Changing student attitudes through interaction: Findings from an interprofessional workshop.

Healthcare professionals are increasingly expected to work in interprofessional teams. Students therefore need opportunities to learn and practise skills that will allow them to be effective team members when they enter the workforce. This article summarises an interprofessional learning experience for 289 undergraduate and graduate students representing 13 programmes in a College of Health Professions (CHP) at a US public university. The half-day workshop provided an opportunity for participants with no prior interprofessional education to collaborate in a problem-solving case study and to inform students of other professions about their professions. Faculty members from all CHP programmes collaborated in writing the case study and facilitating student discussions during the event. Attitudes related to interprofessional collaboration and professional roles were assessed prior to and after workshop participation. A paired t test showed a statistically significant difference in four attitude questions. Participants reported a significant increase in understanding the roles of other professionals in healthcare and community situations. They also reported an increased understanding of the benefits and challenges of working in interprofessional teams. This event successfully introduced participants to interprofessional collaboration and provided them the opportunity to share their professional expertise and understand the expertise of others.

Immunosuppression in pediatric liver transplant recipients: Unique aspects.

Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared with the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism, and drug excretion. Children also have a longer expected period of exposure to immunosuppression, which can impact growth, risk of infection (bacterial, viral, and fungal), carcinogenesis, and likelihood of nonadherence. This review discusses immunosuppressive options for pediatric liver transplant recipients and the unique issues that must be addressed when managing this population. Further advances in the field of tolerance and accommodation are needed to relieve the acute and cumulative burden of chronic immunosuppression in children. Liver Transplantation 23 244-256 2017 AASLD.

Efficacy and safety of high-dose propranolol for the management of infant supraventricular tachyarrhythmias.

OBJECTIVE: To report our experience with high-dose propranolol monotherapy for prophylaxis and treatment of infant supraventricular arrhythmias (SAs). STUDY DESIGN: Patients <1 year of age initiated on enteral propranolol as inpatients for management of SA were identified during a 10-year time period from the Texas Children's Hospital pharmacy database. Patients were included if they received propranolol monotherapy for SA. Propranolol therapy was considered successful when patients were initiated and discharged on monotherapy, without documented recurrence of arrhythmia or requiring additional antiarrhythmic medication. Patients discharged on propranolol were followed as outpatients until therapy was discontinued or a year from initiation, whichever came first. RESULTS: A total of 287 patients met study criteria (59.2% male). Propranolol therapy was initiated at a median of 17 days of age (IQR 6-33 days) at a total daily dose of 3.6 ± 1.0 mg/kg/day. Propranolol was successful in controlling SA throughout the inpatient stay in 67.3% of patients. Only one patient experienced a clinically significant adverse event that required propranolol discontinuation. A multivariable logistic regression analysis identified the presence of congenital heart disease (OR 0.42, 95% CI 0.19-0.94, P = .04) and Wolff-Parkinson-White (OR 0.42, 95% CI 0.21-0.87, P = .01) as factors for nonsuccessful inpatient propranolol monotherapy. Of 190 patients discharged on propranolol monotherapy, 87.7% were recurrence free during follow-up. CONCLUSIONS: High-dose propranolol is safe and reasonably successful in the treatment of infant SA. Inpatient control may be a predictor of continued outpatient efficacy.

Exploring visual-graphic symbol acquisition by pre-school age children with developmental and language delays.

The process of language acquisition requires an individual to organize the world through a system of symbols and referents. For children with severe intellectual disabilities and language delays, the ability to link a symbol to its referent may be a difficult task. In addition to the intervention strategy, issues such as the visual complexity and iconicity of a symbol arise when deciding what to select as a medium to teach language. This study explored the ability of four pre-school age children with developmental and language delays to acquire the meanings of Blissymbols and lexigrams using an observational experiential language intervention. In production, all four of the participants demonstrated symbol-referent relationships, while in comprehension, three of the four participants demonstrated at least emerging symbol-referent relationships. Although the number of symbols learned across participants varied, there were no differences between the learning of arbitrary and comparatively iconic symbols. The participants' comprehension skills appeared to influence their performance.