Parental Impressions Research Articles

Management of Catheter-Related Urethral Injuries in Male Children.

Management of urethral trauma lacks clarity in the paediatric population.There is no clear guidance for management and follow-up of these patientswhich can lead to missing the long-term sequelae of the primary injury. Catheter-associated urethral injuriesare less likely to cause a complete transaction of the urethra. This is due to the mechanism, typically caused by creating a false passage or inflating the balloon in the urethra.In partial urethral injuries, the European Association of Urology (EAU) guidelines suggest follow-up after one-two weeks of bladder drainage or a urethrogram. The purpose of this study was to reviewliterature related to the management and follow-up of catheter-induced urethral injuries,subsequently comparing this toa case seriesin a single paediatric tertiary centre. The aim was to propose a unique algorithm to safely and effectively guide clinicians for thispresentation. In our case series, 11 of 12 required initial bladder drainage.The data demonstrated an inconsistent approach to investigations throughout their admissions. Most cases had a successful trial without catheter (TWOC) or ability to resume continuous intermittent catheterisation. One patient needed a vesicostomy.We had a single bulbar urethral stricture, which wouldn't permit an 8fr catheter. This was managed using cystoscopy and serial urethral dilations. Our cohort islikely an underrepresentation of the actual number of catheter-related injuries in our institute. Some injuries are managed by the parent team without referring to paediatric urologists if spontaneous micturition occurs or if they manage to catheterise after an initial traumatic attempt. Conclusion: Catheter-related urethral injuries arecommonbut underreported. They are less likely to have long-term sequelae than other mechanisms of trauma. The majority of casesdo well following a period of initial bladder drainage. Current practise varies even in one institute as there are no clear management and follow-up guidance in current literature. Our proposed algorithmis a useful tooland decreases the incidence of missing long-term sequelae. Management algorithm: Post urethral injury, a child who is passing urine with conservative management is likely to have good long-term function. They would require re-assessment after discharge. In clinic they would require urinary flow assessment and post-void residuals. If not toilet trained, parental impression of whether their child's stream is interrupted or if they strain during urination would be assessed. Back-pressure changes would be considered on ultrasound scan (USS). If the assessment indicates concern, then a micturating cystourethrogram (MCUG) assessment for children younger than one or a cystoscopic assessment for children older than one would be recommended. Post urethral injury, if a child is unable to pass urine conservatively, then an urgent urological assessment would be appropriate. An attempt at catheterisation would be made. If unsuccessful, the patient would be assessed for theatre. If unfit for it, an ultrasound-guided suprapubic (SP) catheter would be advised. If the patient is fit, then a cystoscopic and wire-guided catheter would be preferred. Later, if they passed a TWOC, they would be managed as per the algorithm described above. If they failed the TWOC, MCUG would be proceeded to. Catheter management and regular follow-up, or for a definitive intervention would be planned for.

Parent eHealth Preferences: Perceived Credibility and Personal Reactions to AbilitiCBT, BEAM, and Triple P Online

Parental eHealth needs and preferences are unknown. Evidence from in-person programs shows that programs that prioritize parent preferences have higher enrollment and adherence. Better knowledge of parental impressions and preferences based on current eHealth programs could help identify programs that are most in line with parental values, goals, and needs. Accordingly, the present study aimed to compare parental perceptions and preferences based on textual descriptions of three eHealth programs that have been prescribed to parents: AbilitiCBT (mental health-focused), BEAM (mental health and parenting-focused), and Triple P Online (parenting-focused). 177 parents of 0-5-year-old children in the United States were recruited through MTurk. Mental health symptoms in this sample were high (70.1% clinically concerning depression and/or anxiety symptoms and 74.6% clinically concerning parenting stress symptoms). Results showed that Triple P was less likely to be chosen than AbilitiCBT or BEAM; AbilitiCBT seemed more helpful to participants. There was considerable variability, and all programs were preferred by at least 17% of parents. Overall, the present study suggests that parents experiencing high psychological distress are less likely to choose to participate in a parenting program without mental health support and that it is important to offer diverse psychosocial service options to meet the needs of more parents. Further research is needed to identify specific program characteristics that parents prefer as well as parents’ rationale for their choices, which would help better tailor interventions to their preferences.

Implementasi Pembelajaran Kitab Berbahasa Melayu Jawi pada Prathomsuksa Di Patani Thailand

Traditional Islamic religious education in Patani studies the yellow book in Javanese Malay without using the government system by holding recitations in mosques or in Islamic halls. Over time, the use of Jawi Malay has decreased. One Prathomsuksah in Panyasa Panare has tried to keep going in his education. Using qualitative ethnography, research is carried out to find out how the learning process works. Parental impressions were also investigated. The learning process with the Malay Jiwa book runs every day and includes several Islamic religious lessons. The learning is also practiced by visiting the homes of parents or students who are having difficulty holding yasinan. This has given parents a good response.

Short-term Non-invasive Ventilation for Children with Palliative Care Needs

Objectives: Non-invasive ventilation (NIV), namely continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP), delivers mechanical ventilation without endotracheal intubation. Short-term NIV (planned for <21 days during initiation) can be used for the management of acute respiratory distress (ARD) among paediatric palliative patients with “Do Not Resuscitate or Intubate” (DNI) as the ceiling of care. This study aimed to describe the usage of short-term NIV among paediatric palliative patients in a woman and child hospital with a paediatric palliative subspecialty. Materials and Methods: A retrospective and observational study was conducted on all paediatric palliative patients who received short-term NIV in Tunku Azizah Hospital Kuala Lumpur, Malaysia, from March 2020 to May 2022. Results: During the study period, short-term NIV was offered on 23 occasions for 20 different children. Indications for short-term NIV include 16 (69.6%) occasions of potentially reversible ARD (NIV Category 1) and 7 (30.4%) occasions of comfort care at the end of life (NIV Category 2). The main cause of ARD was pneumonia (90.3%) due to either aspiration or infection. The modality of NIV used was BiPAP only (14 occasions, 60.9%), CPAP only (three occasions, 13%) and both BiPAP and CPAP (six occasions, 26.1%). The median duration of NIV usage was four days (minimum one day and maximum 15 days). NIV was initiated as an escalation from nasal prong, Ventimask or high-flow mask oxygen on 22 occasions and as weaning down post-extubation on one occasion. For the 22 occasions of escalating therapy, there was significant improvement at six hours compared to pre-NIV in the median heart rate (136 to 121, P=0.002), respiratory rate (40 to 31, P=0.002) and oxygen saturation (96% to 99%, P=0.025). All 17 documented parental impressions of the child’s condition post six hours of NIV were that the child had improved. Adverse events during short-term NIV include five episodes (21.7%) of stomach distension, four episodes (17.4%) of skin sores on the face and one episode (4.3%) of excessive drooling. Three patients passed away while on NIV in the hospital. For the other 20 (87%) occasions, patients were able to wean off NIV. Post-weaning off NIV, three patients passed away during the same admission. On 17 occasions, patients were discharged home after weaning off NIV. Conclusion: Usage of short-term NIV in paediatric palliative care, where children have an advanced directive in place indicating DNI, as seen in our study, can be a valuable modality of management for distressing symptoms, in addition to the pharmacological management of breathlessness. This is shown through our study to be of benefit in potentially reversible ARD as well as comfort care at the end of life. Further rigorous studies will need to be conducted for a clearer understanding of short-term NIV that would enable the formulation of guidelines to improve the quality of life and death in children.

Parental Impressions and Perspectives of Efficacy in Prenatal Counseling for Single Ventricle Congenital Heart Disease

Although commonly performed, optimal techniques, strategies, and content to achieve the most effective prenatal counseling have not been explored. We investigate the efficacy of prenatal counseling via survey feedback of parents of children with prenatally diagnosed single ventricle. Grades of counseling using a Likert scale (1–5) were solicited to assess: (1) overall impression of quantity of counseling, (2) explanation of the heart defect, (3) preparation for heart surgery, (4) preparation for hospital course and care, (5) preparation for complications and outcomes of a Fontan circulation, and (6) preparation for neurological, school-related, or behavioral problems. Impressions were solicited concerning specific providers. A comprehensive fetal counseling score was calculated for each participant. Burden of care including length of hospitalization was explored as impacting prenatal counseling grades. There were 59 survey respondents. Average age of the children at the time of survey was 4.6 ± 3.3 years (range 1–10 years). Highest grades were for explanation of the heart condition, with lowest grades for preparation for neurological, school-related, or behavioral problems. Cardiac surgeon received the highest with social worker lowest grade for provider. Negative correlation was found between the composite fetal counseling score and parental recollection of length of hospitalization (Pearson r = − 0.357, p < 0.01). Prenatal counseling for neurological, school-related, and behavioral problems in single ventricle is deficient. Further studies analyzing prenatal counseling techniques and content can help improve upon the delivery of this important aspect of prenatal care.

Aesthetic results in children with single suture craniosynostosis: proposal for a modified Whitaker classification

ObjectiveAesthetic assessment after surgery for non-syndromic single suture craniosynostosis (SSC) is crucial. Surgeons’ evaluation is generally based on Whitaker classification, while parental impression is generally neglected. The aim of this paper is to compare aesthetic perceptions of parents and surgeons after surgery for SSC, expressed by a 10-item questionnaire that complement Whitaker’s classification.MethodsThe authors submitted a 10-item questionnaire integrating Whitaker’s classification in order to evaluate the degree of satisfaction, the detailed aesthetics results and the need for surgical revision, to surgeons and parents of a consecutive series of patients operated for SSC between January 2007 and December 2018. The results were collected blindly.ResultsA total of 70 patients were included in the study. Scaphocephaly and trigonocephaly were the two most frequent craniosynostosis. Parents and surgeons general aesthetics evaluation and average rating for Whitaker’s classification were 1.86 vs 1.67 (p = 0.69) and 1.19 vs 1.1 (p = 0.45) respectively. Parents’ evaluation for scar perception and alopecia (p < 0.00001), the presence of bony crest (0.002), bony bump (p < 0.00001), or other bone irregularities (p = 0.02) are significantly worse when compared to surgeons’ perception.ConclusionsParents seem to be more sensitive to the detection of some aesthetic anomalies and their opinion should not be neglected. The authors propose a modified Whitaker classification based on their results to better stratify the aesthetic outcome after surgery for SSC.

Parental satisfaction with waiting time in a Swiss tertiary paediatric emergency department

IntroductionPatient numbers in paediatric emergency departments (PED) are steadily increasing. Parental perception of waiting time and reasons for attending a PED with non-emergencies have been investigated in the UK, Australia,...

Beginning power mobility: An exploration of factors associated with child use of early power mobility devices and parent device preference.

ObjectivesDescribe and compare young children’s use of four early power mobility devices and examine associations between child and environmental factors that may influence power mobility use and parent device preference.DesignCross-sectional observational study.MethodsPower Mobility Days introduced four devices: Wizzybug, Bugzi, Tiger Cub, and a switch-adapted ride-on toy car in a single 60–90 min, play-based session.ResultsA convenience sample of 74 children, aged 9–68 months (mean: 32.45, SD: 14.08) with mobility limitations, and their parents participated. Children had a range of motor, postural and communication profiles, with cerebral palsy being the most common condition (n = 55; 73.33%). Assessment of Learning Powered mobility use phase achieved ranged from 1 to 6; mean: 2.34; median: 2. For children who tried all four devices (n = 51), Friedman test (χ2: 8.27, p = 0.04) suggests Assessment of Learning Powered mobility use phase differs across devices. Of 73 parents who identified a device preference, 43 (59%) chose Wizzybug. Regression analyses suggest that access method and communication function may influence children’s power mobility use, while age, access and postural support requirements may influence parent device choice.DiscussionParent impressions of an early power mobility device may be influenced by many factors, yet be less influenced by child performance.

The development of a parental attachment recognition scale for mothers nurturing preschool children.

BackgroundAttachment theory shows that childhood experiences influence the parenting style that the child shows later, as a parent. Nevertheless, at present there are no instruments to efficiently quantify the emotions associated with parents’ early attachment.ObjectiveThis study aims to develop a cognitive scale that measures both the positive and negative emotions reflecting the early attachment experience of Japanese mothers now nurturing their own preschool‐age children.DesignA Parental Attachment Recognition Scale is developed in three phases that include concept analysis, item pool development and validity analysis, and investigation of the scale's statistical features, factor structure, validity, and reliability.Measurements and SampleThe scale development is based on a self‐administered questionnaire survey, answered by 639 mothers.ResultsThe scale consists of 27 items, grouped by factor analysis into three subordinate scales, named: (1) Parent–child contact; (2) Emotional bond; and (3) Parental impressions.ConclusionsThe study proposes a new scale to measure the recognition of early childhood attachment experiences among mothers raising their own preschool children. The instrument has a considerable degree of validity and reliability. The scale is expected to be useful in helping public health nurses assess mothers in need of childrearing support.

Use of Electronic Entertainment and Communication Devices Among a Saudi Pediatric Population: Cross-Sectional Study.

BackgroundExcessive use of various electronic entertainment and communication devices, particularly among children, has been associated with increased behavioral problems. Despite children’s escalating use of these devices, parents’ awareness about the impact thereof is still lacking.ObjectiveThe objective of this study was to assess the use of electronic entertainment and communication devices among children attending a health care facility in Jeddah, Saudi Arabia, as well as the parental impression regarding the impact of electronic devices use on the behavior of their child.MethodsA focused 15-item questionnaire was designed for this cross-sectional study involving mothers of children attending the Well Baby Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from July 1, 2016 to November 30, 2016.ResultsThis study included 190 mothers. The mean ages of the children, mothers, and fathers were 7.3 (SD 3.5), 35 (SD 6.5), and 43 (SD 8.3) years, respectively. Most children were of Saudi Arabian nationality (106/190, 55.8%). The most used device in this study was television (154/190, 81.0%), followed by mobile phones (134/190, 70.5%), and tablets (116/190, 61.0%). Computers were the least used device in this study (59/190, 31.0%). In total, 24.7% (47/190) of children in this study used electronic entertainment and communication devices for more than 4 hours per day. Most mothers (129/190, 67.9%) felt that their child spends too much time on electronic devices. Hyperactivity or behavioral problems were reported by 20.0% (38/190) of mothers in this study. Children spending longer hours on electronic devices were much more likely to be perceived to suffer from hyperactivity or behavioral problems (P=.01).ConclusionsParental awareness is necessary to counteract the harmful effects of using electronic devices for a prolonged period. Parents require help to cope with this problem effectively.

Advanced driver assistance systems for teen drivers: Teen and parent impressions, perceived need, and intervention preferences

ABSTRACTObjective: From the advent of airbags to electronic stability control, technological advances introduced into automobile design have significantly reduced injury and death from motor vehicle crashes. These advances are especially pertinent among teen drivers, a population whose leading cause of death is motor vehicle crashes. Recently developed advanced driver assistance systems (ADAS) have the potential to compensate for skill deficits and reduce overall crash risk. Yet, ADAS is only effective if drivers are willing to use it. Limited research has been conducted on the suitability of ADAS for teen drivers. The goal of this study is to identify teen drivers’ perceived need for ADAS, receptiveness to in-vehicle technology, and intervention preferences. The long-term goal is to understand public perceptions and barriers to ADAS use and to help determine how these systems must evolve to meet the needs of the riskiest driving populations.Methods: Three focus groups (N = 24) were conducted with licensed teen drivers aged 16–19 years and 2 focus groups with parents of teen drivers (N = 12). Discussion topics included views on how ADAS might influence driving skills and behaviors; trust in technology; and data privacy. Discussions were transcribed; the team used conventional content analysis and open coding methods to identify 12 coding domains and code transcripts with NVivo 10. Interrater reliability testing showed moderate to high kappa scores.Results: Overall, participants recognized potential benefits of ADAS, including improved safety and crash reduction. Teens suggested that ADAS is still developing and therefore has potential to malfunction. Many teens reported a greater trust in their own driving ability over vehicle technology. They expressed that novice drivers should learn to drive on non-ADAS-equipped cars and that ADAS should be considered a supplemental aid. Many teens felt that overreliance on ADAS may increase distracted driving or risky behaviors among teens. Parents also expressed skepticism for the technology but felt that it would likely be a useful support for teen drivers after the initial learning phase.Conclusions: This study elicited important end-user viewpoints by exploring the intersection between advanced automobile safety technology and human perception for the particular use case of teen drivers. For example, despite evidence that teens are the highest risk driving population, teens trust their own driving skills and competence more than in-vehicle technology. This understanding will ultimately advance the safety of teen drivers by identifying barriers to effective ADAS use.

Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth.

Silver diamine fluoride (SDF) treatment has been identified as a potential solution to address the dental public health issues of untreated dental caries and insufficient access to care. The current study assessed the effectiveness of 38 percent SDF in arresting active dental caries lesions and in reducing or preventing associated dental pain and infections in young, at-risk children. We enrolled 32 children aged 2-5 years with 118 active caries lesions in primary teeth from a community dental clinic in Oregon. After baseline examinations, carious lesions were treated with 1-2 applications of 38 percent SDF. Children were re-evaluated at 3-week and 3-month recalls to assess color and consistency changes in lesions (soft/hard). Parents were interviewed regarding symptoms of pain or infection and were surveyed regarding subjective feelings about SDF. Of 102 lesions (16 excluded from analyses), 100 were found to be arrested at first recall and all at second recall. The duration of SDF application was not associated with arrest of decay (P = 0.68). No incidence of pain or infection of an SDF-treated tooth was recorded. Parental impression of ease of application, taste, and esthetics was favorable. Our results suggested SDF was effective in arresting active caries lesions in primary teeth in young children and was well accepted by parents. SDF offers an easy and highly efficient nonsurgical alternative treatment to traditional restorative dental treatment in young children, and it has great potential to aid the dental public health community to address dental caries in at-risk populations.

The Effect of Educational Service Quality and Social Responsibility Activity of Private Educational Institute on Parental Satisfaction and Impression of Private Educational Institute: The Moderation Effect of Parents' Social Responsibility Consciousness

The Effect of Educational Service Quality and Social Responsibility Activity of Private Educational Institute on Parental Satisfaction and Impression of Private Educational Institute: The Moderation Effect of Parents' Social Responsibility Consciousness

Improvement of autism spectrum disorder symptoms in three children by using gastrin‐releasing peptide

ObjectiveTo evaluate the safety, tolerability and potential therapeutic effects of gastrin‐releasing peptide in three children with autistic spectrum disorder. MethodsCase series study with the intravenous administration of gastrin‐releasing peptide in the dose of 160pmol/kg for four consecutive days. To evaluate the results, parental impressions the Childhood Autism Rating Scale (CARS) and the Clinical Global Impression (CGI) Scale. Each child underwent a new peptide cycle after two weeks. The children were followed for four weeks after the end of the infusions. ResultsThe gastrin‐releasing peptide was well tolerated and no child had adverse effects. Two children had improved social interaction, with a slight improvement in joint attention and the interaction initiatives. Two showed reduction of stereotypes and improvement in verbal language. One child lost his compulsion to bathe, an effect that lasted two weeks after each infusion cycle. Average reduction in CARS score was 2.8 points. CGI was “minimally better” in two children and “much better” in one. ConclusionsThis study suggests that the gastrin‐releasing peptide is safe and may be effective in improving key symptoms of autism spectrum disorder, but its results should be interpreted with caution. Controlled clinical trials–randomized, double‐blinded, and with more children–are needed to better evaluate the possible therapeutic effects of gastrin‐releasing peptide in autism.

Outcome and recurrence 1 year after pediatric arterial ischemic stroke in a population-based cohort.

Arterial ischemic stroke (AIS) is an important cause of acquired brain injury in children. Few prospective population-based studies of childhood AIS have been completed. We aimed to investigate the outcome of childhood AIS 12 months after the event in a population-based cohort. Children aged 29 days to < 16 years with radiologically confirmed AIS occurring over a 1-year period residing in southern England (population = 5.99 million children) were eligible for inclusion. Outcome was assessed during a home visit using the Pediatric Stroke Outcome Measure (PSOM). Parental impressions of recovery were assessed using the Pediatric Stroke Recurrence and Recovery Questionnaire. PSOM score was estimated via telephone interview or clinician interview whenever home visit was not possible. Ninety-six children with AIS were identified. Two children were lost to follow-up. Nine of 94 (10%) children died before the 12-month follow-up. One child had an AIS recurrence. PSOM scores were available for 78 of 85 living children at follow-up. Thirty-nine of 78 (50%) had a good outcome (total PSOM score < 1), and 39 of 78 (50%) had a poor outcome. Seizures at onset of AIS were associated with a poor outcome (odds ratio = 3.5, 95% confidence interval = 1.16-10.6). Twenty-eight of 73 (38%) children were judged by their carers to have fully recovered. Ten of 84 (12%) children had recurrent seizures, and 17 of 84 (20%) reported recurrent headaches. AIS carries a significant risk of mortality and long-term neurological deficit. However, the rates of mortality, recurrence, and neurological impairment were markedly lower in this study than previously published figures in the United Kingdom. Ann Neurol 2016;79:784-793.

Improvement of autism spectrum disorder symptoms in three children by using gastrin-releasing peptide

ObjectiveTo evaluate the safety, tolerability and potential therapeutic effects of gastrin-releasing peptide in three children with autistic spectrum disorder. MethodsCase series study with the intravenous administration of gastrin-releasing peptide in the dose of 160pmol/kg for four consecutive days. To evaluate the results, parental impressions the Childhood Autism Rating Scale (CARS) and the Clinical Global Impression (CGI) Scale. Each child underwent a new peptide cycle after two weeks. The children were followed for four weeks after the end of the infusions. ResultsThe gastrin-releasing peptide was well tolerated and no child had adverse effects. Two children had improved social interaction, with a slight improvement in joint attention and the interaction initiatives. Two showed reduction of stereotypes and improvement in verbal language. One child lost his compulsion to bathe, an effect that lasted two weeks after each infusion cycle. Average reduction in CARS score was 2.8 points. CGI was “minimally better” in two children and “much better” in one. ConclusionsThis study suggests that the gastrin-releasing peptide is safe and may be effective in improving key symptoms of autism spectrum disorder, but its results should be interpreted with caution. Controlled clinical trials–randomized, double-blinded, and with more children–are needed to better evaluate the possible therapeutic effects of gastrin-releasing peptide in autism.

Parental comparison of the prosodic and paralinguistic ability of children with cochlear implants and their normal hearing siblings

The everyday communication of children is commonly observed by their parents. This paper examines the responses of parents (n = 18) who had both a Cochlear Implant (CI) and a Normal Hearing (NH) child. Through an online questionnaire, parents rated the ability of their children on a gamut of speech communication competencies encountered in everyday settings. Comparative parental ratings of the CI children were significantly poorer than those of their NH siblings in speaker recognition, happy and sad emotion, and question versus statement identification. Parents also reported that they changed the vocal effort and the enunciation of their speech when they addressed their CI child and that their CI child consistently responded when their name was called in normal, but not in noisy backgrounds. Demographic factors were not found to be linked to the parental impressions.

Multicentre prospective clinical application of the T14 paediatric outcome tool.

This study aimed to measure changes in disease-specific quality of life in children following tonsillectomy or adenotonsillectomy. A multicentre prospective cohort study was performed involving seven ENT departments in England. A total of 276 children entered the study over a 2-month period: 107 underwent tonsillectomy and 128 adenotonsillectomy. Forty-one children referred with throat problems initially managed by watchful waiting were also recruited. The follow-up period was 12 months. Outcome measures were the T14, parental impressions of their child's quality of life and the number of days absent from school. One-year follow-up data were obtained from 150 patients (52 per cent). The mean baseline T14 score in the non-surgical group was significantly lower (T14 = 23) than in the tonsillectomy group (T14 = 31) or the adenotonsillectomy group (T14 = 35; p < 0.001). There was a significant improvement in the T14 scores of responders in all groups at follow up. The effect size was 1.3 standard deviations (SD) for the non-surgical group, 2.1 SD for the tonsillectomy group and 1.9 SD for the adenotonsillectomy group. Between-group differences did not reach statistical significance. A third of children in the non-surgical group underwent surgery during the follow-up period. Children who underwent surgical intervention achieved a significant improvement in disease-specific quality of life. Less severely affected children were managed conservatively and also improved over 12 months, but 1 in 3 crossed over to surgical intervention.

Minor surgery procedures: A retrospective review and prospective survey in a pediatric population

Objective The present study evaluated minor surgery procedures undertaken by a single plastic surgeon at BC Children's Hospital (Vancouver, British Columbia) for patient and physician satisfaction, parent impressions, psychological concerns and complications. Methods Data were collected from a retrospective chart review and a prospective patient survey. Eligible subjects for the retrospective study included all pediatric patients undergoing minor surgery between May 2011 and April 2013. Parameters of interest included patient demographics, minor surgery specifics, complications and outcomes. Eligible subjects for the prospective patient survey included consecutive patients undergoing minor surgery between June 2013 and August 2013, as well as their parents. Results A total of 219 procedures were included in the retrospective review. The mean age of subjects was 13.1 years (range two weeks to 18 years). The median length of follow-up was 46 days (range four to 606 days). There were no major complications; however, 45 minor complications in 36 patients were found. Complications included crusting (4.6%), delayed wound healing (3.2%), hypersensitivity (2.3%), scar hypertrophy (1.8%), infection (0.9%) and other (7.8%). Outcomes were categorized as one of four outcomes: both satisfied (89.9%); patient satisfied but physician unsatisfied (0.8%); patient unsatisfied and physician satisfied (3.1%); and both unsatisfied (6.2%). In the prospective study, 32 subjects consented to participate in the survey. Of these subjects, 10 children and 12 parents responded to the questionnaires. Eighty-three percent of respondents indicated that their goals were accomplished by their procedure and that they would be willing to undergo minor surgery again. Conclusion Minor surgery is possible and practical in pediatric plastic surgery clinics, with few complications and high patient and surgeon satisfaction.

A feasibility trial of Cogmed working memory training in fragile X syndrome.

Individuals with fragile X syndrome (FXS) often present with an array of neurocognitive deficits, particularly in working memory (WM) and other executive functions. Evidence is accumulating that WM training can be effective in certain clinical populations in improving WM abilities and decreasing attention deficit hyperactivity disorder symptoms. We report preliminary findings evaluating the feasibility of Cogmed JM program, a computer-based WM intervention, within the FXS population. Twenty-five participants were evaluated for training. Seventeen were deemed eligible, of whom eight enrolled in the 5-wk training. Baseline characteristics were analyzed, as well as training progress and parental impressions. We conclude that Cogmed JM is a feasible intervention in FXS, though a certain baseline level of ability is required, and urge future controlled trials to determine efficacy.