Pediatric Quotes

But I don’t want ice cream, I want a world where there is no need for pediatric oncology, UNICEF, military budgets, or suicide rails on the top floors of tall buildings. The world would drip with mercy. Thy kingdom come, I pray, and my heart aches. And my tongue trips over the rest. Thy will be done.

It is the certainty of never that hurts most. The knowledge that I will never eat star-shaped peanut butter and jelly sandwiches with her in the pediatric ward again. Never dance around her living room, headbanging our wigs to the beat. Never watch her paint a new masterpiece. I understand why people believe in the afterlife, why they soothe themselves with the faith that those who are no longer with us still exist elsewhere, eternally, in a celestial realm free of pain. As for me, all I know is that here on this earth, I cannot find my friend.

The American Academy of Pediatrics officially supports breastfeeding, but receives about half a million dollars from Ross, manufacturers of Similac infant formula.

In this large and fierce world of ours, there are many, many unpleasant places to be. You can be in a river swarming with angry electric eels, or in a supermarket filled with vicious long-distance runners. You can be in a hotel that has no room service, or you can be lost in a forest that is slowly filling up with water. You can be in a hornet's nest or in an abandoned airport or in the office of a pediatric surgeon, but one of the most unpleasant things that can happen is to find yourself in a quandary. Which is where the Baudelaire orphans found themselves that night. Finding yourself in a quandary means that everything seems confusing and dangerous and you don't know what in the world to do about it, and it is one of the worst unpleasantries you can encounter.

Crest, that was his name, was meanwhile droning on, while Kate seemed to be only half listening. I could not hear him clearly, but I could guess at the gist of it. “Blah blah blah, I am handsome, I make a lot of money, this suit is expensive, and my shoes are made of the finest Corinthian leather hand-stitched by virgins under the moonlight. Of course, I could have gone into pediatrics, but for one of my amazing skill, really, plastic surgery was the only option. Beauty is so important, don’t you think? Oh, Kate, you are nearly as attractive as I. Why then should we not be beautiful together?”

You can’t just do whatever you feel like.” “You can’t just do anything you want.” “You have to learn self-restraint.” “You’re only interested in gratifying your desires.” “You don’t care about anything but your own pleasure.” Can you hear the judgmentality in these admonitions? Can you see how they reproduce the mentality of domination that runs our civilization? Goodness comes through conquest. Health comes through conquering bacteria. Agriculture is improved by eliminating pests. Society is made safe by winning the war on crime. On my walk today, students accosted me, asking if I wanted to join the “fight” against pediatric cancer. There are so many fights, crusades, campaigns, so many calls to overcome the enemy by force. No wonder we apply the same strategy to ourselves. Thus it is that the inner devastation of the Western psyche matches exactly the outer devastation it has wreaked upon the planet. Wouldn’t you like to be part of a different kind of revolution?

If we put the right protocols into place in pediatric offices across the city, country, and world, we could intervene in time to walk back epigenetic damage and change long-term health outcomes for the roughly 67 percent of the population with ACEs and their children. And, someday, their great-grandchildren.

A 2019 study showed that a neural net analyzing natural-language clinical metrics was able to diagnose pediatric diseases better than eight junior physicians exposed to the same data—and outperformed all twenty human doctors in some areas.

In the great tornado of life, things sometimes seem out of control, and we can’t see where we are going. But sometimes, when the storm passes and the dust settles, things have landed into place beautifully.

The more love and support your child receives, the richer his or her life becomes, and nurses can certainly add to the circle of love surrounding your child.

You are the only member of this Sleepwalker team with formal medical training, Specialist Yorrik. "Wry self-deprecation: I am a pediatric allergist. Auditory, olfactory, esophageal." Anax Therion and Senna stared at him. "In sheepish explanation: Ear, nose, and throat. I do sniffles.

86. I get angry when believers unhesitatingly attribute every good thing in the world to God — and then respond to bad things by saying, “God works in mysterious ways.” If God’s ways are so mysterious, and we can’t begin to understand his thinking behind tsunamis and drought and pediatric cancer, then what makes you think you understand his intentions when it comes to pretty sunsets or cute puppies or helping you find the peanut butter?

On the flight over to Chicago, I thought of a story Mom had once told me from her days as a pediatric nurse. "There was this little boy I was taking care of," she said "and he was terminally ill,and we all knew it,but he kept hanging on and hanging on. He wouldn't die, it was so sad. And his parents were always there with him,giving him so much love and support,but he was in so much pain,and it really was,time for him to go. So finally some of us nurses took his father aside and we told him, 'You have to tell your son it's okay for him to go. You have to give him permission.' And so the father took his son in his arms and he sat with him in a chair and held on to him and told him over and over, that it was okay for him to go,and,well,after a few moments,his son died.

The only thing that stood out in my memory was when the pediatric nurse placed Layla’s semi-naked body under my T-shirt, against my skin. During those few brief minutes the hurt I felt in my heart temporarily dissipated. I sighed deeply when Layla squirmed contentedly as she soaked up my warmth when I cradled her protectively against me. Then, when I felt her little heart beating close to mine through her teeny bony chest, I choked up with the indescribable distress I felt, and my tears fell

Finding a good nurse is not just about checking off a list of skills the nurse can perform; it’s also about finding someone who is a good fit for your home.

If you were spanked as a child, you may feel disgusted by your body. It may be difficult to care for yourself (including pursuing medical care, dental care, regular exercise, and healthy nutrition) because your body has been a battleground. You may find it validating to know that the American Academy of Pediatrics recommends that parents avoid spanking children for any reason,

Vaccines are harming a certain group of children as they go for their pediatric wellness visits, the government is concealing this information from the doctors, and the children who are affected are damaged for life.

What I really don't understand is why many doctors kick patients our of their practice over this issue. What's wrong with simply disagreeing with parents but still providing medical care to their child? That's what the American Academy of Pediatrics tells us we should do. Read them the riot act once then move on and be their doctor. A family that chooses not to vaccinate still needs medical care. Sure, their child may catch a vaccine-preventable disease, and yes, their unvaccinated child decreases the local herd immunity and puts other kids at risk, but that is still their choice. Parents of patients refuse to follow my medical advice every day.

Even though our journey as parents of a medically fragile child began with emotional turmoil, it has since become a purposeful odyssey that brings meaning and depth to our lives. This is the road we were born to travel.

Parents of medically fragile children find themselves becoming experts in lots of different areas, including laws and regulations, research and treatments, and the various specialists that support the health of their children.

Read-aloud features are best used in addition to parents reading to children, not in place of it. Based on research of early brain development, the American Academy of Pediatrics now recommends that parents start reading to their babies from birth.30

NEUROFEEDBACK IS A SOPHISTICATED FORM of biofeedback and an extremely versatile treatment that is useful for many of the conditions described in this book. It has recently been recognized by the American Academy of Pediatrics as a treatment for removing ADD and ADHD symptoms as effectively as medications.

Dr. Lucy Davis. That’s Davis as in her parents own the team. She’s a pediatric surgeon and just got back from Syria where she was working with Doctors Without Borders.” Whatever. I organize a canned food drive for the homeless shelter in the Bowery every Thanksgiving. Do I go around bragging about it? No.

Science and discovery, especially in the field of non-abnormal pediatric mysteries, is built on the work of those who have been sneezed on before us. Causation and rationale may someday be reached, but until then it is the heartwarming and parental nature of the journey that drives us on; well, that and a fresh box of Kleenex.

That is, findings published in Pediatrics in 2017 concluded that “at 9 years of age, children with father loss have significantly shorter telomeres.”1 Telomeres in our cells are what keep our genes from being deleted as our cells divide. As the National Academy of Sciences reports, “Telomere length in early life predicts lifespan.”2

If the operation is difficult, you are not doing it properly.

An exhausted parent can’t provide the best care, although occasionally, we have all had to do so.

Think of instinct as an unscientific, unquantifiable tool that can be used along with more concrete evaluations to make a well-rounded decision.

We have now reached a level in which many people are not merely unacquainted with the fundamentals of punctuation, but don’t evidently realize that there are fundamentals. Many people—people who make posters for leading publishers, write captions for the BBC, compose letters and advertisements for important institutions—seem to think that capitalization and marks of punctuation are condiments that you sprinkle through any collection of words as if from a salt shaker. Here is a headline, exactly as presented, from a magazine ad for a private school in York: “Ranked by the daily Telegraph the top Northern Co-Educational day and Boarding School for Academic results.” All those capital letters are just random. Does anyone really think that the correct rendering of the newspaper is “the daily Telegraph”? Is it really possible to be that unobservant? Well, yes, as a matter of fact. Not long ago, I received an e-mail from someone at the Department for Children, Schools and Families asking me to take part in a campaign to help raise appreciation for the quality of teaching in Great Britain. Here is the opening line of the message exactly as it was sent to me: “Hi Bill. Hope alls well. Here at the Department of Children Schools and Families…” In the space of one line, fourteen words, the author has made three elemental punctuation errors (two missing commas, one missing apostrophe; I am not telling you more than that) and gotten the name of her own department wrong—this from a person whose job is to promote education. In a similar spirit, I received a letter not long ago from a pediatric surgeon inviting me to speak at a conference. The writer used the word “children’s” twice in her invitation, spelling it two different ways and getting it wrong both times. This was a children’s specialist working in a children’s hospital. How long do you have to be exposed to a word, how central must it be to your working life, to notice how it is spelled?

I planned playdates and barbecues and pediatric dental checkups and adult dental checkups and plain old internists and plain old pediatricians and hair salon treatments and educational testing and cleats-buying and art class attendance and pediatric ophthalmologist and adult ophthalmologist and now, suddenly, mammograms. I made lunch. I made dinner. I made breakfast. I made lunch. I made dinner. I made breakfast. I made lunch. I made dinner.

Surgery is the most masculine of medical disciplines, taking knives and penetrating the body to find disease and destroy it. It is a war game in which cold and shiny stainless steel is pitted against the unseen, sinister but discoverable and conquerable enemy. Pediatrics is in many ways the most feminine of medical disciplines, with its focus on small children, preventive care, nurturing. In terms of gender, neonatology seems to be somewhere in between.

Expertise is the mantra of modern medicine. In the early twentieth century, you needed only a high school diploma and a one-year medical degree to practice medicine. By the century’s end, all doctors had to have a college degree, a four-year medical degree, and an additional three to seven years of residency training in an individual field of practice—pediatrics, surgery, neurology, or the like. In recent years, though, even this level of preparation has not been enough for the new complexity of medicine.

Finally it was time to go into the operating room, and the nurse came to wheel her away from me. My heart tightened. To ease her fears, the pediatric nurses gathered around her and created a “bubble parade,” blowing little soap bubbles as they went into the operating room. To create this fairy-tale experience, they used a wand. Specifically, a bubble wand. All the worry and fear melted from my daughter’s face as she was captivated by the magical moment. As a parent, I felt a great deal of gratitude for this small but meaningful touch. As a marketer, I was awed. I’d just witnessed my daughter’s customer experience switch from anxiety to anticipation in less than ten seconds.

One day, sitting at the dining table, I opened one and started reading. It talked about Michael’s contributions to research into childhood leukemia. His position as head of hematology at the Montreal Children’s Hospital. His work as a lead investigator with the international pediatric oncology group. The writer talked about loss and grief and offered heartfelt condolence. It was from Hillary Rodham Clinton. Secretary Clinton, in the last stages of a bruising brutal campaign for the most powerful job in the world, took time out to write to me. A woman she’d never met. About a man she’d never met. A Canadian who couldn’t even vote for her. It was a private note, not meant to help her in any way, but offering comfort to a stranger in profound grief.

TOBY CALLED HIS therapist, Carla, whom he’d stopped seeing actively when the apps took over his attention span and his time, but it was August and she was gone to the island where mental health professionals vanished to in the summer. The useless social worker from school was even more useless than usual, camping in the Adirondacks with her family for two weeks. He called mental health services at the hospital but was told that all adolescent and pediatric psychologists were out until September. This is what happened when an entire field of medicine was as disrespected as psychologists. They made their own rules, and one of them was that nobody was allowed to have a breakdown during August, and the other was that this was fucking Europe and they got to take a whole month off from work.

How could boredom be beneficial? In Hindu and Buddhist traditions, boredom is described as a precursor to insight and discovery. Parents sometimes want their children to be bored because they have an intuitive sense that grappling with this uncomfortable state is how kids discover what they’re interested in, quiet their mind, and find outlets to channel their energy. We wish more parents would trust that when their kids get bored, they’ll find the way out on their own, resisting the temptation to schedule activities from morning to night to keep boredom at bay. But don’t just take our word for it. The American Academy of Pediatrics released a 2007 consensus statement on how child-directed, exploratory play is far superior when it comes to developing emotional, social, and mental agility than structured, adult-guided activity.

the new “affirmative-care” standard of mental health professionals is a different matter entirely. It surpasses sympathy and leaps straight to demanding that mental health professionals adopt their patients’ beliefs of being in the “wrong body.” Affirmative therapy compels therapists to endorse a falsehood: not that a teenage girl feels more comfortable presenting as a boy—but that she actually is a boy. This is not a subtle distinction, and it isn’t just a matter of humoring a patient. The whole course of appropriate treatment hinges on whether doctors view the patient as a biological girl suffering mental distress or a boy in a girl’s body. But the “affirmative-care” standard, which chooses between these diagnoses before the patient is even examined, has been adopted by nearly every medical accrediting organization. The American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American Psychological Association, and the Pediatric Endocrine Society have all endorsed “gender-affirming care” as the standard for treating patients who self-identify as “transgender” or self-diagnose as “gender dysphoric.

The stories in this book link an ancient story with the children's stories. Rather than medical case reports based on certainty of what scientists currently understand, they are simply an attempt to be faithful to what I have heard. In this sense, they continue Jesus' commissioned work of revealing that there is a realm that we cannot yet fully understand. The greatest gift in my life has been in linking the ancient story and the children's stories to my own...As I sit by the beds of these children, I have seen God's love made manifest in this descending way. I have seen Jesus Christ come again and again and again to bring peace and to link the children's stories with His own.

These books, which cover many of the topics discussed in this book, may be helpful further reading. GENERAL REFERENCE American Academy of Pediatrics. Caring for Your Baby and Young Child: Birth to Age Five. New York: Bantam, 2004. Druckerman, P. Bringing Up Bébé: One American Mother Discovers the Wisdom of French Parenting. New York: Penguin, 2014. Eliot, L. What’s Going On in There?: How the Brain and Mind Develop in the First Five Years of Life. New York: Bantam, 2000. Nathanson, L. The Portable Pediatrician for Parents: A Month-by-Month Guide to Your Child’s Physical and Behavioral Development from Birth to Age Five. New York: HarperCollins, 1994. DISCIPLINE Phelan, T. W. 1-2-3 Magic: Effective Discipline for Children 2–12. Naperville, IL: ParentMagic, Inc., 2010. Webster-Stratton, C. The Incredible Years: A Trouble-Shooting Guide for Parents of Children Aged 2–8. Toronto: Umbrella Press, 1992. SLEEP Ferber, R. Solve Your Child’s Sleep Problems. Rev. ed. New York: Simon & Schuster, 2006. Karp, H. The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Newborn Baby Sleep Longer. Rev. ed. New York: Bantam, 2015. Weissbluth, M. Healthy Sleep Habits, Happy Child: A Step-by-Step Program for a Good Night’s Sleep. 4th ed. New York: Ballantine Books, 2015. POTTY TRAINING Glowacki, J. Oh Crap! Potty Training: Everything Modern Parents Need to Know to Do It Once and Do It Right. New York: Touchstone, 2015.

Here are some of the handicaps mutual-fund managers and other professional investors are saddled with: With billions of dollars under management, they must gravitate toward the biggest stocks—the only ones they can buy in the multimillion-dollar quantities they need to fill their portfolios. Thus many funds end up owning the same few overpriced giants. Investors tend to pour more money into funds as the market rises. The managers use that new cash to buy more of the stocks they already own, driving prices to even more dangerous heights. If fund investors ask for their money back when the market drops, the managers may need to sell stocks to cash them out. Just as the funds are forced to buy stocks at inflated prices in a rising market, they become forced sellers as stocks get cheap again. Many portfolio managers get bonuses for beating the market, so they obsessively measure their returns against benchmarks like the S & P 500 index. If a company gets added to an index, hundreds of funds compulsively buy it. (If they don’t, and that stock then does well, the managers look foolish; on the other hand, if they buy it and it does poorly, no one will blame them.) Increasingly, fund managers are expected to specialize. Just as in medicine the general practitioner has given way to the pediatric allergist and the geriatric otolaryngologist, fund managers must buy only “small growth” stocks, or only “mid-sized value” stocks, or nothing but “large blend” stocks.6 If a company gets too big, or too small, or too cheap, or an itty bit too expensive, the fund has to sell it—even if the manager loves the stock. So

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It’s not like I wasn’t busy. I was an officer in good standing of my kids’ PTA. I owned a car that put my comfort ahead of the health and future of the planet. I had an IRA and a 401(k) and I went on vacations and swam with dolphins and taught my kids to ski. I contributed to the school’s annual fund. I flossed twice a day; I saw a dentist twice a year. I got Pap smears and had my moles checked. I read books about oppressed minorities with my book club. I did physical therapy for an old knee injury, forgoing the other things I’d like to do to ensure I didn’t end up with a repeat injury. I made breakfast. I went on endless moms’ nights out, where I put on tight jeans and trendy blouses and high heels like it mattered and went to the restaurant that was right next to the restaurant we went to with our families. (There were no dads’ nights out for my husband, because the supposition was that the men got to live life all the time, whereas we were caged animals who were sometimes allowed to prowl our local town bar and drink the blood of the free people.) I took polls on whether the Y or the JCC had better swimming lessons. I signed up for soccer leagues in time for the season cutoff, which was months before you’d even think of enrolling a child in soccer, and then organized their attendant carpools. I planned playdates and barbecues and pediatric dental checkups and adult dental checkups and plain old internists and plain old pediatricians and hair salon treatments and educational testing and cleats-buying and art class attendance and pediatric ophthalmologist and adult ophthalmologist and now, suddenly, mammograms. I made lunch. I made dinner. I made breakfast. I made lunch. I made dinner. I made breakfast. I made lunch. I made dinner.

Dr. Lydia Ciarallo in the Department of Pediatrics, Brown University School of Medicine, treated thirty-one asthma patients ages six to eighteen who were deteriorating on conventional treatments. One group was given magnesium sulfate and another group was given saline solution, both intravenously. At fifty minutes the magnesium group had a significantly greater percentage of improvement in lung function, and more magnesium patients than placebo patients were discharged from the emergency department and did not need hospitalization.4 Another study showed a correlation between intracellular magnesium levels and airway spasm. The investigators found that patients who had low cellular magnesium levels had increased bronchial spasm. This finding confirmed not only that magnesium was useful in the treatment of asthma by dilating the bronchial tubes but that lack of magnesium was probably a cause of this condition.5 A team of researchers identified magnesium deficiency as surprisingly common, finding it in 65 percent of an intensive-care population of asthmatics and in 11 percent of an outpatient asthma population. They supported the use of magnesium to help prevent asthma attacks. Magnesium has several antiasthmatic actions. As a calcium antagonist, it relaxes airways and smooth muscles and dilates the lungs. It also reduces airway inflammation, inhibits chemicals that cause spasm, and increases anti-inflammatory substances such as nitric oxide.6 The same study established that a lower dietary magnesium intake was associated with impaired lung function, bronchial hyperreactivity, and an increased risk of wheezing. The study included 2,633 randomly selected adults ages eighteen to seventy. Dietary magnesium intake was calculated by a food frequency questionnaire, and lung function and allergic tendency were evaluated. The investigators concluded that low magnesium intake may be involved in the development of both asthma and chronic obstructive airway disease.

Discipline As your baby becomes more mobile and inquisitive, she’ll naturally become more assertive, as well. This is wonderful for her self-esteem and should be encouraged as much as possible. When she wants to do something that’s dangerous or disrupts the rest of the family, however, you’ll need to take charge. For the first six months or so, the best way to deal with such conflicts is to distract her with an alternative toy or activity Standard discipline won’t work until her memory span increases around the end of her seventh month. Only then can you use a variety of techniques to discourage undesired behavior. When you finally begin to discipline your child, it should never be harsh. Remember that discipline means to teach or instruct, not necessarily to punish. Often the most successful approach is simply to reward desired behavior and withhold rewards when she does not behave as desired. For example, if she cries for no apparent reason, make sure there’s nothing wrong physically; then when she stops, reward her with extra attention, kind words, and hugs. If she starts up again, wait a little longer before turning your attention to her, and use a firm tone of voice as you talk to her. This time, don’t reward her with extra attention or hugs. The main goal of discipline is to teach limits to the child, so try to help her understand exactly what she’s doing wrong when she breaks a rule. If you notice her doing something that’s not allowed, such as pulling your hair, let her know that it’s wrong by calmly saying “no,” stopping her, and redirecting her attention to an acceptable activity. If your child is touching or trying to put something in her mouth that she shouldn’t, gently pull her hand away as you tell her this particular object is off-limits. But since you do want to encourage her to touch other things, avoid saying “Don’t touch.” More pointed phrases, such as “Don’t eat the flowers” or “No eating leaves” will convey the message without confusing her. Because it’s still relatively easy to modify her behavior at this age, this is a good time to establish your authority and a sense of consistency Be careful not to overreact, however. She’s still not old enough to misbehave intentionally and won’t understand if you punish her or raise your voice. She may be confused and even become startled when told that she shouldn’t be doing or touching something. Instead, remain calm, firm, consistent, and loving in your approach. If she learns now that you have the final word, it may make life much more comfortable for both of you later on, when she naturally becomes more headstrong.

Recently, single and multi-institution retrospective studies have shown a higher rate of postoperative stricture in patients who had transanastomotic tubes.

If a direct hernia is obvious during an open operation, a simple Bassini repair in most children suffices.

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De Schipper, E. J., J. M. Riksen-Walraven, S. A. E. Geurts. 2006. Effects of child-caregiver ratio on the interactions between caregivers and children in child-care centers: An experimental study. Child Devel 77:861-74.

Worldwide, it is almost certain that more people over the age of 100 than under 30 have died of SARS-COV-2. Many more children die of influenza than coronavirus; in the 2019-20 flu season, the Centers for Disease Control received about 180 reports of pediatric flu deaths. It has received 19 reports of coronavirus deaths in children under 15 so far.

When you look at it, on the surface Japan is very westernized, but westernized in a Japanese way,” explains Mitsunori Murata, a nutrition expert and professor of pediatrics at Tokyo Women's Medical College. “Maybe we will eat a hamburger, but it will be Japanese-size, not American.

One good online resource is HealthyChildren.org, the website of the American Academy of Pediatrics. You can find a lot of information about common childhood ailments there and, in particular, good guidelines on when to call the pediatrician regarding your child’s fever and other conditions.

según un reciente estudio realizado en Suecia que publicó la prestigiosa revista Pediatrics, los padres que limpian el chupete de sus hijos metiéndoselo en la boca –sin mojarlo en agua ni nada– están aportando a sus hijos una mayor diversidad bacteriana en el sistema digestivo, lo que beneficia a su sistema inmunitario. Estos niños experimentan asma y eccemas en la piel con menor frecuencia que sus compañeros que reciben el chupete siempre debidamente esterilizado.

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When a young employee gasped at his blue language, Simons flashed a grin. “I know—that is an impressive rate!” A few times a week, Marilyn came by to visit, usually with their baby, Nicholas. Other times, Barbara checked in on her ex-husband. Other employees’ spouses and children also wandered around the office. Each afternoon, the team met for tea in the library, where Simons, Baum, and others discussed the latest news and debated the direction of the economy. Simons also hosted staffers on his yacht, The Lord Jim, docked in nearby Port Jefferson. Most days, Simons sat in his office, wearing jeans and a golf shirt, staring at his computer screen, developing new trades—reading the news and predicting where markets were going, like most everyone else. When he was especially engrossed in thought, Simons would hold a cigarette in one hand and chew on his cheek. Baum, in a smaller, nearby office, trading his own account, favored raggedy sweaters, wrinkled trousers, and worn Hush Puppies shoes. To compensate for his worsening eyesight, he hunched close to his computer, trying to ignore the smoke wafting through the office from Simons’s cigarettes. Their traditional trading approach was going so well that, when the boutique next door closed, Simons rented the space and punched through the adjoining wall. The new space was filled with offices for new hires, including an economist and others who provided expert intelligence and made their own trades, helping to boost returns. At the same time, Simons was developing a new passion: backing promising technology companies, including an electronic dictionary company called Franklin Electronic Publishers, which developed the first hand-held computer. In 1982, Simons changed Monemetrics’ name to Renaissance Technologies Corporation, reflecting his developing interest in these upstart companies. Simons came to see himself as a venture capitalist as much as a trader. He spent much of the week working in an office in New York City, where he interacted with his hedge fund’s investors while also dealing with his tech companies. Simons also took time to care for his children, one of whom needed extra attention. Paul, Simons’s second child with Barbara, had been born with a rare hereditary condition called ectodermal dysplasia. Paul’s skin, hair, and sweat glands didn’t develop properly, he was short for his age, and his teeth were few and misshapen. To cope with the resulting insecurities, Paul asked his parents to buy him stylish and popular clothing in the hopes of fitting in with his grade-school peers. Paul’s challenges weighed on Simons, who sometimes drove Paul to Trenton, New Jersey, where a pediatric dentist made cosmetic improvements to Paul’s teeth. Later, a New York dentist fitted Paul with a complete set of implants, improving his self-esteem. Baum was fine with Simons working from the New York office, dealing with his outside investments, and tending to family matters. Baum didn’t need much help. He was making so much money trading various currencies using intuition and instinct that pursuing a systematic, “quantitative” style of trading seemed a waste of

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stepped down as their program director, the residents still humor me on Saturday mornings after rounds as we drink coffee and I draw arrows and boxes on the whiteboard linking their pasts to their futures, each time returning to the topic of identifying mentors on their own career journey, to seek out those with admirable qualities or desirable skill sets to incorporate into a new self.

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What was clear to me was that these young doctors needed to tell their stories to one another. To process the significance of what they were doing every day, to reckon with the feelings that they were coming home with every night. There were no easy answers. But the residents spoke of their patients with

Our experienced and compassionate pediatric chiropractor, Dr. Grewal, understands the unique needs of children and is dedicated to helping them thrive.

He spoke in a rush. 'A pediatric cardiac surgeon working gratis on an abandoned premie with Down Syndrome as a third-rate hospital - so good that twenty years later other surgeons are saying: Wow.' He shook his head. 'How's that for believing in a benevolent universe?

There are controlled ACT studies on work stress, pain, smoking, anxiety, depression, diabetes management, substance use, stigma toward substance users in recovery, adjustment to cancer, epilepsy, coping with psychosis, borderline personality disorder, trichotillomania, obsessive–compulsive disorder, marijuana dependence, skin picking, racial prejudice, prejudice toward people with mental health problems, whiplash-associated disorders, generalized anxiety disorder, chronic pediatric pain, weight maintenance and self-stigma, clinicians’ adoption of evidence-based pharmacotherapy, and training clinicians in psychotherapy methods other than ACT. The only sour notes so far are the use of ACT for more minor problems, where existing technology exceeded ACT outcomes on some measures (e.g., Zettle, 2003).

I kept thinking how grateful I felt to have been part of this magnificent team. For five months we had been one unit, all specialists and all tackling the same problem together. The staff at the pediatric ICU and the consultants in the children's center reacted spectacularly. They rallied behind us and spent countless hours without charge, working to make this operation successful. As pessimistic as I was about the eventual outcome of the surgery, I still felt a glow of pride in being able to work side by side with the best men and women in the medical field. And the end of the surgery wasn't the end of our teamwork. The postoperative care was as spectacular as the surgery. Everything in the weeks following the surgery confirmed again our togetherness. It seemed as if everyone from ward clerks to orderlies to nurses had become personally involved in this historic event. We were a team--a wonderful, marvelous team.

pediatric dentist’s office, and was ashamed. I had

The American Academy of Pediatrics estimates that firearms kill twice as many children as cancer does.

I also praise the cooperative efforts in our pediatric intensive care unit. In fact, this togetherness permeates every aspect of our program here, including our office staff. We're friends, we work well together, we're dedicated to alleviating pain, and we're interested in each other's problems, too. We're a team, and Ben Carson is only part of that team.

How about two?” Elizabeth’s friend Sandra Fielding, who also worked at Chicago General Hospital—as a pediatric psychiatrist—appeared alongside her. Both women were avid knitters, and both lived in the building above the store.

Ohh, what are you knitting?” Sandra asked Angie, deftly changing the subject. “It’s an anatomically correct model of a human uterus,” Angie replied. “I’m giving it to Dawn as a consolation prize.” My head snapped around to stare at her in horror. “What?” Angie snort-laughed. “Kidding. It’s a Peppa Pig for one of my nieces.” Sandra’s lip curled in an expression of distaste. “I rue the day that bacon-limbed hellspawn entered the children’s television landscape. It’s all I hear in the pediatric ward all day long. That precocious, insufferable little pig haunts my dreams.

In 2001, the Institute of Medicine recommended thimerosal’s removal from all pediatric vaccines. In accordance with the IOM recommendation, manufacturers removed thimerosal from childhood vaccines—Hib, hepatitis b, and DTP—except multi-dose flu vaccines in the United States beginning in 2001.

Beauchamp, M. H., Ris, M. D., Taylor, H. G., Peterson, R. L., & Yeates, K. O. (Eds.) (in press). Pediatric neuropsychology: Research, theory, and practice (3rd ed.). New York, NY: Guilford Press.

One 2023 paper in the Journal of Pediatrics concluded that “a primary cause of the rise in mental disorders is a decline over decades in opportunities for children and teens to play, roam, and engage in other activities independent of direct oversight and control by adults.

When out and about, point out social situations in which one person is ignoring the other through their use of a phone (bad dates, parents ignoring soccer games, concerts, Starbucks where every single person is on a phone). Ask them, “What do you think the other person is feeling?” If you’re ready to give a younger child a phone or Internet access, study resources such as Adam Pletter’s iParent101.com and the American Pediatrics Association’s Media and Children Communication Toolkit to educate yourself about the games and apps your kid uses. The Entertainment Software Rating Board (esrb.org) offers useful information about setting parental controls on games. Other sources we recommend are OnGuardOnline, which offers tips for protecting your computers; Common Sense Media, which rates programs and apps; and iKeepSafe.org, a fount of information about keeping kids safe online. Above all, talk to your children and let them know that it’s your job to help them learn to use technology well. Say, “There’s a whole world available on this gadget. If you get into something that’s scary for you, I want you to let me know.” Let kids know you’ll check their texts and Twitter page randomly until you feel they are not using it in a way that’s hurtful to others or that makes them vulnerable to being hurt—and then do it. Make video game use contingent on not freaking out when it’s time to quit. If your kid is using technology excessively, consider consulting with a psychologist or counselor.

Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The Adverse Childhood Experiences Study,” Pediatrics, 2003, 111(3), 564–572.

Keiko Shigeno, a board-certified Family Nurse Practitioner with licenses in 22 states, has shifted her focus to telemedicine in response to the changing healthcare landscape. Collaborating with leading telehealth companies, she delivers comprehensive care across various specialties, including urgent care, pediatric care, addiction health, mental health, weight loss management, women's health, men's health, skincare, and long-term health care.

A must-have for any doctor you’re considering for your baby’s care: a residency in pediatrics or family medicine and board certification by either the American Board of Pediatrics (ABP) or the American Board of Family Medicine (ABFM).

He pitied Bill, of course, and he might have offered some encouragement, some advice, or a ride to his weekly AA meeting, but it seemed Bill was still in denial of his demons. Graham knew his own demons too well. They lived in the pediatric cancer ward.

One by one the Essence Awards honorees were called onto the stage. First went civil rights leader Jesse Jackson, then movie director Spike Lee, followed by comedian Eddie Murphy, and then Dr. Benjamin S. Carson. Ben stood and walked forward to the stage. It was one of the most surreal moments of his life. He wondered how he belonged in the same category as those around him on the stage. It was hard for him to imagine that he, a pediatric neurosurgeon, was being publicly honored along with the most recognizable African American men and women in the country. As he stood onstage, staring out at the crowd, Ben thought about the path his life had taken. Who could have guessed that he, a poor black boy from a single-parent home in Detroit, would end up a brain surgeon? Certainly not those who had considered him the class dummy back in elementary school. Here he was, not just a brain surgeon, but a brain surgeon being honored for the work he had undertaken—experimental surgeries that gave children a chance at life.

In 1983, I moved to San Francisco for my pediatric endocrine fellowship. I had no idea what awaited me in the pediatric ICU: three toddlers, eighteen months old, all on ventilators in congestive heart failure because their parents had placed them on a macrobiotic diet. These ostensibly well-meaning parents were trying to prevent their children from succumbing to the “toxins” associated with meats, oils, and dairy products, so instead they fed their tots grains, cereals, vegetables, and, of course, tater tots. As a result, their hearts ballooned and couldn’t pump from the lack of iron, vitamin D, and calcium.

Honestly, I came upon massage therapy by accident. I never had the intention of becoming a massage therapist. Originally, I studied pediatric occupational therapy knowing that I wanted to work with children in a health care capacity, but I had no interest in “poking and prodding” them. While in the OT program, I soon discovered the extent of the education I would receive in integrative therapies would consist of a three-hour intro to massage/tactile therapy, movement, music and art therapies. When I inquired as to when we would learn more, I was instructed if I wanted to learn more I should seek it elsewhere. I enjoyed receiving massage, so I decided a massage school would be a good place to start. So, I searched for a massage program to simply add as an adjunct to my practice in pediatric occupational therapy.

...had recommended pediatrics as the most honest specialization, because children become sick only when in fact they are sick, and they cannot communicate with the physician using conventional words but only with concrete symptoms of real disease. After a certain age, however, adults either had the symptoms without the diseases or, what was worse, serious diseases with the symptoms of minor ones.

Investors tend to pour more money into funds as the market rises. The managers use that new cash to buy more of the stocks they already own, driving prices to even more dangerous heights. If fund investors ask for their money back when the market drops, the managers may need to sell stocks to cash them out. Just as the funds are forced to buy stocks at inflated prices in a rising market, they become forced sellers as stocks get cheap again. Many portfolio managers get bonuses for beating the market, so they obsessively measure their returns against benchmarks like the S & P 500 index. If a company gets added to an index, hundreds of funds compulsively buy it. (If they don’t, and that stock then does well, the managers look foolish; on the other hand, if they buy it and it does poorly, no one will blame them.) Increasingly, fund managers are expected to specialize. Just as in medicine the general practitioner has given way to the pediatric allergist and the geriatric otolaryngologist, fund managers must buy only “small growth” stocks, or only “mid-sized value” stocks, or nothing but “large blend” stocks.6 If a company gets too big, or too small, or too cheap, or an itty bit too expensive, the fund has to sell it—even if the manager loves the stock. So there’s no reason you can’t

I remember feeling like I had two hands full of thumbs and invincible at the same time.

There is always an applicable Shakespeare quote, even in the operating room. Perhaps especially in the operating room.

Dr. David Wilson is a Utah-licensed psychiatrist whose focus on pediatric patients extends to coordinating care with diverse healthcare providers. Currently, at Salt Lake Behavioral Health, he continues his commitment to mental health.

Dr. David Ford Wilson, a seasonedpsychiatrist, balances family life with a passion for mental health. After a background in neuroscience, he pursued a medical degree at Des Moines University, followed by a 5-year psychiatry residency. He now practices at Salt Lake Behavioral Health, aspiring to grow his practice in both adult and pediatric psychiatry.

I came to understand the importance of time itself as the fourth dimension of anatomy[...]

I prefer to focus on the wonder, and let this next generation of surgeons take up the arguments, find those answers, push the field forward.

Early in your training, there is something powerful about body fluid, sacrificial that you are willing to be bathed in it.

Then in March 1993, everything changed. My one-year-old son, Charlie, had his first seizure. There’s absolutely nothing funny about being the parent of a child with uncontrolled epilepsy. Nothing. After a year of daily seizures, drugs, and a brain surgery, I learned that the cure for Charlie’s epilepsy, the ketogenic diet—a high fat, no sugar, limited protein diet—had been hiding in plain sight for, by then, over seventy years. And despite the diet’s being well documented in medical texts, none of the half-dozen pediatric neurologists we had taken Charlie to see had mentioned a word about it. I found out on my own at a medical library. It was life altering—not just for Charlie and my family, but for tens of thousands like us. Turns out there are powerful forces at work within our health care system that don’t necessarily prioritize good health. For decades, physicians have barely been taught diet therapy or even nutrition in medical school. The pharmaceutical, medical device, and sugar industries make hundreds of billions every year on anti-epileptic drugs and processed foods—but not a nickel if we change what we eat. The cardiology community and American Heart Association demonize fat based on flawed science. Hospitals profit from tests and procedures, but again no money from diet therapy. There is a world epilepsy population of over sixty million people. Most of those people begin having their seizures as children, and only a minuscule percentage ever find out about ketogenic diet therapies. When I realized that 99 percent of what had happened to Charlie and my family was unnecessary, and that there were millions of families worldwide in the same situation, I needed to try to do something. Nancy and I began the Charlie Foundation (charliefoundation.org) in 1994 in order to facilitate research and get the word directly to those who would benefit. Among the high points were countless articles, a couple appearances of Charlie’s story on Dateline NBC, and a movie I produced and directed about another family whose child’s epilepsy had been cured by the ketogenic diet starring Meryl Streep titled First Do No Harm (1997). Today, of course, the diet permeates social media. When we started, there was one hospital in the world offering ketogenic diet therapy. Today, there are 250. Equally important, word about the efficacy of the ketogenic diet for epilepsy spread within the scientific community. In 1995, we hosted the first of many scientific global symposia focused on the diet. As research into its mechanisms and applications has spiked, incredibly the professional communities have found the same metabolic pathway that is triggered by the ketogenic diet to reduce seizures has also been found to benefit Alzheimer’s disease, ALS, severe psychiatric disorders, traumatic brain injury, and even some cancers. I

SOME MONTHS LATER, in July 2003, Rose Firestein was browsing the official Web site of the Food and Drug Administration when she suddenly reared back in surprise. She blinked and looked again. Buried in the third paragraph of an FDA press release, dated June 19, 2003, was this sentence: “Three well-controlled trials in pediatric patients with MDD [major depressive disorder] failed to show that [Paxil] was more effective than placebo.” The reference to these negative findings about Paxil mystified Firestein. Why would doctors so readily prescribe Paxil (making it by 2003 the second most widely prescribed antidepressant for those under eighteen years old) if the results of drug tests were uniformly negative?

Children do not develop what is called the “theory of mind” until ages three to five. Theory of mind is said to be present when someone is able to understand that other people have conscious thoughts and behaviors independent of them. Theory of mind is necessary for empathy and most social interactions—it’s how you understand someone else’s perspective and thinking process. Children who struggle to develop theory of mind are often diagnosed as being on the autism spectrum or having schizophrenia, ADHD, or some other problem. See B. Korkmaz, “Theory of Mind and Neurodevelopmental Disorders in Childhood,” Pediatric Research

Common Childhood Illnesses that may require PICU Care – Motherhood Chaitanya Hospital As parents, we’re no strangers to the occasional bumps, bruises, and sniffles that come with childhood. But there are times when more serious health concerns arise, requiring specialized care and attention. The Pediatric Intensive Care Unit (PICU) becomes a haven for children facing critical illnesses. With expertise from the best PICU hospital in Chandigarh like Motherhood Chaitanya Hospital, let’s delve into some common childhood illnesses that may require PICU care, understanding the challenges and the avenues of support available.

Sometimes, proceeding in the dark and aiming an arrow at the elusive, mythical dragon trumps all the rational arguments for not proceeding. Sometimes, the stakes are so high and the status quo is so unacceptable that taking aim in any direction is better than not shooting at all.

S.P. is a 68-year-old retired painter who is experiencing right leg calf pain. The pain began approximately 2 years ago but has become significantly worse in the past 4 months. The pain is precipitated by exercise and is relieved with rest. Two years ago, S.P. could walk two city blocks before having to stop because of leg pain. Today, he can barely walk across the yard. S.P. has smoked two to three packs of cigarettes per day (PPD) for the past 45 years. He has a history of coronary artery disease (CAD), hypertension (HTN), peripheral vascular disease (PVD), and osteoarthritis. Surgical history includes quadruple coronary artery bypass graft (CABG × 4) 3 years ago. He has had no further symptoms of cardiopulmonary disease since that time, even though he has not been compliant with the exercise regimen his cardiologist prescribed, he continues to eat anything he wants, and continues to smoke two to three PPD. Other surgical history includes open reduction internal fixation of the right femoral fracture 20 years ago. S.P. is in the clinic today for a routine semiannual follow-up appointment with his primary care provider. As you take his vital signs, he tells you that, besides the calf pain, he is experiencing right hip pain that gets worse with exercise, the pain doesn't go away promptly with rest, some days are worse than others, and his condition is not affected by a resting position. � Chart View General Assessment Weight 261 lb Height 5 ft, 10 in. Blood pressure 163/91 mm Hg Pulse 82 beats/min Respiratory rate 16 breaths/min Temperature 98.4° F (36.9° C) Laboratory Testing (Fasting) Cholesterol 239 mg/dL Triglycerides 150 mg/dL HDL 28 mg/dL LDL 181 mg/dL Current Medications Lisinopril (Zestril) 20 mg/day Metoprolol (Lopressor) 25 mg twice a day Aspirin 325 mg/day Simvastatin (Zocor) 20 mg/day Case Study 4 Name Class/Group Date ____________________ Group Members INSTRUCTIONS All questions apply to this case study. Your responses should be brief and to the point. When asked to provide several

Many children use an alternative vocabulary for complex disease names. Hence, some say "smiling mighty Jesus" in place of spinal meningitis or "Luke and Leia" instead of leukemia.

Dr. Kenneth Ginsburg has written a comprehensive and perhaps definitive text on building resilience in children—Building Resilience in Children and Teens: Giving Kids Roots and Wings, published by the American Academy of Pediatrics.17 In it he teaches that resilience is comprised of competence, confidence, connection, character, contribution, coping, and control, which he terms the “7 C’s,” and which emanate from the positive youth movement, itself an outgrowth of the positive psychology movement. Taking

Now, even as her family grieved, she was giving birth again.

To begin, look over the chapters by glancing at the content on the pages. Set aside about 30 minutes every four to five hours or three times a day and look at the bold words, pictures, and highlighted sentences. Nursing exams generally test on multiple chapters so it is important you start this process as soon as you can. Ideally, begin immediately after you have taken your last exam so you can get a head start on new material. This step helps you recognize the words and familiarizes you with the content. After several times of looking at a word read the definition. As you read the definition notice how you are able to focus on what the word means. Doing this simple step can eliminate reading without understanding. We must see a word several times before our brain flags it as important. That is why after the third or fourth time you look over information you finally say to yourself, “Okay, I have heard and seen this several times and I must know more about it!” Once you have reached that point you will find yourself directing all of your attention to the word’s definition. And that motivation is because you have seen it so many times. There is still a problem though, because in nursing school there are thousands upon thousands of words. By just reading you rely on vision to get you through and retain all of this knowledge. Although this is possible, and has probably worked in the past, this is not an ideal way to study for nursing classes. After you look at the words and read the definitions a few times, go back and underline each word and definition. This helps you engage the body by adding movement. Then say the words and definitions out loud. Doing so engages the three senses of sight, touch, and sound. You are also using all three learning styles, which are visual, auditory, and kinesthetic. No matter what type of learner you are predominately, if you constantly use all three styles it helps to lock the information into your brain. I have also noticed that these steps train you to have a photographic memory. This is especially important when there is a long chart you need to memorize. For example, in pediatric nursing you need to know a very extensive growth and development chart, and if you do not have kids yet it can be extremely foreign. At first, incorporating this new study method may be challenging. But once you start using it and see your exam results rise, you will never turn back. After