Efficacy of a 3-hour Aboriginal Health Teaching in the Medical Curriculum: Are We Changing Student Knowledge and Attitudes?

There is national recognition of the need to incorporate Aboriginal health issues within the medical school curricula. This study aims to evaluate changes in medical students’ knowledge and attitudes about Aboriginal health, and their preparedness to work in Aboriginal communities after attending a 3-hour Aboriginal health seminar. A cross-sectional survey was administered before and after the seminar for Year 1 and 2 medical students at the University of Western Ontario. The survey included four true or false questions and 24 questions using a seven-point Likert scale (1 – strongly disagree, 7 – strongly agree). Eighty two of 130 (64 per cent) Year 1 students and 55 of 86 (63 per cent) Year 2 students completed both questionnaires. Knowledge-based questions were answered correctly by most students before the seminar, with an increasing number of correct responses noted after the seminar (p \u3c 0.05). Students’ perceptions about sociocultural and economic factors affecting health showed uncertainty before the seminar, but changed towards greater agreement regarding its impact on health after the seminar (p \u3c 0.05). Students initially felt unprepared to care for Aboriginal patients before the seminar, but felt more prepared after the seminar (p \u3c 0.05). A 3-hour seminar using both didactic and non-traditional teaching methods appears to be effective in the short term in improving knowledge, changing attitudes and reversing some of the uncertainties medical students have about practicing in Aboriginal communities

Lexicon for guidance terminology in pediatric hematology/oncology: A White Paper

Terms used to label types of clinical recommendations and guidance are applied inconsistently and do not reflect the methods used to create each type. Here, the international Pediatric Oncology Supportive Care Guideline Network proposes a lexicon for types of recommendations and guidance documents. A lexicon describing three types of recommendations (clinical practice guideline-derived, good practice statement, and expert opinion statement) and two types of guidance documents (clinical practice guideline and expert opinion) is presented. Consistent use of this lexicon will allow pediatric oncology clinicians to readily appreciate the methods used to create clinical guidance

Identifying clinical practice guidelines for the supportive care of children with cancer: A report from the Children\u27s Oncology Group.

Providing evidence-based supportive care for children with cancer has the potential to optimize treatment outcomes and improve quality of life. The Children's Oncology Group (COG) Supportive Care Guidelines Subcommittee conducted a systematic review to identify current supportive care clinical practice guidelines (CPGs) relevant to childhood cancer or pediatric hematopoietic stem cell transplant. Only 22 papers met the 2011 Institute of Medicine criteria to be considered a CPG. The results highlight the paucity of CPGs available to pediatric oncology healthcare professionals and the pressing need to create CPGs using current methodological standards

Guideline for the management of fatigue in children and adolescents with cancer or pediatric hematopoietic cell transplant recipients: 2023 update

Objective was to update a clinical practice guideline (CPG) for the management of fatigue in children and adolescents with cancer or pediatric hematopoietic cell transplant recipients. We reconvened a multi-disciplinary and multi-national panel. While the previous 2018 CPG evaluated adult and pediatric randomized controlled trials (RCTs) to manage fatigue, this 2023 update revised previous recommendations based only on pediatric RCTs. Twenty RCTs were included in the updated systematic review. Physical activity significantly reduced fatigue (standardized mean difference -0.44, 95% confidence interval -0.64 to -0.24; n = 8 RCTs). Using the 2018 recommendations as a basis, the panel continued to make strong recommendations to use physical activity, and to offer relaxation, mindfulness or both, to manage fatigue in pediatric patients. Cognitive or cognitive behavioral therapies may be offered. Pharmacological approaches should not be routinely used. The panel made a new good practice statement to routinely assess for fatigue, ideally using a validated scale

Expert consensus statements for Waldeyer\u27s ring involvement in pediatric Hodgkin lymphoma: The staging, evaluation, and response criteria harmonization (SEARCH) for childhood, adolescent, and young adult Hodgkin lymphoma (CAYAHL) group.

Waldeyer\u27s ring (WR) involvement in pediatric Hodgkin lymphoma (HL) is extremely rare and criteria for determining involvement and response to treatment are unclear. The international Staging, Evaluation, and Response Criteria Harmonization for Childhood, Adolescent and Young Adult Hodgkin Lymphoma (SEARCH for CAYAHL) Group performed a systematic review of the literature in search of involvement or response criteria, or evidence to support specific criteria. Only 166 cases of HL with WR involvement were reported in the literature, 7 of which were pediatric. To date no standardized diagnostic or response assessment criteria are available. Given the paucity of evidence, using a modified Delphi survey technique, expert consensus statements were developed by the SEARCH group to allow for a more consistent definition of disease and response evaluation related to this rare site of involvement among pediatric oncologists. The available evidence and expert consensus statements are summarized