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Outcomes of neonatal patent ductus arteriosus ligation in Canadian neonatal units with and without pediatric cardiac surgery programs.

https://arctichealth.org/en/permalink/ahliterature113672
Source
J Pediatr Surg. 2013 May;48(5):909-14
Publication Type
Article
Date
May-2013
Author
Charles Wong
Michael Mak
Sandesh Shivananda
Junmin Yang
Prakeshkumar S Shah
Wendy Seidlitz
Julia Pemberton
Peter G Fitzgerald
Brian H Cameron
Author Affiliation
McMaster Pediatric Surgery Research Collaborative, Hamilton ON, Canada.
Source
J Pediatr Surg. 2013 May;48(5):909-14
Date
May-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Multiple - epidemiology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Brain Diseases - epidemiology - etiology - ultrasonography
Canada
Cardiology Service, Hospital - organization & administration
Combined Modality Therapy
Databases, Factual
Ductus Arteriosus, Patent - drug therapy - mortality - surgery
Female
Hospital Departments - organization & administration
Hospital Mortality
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - mortality - surgery
Infant, Small for Gestational Age
Intensive Care Units, Neonatal - statistics & numerical data
Ligation
Male
Patient Transfer - statistics & numerical data
Pediatrics - organization & administration
Postoperative Complications - epidemiology - etiology - ultrasonography
Retrospective Studies
Sepsis - epidemiology - etiology
Severity of Illness Index
Surgery Department, Hospital - organization & administration
Tertiary Care Centers - organization & administration - statistics & numerical data
Treatment Outcome
Abstract
Preterm infants needing patent ductus arteriosus (PDA) ligation are transferred to a pediatric cardiac center (CC) unless the operation can be done locally by a pediatric surgeon at a non-cardiac center (NCC). We compared infant outcomes after PDA ligation at CC and NCC.
We analyzed 990 preterm infants who had PDA ligation between 2005 and 2009 using the Canadian Neonatal Network database. In-hospital mortality and major morbidities were compared between CC (n=18) and NCC (n=9).
SNAP-II-adjusted mortality rates were similar (CC=8.7% vs NCC=10.7%, P=.32). Significant cranial ultrasound abnormalities (CC=24.1% vs NCC=32.1%, P
PubMed ID
23701758 View in PubMed
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Understanding academic clinicians' varying attitudes toward the treatment of childhood obesity in Canada: a descriptive qualitative approach.

https://arctichealth.org/en/permalink/ahliterature113666
Source
J Pediatr Surg. 2013 May;48(5):1012-9
Publication Type
Article
Date
May-2013
Author
Karen Bailey
Julia Pemberton
Claudia Frankfurter
Author Affiliation
Department of Surgery, McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada L8N 3Z5. kbailey@mcmaster.ca
Source
J Pediatr Surg. 2013 May;48(5):1012-9
Date
May-2013
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Attitude to Health
Bariatric Surgery
Canada - epidemiology
Combined Modality Therapy
Decision Making
Disease Management
Endocrinology
Family Health
Family Practice
Female
General Surgery
Humans
Life Style
Male
Obesity - epidemiology - psychology - surgery - therapy
Patient Education as Topic
Pediatrics
Physicians - psychology
Physicians, Family - psychology
Prevalence
Qualitative Research
Referral and Consultation
Abstract
This qualitative study aims to understand academic physicians' attitudes towards the treatment of pediatric obesity in Canada.
A stratified sample of 24 participants (surgeons, pediatricians, family practitioners) were recruited from 4 Canadian regions. Semi-structured interviews were conducted and transcribed. A codebook was developed through iterative data reduction and conceptual saturation ensured. Validity was ensured through triangulation, audit trail, and member-checking.
This study revealed 45 themes with regional, specialty, and experiential differences. Quebec and Ontario emphasized education of physicians and parents to improve treatment and favored surgical intervention. Half of surgeons felt surgery was the only successful treatment option, while non-surgeons favored behavioral interventions. Experienced physicians in Western Canada desired more evidence to improve patient care, while inexperienced physicians focused on early detection and home environments. Across Canada participants advocated for program development and system change. Respondents expressed family involvement as integral to treatment success and shifting away from blame and moving towards a healthy lifestyles approach.
Canadian regional differences in physicians' attitudes towards pediatric obesity treatment exist, influenced by experience and specialty. We will understand how themes identified in this study influence real life clinical decision making by applying these results to create a discrete choice-based conjoint survey.
PubMed ID
23701775 View in PubMed
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