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Bosques G, Houtrow AJ, Holman LK. Pediatric Rehabilitation Medicine Physicians: Your Essential Medical Home Neighbors for Children with Disabilities. Pediatr Clin North Am 2023; 70:371-384. [PMID: 37121631 DOI: 10.1016/j.pcl.2023.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Pediatric rehabilitation medicine (PRM) physicians are subspecialists in the field of physical medicine and rehabilitation trained to promote the health and function of children with disabilities (CWD) across their lifespans. Management strategies employed include prescribing medications, therapy, and adaptive equipment (braces and mobility devices) to optimize function and allow participation. PRM physicians collaborate with other providers to mitigate the negative consequences of health conditions and injuries. Their work is interdisciplinary because CWD with either temporary or permanent impairments needs treatments, services, and support that extend beyond the clinical environment. Owing to this, PRM physicians are essential members of the health neighborhood for CWD.
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Affiliation(s)
- Glendaliz Bosques
- Department of Neurology, Pediatric Neurosciences Program, Dell Medical School at The University of Texas at Austin, Dell Children's Medical Center, 4910 Mueller Boulevard Suite 300, Austin, TX 78723, USA.
| | - Amy J Houtrow
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
| | - Lainie K Holman
- Cleveland Clinic Lerner College of Medicine, Pediatric Rehabilitation, Cleveland Clinic Children's Hospital for Rehabilitation, 2801 Martin Luther King Jr Drive, Cleveland, OH 44104, USA
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Jimenez N, Virtue A, Segar K, Stoep AV, Rivara FP. Effect of School Services on Academic Performance After Traumatic Brain Injury in Hispanic and Non-Hispanic Students. THE JOURNAL OF SCHOOL HEALTH 2019; 89:519-526. [PMID: 31016747 PMCID: PMC6548662 DOI: 10.1111/josh.12776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 04/09/2018] [Accepted: 03/24/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND School reintegration after traumatic brain injuries (TBI) requires school support; however, implementation of services is complex. This study evaluates disparities in receipt of school services for Hispanic children and its effect on academic performance. METHODS Secondary analyses of school data on receipt of pre- and post-TBI school services. A logistic regression compared receipt of services between Hispanic and non-Hispanic white (NHW) children, and a linear regression evaluated services' effect on academic performance. RESULTS The study includes 419 children; 46 Hispanic, 373 NHW. For NHW children there were no differences in receipt of pre- and post-TBI services; Hispanic children had significant increase in receipt of services from 5% to 27% (p < .001). Compared to NHWs, Hispanics had lower grade point average (GPA) at baseline (2.3 [confidence interval, CI: 1.9-2.7] vs 2.9 [CI: 2.8-3.0]). No differences in GPA were found between groups after injury among students who received post-TBI services. CONCLUSIONS Students who receive post-TBI school services benefit academically. NHW students maintain their academic performance and Hispanics increase their performance to their NHW peers' level. This highlights the importance of providing post-TBI school services to ensure better outcomes for all children.
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Affiliation(s)
- Nathalia Jimenez
- Departments of Anesthesiology and Pain Medicine, University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4th Floor, Seattle, WA 98122
| | - Alyssa Virtue
- University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4th Floor, Seattle, WA 98122
| | - Karen Segar
- Harborview Injury Prevention and Research Center, 401 Broadway, 4th Floor, Seattle, WA 98122
| | - Ann Vander Stoep
- Departments of Psychiatry, Behavioral Sciences and Epidemiology, University of Washington, Child Health Institute, P.O. Box 3549, Seattle, WA 98195
| | - Frederick P Rivara
- Epidemiology and Pediatric Dentistry, University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4th Floor, Seattle, WA 98122
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School Reintegration Post-Psychiatric Hospitalization: Protocols and Procedures Across the Nation. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09310-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Schilling EJ, Getch YQ. School reentry services for students with chronic health conditions: An examination of regional practices. PSYCHOLOGY IN THE SCHOOLS 2018. [DOI: 10.1002/pits.22154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Ethan J. Schilling
- Department of Psychology; Western Carolina University; Cullowhee North Carolina
| | - Yvette Q. Getch
- Department of Counseling and Instructional Sciences; University of South Alabama; Mobile Alabama
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Bolger A, Collins A, Michels M, Pruitt D. Characteristics and Outcomes of Children With Conversion Disorder Admitted to a Single Inpatient Rehabilitation Unit, A Retrospective Study. PM R 2018; 10:910-916. [DOI: 10.1016/j.pmrj.2018.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 02/26/2018] [Accepted: 03/04/2018] [Indexed: 11/16/2022]
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Kise SS, Hopkins A, Burke S. Improving School Experiences for Adolescents With Type 1 Diabetes. THE JOURNAL OF SCHOOL HEALTH 2017; 87:363-375. [PMID: 28382666 DOI: 10.1111/josh.12507] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 08/11/2016] [Accepted: 12/09/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Diabetes mellitus (diabetes) is one of the most common metabolic diseases in children worldwide and the incidence of type 1 diabetes (T1D) is growing. T1D is complicated to manage and adolescents with diabetes face unique, age-specific challenges. The purpose of this article is to discuss ways in which schools can create a positive environment and improve the experiences and outcomes for adolescents with T1D. METHODS The Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PubMed databases were searched and yielded a total of 27 articles that were used in this integrative literature review. RESULTS Common concerns identified by students with T1D and their parents included a lack of full-time school nurses, lack of teacher knowledge of diabetes, lack of access to diabetes tools, lack of freedom to perform diabetes self-care, lack of nutritional information in cafeterias, and lack of communication between parents and school personnel. Students who are unable to attend school on a daily basis may not be able to achieve their academic potential. CONCLUSIONS Implications for school health including specifics for school nurses, teachers, students, and school environment were identified.
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Affiliation(s)
- Saori S Kise
- University of Iowa Hospitals and Clinics, 910 West Benton Street, Apartment 304 D, Iowa City, IA
| | - Amanda Hopkins
- School of Nursing, Illinois Wesleyan University, 203 Beecher St., Bloomington, PO Box 2900, IL 61702-2900
| | - Sandra Burke
- Goldfarb School of Nursing at Barnes Jewish College, 4483 Duncan Avenue, St. Louis, Office 512, MO 63110
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Doyle ST, Perrin PB, Nicholls E, Olivera SL, Quintero LM, Otálvaro NYM, Arango-Lasprilla JC. Pediatric SCI/D caregiver mental health and family dynamics in Colombia, South America. Disabil Rehabil 2015; 38:819-27. [PMID: 26696466 DOI: 10.3109/09638288.2015.1046568] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study examined the connections between family dynamics and the mental health of caregivers of youth with spinal cord injuries/disorders (SCI/D) caregivers from Colombia, South America. It was hypothesized that lower family functioning would be associated with poorer caregiver mental health. METHODS A cross-sectional study of self-report data collected from caregivers through the Hospital Universatario Hernando Moncaleano Perdomo in Neiva, Colombia. Thirty caregivers of children with SCI/D from Nevia, Colombia who were a primary caregiver for ≥3 months, providing care for an individual who was ≥6 months post-injury/diagnosis, familiar with the patient's history, and without neurological or psychiatric conditions. Caregivers' average age was 41.30 years (SD = 10.98), and 90% were female. Caregivers completed Spanish versions of instruments assessing their own mental health and family dynamics. RESULTS Family dynamics explained 43.2% of the variance in caregiver burden and 50.1% of the variance in satisfaction with life, although family dynamics were not significantly associated with caregiver depression in the overall analysis. Family satisfaction was the only family dynamics variable to yield a significant unique association with any index of caregiver mental health (satisfaction with life). CONCLUSIONS If similar findings emerge in future intervention research, interventions for pediatric SCI/D caregivers in Colombia and other similar global regions could benefit from including techniques to improve family dynamics, especially family satisfaction, given the strong potentially reciprocal connection between these dynamics and caregiver mental health. IMPLICATIONS FOR REHABILITATION The degree of disability resulting from SCI/D can vary greatly depending on the severity and level of the lesion, though permanent impairment is often present that profoundly impacts both physical and psychological functioning. Very little is known about the impact of pediatric SCI/D in developing countries, despite the high rates of injury reported in these areas. Family interventions could contribute significantly to the lives of children with SCI/D and their families.
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Affiliation(s)
- Sarah T Doyle
- a Department of Psychology , Virginia Commonwealth University , Richmond , VI , USA
| | - Paul B Perrin
- a Department of Psychology , Virginia Commonwealth University , Richmond , VI , USA
| | - Elizabeth Nicholls
- b Department of Psychology , Drexel University , Philadelphia , PA , USA
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Roscigno CI, Fleig DK, Knafl KA. Parent management of the school reintegration needs of children and youth following moderate or severe traumatic brain injury. Disabil Rehabil 2014; 37:523-33. [PMID: 24969697 DOI: 10.3109/09638288.2014.933896] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE School reintegration following children's traumatic brain injury (TBI) is still poorly understood from families' perspectives. We aimed to understand how both unique and common experiences during children's school reintegration were explained by parents to influence the family. METHODS Data came from an investigation using descriptive phenomenology (2005-2007) to understand parents' experiences in the first five years following children's moderate to severe TBI. Parents (N = 42 from 37 families in the United States) participated in two 90-min interviews (first M = 15 months; second M = 27 months). Two investigators independently coded parents' discussions of school reintegration using content analysis to understand the unique and common factors that parents perceived affected the family. RESULTS Parents' school negotiation themes included the following: (1) legal versus moral basis for helping the child; (2) inappropriate state and local services that did not consider needs specific to TBI; and (3) involvement in planning, implementing and evaluating the child's education plan. Parents perceived that coordinated and collaboration leadership with school personnel lessened families' workload. Families who home-schooled had unique challenges. CONCLUSIONS School reintegration can add to family workload by changing roles and relationships and by adding to parents' perceived stress in managing of the child's condition. IMPLICATIONS FOR REHABILITATION Moderate to severe traumatic brain injury is assumed to be the primary cause of children's morbidities post-injury. Despite laws in the United States meant to facilitate children's school reintegration needs, parents often perceived that policies and practices differed from the intentions of laws and added to the family workload and stress. The school environment of the child (physical, cultural or psychological setting) plays an important long-term role in shaping family roles, relationships and management of the child's condition.
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Affiliation(s)
- Cecelia I Roscigno
- School of Nursing, University of North Carolina , Chapel Hill, NC , USA and
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Bruce BS, Newcombe J, Chapman A. School liaison program for children with brain tumors. J Pediatr Oncol Nurs 2012; 29:45-54. [PMID: 22367769 DOI: 10.1177/1043454211432296] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A school liaison program that familiarized teachers with the implications of each child's brain tumor treatment with respect to learning, behavior, and socialization was implemented. The study explored the experiences of nine families and their teachers and health staff who participated in the program. The successes and challenges of the program were captured through interviews that were audio-taped and transcribed verbatim for data analysis. Individualized programs were negotiated between families and education staff to address behavioral, academic, and social needs of each child. Children were able to learn to their ability rather than be judged on the achievements of their respective grade levels. Parents reported that the program strengthened their advocacy skills and improved the children's social and learning achievements. Teachers reported an improved ability to provide more comprehensive educational programming suited to the child's needs. Overall, most children in the program achieved or exceeded their initial academic, social, and behavioral expectations. The school liaison program demonstrated significant potential to enhance the learning experience for children with brain tumors.
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Affiliation(s)
- Beth S Bruce
- Dalhousie University, Halifax, Nova Scotia, Canada.
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Abstract
PURPOSE OF REVIEW Severe childhood traumatic brain injury (TBI) is the leading cause of death and acquired disability in children, causing impairments in children's sensory-motor, cognitive and behavioural functioning, with devastating consequences on community integration. Community integration is the ultimate goal of rehabilitation; it is a complex outcome, with many variables contributing to it. RECENT FINDINGS Community integration and quality of life (QOL) are lower in children who sustained severe TBI at a younger age. Further, a wide range of injury-related, demographic and postinjury factors influence outcomes, and should serve as targets for specific interventions. An increasing number of interventions targeting cognitive, behavioural or family-related issues have been developed, with promising results. SUMMARY Children should benefit from early integrated patient and family-centred specific care, and receive long-term follow-up until early adulthood, with regular assessments, enabling detection and treatment of any emerging problem, and to ensure the acquisition of independent living skills and stable vocational outcome when this is possible. So far, few well conducted intervention studies are available, but their number is increasing with positive results on the trained skills. Well designed studies using large samples and looking at generalization of the skills in everyday life are needed.
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