 Sumy city children's hospital St. Zenaida". Thesis, Sumy State University, 2014. http://essuir.sumdu.edu.ua/handle/123456789/36265.
Testo completoAbstract (sommario):
Over the last half century in most countries respiratory diseases in children has taken the lead in gross morbidity. Prevalence of these diseases is over 60 % in children and 50 % in youths, and the increase is 5–7 % per year. According to WHO, one third of the people in the world suffer from acute respiratory viral infection annually while In Ukraine about 4 millon children under the age of 14 suffer from severe acute respiratory syndrome (SARS) annually. In recent years, according to foreign authors the increase in the prevalence of pneumonia amoung children in Ukraine has gone from 8.66 till 10.34 for 10 thousand child population to 33.8 for 10 thousand population of children under the age of 5.
When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/36265
46
Switala, Juli. "Evaluation of children with haemophagocytic lymphohistiocytosis (HLH) at Red Cross War Memorial Children's Hospital 1991-2010". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/11104.
Testo completoAbstract (sommario):
Includes bibliographical references.Haemophagocytic Lymphohistiocytosis (HLH) is a rare haematological disorder in children. However, this is probably an underestimation due to the difficulty in diagnosing the disease. HLH is characterized clinically by persistent fevers, organomegaly, cytopaenias and typical biochemical derangements viz. hypertriglyceridaemia, hyperferritinaemia and hypofibrinogenaemia. Other associated findings include decreased natural killer cell (NKC) function and raised soluble CD 25. The exact pathophysiology of HLH is not completely understood but involves a trigger (often an infection) which sets off an uncontrolled inflammatory cascade, characterized by an increase in hyperactivated macrophages and T lymphocytes which leads to increased production of cytokines, alongside reduced cellular cytotoxicity as a result of reduced or absent NKC function.
47
Buys, Heloise. "Klebsiella pneumoniae bloodstream infections in hospitalised children at Red Cross War Memorial Children's Hospital : 2006 - 2011". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/19901.
Testo completoAbstract (sommario):
Background: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data about KP in South African children. The focus for the present study was to address this knowledge gap. Methods: This study addressed a retrospective case notes review on bloodstream Klebsiella pneumoniae infections at a children's hospital in Cape Town, South Africa 2006-2011 using conventional descriptive and comparative statistical methods. Results: Of 410 hospitalised children with laboratory confirmed KP bloodstream infection (KPBSI), 339 (83%) were presumed extended-spectrum β-lactamase (ESBL) producing isolates. The median age (interquartile range, IQR) was 5.0 (2-16) months, 212 (51.7%) were male, 82 (20%) were HIV-infected, and 241 (58.8%) were moderately or severely underweight. The infection was nosocomial or healthcare-associated in 389 (95%) children and community-acquired in 21 (5%) children. Significant risk factors for the acquisition of ESBL-KP bloodstream infection included cephalosporin exposure in the preceding 12 months prior to the KPBSI p=<0.0001: aRR 1.25 (95% CI: 1.15-1.36); and those who had intravenous infusions for more than 3 days prior to the KPBSI, p=0.004: aRR 1.18 (95% CI: 1.05-1.31).
48
Davies, John Quail. "Post transplant lymphoproliferative disoders in liver transplant recipients : cases at Red Cross Children's Hospital Cape Town". Master's thesis, University of Cape Town, 2002. http://hdl.handle.net/11427/10375.
Testo completoAbstract (sommario):
Includes bibliography.Between 1985 and 2000, 43 children (age range 6 months-13 years) underwent liver transplantation at Red Cross Children's Hospital. In 46% of these cases, viral infections resulted in considerable morbidity and mortality. Included in this group were: de novo hepatitis B (5 patients, 2 deaths), EBV-related post-transplantation lymphoproliferative disease (6 patients, 4 deaths) and CMV disease (9 patients, 4 deaths).
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Ocheke, Isaac Ejembi. "An audit of pelvi-ureteric junction obstruction at Red Cross Children's Hospital : a six year review". Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/11189.
Testo completoAbstract (sommario):
Includes bibliographical references (leaves 49-57).Pelvi-ureteric junction obstruction is an important cause of congenital renal and urinary tract abnormality. It is the commonest cause of antenatally detected hydronephrosis. The increasing use of antenatal ultrasound as a screening tool for congenital abnormalities in the developing foetus has resulted in a more frequent rate of detection of foetal hydronephrosis with the likely consequence of significant anxiety among parents. This is because most of these infants with antenatally detected hydronephrosis will be subjected to frequent radiological and other investigations and there will also be concern about outcome. Knowing what postnatal investigations are necessary for any child with this condition and when to do it becomes a priority. This is because it is known that a significant percentage of children with antero-posterior (AP) diameter of 12mm or less experienced complete and spontaneous resolution of the hydronephrosis in early life. This study is a retrospective folder review of one hundred children with PUJ obstruction managed at Red Cross Children’s Hospital over a six-year period from Jan 2002 to Dec 2007.
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Barnes, Pamela Alice. "Hospitals and childhood : a case study of the The Royal Manchester Children's hospital, "Pendlebury" 1829-1999". Thesis, University of Manchester, 2001. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.508799.
Testo completo