Ambulatory Child Health最新文献

The greatest impact of war and conflict 战争和冲突的最大影响

Ambulatory Child Health Pub Date : 2009-10-12 DOI: 10.1046/j.1467-0658.2001.0115b.x

Anna Maria Mandalakas

引用次数: 0

Social gradients in child health: why do they occur and what can paediatricians do about them? 儿童健康中的社会梯度:为什么会发生，儿科医生能做些什么?

Ambulatory Child Health Pub Date : 2009-08-12 DOI: 10.1046/j.1467-0658.2000.00086-2.x

引用次数: 0

Current literature 目前的文献

Ambulatory Child Health Pub Date : 2009-08-12 DOI: 10.1046/j.1467-0658.2000.00081-2.x

引用次数: 0

Child, adolescent and student health monitor 儿童、青少年和学生健康监督员

Ambulatory Child Health Pub Date : 2009-08-12 DOI: 10.1046/j.1467-0658.2000.00093.x

Dr Ashok Nathwani

引用次数: 0

Improving compliance with tuberculin skin test interpretation in children 提高儿童结核菌素皮肤试验解释的依从性

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.00031.x

Julie A Boom, Connie Hughes, Teneille Brown, Richard M Rutstein

{"title":"Improving compliance with tuberculin skin test interpretation in children","authors":"Julie A Boom, Connie Hughes, Teneille Brown, Richard M Rutstein","doi":"10.1046/j.1467-0658.2000.00031.x","DOIUrl":"10.1046/j.1467-0658.2000.00031.x","url":null,"abstract":" Objective To evaluate the effect of a quality improvement initiative which utilized educational interventions combined with a phone follow-up program on the rate of return for tuberculin skin test (TST) interpretation. Design Before and after trial with analysis of practice records for all TSTs placed. Setting/Sample\u0000 The study was conducted in a resident and attending primary care practice in an urban children's hospital. All children (n = 1315) who had TSTs placed during August and October of 1995 and August and October of 1996 were included in the study. Intervention Medical staff were re-educated regarding TST screening. Patients families were given written information about tuberculosis. Physicians and nursing staff discussed TST screening with the patients' families prior to TST placement. All patients received a series of three reminder telephone calls on three consecutive days to remind them to return for TST interpretation followed by a letter if necessary. The following data were collected: date of birth, age, zip code, type of provider, transit time from the hospital, type of health insurance, number of telephone calls made, and return status for TST interpretation. Return rates were compared pre- and post-intervention. Results A total of 1315 TSTs were placed during the pre- (n = 611) and post-(n = 704) intervention periods. Return rates increased from 6.2 to 61.5%. Attendings' patients and those with private insurance were more likely to return. There was no relationship to season, age or distance from the practice. Conclusions Targeted screening programs utilizing more effective methods for TST interpretation should be considered.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1467-0658.2000.00031.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81803781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The changing utilization of a children’s emergency department 儿童急诊科使用率的变化

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.00055.x

Robert Boyle, Craig Smith, John McIntyre

{"title":"The changing utilization of a children’s emergency department","authors":"Robert Boyle, Craig Smith, John McIntyre","doi":"10.1046/j.1467-0658.2000.00055.x","DOIUrl":"10.1046/j.1467-0658.2000.00055.x","url":null,"abstract":"<div>\u0000 \u0000 Objective To assess the changing pattern of attendance at an emergency department in a children’s hospital.\u0000 Design A retrospective review of the attendance register from 1 September 1986 to 31 August 1998.\u0000 Setting Derbyshire Children’s Hospital, Derby, serving a mixed urban and rural population within the National Health Service.\u0000 Measurement Total number of attendances and admissions each year. For one week in February and August each year: age and case mix assessed. For the period 1994–98: the source of the referral and the outcome of patients referred by their General Practitioner (GP).\u0000 Results Over the study period: a rise in attendances from 4853 to 8796; no change in the total number admitted to hospital. A decline in the proportion admitted from 56 to 32%. For the period 1994–98: no change in the number of patients referred by their GP; an increasing number of self-referrals. Overall age mix: age < 1 year, 27%; age 1–4 years, 42%; age 5–12 years, 26%; age > 13 years, 5%. Overall case mix: medical, 73%; surgical, 9%; trauma/minor injuries, 18%.\u0000 Conclusion An important change has occurred in the utilization of our paediatric emergency department with increasing numbers of children seeking hospital assessment, largely via self-referrals, but not requiring hospital admission.\u0000 Implications for practice Future planning and deployment of paediatric resources need to take account of the change in use of hospital emergency services.\u0000 </div>","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1467-0658.2000.00055.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78332171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Oral versus initial intravenous therapy for urinary tract infections in young febrile children. 早期发热儿童尿路感染的口服与初始静脉治疗。

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.0062h.x

Robert M Jacobson MD

{"title":"Oral versus initial intravenous therapy for urinary tract infections in young febrile children.","authors":"Robert M Jacobson MD","doi":"10.1046/j.1467-0658.2000.0062h.x","DOIUrl":"10.1046/j.1467-0658.2000.0062h.x","url":null,"abstract":" Background The standard recommendation for treatment of young, febrile children with urinary tract infection has been hospitalization for intravenous antimicrobials. The availability of potent, oral, third-generation cephalosporins, as well as interest in cost containment and avoidance of nosocomial risks prompted evaluation of the safety and efficacy of outpatient therapy. Methods In a multicentre, randomized clinical trial, the investigators evaluated the efficacy of oral versus initial intravenous therapy in 306 children 1 to 24 months old with fever and urinary tract infection, in terms of short-term clinical outcomes (sterilization of the urine and defervescence) and long-term morbidity (incidence of reinfection and incidence and extent of renal scarring documented at 6 months by 99mTc-dimercaptosuccinic acid renal scans). Children received either oral cefixime for 14 days (double dose on day 1) or initial intravenous cefotaxime for 3 days followed by oral cefixime for 11 days. Costs were estimated using charge-data. Results Treatment groups were comparable regarding demographic, clinical, and laboratory characteristics. Of the short-term outcomes: (1) repeat urine cultures were sterile within 24 h in all 306 children, and (2) mean time to defervescence was 25 and 24 h for children treated orally and intravenously, respectively. Of the long-term outcomes: (1) symptomatic re-infections occurred in 4.6% of children treated orally and 7.2% of children treated intravenously; (2) renal scarring at 6 months was noted in 9.8% of children treated orally versus 7.2% of children treated intravenously; and (3) mean extent of scarring was ~8% in both treatment groups. Mean costs were at least twofold higher for children treated intravenously ($3577 versus $1473) compared with those treated orally. Conclusions Oral cefixime can be recommended as a safe and effective treatment for children with fever and urinary tract infection. Use of cefixime will result in substantial reductions of health care expenditures.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"72-73"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86356748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 51

A randomised trial of three marketing strategies to disseminate a screening and brief alcohol intervention programme to general practitioners. 三种营销策略的随机试验，向全科医生传播筛查和简短的酒精干预方案。

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.0062b.x

引用次数: 35

Advising parents of asthmatic children on passive smoking: randomised controlled trial. 建议哮喘儿童家长不要被动吸烟:随机对照试验。

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.0062g.x

Richard Reading

{"title":"Advising parents of asthmatic children on passive smoking: randomised controlled trial.","authors":"Richard Reading","doi":"10.1046/j.1467-0658.2000.0062g.x","DOIUrl":"10.1046/j.1467-0658.2000.0062g.x","url":null,"abstract":" Objective A randomised controlled trial to investigate whether parents of asthmatic children would stop smoking or alter their smoking habits to protect their children from environmental tobacco smoke. Participants 501 families with an asthmatic child aged 2–12 years living with a parent who smoked. Intervention Parents were told about the impact of passive smoking on asthma and advised to stop or change their smoking habits to protect their child’s health. Main outcome measures Salivary cotinine concentrations in children, and changes in reported smoking habits of the parents 1 year after the intervention. Results One year after the baseline visit, a small decrease in salivary cotinine concentrations was found in both groups of children, but there was no significant difference between the groups. Overall, 98% of parents in both groups still smoked at follow-up. However, there was a nonsignificant tendency for parents in the intervention group to report smoking more at follow-up and to having a reduced desire to stop smoking. Conclusions A brief intervention to advise parents of asthmatic children about the risks from passive smoking was ineffective in reducing their children’s exposure to environmental tobacco smoke. If a clinician believes that a child’s health is being affected by parental smoking, the parent’s smoking needs to be addressed as a separate issue from the child’s health.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"71-72"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74912115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

A study of the efficacy of antipyretic drugs in the prevention of febrile seizure recurrence 解热药物预防热性惊厥复发的疗效研究

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.00059.x

Adrianus van Esch, Ewout W Steyerberg, Henriëtte A Moll, Martin Offringa, Arne W Hoes, J Dik F Habbema, Gerdarda Derksen-Lubsen

{"title":"A study of the efficacy of antipyretic drugs in the prevention of febrile seizure recurrence","authors":"Adrianus van Esch, Ewout W Steyerberg, Henriëtte A Moll, Martin Offringa, Arne W Hoes, J Dik F Habbema, Gerdarda Derksen-Lubsen","doi":"10.1046/j.1467-0658.2000.00059.x","DOIUrl":"10.1046/j.1467-0658.2000.00059.x","url":null,"abstract":"<div>\u0000 \u0000 Objective To estimate the potential preventive effect of antipyretic drugs on the recurrence of febrile seizures (FS).\u0000 Design An experimental and a descriptive patient series, both prospectively followed, were combined in this study.\u0000 Setting/participants Children who visited the outpatient department of the Sophia Children’s Hospital because of a FS experienced between the age of 10 and 36 months.\u0000 Intervention A treatment group of 109 children was offered treatment with ibuprofen or acetaminophen syrup during fever, a control group of 103 children was not offered antipyretic treatment. This was not a randomized trial. In an intention-to-treat analysis, the risk of any recurrence and the number of recurrences per fever were compared between both groups. In an additional on-treatment analysis, we compared the number of recurrences per fever between the control group and the children in the treatment group who actually received the study medication during fever. Effect measures were odds ratio (OR) as estimated by the Mantel–Haenszel procedure and hazard ratios (HR) as estimated by Cox regression.\u0000 Results According to the intention-to-treat analysis, the hazard ratio of any recurrence in the treatment group compared with the control group was 1.1 [95% confidence interval (CI), 0.7–1.8]. The recurrence risk per fever was 15% in the treatment group and 12% in the control group (OR, 1.2; 95% CI, 0.7–2.3). In the exploratory on-treatment analysis, the recurrence risk in the treatment group was estimated 6.9% in the treatment group versus 12% in the control group (OR, 0.5; 95% CI, 0.2–1.3).\u0000 Conclusions/implications for practice We conclude that antipyretic treatment may have little or no preventive effect on the recurrence of febrile seizures in common practice. Some reduction of the risk of a recurrence may be acquired under optimal circumstances, namely that fever is noticed at once and that antipyretic drugs can be administered on time.\u0000 </div>","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1467-0658.2000.00059.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83320659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23