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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: closed (20 November 2021) | Viewed by 16296

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Special Issue Editor

Prof. Dr. Karen Benzies

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Guest Editor

Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
Interests: early brain and biological development; family environment; parenting; child development; health quality indicators; health services research; health economics

Special Issue Information

Dear Colleagues,

Clinical care in neonatology and paediatrics has seen unprecedented change in the last few decades. These changes have decreased mortality and morbidity for children, and improved patient- and family-oriented experiences and outcomes. With advocacy from parent organizations and the recognition of the value of parental engagement in the care of children, neonatal intensive care and paediatric health service delivery have increasingly adopted co-design approaches to shape innovations in clinical care. In general, clinicians, administrators and the parents of sick newborns and children agree that a move towards more family-centred care has multiple benefits. However, family-centred care is a philosophy of care with variable approaches to implementation and evaluation. Greater clarity is needed regarding specific frameworks and models of family-centred care that are effective within different populations in different contexts. In addition, there is limited clarity on the “active ingredients” in family-centred clinical care in neonatology and paediatrics. Given expectations of the greater involvement of families in adult acute care, evidence of effective clinical care in neonatal and paediatric settings has demonstrated synergies and spin-offs in those settings. A better understanding of the effective components of family-centred clinical care, and how to strengthen them, would assist clinical and policy decision-makers in prioritizing scarce resources where they will have the greatest effect. The present Special Issue of the Journal of Clinical Medicine, Clinical Care for Neonatology and Paediatrics, aims to provide high-quality evidence of promising and effective interventions for improving the quality of clinical care in neonatal and paediatric settings.

Prof. Dr. Karen Benzies
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

Infants
Children
Family-centred care
Patient and family experiences
Patient and family outcomes
Health service delivery
Health system sustainability

Published Papers (6 papers)

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Research

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13 pages, 273 KiB

Open AccessArticle

Effects of Alberta Family Integrated Care (FICare) on Preterm Infant Development: Two Studies at 2 Months and between 6 and 24 Months Corrected Age

by Amanda M. Moe, Jana Kurilova, Arfan R. Afzal and Karen M. Benzies

J. Clin. Med. 2022, 11(6), 1684; https://doi.org/10.3390/jcm11061684 - 18 Mar 2022

Cited by 8 | Viewed by 2110

Abstract

Preterm infants are at increased risk for developmental delays. Family integrated care (FICare) is a novel care delivery model that integrates parents into their infant’s care in the neonatal intensive care unit. Two follow-up studies are presented to identify effects of Alberta FICare™ on the development of preterm infants born between 32 and 34 weeks of gestation. Data for Study 1 were collected at an age of 2 months, and between 6 and 24 months for Study 2. In Study 1, Ages and Stages Questionnaires (ASQ) and maternal psychosocial distress measures were completed by 330 mothers of 387 infants (FICare, n = 223; standard care, n = 164). Study 2 utilised an additional measure, the Parent–Child Interaction Teaching Scale, with 50 mothers of 61 infants (FICare, n = 30; standard care, n = 31). For Study 1, there was no effect of Alberta FICare™ on the ASQ domains of communication, problem solving, or personal–social at an age of 2 months. For Study 2, the risk of communication delay was significantly lower for infants in Alberta FICare™ compared with standard care. Results from Study 2 suggest a possible protective effect of Alberta FICare™ for the risk of communication delays between 6 and 24 months. Further investigation into the effect of Alberta FICare™ on parent–child interactions and implications for long-term development is warranted. Full article

(This article belongs to the Special Issue Clinical Care for Neonatology and Paediatrics)

9 pages, 250 KiB

Open AccessArticle

Early Preeclampsia Effect on Preterm Newborns Outcome

by Melinda Matyas, Monica Hasmasanu, Ciprian N. Silaghi, Gabriel Samasca, Iulia Lupan, Kovacs Orsolya and Gabriela Zaharie

J. Clin. Med. 2022, 11(2), 452; https://doi.org/10.3390/jcm11020452 - 17 Jan 2022

Cited by 6 | Viewed by 3456

Abstract

Background: An early form of preeclampsia is rare. Abnormal placentation, placental perfusion disorders, and inflammatory cytokine release will have an effect on the fetus and newborn. Material and methods: The study group consisted of preterm newborns whose mothers had a history of preeclampsia and a gestational age of between 30 weeks and 34 weeks + 6 days. The control group consists of neonates matched for gestational age with the case group, whose mothers had normal blood pressure. The incidence and severity of respiratory distress syndrome (RDS), intraventricular hemorrhage, hypoglycemia, pH gas changes, and hematological parameters were analyzed in the two groups. Results: The study group of preterm neonates had a lower birth weight than the control group (p < 0.001). Most of the deliveries in the group of newborns exposed to preeclampsia were performed by cesarean section. Severe forms of RDS were two times more frequent in the group of newborns exposed to preeclampsia compared to those in the control group. Even though we expected to see a lower incidence, owing to the high number of deliveries by cesarean section, we still observed a higher rate of intraventricular hemorrhage in the preeclampsia group (16 cases in the study group vs. 7 in the control, p = 0.085). Neutropenia and thrombocytopenia were more frequent in preterm newborns exposed to preeclampsia. Conclusions: The study shows that early preeclampsia increases the risk of complications in preterm neonates. RDS was more frequent in the exposed group than in the control group. The severity of preeclampsia correlates with hematological changes. Full article

(This article belongs to the Special Issue Clinical Care for Neonatology and Paediatrics)

9 pages, 556 KiB

Open AccessArticle

Effectiveness of Alberta Family-Integrated Care on Neonatal Outcomes: A Cluster Randomized Controlled Trial

by Madeleine Murphy, Vibhuti Shah and Karen Benzies

J. Clin. Med. 2021, 10(24), 5871; https://doi.org/10.3390/jcm10245871 - 14 Dec 2021

Cited by 10 | Viewed by 2611

Abstract

Family-Integrated Care (FICare) empowers parents to play an active role as a caregiver for their infant in the neonatal intensive care unit (NICU). This model of care is associated with improved neonatal outcomes, such as improved weight gain and higher breastfeeding rates at discharge in infants admitted to level III NICUs; however, its effectiveness in level II NICUs remains unproven. The objective of this study was to evaluate the effectiveness of the model on neonatal outcomes in a cluster randomized controlled trial conducted in 10 level II NICUs randomized to Alberta FICare or standard care. Mothers and their preterm infants born between 32⁺⁰ and 34⁺⁶ weeks’ gestational age were included. The primary outcome was the proportion of infants who regained their birth weight (BW) after 14 days of life. The analysis included 353 infants/308 mothers at Alberta FICare sites and 365 infants/306 mothers at standard care sites. There was no difference in the proportion of infants who had regained their BW by 14 days between the groups. A lack of perceived improved weight gain trajectory for those in the FICare group is attributed to a shorter length of hospital stay and infants being discharged prior to regaining BW. Full article

(This article belongs to the Special Issue Clinical Care for Neonatology and Paediatrics)

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8 pages, 362 KiB

Open AccessArticle

Crawl Position Depends on Specific Earlier Motor Skills

by Ewa Gajewska, Jerzy Moczko, Mariusz Naczk, Alicja Naczk, Barbara Steinborn, Anna Winczewska-Wiktor, Paulina Komasińska and Magdalena Sobieska

J. Clin. Med. 2021, 10(23), 5605; https://doi.org/10.3390/jcm10235605 - 29 Nov 2021

Cited by 2 | Viewed by 1947

Abstract

Early assessment of motor performance should allow not only the detection of disturbances but also create a starting point for the therapy. Unfortunately, a commonly recognised method that should combine these two aspects is still missing. The aim of the study is to analyse the relationship between the qualitative assessment of motor development at the age of 3 months and the acquisition of the crawl position in the 7th month of life. A total of 135 children were enrolled (66 females). The analysis was based on physiotherapeutic and neurological assessment and was performed in the 3rd, 7th and 9th months of life in children, who were classified according to whether they attained the crawl position or not in the 7th month. Children who did not attain the crawl position in the 7th month did not show distal elements of motor performance at the age of 3 months and thus achieved a lower sum in the qualitative assessment. Proper position of the pelvis at the age of 3 months proved to be very important for the achievement of the proper crawl position at the 7th month. Failure to attain the crawl position in the 7th month delays further motor development. The proximal-distal development must be achieved before a child is able to assume the crawl position. Supine position in the 3rd month seemed more strongly related to achieving the crawl position than assessment in the prone position. Full article

(This article belongs to the Special Issue Clinical Care for Neonatology and Paediatrics)

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12 pages, 2328 KiB

Open AccessArticle

Natural-Course Evaluation of Infants with Positional Severe Plagiocephaly Using a Three-Dimensional Scanner in Japan: Comparison with Those Who Received Cranial Helmet Therapy

by Takanori Noto, Nobuhiko Nagano, Risa Kato, Shin Hashimoto, Katsuya Saito, Hiroshi Miyabayashi, Mari Sasano, Koichiro Sumi, Atsuo Yoshino and Ichiro Morioka

J. Clin. Med. 2021, 10(16), 3531; https://doi.org/10.3390/jcm10163531 - 11 Aug 2021

Cited by 9 | Viewed by 2858

Abstract

This study aimed to clarify the natural course of positional plagiocephaly using a three-dimensional (3D) scanner and investigate the effectiveness of cranial helmet therapy (CHT). One hundred infants with severe plagiocephaly who visited our institutions between April 2020 and March 2021 were included. Cranial shape was measured using an Artec Eva 3D scanner. A cranial asymmetry (CA) >12 mm was diagnosed as severe plagiocephaly. An infant whose CA subsided to <12 mm was considered to have improved naturally or by CHT. The difference in CA between the second and initial scans was defined as the improvement value (median scan interval was two months). In the natural-course group comprising 56 infants with severe plagiocephaly, 37 (66%) with a median CA of 15.6 mm exhibited no improvement after two months. In the scan age- and evaluation interval-matched case-control study, the CA value in the CHT group improved by three times that in the natural-course group (−4.6 mm [n = 33] vs. −1.55 mm [n = 24], p < 0.001). Severe plagiocephaly did not improve naturally in 66% of the cases. Therefore, CHT should be considered if the CA is >12 mm on the initial evaluation. Full article

(This article belongs to the Special Issue Clinical Care for Neonatology and Paediatrics)

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Review

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11 pages, 270 KiB

Open AccessReview

Fetal Tachyarrhythmia Management from Digoxin to Amiodarone—A Review

by Liliana Gozar, Dorottya Gabor-Miklosi, Rodica Toganel, Amalia Fagarasan, Horea Gozar, Daniela Toma and Andreea Cerghit-Paler

J. Clin. Med. 2022, 11(3), 804; https://doi.org/10.3390/jcm11030804 - 02 Feb 2022

Cited by 8 | Viewed by 2372

Abstract

Sustained fetal tachycardias are rare but represent a high risk of mortality and morbidity. Consensus has yet to be found regarding their optimal management. The aim of this narrative review is to summarize the data available in the current literature regarding the efficacy and safety of medications used in the management of intrauterine tachyarrhythmias and to provide possible treatment protocols. In this review, we would like to emphasize the importance of a thorough evaluation of both the fetus and the mother, prior to transplacental antiarrhythmic drug initiation. Factors such as the hemodynamic status of the fetus, possible mechanisms of fetal arrhythmia, and concomitant maternal conditions are of primordial importance. As a possible treatment protocol, we would like to recommend the following: due to the risk of sustained supraventricular tachycardia (SVT), fetuses with frequent premature atrial beats should be evaluated more frequently by echocardiography. A careful hemodynamic evaluation of a fetus with tachycardia is primordial in forestalling the appearance of hydrops. In the case of atrial flutter (AFL), sotalol therapy could represent a first choice, whereas when dealing with SVT patients, flecainide should be considered, especially for hydropic patients. These data require consolidation through larger scale, non-randomized studies and should be handled with caution. Full article

(This article belongs to the Special Issue Clinical Care for Neonatology and Paediatrics)

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