Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Pediatric ependymomas: Something old, something new

Ependymoma is one of the most common central nervous system (CNS) tumors in childhood. Ependymoma had previously been considered a single disease entity that arises in the posterior fossa, supratentorial compartment, or spinal cord; however recent advances in our understanding of the molecular make-up of this tumor reveal it to be not one disease, but many. In addition, the behavior of the disease and outcomes for children stricken with it are associated with the molecular abnormalities noted. In this update, we will review what is known about the molecular classification of ependymoma, the treatments that have been proven to work (namely surgery and radiation), the role of chemotherapy, newer agents being investigated, and the impact of molecular characteristics on strategies to design clinical trials and improve outcomes for children with ependymoma

Parental coping in the context of having a child who is facing death: a theoretical framework

While improvements in healthcare have resulted in children with complex and life-threatening conditions living longer, a proportion of them still die. The death of a child puts parents at increased risk for anxiety, depression, and complicated grief. Increasing our understanding of the coping strategies that parents use under such extreme circumstances will enable us to best provide support to families, before and after a child's death. Our aim herein was to develop a theoretical framework of parental coping. Evidence from the literature was employed to develop a theoretical framework to describe parental coping in the context of having a child with a life-limiting illness who is declining and facing eventual death. The reasoning and argument consists of three guiding elements: (1) the importance of approach as well as avoidance (as coping strategies) in the context of managing the extreme emotions; (2) the importance of the social aspect of coping within a family, whereby parents cope for others as well as for themselves; and (3) the importance of a flexible and balanced coping profile, with parents using different coping strategies simultaneously. Central to the proposed framework is that effective coping, in terms of adjustment, is achieved by balancing coping strategies: accessing different coping strategies simultaneously or in parallel with a specific focus on (1) approach and avoidance and (2) coping aimed at self and others. Understanding of parental coping strategies is essential for health professionals in order to support parents effectively