human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives . To estimate ( 1 ) family‐centered care ( FCC ) and shared decision‐making ( SDM ) prevalence , and ( 2 ) associations of FCC and SDM ( FCC/SDM ) with health care outcomes among U.S. children . Data Source . The Medical Expenditure Panel Survey Household Component ( MEPS‐HC ) , a nationally representative survey of the noninstitutionalized , civilian population . Study Design . Secondary analyses of prospect ively collected data on 15,764 U.S. children were conducted to examine FCC/SDM prevalence in year 1 and associations of FCC/SDM in year 1 with health services utilization , medical expenditures , and unmet health care needs in year 2 . Data Collection / Extraction Methods . We combined four MEPS‐HC longitudinal files from 2007 to 2011 . Principal Findings . FCC/SDM prevalence in year 1 varied from 38.6 to 93.7 percent , and it was lower for composites with more stringent scoring approaches . FCC/SDM composites with stringent scoring approaches in year 1 were associated with reduced unmet needs in year 2 . FCC/SDM , across all year 1 composites , was not associated with health services utilization or medical expenditures in year 2 . FCC/SDM year 1 subcomponents describing consensus building and mutual agreement were consistently associated with unmet health care needs in year 2 . Conclusions . FCC/SDM composites with stringent scoring approaches measuring consensus building and mutual agreement may have the greatest utility for pediatric health care quality improvement efforts OBJECTIVE : To examine integrated personal health record ( PHR ) use patterns among parents of children with chronic disease and compare ratings of care experiences between integrated PHR users and nonusers . METHODS : A survey was mailed to 600 r and omly selected parents of children with chronic disease ≤5 years old and enrolled at Group Health for ≥1 year . Respondents reported integrated PHR use in the past 12 months , types of services used , or reasons for nonuse . We measured parent ratings of care experiences by using Consumer Assessment s of Healthcare Providers and Systems ( CAHPS ) composite measures : Attention to Growth and Development , Attention to Safety and Health , Getting Care Quickly , Getting Needed Care , Prescription Medications , and Care Coordination . We used multivariate logistic regression to test the association between integrated PHR use and each CAHPS composite measure dichotomized by using the top box score method . RESULTS : Of 256 respondents ( 43 % eligible response rate ) , 166 ( 65 % ) were integrated PHR users and 90 ( 35 % ) were nonusers . The top  integrated PHR services used were viewing immunization records , viewing medical records , secured messaging , and scheduling appointments . The top reasons for not using the integrated PHR were “ too busy , ” “ forgot login/password , ” and “ my child does not have health care needs . ” Adjusted logistic regression did not reveal any significant differences between users and nonusers . CONCLUSIONS : Parents of children with chronic disease appear willing to use an integrated PHR to address health care needs for their child . Integrated PHR use was not associated with higher scores on CAHPS composite measures in this health plan BACKGROUND : There is growing interest in clinical screening for pediatric social determinants of health , but little evidence on formats that maximize disclosure rates on a wide range of potentially sensitive topics . We design ed a study to examine disclosure rates and hypothesized that there would be no difference in disclosure rates on face-to-face versus electronic screening formats for items other than highly sensitive items . METHODS : We conducted a r and omized trial of electronic versus face-to-face social screening formats in a pediatric emergency department . Consenting English-speaking and Spanish-speaking adult caregivers familiar with the presenting child ’s household were r and omized to social screening via tablet computer ( with option for audio assist ) versus a face-to-face interview conducted by a fully bilingual/bicultural research er . RESULTS : Almost all caregivers ( 96.8 % ) reported at least 1 social need , but rates of reporting on the more sensitive issues ( household violence and substance abuse ) were significantly higher in electronic format , and disclosure was marginally higher in electronic format for financial insecurity and neighborhood and school safety . There was a significant difference in the proportion of social needs items with higher endorsement in the computer-based group ( 70 % ) than the face-to-face group ( 30 % ) . CONCLUSIONS : Pediatric clinical sites interested in incorporating caregiver-reported socioeconomic , environmental , and behavioral needs screening should consider electronic screening when feasible , particularly when assessing sensitive topics such as child safety and household member substance use Background : Family-centered care ( FCC ) involves holistic care and requires cooperation with the family in planning , intervention , and the evolution of the care that is being provided . Many previous studies have provided results that indicate the importance of the family ’s involvement in pediatric care , but there is still resistance in doing so within the organizational culture of the hospitals in Iran . The aim of this study was to determine the effects of FCC on the satisfaction of  parents of children hospitalized in 2012 in the pediatric ward at Razi Hospital in Chaloos , Iran . Methods : This Quasi-experimental study was conducted in 2012 in the pediatric ward at Razi Hospital in Chaloos , Iran . Seventy hospitalized children between the ages of 1 and 3 who suffered from diarrhea , vomiting , or pneumonia were selected through convenience sampling . They were divided r and omly into two equal groups , a control group ( routine care ) and an experimental group ( family-centered care ) . SPSS Statistics 14 software was used to analyze the data , and p<0.05 was considered to be significant . Results : In the FCC group , the mean score of satisfaction among the parents of the children was 20 out of 90 before the intervention , but , after the FCC method was used , it increased to 83.2 out of 90 . In addition , a significant difference was found between the scores of satisfaction for the control and experimental groups ( p<0.001 ) , and all parents of children in the experimental group expressed high satisfaction . Conclusion : Our findings showed that the practice of FCC in caring for the sick children can increase the satisfaction of their parents significantly . The role of the family ’s involvement is critical in every component of the intervention efforts , as shown by the constructs of participatory support , educational support , and psychological support . Thus , a notable implication here is that FCC may lead to increased quality of care and should be included in the educational programs of the nursing staff in pediatric In an effort to examine translation of family nursing knowledge to practice , the L and spitali University Hospital Family Nursing Implementation Project ( 2007 - 2011 ) , was thoughtfully initiated in Reykjavik , Icel and and systematic ally evaluated . The mission was to implement family nursing in every department of the hospital . This publication is the first formal research report from this l and mark project . The purpose of this research was to evaluate the effectiveness of a short-term therapeutic conversation intervention  with families who were receiving health care services at the Children ’s Hospital at L and spitali University Hospital in Icel and related to childhood and adolescent acute and chronic illnesses . The therapeutic conversation was guided by Family Systems Nursing and used the Calgary Family Assessment and Intervention Models ( Wright & Leahey , 2005 , 2009 ) . Families ( N = 76 ) were r and omly assigned to either an experimental group ( short-term therapeutic conversation : n = 41 ) or to a control group ( traditional care : n = 35 ) . Parents in the experimental group reported significantly higher family support after the intervention , compared to the parents in the control group . Differences were noted between families experiencing acute versus chronic illnesses . Recommendations are made for conducting and design ing intervention research with families experiencing the hospitalization of a child or adolescent Purpose This study assessed the effectiveness of animal‐assisted activities ( AAA ) on biobehavioral stress responses ( anxiety , positive and negative affect , and salivary cortisol and C‐reactive protein [ CRP ] levels ) in hospitalized children . Design and Methods This was a r and omized , controlled study . Method Forty‐eight participants were r and omly assigned to receive a 10‐minute AAA ( n = 24 ) or a control condition ( n = 24 ) . Anxiety , positive and negative affect , and levels of salivary biomarkers were assessed before and after the intervention . Results Although increases in positive affect and decreases in negative affect were larger in the AAA condition , pre‐ and post‐intervention differences between the AAA and control conditions were not significant . In addition , pre‐ and post‐intervention differences between the conditions in salivary cortisol and CRP were not statistically significant . Baseline levels of anxiety , cortisol , and CRP had a significant and large correlation to the corresponding post‐intervention measures . Scores on the Pet Attitude Scale were high but were not associated with changes in anxiety , positive affect , negative affect , or stress biomarkers . Conclusions Although changes were in the expected direction , the magnitude of the effect was small . Future r and omized controlled trials with larger recruitment are needed to determine the effectiveness of AAAs in reducing biobehavioral stress responses in hospitalized children . Practice Implication s Nurses are positioned to recommend AAA as a beneficial and safe experience for hospitalized children . HighlightsDifferences between the AAA and control conditions were not significant . Increases in positive affect were larger in the AAA condition . Decreases in negative affect were larger in the AAA condition . Patients reported positive attitude towards pets and reported enjoying the AAAs . Nurses may recommend AAA as a beneficial experience for hospitalized children INTRODUCTION Screening and management of the social determinants of health ( SDH ) are critical for child health promotion . We sought to evaluate the impact of a facilitated video curriculum on resident SDH screening competence , parental perceptions of resident practice , resident-initiated referrals to a medical-legal partnership ( MLP ) , and formula distribution to food-insecure families . METHODS This was a pre-post study with concurrent control performed at a large pediatric residency program . Second- and third-year residents were assigned to control and intervention groups on the basis of their continuity clinic day . The curriculum included videotaped vignettes of screening for SDH and a " day in the life " series of families describing the impact of intervention on their lives . Residents completed self- assessment s on screening competence and re source knowledge . After a well-child encounter , families ( 3 per resident ) assessed their level of trust and respect for the resident and the number of SDHs screened for . MLP referral rates and formula distribution were compared . RESULTS The intervention group 's self-assessed competence in screening for housing , benefits , and educational concerns was significantly higher compared to controls ( each P ≤ .05 ) . Parents ' rating of trust and respect was high and did not differ between groups . Screening for each SDH was higher in the intervention group with domestic violence ( odds ratio 2.16 , 95 % confidence interval 1.01 - 4.63 ) and depression ( odds ratio 2.63 , 95 % confidence interval 1.15 - 5.99 ) , reaching statistical significance . MLP referral rates increased ( P = .06 ) , and formula distribution ( P = .02 ) reached statistical significance in the intervention group . CONCLUSIONS This SDH video curriculum improved resident self-assessed screening competence , parental perception of screening , and both MLP referrals and formula distribution Purpose : To explore the effectiveness of canine visitation therapy ( CVT ) in pediatric pain management in a tertiary care children 's hospital , a descriptive pilot study was conducted . Method : A convenience sample of 25 English-speaking children ages 5 to 18 years who underwent surgery and experienced acute postoperative pain participated in a st and ard , one-time CVT intervention . Each child completed a pre-post survey and a postintervention interview . Findings : Quantitative pre-post findings indicate that CVT significantly reduced perceived pain . Qualitative findings suggest that one mechanism that makes CVT effective may be cognitive . That is , CVTdistracts children from pain-related cognition and possibly activates comforting thoughts regarding companionship or home . Conclusion : The study findings suggest that CVT may be a useful adjunct to traditional pain management for children . Implication s : Nurses may better serve their patients when CVT is an option BACKGROUND Patient- and family-centered care ( PFCC ) approaches to care are important in enhancing the patient-centeredness of the health care experience , yet little is known about the effectiveness of formal approaches for teaching patient-centeredness in residency . INTERVENTION We developed and implemented a PFCC curriculum and assessed its impact on residents ' self-perceptions of patient-centered behavior and practice s. METHODS We used a quasi-experimental , nonr and omized approach with a pretest-posttest design . An experimental group of 24 interns filled out the Patient Practitioner Orientation Scale ( PPOS ) before residency , and a control group of 18 graduating residents who had not been exposed to a PFCC curriculum  also completed the PPOS . After 2 years of residency and exposure to a PFCC curriculum , interns in the experimental group repeated the PPOS . We compared mean total and subscale PPOS scores . RESULTS There was no difference in baseline total or subscale PPOS scores between the experimental and control group . The mean total PPOS score for the experimental group after exposure to the curriculum was 4.55 ( P = .45 ) , reflecting no change in patient-centeredness . The 17 female interns in the intervention group were more patient centered ( 4.8 ± 0.36 ) than the 6 male interns ( 4.2 ± 0.38 ) ( P = .005 ) , scoring significantly higher ( 4.6 ± 0.39 versus 4.0 ± 0.38 ) in the sharing domain ( P = .001 ) . CONCLUSION Interns ' exposure to a PFCC curriculum did not result in a change in their perce 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives . To estimate ( 1 ) family‐centered care ( FCC ) and shared decision‐making ( SDM ) prevalence , and ( 2 ) associations of FCC and SDM ( FCC/SDM ) with health care outcomes among U.S. children . Data Source . The Medical Expenditure Panel Survey Household Component ( MEPS‐HC ) , a nationally representative survey of the noninstitutionalized , civilian population . Study Design . Secondary analyses of prospect ively collected data on 15,764 U.S. children were conducted to examine FCC/SDM prevalence in year 1 and associations of FCC/SDM in year 1 with health services utilization , medical expenditures , and unmet health care needs in year 2 . Data Collection / Extraction Methods . We combined four MEPS‐HC longitudinal files from 2007 to 2011 . Principal Findings . FCC/SDM prevalence in year 1 varied from 38.6 to 93.7 percent , and it was lower for composites with more stringent scoring approaches . FCC/SDM composites with stringent scoring approaches in year 1 were associated with reduced unmet needs in year 2 . FCC/SDM , across all year 1 composites , was not associated with health services utilization or medical expenditures in year 2 . FCC/SDM year 1 subcomponents describing consensus building and mutual agreement were consistently associated with unmet health care needs in year 2 . Conclusions . FCC/SDM composites with stringent scoring approaches measuring consensus building and mutual agreement may have the greatest utility for pediatric health care quality improvement efforts OBJECTIVE : To examine integrated personal health record ( PHR ) use patterns among parents of children with chronic disease and compare ratings of care experiences between integrated PHR users and nonusers . METHODS : A survey was mailed to 600 r and omly selected parents of children with chronic disease ≤5 years old and enrolled at Group Health for ≥1 year . Respondents reported integrated PHR use in the past 12 months , types of services used , or reasons for nonuse . We measured parent ratings of care experiences by using Consumer Assessment s of Healthcare Providers and Systems ( CAHPS ) composite measures : Attention to Growth and Development , Attention to Safety and Health , Getting Care Quickly , Getting Needed Care , Prescription Medications , and Care Coordination . We used multivariate logistic regression to test the association between integrated PHR use and each CAHPS composite measure dichotomized by using the top box score method . RESULTS : Of 256 respondents ( 43 % eligible response rate ) , 166 ( 65 % ) were integrated PHR users and 90 ( 35 % ) were nonusers . The top  integrated PHR services used were viewing immunization records , viewing medical records , secured messaging , and scheduling appointments . The top reasons for not using the integrated PHR were “ too busy , ” “ forgot login/password , ” and “ my child does not have health care needs . ” Adjusted logistic regression did not reveal any significant differences between users and nonusers . CONCLUSIONS : Parents of children with chronic disease appear willing to use an integrated PHR to address health care needs for their child . Integrated PHR use was not associated with higher scores on CAHPS composite measures in this health plan BACKGROUND : There is growing interest in clinical screening for pediatric social determinants of health , but little evidence on formats that maximize disclosure rates on a wide range of potentially sensitive topics . We design ed a study to examine disclosure rates and hypothesized that there would be no difference in disclosure rates on face-to-face versus electronic screening formats for items other than highly sensitive items . METHODS : We conducted a r and omized trial of electronic versus face-to-face social screening formats in a pediatric emergency department . Consenting English-speaking and Spanish-speaking adult caregivers familiar with the presenting child ’s household were r and omized to social screening via tablet computer ( with option for audio assist ) versus a face-to-face interview conducted by a fully bilingual/bicultural research er . RESULTS : Almost all caregivers ( 96.8 % ) reported at least 1 social need , but rates of reporting on the more sensitive issues ( household violence and substance abuse ) were significantly higher in electronic format , and disclosure was marginally higher in electronic format for financial insecurity and neighborhood and school safety . There was a significant difference in the proportion of social needs items with higher endorsement in the computer-based group ( 70 % ) than the face-to-face group ( 30 % ) . CONCLUSIONS : Pediatric clinical sites interested in incorporating caregiver-reported socioeconomic , environmental , and behavioral needs screening should consider electronic screening when feasible , particularly when assessing sensitive topics such as child safety and household member substance use Background : Family-centered care ( FCC ) involves holistic care and requires cooperation with the family in planning , intervention , and the evolution of the care that is being provided . Many previous studies have provided results that indicate the importance of the family ’s involvement in pediatric care , but there is still resistance in doing so within the organizational culture of the hospitals in Iran . The aim of this study was to determine the effects of FCC on the satisfaction of  parents of children hospitalized in 2012 in the pediatric ward at Razi Hospital in Chaloos , Iran . Methods : This Quasi-experimental study was conducted in 2012 in the pediatric ward at Razi Hospital in Chaloos , Iran . Seventy hospitalized children between the ages of 1 and 3 who suffered from diarrhea , vomiting , or pneumonia were selected through convenience sampling . They were divided r and omly into two equal groups , a control group ( routine care ) and an experimental group ( family-centered care ) . SPSS Statistics 14 software was used to analyze the data , and p<0.05 was considered to be significant . Results : In the FCC group , the mean score of satisfaction among the parents of the children was 20 out of 90 before the intervention , but , after the FCC method was used , it increased to 83.2 out of 90 . In addition , a significant difference was found between the scores of satisfaction for the control and experimental groups ( p<0.001 ) , and all parents of children in the experimental group expressed high satisfaction . Conclusion : Our findings showed that the practice of FCC in caring for the sick children can increase the satisfaction of their parents significantly . The role of the family ’s involvement is critical in every component of the intervention efforts , as shown by the constructs of participatory support , educational support , and psychological support . Thus , a notable implication here is that FCC may lead to increased quality of care and should be included in the educational programs of the nursing staff in pediatric In an effort to examine translation of family nursing knowledge to practice , the L and spitali University Hospital Family Nursing Implementation Project ( 2007 - 2011 ) , was thoughtfully initiated in Reykjavik , Icel and and systematic ally evaluated . The mission was to implement family nursing in every department of the hospital . This publication is the first formal research report from this l and mark project . The purpose of this research was to evaluate the effectiveness of a short-term therapeutic conversation intervention  with families who were receiving health care services at the Children ’s Hospital at L and spitali University Hospital in Icel and related to childhood and adolescent acute and chronic illnesses . The therapeutic conversation was guided by Family Systems Nursing and used the Calgary Family Assessment and Intervention Models ( Wright & Leahey , 2005 , 2009 ) . Families ( N = 76 ) were r and omly assigned to either an experimental group ( short-term therapeutic conversation : n = 41 ) or to a control group ( traditional care : n = 35 ) . Parents in the experimental group reported significantly higher family support after the intervention , compared to the parents in the control group . Differences were noted between families experiencing acute versus chronic illnesses . Recommendations are made for conducting and design ing intervention research with families experiencing the hospitalization of a child or adolescent Purpose This study assessed the effectiveness of animal‐assisted activities ( AAA ) on biobehavioral stress responses ( anxiety , positive and negative affect , and salivary cortisol and C‐reactive protein [ CRP ] levels ) in hospitalized children . Design and Methods This was a r and omized , controlled study . Method Forty‐eight participants were r and omly assigned to receive a 10‐minute AAA ( n = 24 ) or a control condition ( n = 24 ) . Anxiety , positive and negative affect , and levels of salivary biomarkers were assessed before and after the intervention . Results Although increases in positive affect and decreases in negative affect were larger in the AAA condition , pre‐ and post‐intervention differences between the AAA and control conditions were not significant . In addition , pre‐ and post‐intervention differences between the conditions in salivary cortisol and CRP were not statistically significant . Baseline levels of anxiety , cortisol , and CRP had a significant and large correlation to the corresponding post‐intervention measures . Scores on the Pet Attitude Scale were high but were not associated with changes in anxiety , positive affect , negative affect , or stress biomarkers . Conclusions Although changes were in the expected direction , the magnitude of the effect was small . Future r and omized controlled trials with larger recruitment are needed to determine the effectiveness of AAAs in reducing biobehavioral stress responses in hospitalized children . Practice Implication s Nurses are positioned to recommend AAA as a beneficial and safe experience for hospitalized children . HighlightsDifferences between the AAA and control conditions were not significant . Increases in positive affect were larger in the AAA condition . Decreases in negative affect were larger in the AAA condition . Patients reported positive attitude towards pets and reported enjoying the AAAs . Nurses may recommend AAA as a beneficial experience for hospitalized children INTRODUCTION Screening and management of the social determinants of health ( SDH ) are critical for child health promotion . We sought to evaluate the impact of a facilitated video curriculum on resident SDH screening competence , parental perceptions of resident practice , resident-initiated referrals to a medical-legal partnership ( MLP ) , and formula distribution to food-insecure families . METHODS This was a pre-post study with concurrent control performed at a large pediatric residency program . Second- and third-year residents were assigned to control and intervention groups on the basis of their continuity clinic day . The curriculum included videotaped vignettes of screening for SDH and a " day in the life " series of families describing the impact of intervention on their lives . Residents completed self- assessment s on screening competence and re source knowledge . After a well-child encounter , families ( 3 per resident ) assessed their level of trust and respect for the resident and the number of SDHs screened for . MLP referral rates and formula distribution were compared . RESULTS The intervention group 's self-assessed competence in screening for housing , benefits , and educational concerns was significantly higher compared to controls ( each P ≤ .05 ) . Parents ' rating of trust and respect was high and did not differ between groups . Screening for each SDH was higher in the intervention group with domestic violence ( odds ratio 2.16 , 95 % confidence interval 1.01 - 4.63 ) and depression ( odds ratio 2.63 , 95 % confidence interval 1.15 - 5.99 ) , reaching statistical significance . MLP referral rates increased ( P = .06 ) , and formula distribution ( P = .02 ) reached statistical significance in the intervention group . CONCLUSIONS This SDH video curriculum improved resident self-assessed screening competence , parental perception of screening , and both MLP referrals and formula distribution Purpose : To explore the effectiveness of canine visitation therapy ( CVT ) in pediatric pain management in a tertiary care children 's hospital , a descriptive pilot study was conducted . Method : A convenience sample of 25 English-speaking children ages 5 to 18 years who underwent surgery and experienced acute postoperative pain participated in a st and ard , one-time CVT intervention . Each child completed a pre-post survey and a postintervention interview . Findings : Quantitative pre-post findings indicate that CVT significantly reduced perceived pain . Qualitative findings suggest that one mechanism that makes CVT effective may be cognitive . That is , CVTdistracts children from pain-related cognition and possibly activates comforting thoughts regarding companionship or home . Conclusion : The study findings suggest that CVT may be a useful adjunct to traditional pain management for children . Implication s : Nurses may better serve their patients when CVT is an option BACKGROUND Patient- and family-centered care ( PFCC ) approaches to care are important in enhancing the patient-centeredness of the health care experience , yet little is known about the effectiveness of formal approaches for teaching patient-centeredness in residency . INTERVENTION We developed and implemented a PFCC curriculum and assessed its impact on residents ' self-perceptions of patient-centered behavior and practice s. METHODS We used a quasi-experimental , nonr and omized approach with a pretest-posttest design . An experimental group of 24 interns filled out the Patient Practitioner Orientation Scale ( PPOS ) before residency , and a control group of 18 graduating residents who had not been exposed to a PFCC curriculum  also completed the PPOS . After 2 years of residency and exposure to a PFCC curriculum , interns in the experimental group repeated the PPOS . We compared mean total and subscale PPOS scores . RESULTS There was no difference in baseline total or subscale PPOS scores between the experimental and control group . The mean total PPOS score for the experimental group after exposure to the curriculum was 4.55 ( P = .45 ) , reflecting no change in patient-centeredness . The 17 female interns in the intervention group were more patient centered ( 4.8 ± 0.36 ) than the 6 male interns ( 4.2 ± 0.38 ) ( P = .005 ) , scoring significantly higher ( 4.6 ± 0.39 versus 4.0 ± 0.38 ) in the sharing domain ( P = .001 ) . CONCLUSION Interns ' exposure to a PFCC curriculum did not result in a change in their perce 
    Output:
    