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  • 1
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    Online Resource
    Mental Health of Siblings of Children with Rare Congenital Surgical Diseases during the COVID-19 Pandemic
    Georg Thieme Verlag KG ; 2022
    In:  European Journal of Pediatric Surgery Vol. 32, No. 05 ( 2022-10), p. 422-428
    Details
    In: European Journal of Pediatric Surgery, Georg Thieme Verlag KG, Vol. 32, No. 05 ( 2022-10), p. 422-428
    Abstract: Introduction The COVID-19 pandemic has affected every aspect of our society, particularly vulnerable groups, such as families with children suffering from rare diseases. However, the psychosocial influences of COVID-19 on the healthy siblings of children with rare diseases have not been investigated yet. Thus, the study aimed to evaluate the mental health of healthy siblings of children with rare congenital surgical diseases during the COVID-19 pandemic. Material and methods Siblings of children with rare congenital surgical diseases were investigated cross-sectionally between April 2020 and April 2021. Data on mental health were collected using the parent-version of the Strengths and Difficulties Questionnaire (SDQ). Results Out of 104 families, 81 (77.88%) participated in the survey. Healthy siblings presented with comparable levels of emotional and behavioral difficulties compared with population norms before the COVID-19 pandemic. Compared with studies that surveyed child and adolescent mental health during the COVID-19 pandemic, parents of siblings in this study reported a significantly lower impairment rate. Psychosocial and disease-specific risk factors of the respective outcomes in healthy siblings were identified through regression analysis models. Conclusion In general, health-care professionals should be aware of the possibility of siblings' mental health being at risk. Therefore, screening for psychosocial deficits may be essential in preventing psychiatric disorders in this population, especially during pandemics. Trial registration ClinicalTrials.gov: NCT04382820 (registered April 8, 2020)
    Type of Medium: Online Resource
    ISSN: 0939-7248 , 1439-359X
    URL: Article
    DOI: 10.1055/s-0041-1740978
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
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  • 2
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    The Spaced Learning Concept Significantly Improves Acquisition of Laparoscopic Suturing Skills in Students and Residents: A Randomized Control Trial
    Georg Thieme Verlag KG ; 2021
    In:  European Journal of Pediatric Surgery Vol. 31, No. 06 ( 2021-12), p. 518-524
    Details
    In: European Journal of Pediatric Surgery, Georg Thieme Verlag KG, Vol. 31, No. 06 ( 2021-12), p. 518-524
    Abstract: Introduction Spaced learning consists of blocks with highly condensed content that interrupted by breaks during which distractor activities, such as physical activity, are performed. The concept has been shown to be superior in complex motor skill acquisition like laparoscopic suturing and knot tying. Preliminary studies have solely been conducted with medical students. Therefore, it remained unanswered if the spaced learning concept would also work for pediatric surgery residents. Materials and Methods The study aimed to evaluate the effectiveness of spaced learning, students, and residents were asked to perform four surgeons' square knots on a bowel model within 30 minutes prior and post 3 hours of hands-on training. To examine the long-term skills, the same subjects were asked to perform a comparable, but more complex task 12 months later without receiving training in the meantime. Total time, knot stability, suture accuracy, knot quality, and laparoscopic performance were assessed. Additionally, motivation was accessed by using the questionnaire on current motivation. Differences were calculated using mixed analysis of variance, Mann–Whitney U test, and multivariate analysis of covariance. Results A total of 20 medical students and 14 residents participated in the study. After randomization, 18 were trained using the spaced learning concept and 16 via conventional methods. Both groups had comparable baseline characteristics and improved significantly after training in all assessed measures. The spaced learning concept improved procedure performance as well as knot quality and stability in both students and residents. However, residents that trained via spaced learning showed significantly better long-term results regarding knot quality and speed in comparison to students. Although anxiety was significantly reduced in both training groups over time, residents were significantly more interested regarding knot tying than students. Conclusion This study dispels any remaining doubt that the spaced learning concept might only work for medical students. It appears that the spaced learning concept is very suitable for residents in acquiring complex motor skills. It is superior to conventional training, resulting in improved procedural performance as well as knot quality and speed. Hence, tailored training programs should not only be integrated early on in students' curricula but also in surgical training programs.
    Type of Medium: Online Resource
    ISSN: 0939-7248 , 1439-359X
    URL: Article
    DOI: 10.1055/s-0040-1721041
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
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  • 3
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    The spaced learning concept significantly improves training for laparoscopic suturing: a pilot randomized controlled study
    Springer Science and Business Media LLC ; 2018
    In:  Surgical Endoscopy Vol. 32, No. 1 ( 2018-1), p. 154-159
    Details
    In: Surgical Endoscopy, Springer Science and Business Media LLC, Vol. 32, No. 1 ( 2018-1), p. 154-159
    Type of Medium: Online Resource
    ISSN: 0930-2794 , 1432-2218
    URL: Article
    DOI: 10.1007/s00464-017-5650-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 1463171-4
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  • 4
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    Perceived mental health in parents of children with rare congenital surgical diseases: a double ABCX model considering gender
    Springer Science and Business Media LLC ; 2021
    In:  Orphanet Journal of Rare Diseases Vol. 16, No. 1 ( 2021-12)
    Details
    In: Orphanet Journal of Rare Diseases, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2021-12)
    Abstract: Previous research has supported the utility of the Double ABCX model of family adaptation for parents in various diseases. Nonetheless, it remains unclear how raising a child with rare congenital surgical diseases impacts the mental health of both mothers and fathers. Methods The potential predictors of maternal and paternal mental health in a German sample of 210 parents of children with rare congenital surgical diseases were investigated. Parents were investigated cross-sectionally utilizing standardized psychometric questionnaires that assessed factors attributed to parental adaptation within the Double ABCX model. Results Stressor pile-up, family functioning, perceived stress, and mental health were positively associated with mothers and fathers. However, further analyses revealed that family functioning, social support, and perceived stress fully mediated the positive association between stressor pile-up and mental health in mothers, but not fathers. Conclusion Our findings suggest that parental adaptation to a rare congenital surgical disease in their children may be improved by increased intra- and extrafamilial resources and decreased perceived family-related stress in mothers, but not fathers. Our results may help to identify gender-specific factors that may guide clinicians and future interventions.
    Type of Medium: Online Resource
    ISSN: 1750-1172
    URL: Article
    DOI: 10.1186/s13023-021-01998-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2225857-7
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  • 5
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    Clinical outcome, quality of life, and mental health in long-gap esophageal atresia: comparison of gastric sleeve pull-up and delayed primary anastomosis
    Springer Science and Business Media LLC ; 2023
    In:  Pediatric Surgery International Vol. 39, No. 1 ( 2023-04-04)
    Details
    In: Pediatric Surgery International, Springer Science and Business Media LLC, Vol. 39, No. 1 ( 2023-04-04)
    Abstract: Pediatric surgeons have yet to reach a consensus whether a gastric sleeve pull-up or delayed primary anastomosis for the treatment of esophageal atresia (EA), especially of the long-gap type (LGEA) should be performed. Thus, the aim of this study was to evaluate clinical outcome, quality of life (QoL), and mental health of patients with EA and their parents. Methods Clinical outcomes of all children treated with EA from 2007 to 2021 were collected and parents of affected children were asked to participate in questionnaires regarding their Quality of Life (QoL) and their child’s Health-Related Quality of Life (HRQoL), as well as mental health. Results A total of 98 EA patients were included in the study. For analysis, the cohort was divided into two groups: (1) primary versus (2) secondary anastomosis, while the secondary anastomosis group was subdivided into (a) delayed primary anastomosis and (b) gastric sleeve pull-up and compared with each other. When comparing the secondary anastomosis group, significant differences were found between the delayed primary anastomosis and gastric sleeve pull-up group; the duration of anesthesia during anastomosis surgery (478.54 vs 328.82 min, p   〈  0.001), endoscopic dilatation rate (100% vs 69%, p  = 0.03), cumulative time spent in intensive care (42.31 vs 94.75 days, p  = 0.03) and the mortality rate (0% vs 31%, p  = 0.03). HRQoL and mental health did not differ between any of the groups. Conclusion Delayed primary anastomosis or gastric sleeve pull-up appear to be similar in patients with long-gap esophageal atresia in many key aspects like leakage rate, strictures, re-fistula, tracheomalacia, recurrent infections, thrive or reflux. Moreover, HrQoL was comparable in patients with (a) gastric sleeve pull-up and (b) delayed primary anastomosis. Future studies should focus on the long-term results of either preservation or replacement of the esophagus in children.
    Type of Medium: Online Resource
    ISSN: 1437-9813
    URL: Article
    DOI: 10.1007/s00383-023-05448-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463010-2
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  • 6
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    Factors Influencing Performance in Laparoscopic Suturing and Knot Tying: A Cohort Study
    Georg Thieme Verlag KG ; 2023
    In:  European Journal of Pediatric Surgery Vol. 33, No. 02 ( 2023-04), p. 144-151
    Details
    In: European Journal of Pediatric Surgery, Georg Thieme Verlag KG, Vol. 33, No. 02 ( 2023-04), p. 144-151
    Abstract: Background Laparoscopic suturing and knot tying are regarded as some of the most difficult laparoscopic skills to learn. Training is essential to reach proficiency, but available training opportunities are limited. Various techniques to improve training have been evaluated. It appears that individual-related factors affect initial performance and response to training. Thus, the current study aimed to assess factors influencing laparoscopic-suturing and knot-tying performances. Methods All patients were trained one-on-one (teacher–student) for 3 hours. Patients were tested before training (bowel anastomosis model) and directly after training (congenital diaphragmatic hernia or esophageal atresia model) to evaluate transferability. Primary endpoints were time, knot quality, precision, knot strength, and overall laparoscopic knotting performance. Moreover, factors such as (1) age, (2) gender, (3) handedness, (4) previous training or operative experience, (5) playing an instrument, (6) sportive activities, and (7) computer gaming which may influence the primary endpoints were assessed. Results In total, 172 medical students or novice surgical residents were included. Training significantly improved all outcome parameters assessed in the current study. More than 50% of the patients reached proficiency after 3 hours of training. Personal factors like operative experience, playing music instruments, sportive activities, and computer gaming affected some outcome parameters. Handedness and gender affected initial performance but differences partially subsided after training. Younger participants showed a much better response to training. Conclusion In conclusion, several factors influence initial performance and response to the training of laparoscopic suturing and knot tying. Surgeons who want to improve their laparoscopic performance, should concentrate on playing a musical instrument and performing sports rather than playing videos gaming. It appears that training is a key and more practice opportunities should be incorporated into medical school and surgical curricula. Moreover, handedness may affect the outcome but only if the training concepts are not tailored to the dominant hand of the surgeon. Future training and surgical curricula should adapt to this and tailor their concepts accordingly.
    Type of Medium: Online Resource
    ISSN: 0939-7248 , 1439-359X
    URL: Article
    DOI: 10.1055/s-0042-1742302
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
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  • 7
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    Training Significantly Improves Fetoscopy Performance: A Pilot Randomized Controlled Trial
    Georg Thieme Verlag KG ; 2015
    In:  European Journal of Pediatric Surgery Vol. 26, No. 05 ( 2015-10-7), p. 436-442
    Details
    In: European Journal of Pediatric Surgery, Georg Thieme Verlag KG, Vol. 26, No. 05 ( 2015-10-7), p. 436-442
    Type of Medium: Online Resource
    ISSN: 0939-7248 , 1439-359X
    URL: Article
    DOI: 10.1055/s-0035-1564712
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2015
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  • 8
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    Lidocaine-Epinephrine-Tetracaine Gel Is More Efficient than Eutectic Mixture of Local Anesthetics and Mepivacaine Injection for Pain Control during Skin Repair in Children: A Prospective, Propensity Score Matched Two-Center Study
    Georg Thieme Verlag KG ; 2020
    In:  European Journal of Pediatric Surgery Vol. 30, No. 06 ( 2020-12), p. 512-516
    Details
    In: European Journal of Pediatric Surgery, Georg Thieme Verlag KG, Vol. 30, No. 06 ( 2020-12), p. 512-516
    Abstract: Introduction Skin lacerations are common in children and their repair is a very unpleasant experience for a child. While pain management has been recognized as a key element of high-quality patient care, recent studies report that pain management in the pediatric emergency departments is still suboptimal. Lidocaine-epinephrine-tetracaine (LET) gel could potentially improve the traumatic experience caused by skin repair as it obviates the need for infiltration. Thus, the aim of the current study was to compare local eutectic mixture of local anesthetics (EMLA) plus mepivacaine infiltration with topical anesthetics (LET-gel). Materials and Methods Prospective, propensity score-matched multicenter study including all children between 3 and 16 years presented at two centers. After anesthetics (LET vs. EMLA and infiltration) standardized skin repair was performed. Pain assessment was performed using the faces pain rating scale or visual analogue scale. Follow-up, performed 2 weeks after initial presentation, assessed wound infection rates and overall satisfaction. Results Of 73 subjects 59 children (37 LET vs. 22 EMLA) were included after propensity score matching. Groups had similar baseline characteristics. Pretreatment was significantly less painful in LET versus local anesthetics group. Pain during skin repair was similar between groups (LET and EMLA with mepivacaine infiltration) and both groups demonstrated similar efficacy (procedure time, need for secondary infiltration, infection rate). Ultimately, pain levels during pretreatment and the surgical procedure were perceived significantly higher by the children than estimated by parents or surgeons. Conclusion In conclusion, it appears that LET is superior to conventional anesthesia including mepivacaine infiltration in the pediatric emergency departments. Pretreatment with LET is significantly less painful but equally effective. Hence, we recommend LET as a topical anesthetic in the pediatric emergency department.
    Type of Medium: Online Resource
    ISSN: 0939-7248 , 1439-359X
    URL: Article
    DOI: 10.1055/s-0039-3400283
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
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  • 9
    Online Resource
    Online Resource
    Quality of life and mental health of children with rare congenital surgical diseases and their parents during the COVID-19 pandemic
    Springer Science and Business Media LLC ; 2021
    In:  Orphanet Journal of Rare Diseases Vol. 16, No. 1 ( 2021-12)
    Details
    In: Orphanet Journal of Rare Diseases, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2021-12)
    Abstract: COVID-19 has affected our society at large, particularly vulnerable groups, such as children suffering from rare diseases and their parents. However, the psychosocial influences of COVID-19 on these have yet to be investigated. As such, the study’s goal was to evaluate the health-related quality of life (HRQoL), quality of life (QoL), and mental health of children with rare congenital surgical diseases and their parents during the COVID-19 pandemic and lockdown measures. Methods A survey of n  = 210 parents of children with rare congenital surgical diseases and a control group of n  = 88 parents of children without rare diseases was conducted cross-sectionally between April 2020 to April 2021. Data on HRQoL, QoL, and mental health was collected using standardized psychometric questionnaires for children and parents presenting to the pediatric surgery department at a university hospital. Results Mothers of children with rare pediatric surgical diseases showed significantly lower QoL and significantly higher impairment in mental health than a control group and norm data. For fathers, this was solely the case for their QoL. Children’s parent-reported HRQoL and mental health were partially impaired. Social and disease-specific risk factors of the respective outcomes in affected families were identified through regression analysis models. Conclusion Parents of children with rare diseases report severe psychosocial impairment regarding themselves and their children during the COVID-19 pandemic. Therefore, affected families should receive attention and supportive care in the form of a family-center approach to alleviate the additional burden of the COVID-19 pandemic.
    Type of Medium: Online Resource
    ISSN: 1750-1172
    URL: Article
    DOI: 10.1186/s13023-021-02129-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 10
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    The Spaced Learning Concept in Combination With Halsted and Peyton – A Randomized Controlled Study
    Elsevier BV ; 2022
    In:  Journal of Surgical Education Vol. 79, No. 5 ( 2022-09), p. 1228-1236
    Details
    In: Journal of Surgical Education, Elsevier BV, Vol. 79, No. 5 ( 2022-09), p. 1228-1236
    Type of Medium: Online Resource
    ISSN: 1931-7204
    URL: Article
    DOI: 10.1016/j.jsurg.2022.04.003
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2277548-1
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