Prolonged Fever: Kawasaki Disease in a Pediatric Patient With COVID-19.

Kawasaki disease (KD) is the leading cause of acquired heart disease. The cardiac clinical features seen with KD require diagnosis and treatment within 10 days of symptoms to decrease the risk of complications. This case report examines the complexity of prolonged fever in a pediatric patient with a positive test for severe acute respiratory coronavirus 2 and meets the KD criteria.

Creating a sustainable pediatric diabetes transition program.

BACKGROUND AND PROBLEM: A health care transition focused quality improvement project was implemented in a large urban pediatric endocrinology clinic to evaluate the effectiveness of the administration of the Transition Readiness Assessment Questionnaire (TRAQ) by identifying barriers to implementation and creating a more sustainable format. METHODS AND INTERVENTION: A pre- and post-intervention evaluation design was used in this quality improvement project. A twelve-month chart review of pediatric endocrine clinic patients diagnosed with diabetes who were 14 years of age or older and met eligibility criteria was conducted. Patients given the TRAQ tool were identified and assessed for documentation of goals and goal achievement. Discussions regarding the implementation of the TRAQ tool were conducted with clinic staff to identify process barriers and develop solutions. A post-implementation twelve-month review was conducted to evaluate for improved documentation and achievement of transition focused goals. RESULTS: Several barriers were identified that minimized the effectiveness of the TRAQ tool including lack of staff trained to assist with insulin pump and meter downloads and proximity of diabetes software. Additional staff were trained, and software was relocated to a more centrally located area with greater staff accessibility to allow for discussion of transition goals with patient and family. The new process resulted in a 100% increase in documentation of transition goals and met goals (p ≤0.001). CONCLUSIONS: The TRAQ tool is valuable for directing transition needs if implementation barriers such as staff training and accessibility to software are monitored and addressed. Frequent evaluation of the administration of the TRAQ tool protocol in the clinic setting is recommended in order to support pediatric patients' successful transition to adult care.

An update on practice guidelines for primary care treatment of pediatric migraine.

ABSTRACT: Headaches are a frequent reason for children and adolescents to seek healthcare, and such visits include pediatric ED visits. Headache-related school absences can affect academic performance. Diagnosing and treating headaches in this population can be challenging for the primary care NP. This article reviews recent management and treatment guidelines.

Improving Self-Esteem and Building Self-Confidence in Adolescent Mothers: Implementation of Self-Efficacy-Focused Activity Sessions.

Adolescent mothers have been shown to have lower self-esteem than nonparenting adolescents. The purpose of the current clinical project was to explore the feasibility of adopting a school-based support group model to provide education and skills for increasing self-esteem and self-confidence among adolescent mothers using self-efficacy-focused activity sessions. This project took place at an alternative public school for pregnant and/or parenting female adolescents. Participants attended self-efficacy-focused activity sessions, and completed the General Self-Efficacy Scale. Increased confidence in finding solutions demonstrated statistical correlation with the number of sessions attended. Development of positive self-esteem and self-confidence remain important concerns during the adolescent period. Implementing self-efficacy activities in a school-based setting is one potential approach to improving self-esteem. Further exploration into ways to foster positive mental health and build confidence in adolescents is recommended. [Journal of Psychosocial Nursing and Mental Health Services, 57(8), 11-15.].

Quality of Life and Health Outcomes in Overweight and Non-Overweight Children With Asthma.

BACKGROUND: During the past two decades, the number of children and adolescents who are obese has more than doubled. Following this trend in childhood obesity, there has been an alarming increase in the number of children with asthma who are overweight. OBJECTIVE: The aim of this study was to examine the differences in quality of life (QOL) and health outcomes of obese and overweight children with asthma compared with normal-weight children with asthma using a descriptive comparative survey design. METHODS: This comparative study consisted of 90 overweight and normal-weight 9- to 14-year-olds with asthma. Health outcomes examined included asthma-related missed number of school days, emergency department (ED) visits, hospitalizations, number of days wheezing, and number of night awakenings. QOL was measured using the Pediatric Asthma Quality of Life Questionnaire. RESULTS: The obese group reported the highest percentage of ED visits, hospitalizations, and number of days wheezing compared with the normal-weight group. A risk ratio analysis showed that the obese group had an overall 2.73 (95% confidence interval [CI] 2.15, 3.63) times higher likelihood of going to the ED and a 2.46 (95% CI 1.97, 3.19) times higher likelihood of hospitalization than the overweight and normal-weight groups. Asthma severity was a significant predictor of overall QOL (ß = -23.737, p = .002). CONCLUSIONS: The study results are consistent with other investigations that demonstrate that obese persons are at higher risk of experiencing severe asthma symptoms and support obesity as a potentially modifiable risk factor for asthma mitigation and prevention.

Pediatric obesity and asthma quality of life.

Widely researched as separate entities, our understanding of the comorbid effects of childhood obesity and asthma on quality of life is limited. This article discusses the effects of childhood obesity and asthma on self-reported quality of life in low-income African American teens with asthma. When controlling for the influence of symptom frequency, asthma classification, asthma self-efficacy, and asthma self-care levels, body mass index remains a most important factor in determining self-reported quality of life among teens with asthma. Although overweight and obesity did not change the effectiveness of the asthma intervention program, obesity did affect participants quality of life scores.

Asthma and obesity: the dose effect.

Asthma is one of the most common chronic illnesses in the world, affecting an estimated 300 million people. Globally, the prevalence of asthma has continued to spread as economic improvements in developing countries create a population trend toward urbanization and adoption of a western lifestyle. Research supports an association between obesity and asthma. Only by making weight management a priority in the treatment of asthma can the rising prevalence of both diseases be hindered and global health improved.