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Clinical training is of paramount importance in nursing education and clinical evaluation is one of the most challenging responsibilities of nursing faculty. The use of objective tools and criteria and involvement of the students in the evaluation process are some techniques to facilitate quality learning in the clinical setting. Aim: The aim of the present study was to assess the relationship of self and faculty evaluation of clinical competency of baccalaureate nursing students using SBAR tool. Methods: A cross-sectional comparative design was adopted. 53 undergraduate nursing students enrolled for pediatric nursing course during the study period were included in the study. Three pediatric nursing clinical faculty conducted evaluation of these students with SBAR tool followed by self-evaluation by students using the same tool. The data were analyzed using SPSS software descriptive (mean and standard deviation) and inferential (Independent sample t-test and Pearson correlation coefficients) statistics. Results: There was no significant difference between self and faculty evaluation on most of the domains of the tool and there was a significant correlation between self and faculty evaluation on all the four domains of SBAR. Conclusion: The results of the present study support the use of SBAR tool and self-evaluation along with faculty evaluation to facilitate clinical learning of undergraduate nursing students.

Objectives: To investigate the relation between the students' scores in MCQs and MEQs of the summative assessment in pediatrics at the College of medicine KKU. Introduction: Student assessment is the most difficult task in medicine since it is ultimately related to human life and safety. Assessment can take different types of formats with advantages and disadvantages and there is no single prescribed method of choice. Research Methods: This is a quantitative, observational retrospective study enrolling 50 students who completed the final MBBS examination in pediatrics in 2015. The medical students' scores in MCQs and MEQs in the final MBBS pediatrics examination were collected and SPSS used for analysis. Results: 52% of the students scored A and B, 46% scored C and 2% scored D and nobody scored F. The mean percentage scores in MCQs, MEQs and the combined are 75.03%, 79.99% and 76.68% respectively. The standard deviation (SD) for MCQs, MEQs and combined are 0.0753, 0.0763 and 0.0559 respectively. There are no significant differences in means and SD. The correlation (CR) between MCQs and MEQs is -1.73%. The CR between MCQs and MEQs for those who scored A and B is 7.38% which could indicate a weak but significant +ve CR (p value 0.017), (table 3). For those who scored C inverse CR (-74.38%) was observed between MCQs and MEQs. Discussion: The main finding of this study was the weakly negative CR between students' performance on MCQs and MEQs. Good performance in MCQs is not necessarily correlated with good performance in LEQs. This is not in agreement with Oyebola et al. and Moqattash et al findings, who reported positive CR in the performance of their students. The discrepancy observed in performance between MCQs and MEQs could be explained by the subjectivity and the difficulty in avoiding bias in setting and marking essay questions.

This study aimed to define the current functions and operations of hospital school programs nationwide. A 56-item survey was disseminated to hospital teachers across the country to examine perceptions about their work, programs, and professional practice. Quantitative findings were analyzed using descriptive statistics at the individual item-level. Qualitative responses were categorized for thematic review and analyzed using an inductive approach. The final sample included 88 completed surveys. Findings were classified into three broad categories: hospital school programming, hospital school teachers, and hospital school instruction. Results revealed that great variability exists across hospitals. Differences were evident in how programs were staffed, funded, and how services are allocated to patients during hospitalizations. Findings will contribute to the establishment of best practices for hospital school programs.

Friedrich Wilhelm August Froebel (1782-1852) yearned to promote and foster the harmonious and holistic development of young children through a combination of outdoor activities, songs and games. His Mother Songs, with games and exercises for mothers and their infants, aimed to encourage the use of senses, limbs and body to increase body awareness and promote mental activity. This article reports on a qualitative interpretive study into the role of a Singing Medicine project in a children's hospital where children on all wards are invited to participate in singing games and activities. An aim was to understand how the application of Froebelian principles can help us to understand and conceptualise children's rights and well-being in restricted environments such as a Children's Hospital. Methods included semi-structured interviews with a range of health and education professionals who support children in a children's hospital in England. In contrast to previous largely quantitative studies relating to the transferable benefits of arts in health projects, the findings from this study suggest that participants value the human connectedness imbued by a Singing Medicine project to children, families and health professionals. Wider benefits for children's holistic development and empowerment to make choices through participation in singing games were also raised.

The field of Mind, Brain, and Education (MBE) has debated the strategies and merit of training teachers in principles of neuroscience. A previous study argued for groups of teachers to be trained as "educational engineers" capable of translating the work of cognitive neuroscientists and education researchers into practical application. While several teacher education programs currently offer MBE courses, we offer a program description of a "situated learning" model of MBE that brings teachers to a unique pediatric hospital with a focus on neurodevelopmental disabilities. The aims of the program are to train educational engineers capable of improving special education services through applications of MBE. Teachers participating in this program learn about neurodevelopment, behavior, models of scientific knowledge acquisition, as well as applications of educational law, policy, leadership, and instruction. This unique program may offer a way to develop competent educational engineers capable of improving education for students with disabilities.

Background: Most pediatric prevalence studies of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have been based upon data from tertiary care centers, a process known for systematic biases such as excluding youth of lower socioeconomic status and those less likely to have access to health care. In addition, most pediatric ME/CFS epidemiologic studies have not included a thorough medical and psychiatric examination. The purpose of this study was to determine the prevalence of pediatric ME/CFS from an ethnically and sociodemographically diverse community-based random sample. Method: A sample of 10,119 youth aged 5-17 from 5622 households in the Chicagoland area were screened. Following evaluations, a team of physicians made final diagnoses. Youth were given a diagnosis of ME/CFS if they met criteria for three selected case definitions. A probabilistic, multi-stage formula was used for final prevalence calculations. Results: The prevalence of pediatric ME/CFS was 0.75%, with a higher percentage being African American and Latinx than Caucasian. Of the youth diagnosed with ME/CFS, less than 5% had been previously diagnosed with the illness. Conclusions: Many youth with the illness have not been previously diagnosed with ME/CFS. These findings point to the need for better ways to identify and diagnose youth with this illness.

Infants and toddlers account for a disproportionate percentage of children diagnosed with cancer. These young children and their families benefit when infant and early childhood mental health is recognized as vital and integrated with medical treatment. Such interventions are beneficial for supporting families in coping when cancer is the only stressor, and they become even more essential when cancer is just one in a series of stressors impacting a family, as is often the case. The authors discuss three abridged stories of collaborative, interdisciplinary, family-centered services provided for young children with cancer and their families, elucidating the importance of supporting the whole family and the young child alike in the context of pediatric cancer treatment.

Background: Pediatric cancer treatments interfere with the patient's life on physical, psychological, and social levels. Hospital Clowns (HCs) use nonpharmacological techniques to reduce the distress that hospital treatments can cause and increase children's wellbeing, but few studies have analyzed their effects. Objective: This study examined the HC effects on the physical and emotional responses of pediatric patients during ambulatory chemotherapy. Given the variability in patients' adjustments to cancer treatment, the role of a child's age and temperament, and caregiver anxiety was considered in explaining the responses over and beyond the HC effects on patient outcomes. Method: Following a quasi-experimental design, 82 pediatric patients were assigned to one of two conditions: HC intervention versus control group (CG) in two separate trials. Pediatric patients self-reported of physical symptoms (pain, nausea, and fatigue) and emotional states (distress, happiness, and calm) were measured at baseline and post-chemotherapy in both trials. Caregivers provided information on children's temperament and reported their own anxiety. Marginal Multilevel Modeling was used to examine the effects of the HC interventions on the outcomes by controlling caregiver anxiety, and child age and emotionality. Results: Compared to the CG, patients receiving the HC visit during chemotherapy reported higher levels of calm and happiness, and less fatigue, pain, and distress. HCs did not affect nausea. Conclusions: This study showed the importance of HCs as agents of supportive pediatric care, whose short-term effects during ambulatory chemotherapy seem to contribute to increasing the well-being of pediatric patients.

This article describes the results of a qualitative investigation of social changes and challenges for rural adolescents who have a traumatic brain injury (TBI). We interviewed adolescents with mild to moderate TBI and their mothers using an iterative approach based in grounded theory. Interviews focused on social adjustment and interaction as well as environmental variables, especially those related to the adolescents' rural status. In-depth interviews produced multifaceted and interrelated social process themes expressed by participants in the study. Four umbrella themes emerged, which were personal change, environmental response, social needs, and facilitators and inhibitors of intentional changes (FIICs). These themes, and their subthemes, capture both assets and needs as they develop over time and provide guidance for both researchers and practitioners working with adolescents who have a TBI.

The American Psychological Association and the National Association of School Psychologists agree in parallel calls for school psychologists to develop pediatric-related competencies. To achieve these competencies, trainers and practitioners require a suitably supportive literature. Ideally, this literature would link pediatric knowledge to school-based practice and address evidence-based assessment and intervention. The present article updates prior research (Wodrich & Schmitt, 2003) on this topic by addressing the rate at which pediatric-related topics were published between 2002 and 2019 in five key journals: "Journal of School Psychology," "Psychology in the Schools," "School Psychology International," "School Psychology Review," and "School Psychology Quarterly." To establish publication trends across time and to extend the earlier research, articles were first coded as either empirical or nonempirical, then coded further according to content (i.e., attention-deficit/hyperactivity disorder [ADHD], a pediatric condition [other than ADHD], professional role issue). The empirical subset of articles was additionally coded according to assessment, intervention, or general knowledge foci. The category comprising the greatest number of articles was pediatric condition (n = 121), followed by ADHD (n = 108) and professional role issue (n = 18). The most specific, commonly appearing pediatric topic was ADHD, as was true when the 2003 article was published, with a surge in empirical ADHD articles noted. The least common topic was pediatric professional role issues. Current trends highlight a need for future empirical articles related to assessment and, particularly, school-based intervention for non-ADHD pediatric health conditions. Limitations of the present research are also discussed.

Efavirenz (EFV) is a well-known, effective anti-retroviral drug long used in first-line treatment for children and adults with HIV and HIV/AIDS. Due to its narrow window of effective concentrations, between 1 and 4 µg/mL, and neurological side effects at supratherapeutic levels, several investigations into the pharmacokinetics of the drug and its genetic underpinnings have been carried out, primarily with adult samples. A number of studies, however, have examined the genetic influences on the metabolism of EFV in children. Their primary goal has been to shed light on issues of appropriate pediatric dosing, as well as the manifestation of neurotoxic effects of EFV in some children. Although EFV is currently being phased out of use for the treatment of both adults and children, we share this line of research to highlight an important aspect of medical treatment that is relevant to understanding the development of children diagnosed with HIV.

We sought to determine whether pediatric primary care interventions targeting positive parenting among low socioeconomic status mothers resulted in reduced referrals to the New York City Early Intervention Program (NYC-EIP). Participants in Building Blocks (BB) and the Video Interaction Project (VIP) were linked with the NYC-EIP administrative dataset to determine referrals. In all, 139 of 422 study participants (31.4%) meeting inclusion criteria were referred to the NYC-EIP. Although referrals did not differ overall by group (VIP 29.8%; BB 33.8%; control 35.3%), differences were found for mothers with education/literacy of seventh grade or higher (interaction p = 0.02). In that subgroup, VIP was associated with reduced referrals by age 3 years (22.4%; adjusted odds ratio 0.53; 95% confidence interval [0.29, 0.97]), compared with BB (35.0%) and controls (34.3%), with survival analysis showing reduced cumulative risk (p = 0.04). We conclude that VIP resulted in reduced referrals for early intervention evaluation among children of mothers with seventh-grade education or higher.

Purpose: A variety of pediatric clinical populations have difficulty with the correct use of pronouns. The available clinical literature labels these errors in inconsistent terms leading to great variation in how treatment objectives are worded. The purpose of this tutorial is to encourage a shift in pronoun assessment and treatment planning toward uniform, specific wording to assist clinicians in identifying patterns of error and selecting appropriate treatment targets. Method: This tutorial presents a description of the 4 grammatical features of English personal pronouns: person, number, gender, and case. Within each feature description are examples of errors commonly observed in clinical practice. Also included are proposals for why each type of pronoun error occurs within different clinical populations. Recommendations for elicitation, classification of errors, goal writing, and treatment planning follow. Conclusions: This tutorial provides clinicians with a feature-based approach to assessment and treatment planning for their clients' pronoun errors. The tutorial may facilitate clinicians' understanding of the grammatical features represented by pronouns and the features that are challenging to different pediatric clinical populations. With this information, pronoun attempts can be elicited, errors can be classified based on grammatical features, and goals can be written with regard to features to set up therapy that teaches clients relevant meaningful contrasts.

Meta-analyses of clinical trials targeting rare events face particular challenges when the data lack adequate numbers of events for all treatment arms. Especially when the number of studies is low, standard random-effects meta-analysis methods can lead to serious distortions because of such data sparsity. To overcome this, we suggest the use of "weakly informative priors" (WIPs) for the treatment effect parameter of a Bayesian meta-analysis model, which may also be seen as a form of penalization. As a data model, we use a binomial-normal hierarchical model (BNHM) that does not require continuity corrections in case of zero counts in one or both arms. We suggest a normal prior for the log-odds ratio with mean 0 and standard deviation 2.82, which is motivated (a) as a symmetric prior centered around unity and constraining the odds ratio within a range from 1/250 to 250 with 95% probability and (b) as consistent with empirically observed effect estimates from a set of 37 773 meta-analyses from the Cochrane Database of Systematic Reviews. In a simulation study with rare events and few studies, our BNHM with a WIP outperformed a Bayesian method without a WIP and a maximum likelihood estimator in terms of smaller bias and shorter interval estimates with similar coverage. Furthermore, the methods are illustrated by a systematic review in immunosuppression of rare safety events following pediatric transplantation. A publicly available R package, MetaStan, is developed to automate a Bayesian implementation of meta-analysis models using WIPs.

Pediatric developmental assessments from the early 1900s are different from those used more often today. Certain present-day pediatric expectations of fine motor skills, specifically those of pre-writing strokes, appear more advanced when compared to those of the past. In the mid-20th century, child developmentalists described the sequences in which children learn, but observed that skill regression occurred as children grew older and academic expectations changed. The educational theories of today neglect to examine early learning progression through the foundations of fine motor performance. Comparisons of contemporary prewriting stroke developmental sequencing within the early Gesell Developmental Schedules reveal various factors to consider when assessing children's' school readiness and academic access and choosing the appropriate protocol for assessment purposes. A comparison of prewriting stroke expectations gives way to the idea that today's educational instruction expects students to do more than the developmental norms. Investigating the advances of different developmental protocols throughout the decades brings question to how prewriting stroke norms are developed and whether they need to be updated based on how expectations are determined.

Limited attention has been devoted in school psychology training programs to students with chronic health conditions. School psychologists are situated to provide behavioral and mental health services to students with chronic health conditions. The focus of this report is on pediatric chronic pain. Pediatric chronic pain is prevalent and can be debilitating, putting students at significant risk for adverse personal, social, and academic outcomes. This primer is designed to educate school psychologists about pediatric chronic pain, within the context of the biopsychosocial model of chronic pain, and to highlight the necessary components of a comprehensive model of intervention for students with pediatric chronic pain. Examples of interventions that can be provided within a school setting are presented in the framework of a multitiered system of support.

Increasing numbers of young children are now routinely screened for developmental delays during well-child visits in primary care settings which support early identification of developmental delays. Unfortunately, research indicates that there is often a gap between the number of children who receive an abnormal screen and the number who successfully follow through with a referral for further evaluation. This article highlights how, with support from Colorado Project LAUNCH, care navigation services in South Adams County, Colorado, have evolved over the past 4 years to address these issues and successfully reduce the referral gap.

The study aimed to assess the nursing students' class engagement and academic performance using flipped class using a mixed-methods research and explored their feedback and perceptions about the flipped classroom (FCR) in comparison to the current teaching methodology. Participants were 22 females and 4 males, selected through convenience sampling method, and were evaluated at pre-cycle with case-based learning, post-cycle I with FCR, and post-cycle II, using FCR with an extra class time, in a cyclical nature of inquiry. Data collection involved a triangulation technique using checklists to observe and assess students' class engagement, quizzes for measuring class performance, and focus group interviews. The focus group interview reflections and feedback were used to refine and plan the next cycle.The quiz and the class engagement scores were highly significant at post-cycle II where the FCR was used with extra class time compared to post-cycle I and pre-cycle. The participants stated that they gained a deeper understanding of concepts, were motivated and more confident in learning the course material. The study findings support the use of FCR in learning pediatric course content. Further empirical evidence is required for adapting FCR to other courses in the curricula to determine its suitability to a particular teaching content.

Employing the ideal type of "The Physical Education System," in this analysis I explore the import of systems frameworks for new institutional designs which hold promise for better outcomes. The inherited idea of a system is restricted to the relationship between teacher education and school programs. It draws on the developmental trajectory of the specialized field of study which pre-dated Kinesiology, and it conforms to the industrial age school, particularly its assumptions regarding standardized curricula, teachers' roles, student classification, and cultural assimilation. When this inherited framework reigns, other key systems components (e.g., public policy, influential peer/family/community ecologies) get short shrift, important "outcome chains" are not addressed, and both Kinesiology's and Public Health's contributions are constrained. Once the inherited physical education system is recognized as a consequential social determinant of pediatric health and well-being, needs and opportunities for redesign become apparent.

Purpose: This clinical focus article describes considerations for recommending assistive hearing technology to infants and young children who have mild bilateral or unilateral hearing loss. These conditions present special challenges compared to bilateral permanent hearing losses that are moderate to profound in their degree in that the recommendation to proceed with technology is not as clear. Conclusion: Current clinical practice guidelines and protocols for pediatric hearing aid fitting recommend managing these conditions on a case-by-case basis. Descriptions of key considerations for recommending assistive hearing technology for infants and young children with mild bilateral hearing loss or unilateral hearing loss are offered herein.

Background: Event-related potentials (ERPs), which are electrophysiological neural responses time-locked to a stimulus, have become an increasingly common tool in language and communication disorders research. They can provide complementary evidence to behavioural measures as well as unique perspectives on communication disorders. ERPs have the distinct advantage of providing precise information about the timing of neural processes and can be used in cases where it is difficult to obtain responses from participants, such as infants or individuals who are minimally verbal. However, clinicians and clinician-scientists rarely receive training in how to interpret ERP research. Aims: To provide information that allows readers to better understand, interpret and evaluate research using ERPs. We focus on research related to communication sciences and disorders and the information that is most relevant to interpreting research articles. Method: We explain what ERPs are and how ERP data are collected, referencing key texts and primary research articles. Potential threats to validity, guidelines for interpreting data, and the pros and cons using of ERPs are discussed. Research in the area of paediatric language disorders is used as a model; common paradigms such as the semantic incongruity N400 and auditory mismatch negativity are used as tangible examples. With this foundation of understanding ERPs, the state of the field in terms of how ERPs are used and the ways they may inform the field are discussed. Main Contribution: To date, no review has focused on ERPs as they relate to clinical or communication research. The main contribution of this review is that it provides practical information geared toward understanding ERP research. Conclusions: ERPs offer insights into neural processes supporting communication and can both complement behaviour and provide information that behavioural measures cannot. We encourage readers to evaluate articles using ERPs critically, effectively pushing the field forward through increased understanding and rigor.

Background: The involvement of speech and language therapists (SLTs) within paediatric palliative care (PPC) settings has been recognized within the extant literature. However, there is little understanding of SLT's specific roles and practices when working with this vulnerable cohort of children and their families. As part of a larger body of work to develop consensus-based recommendations for SLTs working in PPC, it is important to investigate demographic and caseload characteristics. Aims: This exploratory study aimed to gather previously undocumented international demographic data pertaining to SLT service provision, caseload and training in PPC. Additionally, it sought to ascertain the current treatment and assessment approaches of SLTs, and if variations exist in beliefs and practices. Methods & Procedures: An anonymous cross-sectional survey was designed and reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). The online survey consisted of 40 items spanning four domains: (1) demographic information; (2) caseload information; (3) service provision; and (4) training and education. SLTs from Australia, Canada, New Zealand, the UK, Ireland and the United States were recruited using a purposive snowball sampling approach. Descriptive analysis of closed-ended survey responses and content analysis of open-ended responses are presented. Outcomes & Results: A total of 52 respondents completed the survey. SLTs worked in a variety of PPC settings, with patients of varying age and disease groups. Over 50% of participants reported working in PPC for [less than or equal to] 4 years. Genetic disorders (34%), oncology (27%) and neurological conditions (21%) made up a significant portion of respondents' caseloads. Reported treatments and assessment approaches used by SLTs are not unique to a PPC population. Barriers and enablers for practice were identified. A portion of participants did not feel trained and prepared to assess (19.2%) or treat (15.4%) PPC clients. Conclusions & Implications: This study confirms that SLTs internationally have a role in the management of communication and swallowing impairments in a PPC context. However, whether current training and resources adequately support SLTs in this role remains questionable. This paper helps to provide SLTs, administrators, professional associations and tertiary institutions with foundational data to help inform workforce planning, advocacy efforts and training priorities.

Background: Medical research on children has increased in the last 20 years. International ethical regulations for conducting clinical research on children may not pertain to Muslim communities where religious beliefs play a big role in decision-making process. Methods: The aim of this paper was to illustrate the origins of bioethics principles in Islam, to appraise the existing regulations of Islamic countries, and to systematically review areas of improvements. Conclusion: This review recommends a customized approach for regulators to set culturally adapted ethical guidelines that highlight Islamic traditions in dealing with children of different ages.

The Artist in Residence at UCSF Benioff Children's Hospital Oakland offers an arts program that is deeply engaged with the field of disability studies. By moving beyond an exclusively medicalized model of disability, hospitalized children and adolescents are situated as experts on their own lived experience. Artists, art therapists, and pediatric healthcare professionals can afford young people more avenues to engage in creative dialogue with topics related to disability arts and culture. These concepts are highlighted through three examples: stop-motion animation, closed-circuit television show, and art exhibitions that feature disabled artists.

Measurement of optimum treatment efficacy to address language delays in children using cochlear implants is difficult, but important, to promote evidence-based treatments and reduce treatment inequities. This exploratory retrospective study investigated associations between; frequency of early intervention (weekly, fortnightly, monthly); total dose (calculated in hours over a year); and child involvement in family activities on language outcomes for 42 pediatric cochlear implant recipients enrolled in aural/oral programs. Parents who attended the Cochlear Implant Clinic completed the Family and Educational Characteristics Questionnaires (FamEd-Q) at each post-operative review, and their children completed formal language assessments. Family and child demographic characteristics were collated. Children whose parents reported lower doses (in hours) of early intervention demonstrated better expressive language skills than children who received more intervention, but this result was confounded by other underlying differences between groups regarding age-at-first-implant and cognitive function. Additionally, children from families with greater relative socio-economic advantage tended to receive more frequent intervention sessions. Of practical significance, greater levels of child involvement in family activities were associated with higher child language scores.

The physical education (PE) system is a consequential social determinant of pediatric health and well-being. Granting selective achievements, sub-optimal PE outcomes for school-aged children as well as teachers necessitate improvement models and redesign initiatives. This agenda depends on knowledge about the malleable social determinants of the PE system, particularly social-institutional reproduction dynamics, occupational socialization, and public policy. Theoretical propositions and their corollaries lend structure to discipline-specific and interdisciplinary research and development agendas. Pediatric researchers from Kinesiology and Public Health are essential contributors, particularly as social-ecological models gain traction, physical activity discourses replace PE's, and interest resides in whether and how children's participation extends beyond schools and stretches into adulthood.

This investigation extended work on the linkage between knowledge and remembering by exploring the relation between generic and episodic memory representations. Thirty 6-year-old children experienced a mock physical examination with some expected components omitted and other unexpected actions included. Immediately and again after 12 weeks, the children reported the event, answered questions about what usually happens in an examination, and rated their confidence in aspects of their reports. They remembered more typical than atypical present components, that is, those included in the examination, and, over time, falsely reported more typical than atypical actions. The children produced intrusions of expected-but-omitted medical features at the delay but with lower confidence ratings than they provided for correctly recalled items. Performance on a source monitoring task was associated with aspects of the children's confidence ratings for intrusions. The findings provide evidence that the relation between episodic and generic representations is dynamic and suggest that the capacity to differentiate between them contributes to the development of accurate eyewitness memory.

This manuscript identifies the challenges of children with special needs and their families. This text further highlights the complexity of integrating children with intellectual differences into inclusive settings. Furthermore, the author incorporates the teamwork and collaboration principles and practices of the Division for Early Childhood (DEC) of the Council for Exceptional Children (CEC, 1990). In keeping with the Council's principles, the most important aspect of the Council's mission and goals is to work across systems to meet the needs of children and families (DEC 2009). These principles focus on the importance of parent involvement, collaboration and interdisciplinary approaches to services. Lastly, this paper examines inclusion, advocacy and support for parents while reflectively examining a study (Scott-Croff, 2017) that details the perspectives of parents and pediatricians caring for children on the autism spectrum.

Rates of pediatric human immunodeficiency virus (HIV) as well as mortality and morbidity related to HIV and Acquired Immune Deficiency Syndrome (AIDS) depend, in part, on the resources available in the child's country. HIV prevention and intervention efforts also are influenced by cultural factors. The purpose of this article is to summarize key findings from this special issue on international perspectives of HIV/AIDS in schools with a focus on neuropsychological and psychoeducational implications. After providing a brief summary of each article, we outline a call to action for school psychologists and educators.

Knowledge about the quality of care delivered to children with autism spectrum disorders (ASD) in relation to that recommended by clinical practice guidelines (CPGs) is limited. ASD care quality indicators were developed from CPGs and validated by experts, then used to assess the quality of care delivered by general practitioners (GPs) and pediatricians in Australia. Data were retrospectively collected from the medical records of 228 children (= 15 years) with ASD for 2012-2013. Overall quality of care was high, but with considerable variation among indicators, and between GPs and pediatricians--e.g., GPs were less likely to complete the assessment care bundle (61%; 95% CI 21-92). Findings highlight potential areas for improvement in the need for standardized criteria for diagnosis. [The CareTrack Kids Investigation Team participated in writing this article.]

The pediatric developmental passport was created to aid service navigation for children with autism spectrum disorder (ASD). A pilot-randomized-control trial was conducted at two developmental clinics. The intervention group received the Passport card versus the control group who received the placebo card. Primary outcome was the proportion of families who contacted ASD services 1-year following diagnosis. Of 40 families, 95% in the intervention group contacted services versus 70% in the control (p = 0.04). All families at the academic site contacted services; at the community site 90% in the intervention group contacted versus 40% in the control (p = 0.02). The Passport shows promise aiding families of children with ASD in service navigation, particularly at community clinics where specialist follow-up is not readily available.

Background: School-based health centers (SBHCs) provide primary and preventive health services and have been debated as possible medical homes for the pediatric population. The effect of a SBHC as an expanded medical home has yet to be determined. Objective: The purpose of this paper was to review the research evaluating the use of SBHCs as a pediatric patient's expanded medical home. Methods: The databases PubMed and CINAHL were searched for research articles pertaining to the value of using a SBHC as a pediatric medical home. Results: SBHCs provide care that is accessible, coordinated, comprehensive, continuous, family-centered, compassionate, and mildly culturally effective for adolescents. Conclusions: Community health systems and primary care providers should partner with SBHCs to establish an expanded medical home and promote greater coordination and continuity of care for adolescents.

Children and adolescents with the genetic, tumor predisposition syndromeneurofibromatosis type I (NF1) have varying degrees of physical stigmata characteristic of the disease and experience high rates of social difficulties. The present study was the first to formally examine the rate (i.e., percentage of participants) and frequency of bullying victimization in a school-age sample of individuals with NF1. Bullying is defined as harmful behavior that is intentional, repeated, and involves a power imbalance between perpetrators and targets. Given that physical stigmata are characteristic of NF1 to varying degrees, it was hypothesized that bullying experiences would be common in school-age children with NF1. The present study also examined factors including age, gender, and health care provider ratings of severity of physical stigmata on self-reported rates of bullying victimization. Eighty-one school-age children with NF1 and a parent completed established bullying questionnaires. Results showed about 62% of the sample reported being bullied at least once in the last year, with 24.7% reporting being bullied daily. Boys reported significantly greater frequencies of bullying than did girls. Unique differences of gender and level of physical stigmata emerged, such that girls with low stigmata burden experienced significantly higher rates of bullying than girls with high stigmata burden. No differences in frequencies of bullying between low stigmata boys and high stigmata boys were found. The present study suggests that rates of bullying in NF1 are very high, which may be undervalued among adults and medical professionals, given the lack of research on bullying toward youth with NF1. School psychologists are uniquely positioned to implement programs and interventions to address the high rate of bullying toward the school-age NF1 population.

Hypospadias is a common congenital anomaly with a prevalence estimated to be as high as 1 in 125 live male births. Complications after surgical procedures are possible. The incidence of complications can be reduced by meticulous preoperative planning, and judicious postoperative care. So the aim of the study was to investigate the effect of pre-designed instructions for mothers of children with hypospadias on reducing postoperative complications. A convenient sample consists of 60 mothers of children with hypospadias were included in the study. The sample was divided into 2 equal groups; the control group and the study group. Pre-post quasi experimental design was utilized to perform the aim of the study. The study was conducted in the pediatric surgical department and urology outpatient clinic at one Pediatric Hospital in Cairo. Three tools were carried out; first a questionnaire sheet (pre-post test) to assess mothers' knowledge about hypospadias, and includes also demographic data, second tool; observational checklist to evaluate mothers' practices regarding hypospadias, third tool, postoperative complications assessment sheet, which was examined occurrence of early postoperative complications. And pre-designed instructions were provided for those mothers preoperatively. The study results revealed that a highly significant difference was present between the control and the study group regarding mothers' knowledge in post-test. The majority of mothers in the control group and the study group had inadequate level of knowledge about hypospadias in pre-test. While more than two fifth of mothers in the study group had adequate level of knowledge in post-test. The results proved that the mothers' practices in post-test were increased more than in pre-test, less than half of the mothers in pre-test were not satisfied about performing diaper care correctly, however in post-test more than three quarters of those mothers were performed this procedure correctly, and there were highly statistical significant difference between pre and post-test. Regarding early postoperative complications; the results demonstrated that more than two thirds of children in pre-test, while less than two fifth in post-test suffering from postoperative complications as; infection, urinary tract obstruction and bleeding. The difference between pre and post-test was significant. The current study concluded that the pre-designed instructions for mothers of children with hypospadias were efficient by means of marked improvement of the knowledge and practices of the study group, which support the research hypotheses. So the results indicated that children with hypospadias were fewer early postoperative complications in the study group than the control group. The study recommended that important of pre-designed instructions for mothers of children with hypospadias for reducing postoperative complications. Also highlighting additional researches about assessment of mothers' knowledge and practice in relation to care provided to their children with hypospadias. In addition to a longer follow-up is necessary to monitor the late post operative complications.

Ventilator associated pneumonia (VAP) is a costly, preventable, and often fatal consequence of medical therapy that increases hospital and intensive care stays in mechanically ventilated patients. The prevention of VAP is primarily the responsibility of the bedside nurse whose knowledge, beliefs, and practices influence the health outcome of ICU patients. Unfortunately little is known about the degree of nursing knowledge on evidence based guidelines for the prevention of VAP. This descriptive study aimed to assess knowledge of pediatric critical care nurses regarding evidence based guidelines for prevention of VAP in both pediatric and neonatal intensive care units. The current study revealed inadequate knowledge of pediatric critical care nurses regarding evidence based guidelines for prevention of ventilator associated. There is strong correlation between years of experiences, previous training on guidelines of prevention of VAP and knowledge of nurses on the evidence based guidelines for prevention of VAP. Moreover, there is no correlation between age and knowledge of nurses on evidence based guidelines for prevention of VAP. The study concluded that written unit protocols should be present and reviewed regularly as updates and new evidence for best practice are constantly emerging and staff should be educated on the updated protocols.

Background: Educational surroundings is one of the most vital factors in figuring out the fulfillment of an powerful curriculum and gaining of knowledge. Aim: To compare students' perceptions of the academic learning environment in Pediatric and Maternity courses using DREEM Questionnaire. Design: This is a comparative study. Subjects: Five hundred and eleven of the third year nursing students studying maternity and pediatric courses by traditional policy participated in the study during the academic year 2014-2015. Setting: Pediatric and maternity nursing departments at Faculty of Nursing, Mansoura University, Egypt. Tool: An interviewing Questionnaire of two parts: First includes general characteristics such as: age, sex and courses involved. Part two: Includes the DREEM questionnaire. Results: The total mean score for pediatric and maternity nursing students' perception of their learning environment were 115.0±.23.02 and 110.3±17.4; respectively. Students' belief in their gaining knowledge of environment in both specialties were "more positive than negative" with a significant difference between both groups (t=2.6, p=0.01). All students agreed to a more positive approach regarding their learning "moving in the right direction" for their teachers, feeling "more on the positive side" for their academic self perception, feeling "more on the positive side" for their learning atmosphere "a more positive attitude" they also reported that their social self perceptions were" not too bad. The results showed that 10% of both pediatrics and maternity students have mean score = 2 consider (problem areas). More than one third of pediatrics and maternity students have mean score 2.1 - 3 (which needing improvement). About half of pediatrics and maternity students have mean score 3.1 - 3.5 (positive aspect) while none of our students scored >3.5 (excellent items). Conclusion: The perceptions of nursing students of their mastering learning environment were "more positive than negative" with a significant difference between pediatric and maternity students. Although the overall questionnaire score was showed to be "more positive than negative" there were five objects out of the 50 that determined mean scores of less than 2.00 that have to be tested greater carefully.

Due to medical advances, many students with acute chronic illnesses, like pediatric cancer, are able to attend school. The professional literature reflects the need for reform of educational strategies for children facing cancer treatment and who will be absent for extended periods of time. In order to promote successful educational services and the reintegration of students into school, it is vital for multidisciplinary teams and families to collaborate effectively. This article provides a plan to promote successful integration of students with cancer within regular classrooms.

Background: Brain tumours are the most common and fatal of all solid tumours for children and adolescents. The effects of the tumour and treatment (chemotherapy, radiation, and/or surgery) results in significant disruptions to childhood development and large amounts of missed schooling. Among other challenges for families, this produces obstacles for children and adolescents to achieve and maintain academic performance and experience positive schooling encounters. Aims: We thus aimed to systematically identify and synthesize qualitative evidence on how families experience paediatric brain tumour from diagnosis and beyond with regards to their schooling and education to identify gaps in service delivery, research, and policy. Methods: A protocol for this review was registered with PROSPERO (ID: CRD42020177165). Searches were conducted in Medline, CINAHL, PsycInfo, Embase, and Web of Science, and yielded 22 eligible papers (representing 17 studies). Data were extracted into NVivo12 and analysed by qualitative description. Results: We formed the following domain summaries: academic (perceived failure to keep up with peers and finding success where one could, the importance of encouragement for diagnosed children), social (the importance of friendships and the harm of bullying), and support (the defining factor in overall return-to-school experience, often not enough received from educational professionals and clinicians). Our review highlights the need for more comprehensive, individualized, and integrated support for diagnosed children to return to educational institutions, and for the need to address their social experiences, particularly with regards to bullying, potentially through a school-wide social and emotional learning approach. Conclusion: Funding support, evidence-based guidelines, staff skill development, and clear communication structures across families, health care facilities, schools, and educational departments are essential to achieving this.

Introduction: Worldwide, several studies have shown adolescent simulated patients being used for teaching of communications skills with adolescents. In Malaysia, there is scarce research demonstrating the educational benefits of simulated patients in adolescent medicine teaching over traditional teaching methods. Objective: To evaluate the role and effectiveness of adolescent aged simulated patient as a teaching tool, in the adolescent medicine module at National Defence University of Malaysia. Methodology: This is a cross-sectional study. Forty-four third year medical students participated. A total of 6 simulated patients (16 to 19 years old) were recruited to portray roles of adolescents with various psychosocial issues for two times during each posting for four postings. Each of the students, as a pair had two encounters, (as interviewer and observer). All students (in the interviewer roles) rated the abilities of the adolescent simulated patient playing a specific role on a validated questionnaire. The adolescent simulated patients and faculty teachers also gave feedback on similar validated questionnaires. Result: Forty-four students gave the adolescent simulated patients general performance a mean mark 3.4 out of 4 point scale (p=0.050). All medical students reported that the simulated patients helped them in: (a) communicating with adolescents (p=0.006), and (b) understanding the different psychosocial issues that adolescents may encounter (p=0.048). Feedback by teachers and adolescent simulated patient about the adolescent simulated patient program was very positive. Conclusion: The lessons learned have shown that structured case scenario portrayal by the simulated patients had significantly complemented students' learning in communicating with adolescents.

Objective: The current study examines the relationship between obesity and academic performance among second grade students. We hypothesized that students who were overweight or obese would have poorer grades than students who were normal weight. Design: Cross-sectional. Setting: Seven elementary schools from a southeast Texas Independent School District. Participants: The sample was composed of 798 ethnically and racially diverse elementary school children. Students were classified as normal weight, overweight, and obese. Main Outcome Measures: Differences in cumulative grades (math, science, and reading) across weight classifications were examined using sex, race/ethnicity, and school socioeconomic level as covariates. Additionally, all subject areas were analyzed independently. Analysis: Linear mixed models and follow-up pairwise comparisons. Results:The linear mixed model revealed significant differences in grades across weight classifications (p<0.05). Conclusions and Implications: This study suggests that weight status is an important marker of scholastic success. Addressing overweight may bolster efforts to improve academic performance.

The study aimed to investigate whether learning from peers, learning from a clinical educator, or being the peer teacher during clinical group sessions was more effective at enhancing student learning outcomes for different health conditions. A secondary aim was to determine which method students found more satisfactory. Physiotherapy students at the University of Cape Town were sent to different paediatric sites for clinical experience, including a children's convalescent home, two special schools, a day care centre for children with severe disabilities, and a mainstream school. The research design was quasi-experimental in that different teachers (peer vs. educator) were assigned randomly to each health condition. All 38 third year students were eligible for inclusion in the study. Approximately 10 students attended each weekly group teaching session, which was either peer-led or educator-led. Students were required to complete a test covering content taught by the different teachers. The nature of the person presenting to the small group did not have an impact on test scores. There were no significant differences in students' mean test scores between the peer-led, educator-led, or self-led conditions. However, test scores were significantly higher in the health conditions with severe disability than the other conditions. Students also reported higher satisfaction with clinical educator teaching.

Introduction: In pediatric hospitals there are varying opinions regarding who is part of the healthcare team. Each specialty has a different view on the various aspects of care. Objective: The study explores healthcare providers' diverse points-of-view on stress and compares coping strategies to obtain the most effective way to reduce stress in pediatric patients with a chronic condition. Method: The study used a qualitative research design. The sample population included six nurses and five child life specialists who have significant experience in pediatrics. Data were collected using semistructured interviews. To identify common themes, a content/data analysis was performed. Results: Six themes were recognized and led to the identification of differences and similarities between nurses and child life specialists, both of whom reported fear of the unknown as the biggest stressor for the pediatric patient. The act of healthcare workers lying to the child as an attempt to reduce stress on the child was reported as an ineffective coping strategy. Nurses reported crying as a symptom of stress, while child life specialists reported crying as an effective coping strategy. The care of a child coping under stress needs to be a collaborative group effort. Most professionals reported that situations would have been conducted more efficiently if better communication had been in place. Family-centered care was perceived as valuable for improving pediatric patient coping mechanisms. Implications: The discovered data help to identify the importance of collaborating with all available resources to obtain the best care possible for patients. This article provides effective coping strategies to care for patients. It will help nurses and other healthcare professionals understand how child life specialists help chronically-ill patients cope effectively with stress.

As health education professionals, it may be easy to overlook the significance of the National Commission for Health Education Credentialing (NCHEC) Responsibilities and Competencies. This commentary discusses how Certified Health Education Specialists at one nonprofit organization brought the Responsibilities and Competencies to life as they planned, implemented and evaluated a novel integrated health program for youth with co-occurring behavioral and physical health needs. Through their commitment to high-quality demonstration of the NCHEC Responsibilities and Competencies, these Certified Health Education Specialists successfully introduced the valuable role of the CHES® certification to the multidisciplinary providers and diverse families within their community.

Purpose: The aim of the current study was to review neuromuscular development, summarize the current body of evidence describing the use of neuromuscular electrical stimulation (NMES) therapy in infants, and identify possible contraindications for the use of NMES in the neonate and young infant. Method: After a review of the literature describing neuromuscular development, we created a timeline of the developmental processes. Key milestones were determined, and a literature search was conducted to identify potential effects of electrical stimulation on this process. Results: Current evidence supporting the use of NMES in the pediatric population is limited and of poor quality. Contraindications of the use of NMES in the neonate and young infant were identified, including (a) inhibited expression of the neural cell adhesion molecule that is vital for neuromuscular development, (b) alteration of muscle fiber type metabolic profile away from intended muscle fiber type morphology, and (c) interruption of postsynaptic acetylcholine receptor synthesis during neuromuscular junction development. Conclusion: The use of NMES for the treatment of dysphagia in the neonate and young infant may influence early neuromuscular development in a manner that is not currently well understood. Future research is needed to further understand the effects of NMES on the developing neuromuscular system.

Deaf and Hard of Hearing (DHH) children need to master at least one language (spoken or signed) to reach their full potential. Providing access to a natural sign language supports this goal. Despite evidence that natural sign languages are beneficial to DHH children, many researchers and practitioners advise families to focus exclusively on spoken language. We critique the "Pediatrics" article 'Early Sign Language Exposure and Cochlear Implants' (Geers et al., 2017) as an example of research that makes unsupported claims against the inclusion of natural sign languages. We refute claims that (1) there are harmful effects of sign language and (2) that listening and spoken language are necessary for optimal development of deaf children. While practical challenges remain (and are discussed) for providing a sign language-rich environment, research evidence suggests that such challenges are worth tackling in light of natural sign languages providing a host of benefits for DHH children -- especially in the prevention and reduction of language deprivation.

Children from birth to 3 years old with complex medical needs often experience psychological issues, but there are limited services and supports to meet their needs. To bridge this gap, the authors created the Pediatric Birth to Three Clinic and Early Childhood Mental Health Program at the University of Minnesota. They describe the toxic stress framework of their approach and the relationship-based and trauma-informed treatment modalities used to support the young children and their families in their care.

Background: Parental trust in their child's health care provider and the number and type of vaccine information sources are important dimensions of vaccine hesitancy and may suggest intervention components for future research. Method: We conducted secondary analysis of survey data from mothers of healthy newborns in Washington State, and examined the association between parental trust in their child's health care provider and vaccine information sources. Results: We found that mothers with less trust in their child's health care provider used more sources, more informal sources, and were less likely to consider their child's pediatrician their main source of vaccine information compared with more trusting mothers. However, less trusting mothers did not report more effort to read or watch stories about vaccines than more trusting mothers, nor were they more likely to report the internet as their main vaccine information source. Conclusions: Future interventions seeking to reduce parental vaccine hesitancy should consider intervention components focused on building or improving parent trust in their child's health care provider.