Essential pediatric hypertension: defining the educational needs of primary care pediatricians

BACKGROUND: In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. METHODS: We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. RESULTS: Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. CONCLUSIONS: There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN

The Effects of Hypertension on Cognitive Function in Children and Adolescents

Hypertension (HTN) is found in about 3-4% of the pediatric population with long-term risks of end organ damage if untreated or poorly controlled. Although children with HTN are being more frequently screened for end organ damage (i.e., LVH), the cognitive effects of HTN and methods to screen for cognitive dysfunction have not been extensively explored. In recent years, there have been a small number of studies that have provided important insights that can guide future research in this area. These studies show that HTN can be associated with headaches, restlessness, sleep disturbance, anxiety, depression, decreased attention, and also poor executive functioning. By increasing the utilization of cognitive tests in hypertensive children and adolescents, important cognitive defects secondary to HTN may be detected. More research is needed in the area, and the results of future studies could have far reaching implications for long-term outcomes in hypertensive children and adolescents

Stability of fermionic Feshbach molecules in a Bose-Fermi mixture

In the wake of successful experiments in Fermi condensates, experimental attention is broadening to study resonant interactions in degenerate Bose-Fermi mixtures. Here we consider the properties and stability of the fermionic molecules that can be created in such a mixture near a Feshbach resonance (FR). To do this, we consider the two-body scattering matrix in the many-body environment, and assess its complex poles. The stability properties of these molecules strongly depend on their centre-of-mass motion, because they must satisfy Fermi statistics. At low centre-of-mass momenta the molecules are more stable than in the absence of the environment (due to Pauli-blocking effects), while at high centre-of-mass momenta nontrivial many body effects render them somewhat less stable

Spin susceptibilities, spin densities and their connection to spin-currents

We calculate the frequency dependent spin susceptibilities for a two-dimensional electron gas with both Rashba and Dresselhaus spin-orbit interaction. The resonances of the susceptibilities depends on the relative values of the Rashba and Dresselhaus spin-orbit constants, which could be manipulated by gate voltages. We derive exact continuity equations, with source terms, for the spin density and use those to connect the spin current to the spin density. In the free electron model the susceptibilities play a central role in the spin dynamics since both the spin density and the spin current are proportional to them.Comment: 6 pages, revtex4 styl

The Kondo Dynamics of YbIn(1-x)AgxCu4

We present an infrared/optical study of the dynamics of the strongly correlated electron system YbIn(1-x)AgxCu4 as a function of doping and temperature for x ranging from 0 to 1, and T between 20 and 300 K. This study reveals information about the unusual phase transition as well as the phases themselves. Scaling relations emerge from the data and are investigated in detail using a periodic Anderson model based calculation. We also provide a picture in which to view both the low and high-energy x-dependent features of the infrared data, including identification of high energy, temperature dependent features.Comment: 12 pages, 11 figures, submitted Phys. Rev.

Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA)

The transfer of young patients from pediatric to adult renal care takes place after a transition process which involves both sides. It is important that it is individualized for each young person, focusing on self-management skills as well as assessing support structures. The consensus statement has been developed by the panel of adult and pediatric nephrologists and endorsed by the councils of both ISN and IPNA. It is hoped that the statement will provide a basis for the development of locally appropriate recommendations for clinical practice

Free energy of the Fr\"ohlich polaron in two and three dimensions

We present a novel Path Integral Monte Carlo scheme to solve the Fr\"ohlich polaron model. At intermediate and strong electron-phonon coupling, the polaron self-trapping is properly taken into account at the level of an effective action obtained by a preaveraging procedure with a retarded trial action. We compute the free energy at several couplings and temperatures in three and two dimensions. Our results show that the accuracy of the Feynman variational upper bound for the free energy is always better than 5% although the thermodynamics derived from it is not correct. Our estimates of the ground state energies demonstrate that the second cumulant correction to the variational upper bound predicts the self energy to better than 1% at intermediate and strong coupling.Comment: RevTeX 7 pages 3 figures, revised versio