Obstacles to progress in paediatric gender medicine

This study aims to carry out a bibliometric analysis of the studies that have been carried out related to Augmented Reality (AR) in particular in the field of medicine. Augmented reality technology, which is becoming increasingly popular in the field of medicine, has the potential to improve medical diagnosis, treatment, and training. In this research, we perform bibliometric analysis of relevant scientific publications published in a particular period. Bibliometric analysis methodology gathers data on AR research in the field of medicine. This includes the title, author, journal where it was published, year of publication, and keyword used. The results of bibliometric analysis showed rapid progress in AR research in the field of medicine. In the last five years (2018-2023), as many as 250 publications were selected based on research criteria. This analysis reaches the conclusion that research on AR in the field of medicine is vital and increasingly recognized in the scientific community. The results of this analysis can help researchers and medical practitioners understand current trends with the use of AR in medical practice.

Historically, computational methods are the third avenue of the sciences, but this approach is now one of the most important, paralleling experimental and theoretical approaches. It has already been adopted in many fields of engineering and is regarded as a sine qua non tool for industrial design and manufacturing. Although its application in the fields of medicine and biology has so far been limited, the use of computational methods can be extended to wide areas of medical practice. In addition, the explosion of Internet technology will undoubtedly enhance and accelerate the development of biological and medical applications of computational mechanics. This article discusses a broad spectrum of computational approaches that can widen the horizon of computational biomechanics, and focuses on recent realistic models and simulations in the field of cardiovascular medicine.

As the field of physical medicine and rehabilitation grows, there is an increased need for books that discuss its applications in the various fields of medicine. This monograph relates clearly, yet briefly, the usefulness of physical medicine and rehabilitation in the field of geriatrics. A two page chapter outlines the physiological changes in the aged that influence response to treatment. The next chapter briefly describes therapeutic physical agents, such as water, electricity, radiant energy, and mechanical force. It is unfortunate that, in the latter portion of this chapter, reference is made to the Zander apparatus, which has little therapeutic value for the younger patient and might result in frightening consequences if used on the aged. The chapter on application of physical medicine in specific medical conditions, describes the treatment of various forms of arthritis and related disorders in general terms. A section on spa therapy is included, with special reference

In June 2004, an article in American Journal of Nursing reported findings of a three-year study of organizational culture, attitudes, and assignment of responsibility for patient safety in small, rural hospitals in nine Western states. The study found that most errors fall within realm of nursing practice and that physicians, administrators, and nurses themselves tend to see patient safety as largely a nursing responsibility. Asked to identify which profession has primary responsibility for ensuring patient safety, 96 percent of nurses and more than 90 percent of physicians, administrators, and pharmacists assigned primary responsibility to nurses. Only 22 percent of respondents believed that physicians, nurses, pharmacists, and administrators share responsibility for patient safety equally. Unfortunately, however, nurses and physicians differed on role of nurses in effecting change. Most of nurses indicated that they had several responsibilities in reducing medical errors, including reporting them, educating themselves and colleagues, serving as role models, making recommendations for changes in procedure and policy, reviewing reported adverse patient-safety events, and participating in investigations. Only 8 percent of physicians who responded to survey identified nurses as members of decisionmaking team. Nurses have a genuine impact on patient safety. Studies have found a link between patient safety and RN staffing and an increased rate of error when hospital nursing staff has a smaller proportion of RNs. These are worrisome findings in light of severe national shortage of nurses. Part of medical malpractice crisis, then, is confusion in health care system and how it affects role of nurse. There is no confusion in American Nurses Association's code of ethics. This document, first adopted in 1950 and revised in 2001 to reflect and embrace role of today's nurse, consists of a set of planks that set out nurses' fundamental values and commitments. They also offer a starting point for understanding how nurses should be involved in thinking about medical error, and why nurses blame themselves for medical errors. The first few planks are most important. These planks state that nurse's primary commitment is to patient (plank 2), and that nurse promotes, advocates for, and strives to protect health, safety, and rights of patient (plank 3). Interpretive Statements that accompany code add that nurses are committed to patient's health, well-being, and safety throughout patient's life span, and in all settings in which health care needs are addressed. Further, code directs that, as an advocate for patient, the nurse must take appropriate actions regarding any instances of incompetent, unethical, and illegal practice by any member of health care team or health care system or any action on part of others that places rights or best interest of patient in jeopardy. For nurses to function effectively in this role, they must be knowledgeable about code of ethics, standards of practice, relevant laws, and their own organization's policies and procedures. Moreover, when nurse is aware of inappropriate or questionable practice in provision or denial of health care, concerns should be expressed to person engaging in questionable practice. Attention should be called to possible detrimental effect upon patient's well-being or best interests, as well as to integrity of nursing practice. When factors in health care delivery system or health care organization threaten welfare of patient, concerns should be directed to responsible administrator. If indicated, problem should be reported to an appropriate higher authority within institution or agency, or to an appropriate external authority. The interpretive statements for third plank also remind nurses that they have a responsibility to implement and maintain standards of professional nursing practice. …

The Emergence of Pediatric Sleep Medicine

Editorial: Introduction to Special Section on Evidence-Based Practices for Persons With Intellectual and Developmental Disabilities

There is enough interest in iatrogenesis in adult medicine today. The press echoes this, too. In the late 1950s, a new field of medicine in pediatrics began to emerge — Neonatology. The technology and information gained from research in physiology and biochemistry, pharmacology and antibacterial drugs and capability for micro-monitoring and micro-chemistry gained from aviation and space research contributed to the increased interest in the study and treatment of newborns. The infants of that time were already being looked upon as "Therapeutic Orphans" as a burst of harmful and disastrous results were being reported, not only from new drugs and technology, but from the old and accepted ones. This body of knowledge needed to be coordinated and controlled for education and research. Thus, iatrogenic observations truly served as an impetus for the cartoon, "Neonatology — A Six-Finger Exercise" in 1958, which showed the importance of thinking about iatrogenesis when looking at each sick infant along with the traditional clinical conditions, each body system and for birth defects. An appendage was tied with a suture and appropriately called pediatrica iatrogenica.

BackgroundPaediatric sleep medicine is an expanding area of clinical practice. A recent report1 highlighted the heterogeneity in both service provision and training between UK paediatric sleep centres. It was felt...

This is a short book with a 130-page introduction that takes up almost 40% of the written material. It has brief chapters covering fetal through late adolescent growth and development. It could best be described as an overview of an incredibly vast amount of material, but not in enough detail to qualify as a practical text or a comprehensive reference. I find it to be interesting reading but mostly covering material available in other sources and lacking any originality in its style of presentation. It does contain valuable material for medical students who are rotating through general pediatrics, adolescent medicine, or developmental pediatrics, although not as a required primary text. I find the chapter on fetal development sufficiently convincing that we are dealing with indispensable humanity and not disposable amorphous tissue. In the chapter on the newborn it is fascinating to discover what an intelligent infant, with memory and preferences,

Single case research results as clinical outcomes

Loads of reactive oxygen species (ROS), including superoxide anion and nitric oxide, that overburden antioxidant systems induce oxidative stress in the body. Major cellular targets of ROS are membrane lipids, proteins, nucleic acids, and carbohydrates. Circumstantial evidence suggests that ROS play a crucial role in the initiation and progression of various diseases in children and adolescents. The involvement of ROS and oxidative stress in pediatric diseases is an important concern, but oxidative stress status in young subjects and appropriate methods for its measurement remain to be defined. Recently, specific biomarkers for oxidative damage and antioxidant defense have been introduced into the field of pediatric medicine. This review is intended to provide an overview of clinical applications of oxidative stress biomarkers in the field of pediatric medicine. First, this review presents the biochemistry and pathophysiology of ROS and antioxidant defense systems. Second, it presents a list of clinically applicable biomarkers, along with pediatric diseases in which enhanced oxidative stress might be involved. The discussion emphasizes that several reliable biomarkers are easily measurable using enzyme-linked immunosorbent assay. Third, this review presents age-related reference normal ranges of oxidative stress biomarkers, including urinary acrolein-lysine, 8-hydroxy-2'-deoxyguanosine, nitrite/nitrate, and pentosidine, and the changes of the parameters in several clinical conditions, including atopic dermatitis and diabetes mellitus. New and interesting data on oxidative stress and antioxidant defenses in neonatal biology are also presented. Fourth, this review discusses the ever-accumulating body of data linking oxidative stress to disturbances of the nitric oxide system and vascular endothelial activation/dysfunction. Finally, this review describes the reported clinical trials that have evaluated the efficacy of antioxidants for oxidative-stress related diseases. Suggestions are advanced for the direction of future trials using antioxidant therapies. Repeated measurement of appropriate parameters will enable us to discern the pathophysiological patterns of pediatric diseases and guide our therapies appropriately.

This module, Developmental Perspectives of Emotions and Illness, discusses the impact of development on a child's understanding and experience of illness. Cognitive developmental influences are emphasized and the concepts of “immanent justice” (the belief that a form of natural justice exists and is the consequence of misdeeds), germ theories, and contagion are illustrated via a video clip interview with a 12 year old girl. Influences on the adaptation of children and adolescents to medical conditions related to onset, etiology, diagnosis, disability/deformity, and prognosis are reviewed and the concept of risk/protective factor is introduced. Additionally, pediatric hospitalization and its influential variables and developmental considerations are highlighted via a video clip interview of two boys (ages 12 and 14) discussing the older boy's hospitalization at age 10. Strategies to maximize coping in the ill child as well as other family members are reviewed. This submission is one of six modules which can be used together as a complete course or independently by topic. Each module uses teaching tools which include learning objectives, lecture outline lecture text, clinical correlations or case vignettes, sample test questions, recent related research, after-class exercises or activities, audiovisual aids including some dedicated teaching clips or transcripts, bibliographies, and PowerPoint presentations. It is not unusual for medical learners to devalue course material deemed “soft science” even when the learner is psychologically sophisticated, particularly when taught concurrent with challenging and volume intensive courses requiring memorization of many details. Such was the case when this course was instituted at a large medical school 15 or more years ago. Because educational leaders felt the material to be essential to the learner's integration of the “biopsychosocial” approach to patient care, and also supported on of the course's tenets (that improved self-understanding and self-reflection supports physician self-care and the doctor-patient relationship), course leaders undertook a process of course examination and improvement which is ongoing. Included in this submission are assessment samples from in-house course evaluations and also from other institutions exposed to the materials that support the success of this curriculum. The authors of this submission believe that the comprehensive course format utilizing a multi-media approach, lectures as well as after-class activities, case correlations, etc. appeals to almost all learners.

Citation analysis reflects the influence a work has on a field of research and can be used to identify "classic" works and their qualities in medical specialties. By analyzing the characteristics of these works, we intended to determine what qualities make for a highly cited work in pediatric orthopaedic sports medicine. To identify the top 25 most cited articles in the field of pediatric orthopaedic sports medicine. Cross-sectional study. The Science Citation Index Expanded feature within the Web of Science database was searched using a Boolean string, generating 2008 pediatric orthopaedic sports medicine articles arranged by number of citations. The top 25 most cited articles were reviewed for authors, year of publication, source journal, country of origin, region of origin, diagnosis or condition of focus, and level of evidence (LOE). Most of the articles were published in the 2000s (range, 1992-2016). The mean number of citations was 166 (range, 119-329), and the mean citation density was 13.25 (range, 4.25-29.57). There were 18 of 25 studies performed in the United States. A plurality of the articles were published in the American Journal of Sports Medicine. The LOE ranged from 2 to 4, with the most common being level 2 (11/25). Anterior cruciate ligament (ACL) injury management (14/25) and epidemiological studies on the incidence of various sports injuries (6/25) were the most represented topics of study. Since the 1990s, the mean citation density for articles related to ACL injuries in young athletes and the epidemiology of sports injuries has been increasing. This evaluation demonstrated that ACL injuries and the epidemiology of sports injuries had the highest citation density of the most influential studies in pediatric orthopaedic sports medicine. We identified attributes such as country of publication, journal of publication, and LOE that make for a highly cited pediatric orthopaedic sports medicine article. Overall, citation density in pediatric sports medicine is increasing. Nonetheless, the most represented LOE in the most cited works is level 2, with no level 1 studies being represented in the top 25. In terms of both topics and LOE, this study allows surgeons to identify deficiencies in the existing literature and meaningfully design future studies to improve on these.

Pain is ubiquitous. At some point in time it affects everyone. For many millions pain becomes chronic, a scourge that impacts every facet of life-work, hobbies, family relations, social fabric, finances, happiness, mood, and even the very essence of identity. According to the National Institutes of Health (NIH), pain is one of our most important national public health problems, a silent epidemic. In 1998, NIH reported that the annual amount spent on health care, compensation, and litigation related to pain had reached one hundred billion dollars ($100,000,000,000). Considering that health care costs have doubled since then, it is not unreasonable to assume that the costs related to pain care have doubled as well. Millions of patients suffer needlessly with acute pain, with cancer pain, and with chronic pain. The ineffective management of pain results in an escalating cascade of health care issues. Acute pain that is not treated adequately and promptly results in persistent pain that eventually causes irreversible changes in the nervous system. This translates into progressive bio-psycho-social epiphenomena resulting in further pain and disability. It creates a vicious cycle transforming a functional human being into an invalid who becomes a burden to family, to society, and to oneself. In the face of adequate medical science, adequate technical skills, and adequate resources the reality of delayed and inadequate pain care is paradoxical. This dilemma deserves close scrutiny and effective remediation. The American Medical Association (AMA), long dedicated to the need to improve pain care in this country, has been faced with this reality. It was from this vision that the idea of holding a Pain Medicine Summit was conceived. Resolution 321 (A-08) set in motion a process that would bring together a diverse group of stakeholders for the purpose of discussing the present and future status of pain care; a process that culminated in a broad-based coalition of physicians and organizations dedicated to improving pain care, the first National Pain Medicine Summit. The process began with the adoption of Resolution 321 (A-08) at an AMA Annual House of Delegates meeting in June 2008. Resolution 321 (A-08) states, in part, that "...the AMA encourages relevant specialties to collaborate in studying: 1) the scope and practice and body of knowledge encompassed by the field of Pain Medicine; 2) the adequacy of undergraduate, graduate, and post graduate education in the principles and practices of the field of Pain Medicine, considering the current and anticipated medical need for the delivery of quality pain care; and 3) appropriate training and credentialing criteria for this multi-disciplinary field of medical practice." The next step was delegating the responsibility for implementing Resolution 321 (A-08) to the Pain and Palliative Medicine Specialty Section Council (PPMSSC). The PPMSSC, under the direction of its chairman, Philipp M. Lippe, MD, FACS, assumed responsibility in November 2008 for identifying a process that would achieve the goals established by Resolution 321 (A-08). The PPMSSC in turn established an Advisory Committee, charged with strategic planning, and an Implementation Committee, charged with tactical operations. The two groups began work immediately. The process included three distinct phases centered on a Pain Medicine Summit. Phase One involved a modified Delphi process identifying the five most pressing and relevant themes in pain care. Phase Two consisted of the Pain Medicine Summit itself, including a gathering of representatives from across the pain care spectrum to address the previously identified five most pressing themes. Phase Three was the preparation of this report, which describes the conclusions drawn and recommendations developed by the attendees at the Pain Medicine Summit. Based on a recommendation from the Advisory Committee, the PPMSSC decided to retain the services of a consulting firm to help the PPMSSC implement the Pain Medicine Summit process. In August 2009, PPMSSC selected Grey Matters, a New York-based advisory firm. The PPMSSC also appointed a Steering Committee to assist Grey Matters and to coordinate all activities. The Committee consisted of Charles Brock, MD; Ronald Crossno, MD; Jose David, MD; Michel Dubois, MD; Albert Ray, MD; and Philipp M. Lippe, MD, FACS (chair). The consulting firm, Grey Matters, proposed a multi-phasic process in order to facilitate the implementation of the Pain Medicine Summit and to ensure a coordinated, efficient, and productive outcome. This process consisting of three phases-pre-summit, summit, and post-summit-is described in detail in the following section. All aspects of the project were closely coordinated and supervised by the Steering Committee, which included the selection of the team leaders of the five Workgroups, based on specific criteria. The Pain Medicine Summit, adhering to the dictates of Resolution 321 (A-08), explored the body of knowledge and the scope of practice of Pain Medicine; the education and training in medical school, graduate, and postgraduate programs; and the credentialing and certification processes in the field of Pain Medicine. It addressed the barriers hampering delivery of high quality pain care. It recognized the need for clarification and consensus in many areas. Several points of consensus emerged: The continuum of medical education in the field of Pain Medicine is inadequate and fragmented. It needs to be fortified in scope, content, and duration. Credentialing and certification processes in Pain Medicine are variable, diverse, and deficient in many instances. Deficiencies in these areas lead to suboptimal and fragmented pain care having a negative impact on direct patient care and public health. Effective and prompt remediation is desirable and essential to achieving the goal of high quality pain care. Barriers exist inhibiting or retarding progress toward the common good. There are several viable avenues to achieving our stated goal, "excellence in the delivery of high quality, cost-effective pain care to the patients we serve," including the development of Pain Medicine as a distinct specialty with ACGME accredited residency programs and ABMS certification. The Pain Medicine Summit concluded with a number of recommendations, including the following: That the pain community remains engaged in addressing the issues raised and in mitigating the barriers. That the recommendations be referred to the AMA and the PPMSSC for support and implementation. That another national Pain Medicine Summit with enhanced participation be convened. That consideration be given to convening an International Pain Summit in conjunction with the IASP World Congress in Montreal. That the final report of the Pain Medicine Summit be widely disseminated.

Social work is a complex and multidisciplinary field drawing on a wide range of literature in terms of format, age, and discipline. Librarians in both collections and public services must be aware of this diversity in order to serve this rapidly growing field. This study was designed to identify core journals in the social work field, the most commonly cited formats and the age of citations, to assess the use of non-social work journals in the social work literature, and to draw comparisons to results in allied health and social science disciplines. The ultimate goal of this work is to provide librarians supporting social work programs with data which can contribute to their assessment of collections, both for maintenance and accreditation, and which can allow them to have a broader understanding of the field and a more effective approach to instruction. 28,269 citations from 567 source articles were examined. Journal articles were the most commonly cited format (69.90%), followed by books (17.69%). Over 91% of all citations came from materials published after 1990 and over 50% of citations came from materials published in the last ten years. Of the 2,520 journals cited, 32 top journals (1.27%) accounted for 6,612 (33.46%) of all citations to journals. Of those 32 journals, six were assigned to the field of social work. The remaining core journals came from the fields of psychology, public health, psychiatry, family and gender studies, pediatrics, and medicine. Format distribution and citation age were found to be similar to that of psychology, health care management, health education, and nurse practitioners. There was little similarity with the fields of addictions treatment and sociology. Practical implications for librarians are discussed.