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Purpose: The purpose of this paper is to describe the implementation of evidence‐based, individualized coping plans and to compare the rates of child anxiety, child cooperation, and parent anxiety before and after implementation of these coping plans for children receiving recurring BoNT‐A injections emphasizing the role of Certified Child Life Specialists (CCLSs) within the interdisciplinary team approach. Design and Methods: A retrospective chart review was conducted for children receiving BoNT‐A injections at a Physical Medicine clinic pre‐ and post‐implementation of the coping plan. Descriptive statistics were used to evaluate care plan implementation, child cooperation, child anxiety, and parent anxiety. Results: Post‐implementation of coping care plans, children experienced improved cooperation during BoNT‐A injections. Parental anxiety decreased once coping plans were implemented. Documentation improved after the implementation of coping plans specific to areas involving cooperation, child's anxiety and distress, and parental anxiety and distress. It was also noted that there was an increase in child anxiety assessments within documentation. Practice Implications: CCLS were able to utilize their expertise to collaboratively create individualized coping care plans to increase child's cooperation and decrease parental anxiety during BoNT‐A injections. [ABSTRACT FROM AUTHOR]

BACKGROUND Delirium is associated with poor outcomes in adults but is less extensively studied in children. OBJECTIVES To describe a quality improvement initiative to implement delirium assessment in a pediatric intensive care unit and to identify barriers to delirium screening completion. METHODS A survey identified perceived barriers to delirium assessment. Failure modes and effects analysis characterized factors likely to impede assessment. A randomized case-control study evaluated factors affecting assessment by comparing patients always assessed with patients never assessed. RESULTS Delirium assessment was completed in 57% of opportunities over 1 year, with 2% positive screen results. Education improved screening completion by 20%. Barriers to assessment identified by survey (n = 25) included remembering to complete assessments, documentation outside workflow, and "busy patient." Factors with high risk prediction numbers were lack of time and paper charting. Patients always assessed had more severe illness (median Pediatric Index of Mortality 2 score, 0.90 vs 0.36; P < .001), more developmental disabilities (moderate to severe pediatric cerebral performance category score, 54% vs 32%; P = .007), and admission during lower pediatric intensive care unit census (median [interquartile range], 10 [9-12] vs 12 [10-13]; P < .001) than did those never assessed (each group, n = 80). Patients receiving mechanical ventilation were less likely to be assessed (41.0% vs 51.2%, P < .001). CONCLUSIONS Successful implementation of pediatric delirium screening may be associated with early use of quality improvement tools to identify assessment barriers, comprehensive education, monitoring system with feedback, multidisciplinary team involvement, and incorporation into nursing workflow models. [ABSTRACT FROM AUTHOR]

This paper explores associations between two demographic characteristics (i.e., sex and grade level) and the peer network features (i.e., size, density, and demographic homophily) of 144 third through eighth grade students (ages 8—15) in an urban, US elementary school with considerable diversity in race and socioeconomic status. The results offer only partial support for the two cultures theory, as sex differences in network size attenuated with increasing grade levels. The findings also highlight developmental trends, including a curvilinear effect of grade on network density and grade-level increases in cross-sex and same-race relationships. Finally, the paper includes a discussion of the importance of opportunity structures for, and the joint consideration of sex and developmental influences on, children’s peer social networks. [ABSTRACT FROM PUBLISHER]

This paper applies a sociology of childhood approach to the study of the sexual socialisation of young children in the USA. It examines both children's and parents' active participation in this dynamic and collaborative process through conversations between 49 parents and their 54 preschool children that were audio-recorded while they read books about ‘where babies come from’. Parents also participated in a brief survey. The authors found that, while parents do foreclose such conversations as previous research has indicated, they also use a variety of other tactics, including adding information and emotion management. These findings illustrate children's active engagement in their own sexual socialisation through their questions, confusions and distractions, which affected the amount and type of information that was elicited. [ABSTRACT FROM PUBLISHER]