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Functional outcome measures for pediatric upper limb deficiencies with and without prostheses: A systematic review and appraisal.
No full textEffective orthopedic care/rehabilitation for pediatric upper limb deficiencies (ULDs) requires understanding how function and prosthetic control progress as the child develops. Psychometrically sound outcome measures are imperative. This systematic review critically appraised the instruments available for assessing upper limb function among children with ULDs. PubMed, Embase, CINAHL, and Scopus were searched. Eligible studies evaluated instruments\u27 validity, reliability, and/or responsiveness and included children under 18 years. Following PRISMA guidelines, multiple reviewers independently screened studies, extracted data, assessed risk of bias, and rated psychometrics and evidence quality by the COnsensus-based Standards for selection of health Measurement INstruments methodology. Reviewers screened 2513 studies; 19 reports describing 4 performance-based tests and 6 patient-reported outcome measures were included. An ideal outcome measure for pediatric ULDs does not yet exist. For clinicians/researchers seeking a standardized observational assessment, the Assessment of Capacity for Myoelectric Control (valid only for myoelectric prostheses) and Assisting Hand Assessment are the most promising options, showing the best feasibility and psychometrics. A modified Assisting Hand Assessment is under development for ULDs with or without prosthesis use. For clinicians/researchers seeking a more practical questionnaire that they can implement beyond the clinic, all existing options would benefit from revision and simplification. We provisionally recommend the 10-min, parent-reported Child Amputee Prosthetics Project-Functional Status Inventory. However, the preschooler version needs construct revisions, and all versions need reliability studies. Two well-known pediatric instruments, the Patient-Reported Outcomes Measurement Information System and Pediatric Outcomes Data Collection Instrument, are invalid for assessing upper limb function among patients with ULDs
6 Delivery Methods of an Entrustable Professional Activities-Driven Systems-Based Practice Curriculum
No full text25 Gaps in Advance Care Planning Among High End-of-Life Index Emergency Department Patients Destined for Psychiatric Facilities
No full textLaser Surgery in Pediatric Skin of Color Patients: A Systematic Review.
No full textThere are unique challenges in treating dermatologic conditions with lasers in pediatric patients with skin of color. Melanin in the basal epidermis scatters thermal energy, reducing laser effectiveness and increasing the risk of adverse effects. This systematic review summarizes laser treatment of dermatological conditions in pediatric patients with Fitzpatrick skin types (FST) IV-VI, reviewing laser parameters, efficacy, and potential side effects in this vulnerable population. Twenty-three studies using various designs were included after screening, with a total of 164 patients, aged 1 month-17 years. Our systematic review demonstrates that laser surgery in children with FST IV-VI is an excellent option for various dermatological conditions. Children with skin of color should not be excluded from laser surgery, as early treatment can lead to improved clearance and better clinical results. However, laser surgery in this population requires careful consideration regarding laser parameters and desired clinical outcomes. Trial Registration: Prospero ID CRD42024524971
F-123 | Intravenous Versus Intraosseous Epinephrine in Out-Of-Hospital Cardiac Arrest : An Updated Meta-Analysis And Systematic Review
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