Ambulatory Child Health最新文献_第2页

Is preschool child health surveillance an effective means of detecting key physical abnormalities? 学龄前儿童健康监测是发现关键身体异常的有效手段吗?

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

Dr Cliona Ni Bhrolchain

{"title":"Is preschool child health surveillance an effective means of detecting key physical abnormalities?","authors":"Dr Cliona Ni Bhrolchain","doi":"10.1046/j.1467-0658.2000.0062e.x","DOIUrl":"10.1046/j.1467-0658.2000.0062e.x","url":null,"abstract":" Method This was a prospective study of a 1-year cohort of children born to mothers registered with 25% of general practices in Nottingham. A cohort of 2308 babies was followed up for 15–18 months. All referrals for five tracer physical conditions (undescended testes, congenital heart disease, squints, developmental dysplasia of the hip and congenital hearing loss) were followed up through hospital record systems and copies of child health surveillance reviews from the personal child health records. Results One thousand, nine hundred and seventy-two (85%) of the initial cohort were followed up. Four hundred and thirteen (21%) children had been referred for one of the tracer conditions and 91% had been referred directly from child health surveillance reviews. Only 49 (12%) children needed treatment or follow-up after assessment. The sensitivity of screening was high, ranging from 72% for congenital heart disease to 100% for developmental dysplasia of the hip and hearing loss. However, false positive rates were also very high, ranging from 60% for undescended testes to 97% for developmental dysplasia of the hip and hearing loss. Thus the positive predictive value of referral for dysplasia of the hip or hearing loss was only 5%, with a negative predictive value of 100%. In contrast, the positive predictive value for undescended testes was 67%, with a false negative rate of 14%. Eighty-four per cent of those who needed treatment or follow-up after assessment had been referred from the child health surveillance programme. The largest proportion of abnormalities was identified from the 6-week review, but most referrals came from the neonatal review and the health visitor distraction test. Conclusion The majority of children with the five tracer conditions used in this study were identified during child health surveillance examinations.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"70-71"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83913271","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

Addressing barriers to change: an RCT of practice-based education to improve the management of hypertension in the elderly. 解决改变的障碍:一项基于实践的教育改善老年人高血压管理的随机对照试验。

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

Cliona Ni Bhrolchain Dr

{"title":"Addressing barriers to change: an RCT of practice-based education to improve the management of hypertension in the elderly.","authors":"Cliona Ni Bhrolchain Dr","doi":"10.1046/j.1467-0658.2000.0062d.x","DOIUrl":"https://doi.org/10.1046/j.1467-0658.2000.0062d.x","url":null,"abstract":" Method A randomised, single-blind, controlled trial of incorporating an exploration of barriers to changing practice into an educational strategy for GPs was conducted in 18 practices. Both groups of practices received visits during which they received the results of a previous audit on the management of hypertension in the elderly. The nine intervention practices were encouraged to explore barriers that would prevent them from implementing the pertinent research findings, in addition to an exploration of the issues and creation of a practice action plan. Control groups received the education without the element of exploring barriers to change. The outcome measures were changes in response to a questionnaire before and after the educational intervention. Results There were statistically significant differences between the two groups after the educational visit. Those practices who were encouraged to explore barriers to change were more likely to show change in behaviour compared to the control group. All the intervention practices produced an action plan for improving the performance, whereas none of the controls did so. The intervention practices also showed more concordance in management protocols after the intervention. Conclusion Addressing the barriers preventing practitioners from implementing research findings is effective in implementing change.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"69"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137641211","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

Addressing barriers to change: an RCT of practice-based education to improve the management of hypertension in the elderly. 解决改变的障碍:一项基于实践的教育改善老年人高血压管理的随机对照试验。

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

Cliona Ni Bhrolchain Dr

{"title":"Addressing barriers to change: an RCT of practice-based education to improve the management of hypertension in the elderly.","authors":"Cliona Ni Bhrolchain Dr","doi":"10.1046/j.1467-0658.2000.0062c.x","DOIUrl":"https://doi.org/10.1046/j.1467-0658.2000.0062c.x","url":null,"abstract":" Method A randomised, single-blind, controlled trial of incorporating an exploration of barriers to changing practice into an educational strategy for GPs was conducted in 18 practices. Both groups of practices received visits during which they received the results of a previous audit on the management of hypertension in the elderly. The nine intervention practices were encouraged to explore barriers that would prevent them from implementing the pertinent research findings, in addition to an exploration of the issues and creation of a practice action plan. Control groups received the education without the element of exploring barriers to change. The outcome measures were changes in response to a questionnaire before and after the educational intervention. Results There were statistically significant differences between the two groups after the educational visit. Those practices who were encouraged to explore barriers to change were more likely to show change in behaviour compared to the control group. All the intervention practices produced an action plan for improving the performance, whereas none of the controls did so. The intervention practices also showed more concordance in management protocols after the intervention. Conclusion Addressing the barriers preventing practitioners from implementing research findings is effective in implementing change.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"69"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137489780","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: 2

Recurrent periorbital zosteriform herpes simplex virus infection in childhood 儿童复发性眶周带状疱疹病毒感染

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.00056.x

Tibisay Villalobos, Megan C McMahon, Mobeen H Rathore

引用次数: 2

Population screening for anaemia in the inner city 在市中心进行人口贫血筛查

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.00057.x

Robert Moy, Anne Aukett

{"title":"Population screening for anaemia in the inner city","authors":"Robert Moy, Anne Aukett","doi":"10.1046/j.1467-0658.2000.00057.x","DOIUrl":"10.1046/j.1467-0658.2000.00057.x","url":null,"abstract":"<div>\u0000 \u0000 Objective An evaluation of the effectiveness and acceptability of a screening programme for anaemia linked to routine child health surveillance.\u0000 Design A community-based study of the screening process with re-evaluation after treatment and again 9 months later, supported by a questionnaire study of the opinions of GPs, health visitors and parents.\u0000 Setting Child Health clinics and GP surgeries in an area of Birmingham with high levels of deprivation and ethnic minority groups.\u0000 Subjects All 625 children turning 21 months of age during a 2-month period who were resident in the study area.\u0000 Main outcome measures Attendance for screening, haemoglobin result, compliance with medication, and post-treatment haemoglobin.\u0000 Results Sixty-three per cent of the target population attended for blood screening. 46% of 365 children tested were anaemic (Hb < 110 g/L). The thumb-prick blood test was acceptable to children, parents and health visitors. Two months of iron therapy was effective in raising haemoglobin by a mean of 15.5 g/l, but one-third of cases were noncompliant with oral iron. At 30 months of age, haemoglobin tended to fall in those previously not anaemic at 21 months from a mean of 122.2 to 115.5 g/l, and 33% who had been successfully treated later relapsed.\u0000 Conclusions The effectiveness of the programme from the public health perspective was reduced by nonattendance. Nevertheless, it could identify and treat anaemic children successfully. Despite shortcomings, we feel that screening is a useful adjunct to ongoing primary prevention of anaemia.\u0000 </div>","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1467-0658.2000.00057.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87780065","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: 6

Biosketches 简历

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.0059a.x

引用次数: 0

Biosketches 简历

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.0054a.x

引用次数: 0

Psychopharmacotherapy in children and adults with intellectual disability. 智力残疾儿童和成人的精神药物治疗。

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

Richard Reading

{"title":"Psychopharmacotherapy in children and adults with intellectual disability.","authors":"Richard Reading","doi":"10.1046/j.1467-0658.2000.0062m.x","DOIUrl":"10.1046/j.1467-0658.2000.0062m.x","url":null,"abstract":"The prevalence of psychiatric disorders is increased in children and adults with intellectual disability. Brain damage or dysfunction interact with social and family factors to increase susceptibility to mental illness. Psychiatric disorders in the context of genetic syndromes are commonly overlooked, and there is substantial underdiagnosis of mental disorders because of the atypical and non-specific clinical presentations, and the frequent assumption that psychiatric symptoms are an inherent part of the underlying intellectual disability. There is a strong need for evidence-based practice in the use of drugs in this population, especially since many are unlicensed for use in children. There is an urgent need to understand and establish the pharmacokinetics, pharmacodynamics, and side-effect profiles of psychotropic medication in this population. Positive trends in pharmacotherapy include the use of atypical antipsychotics instead of the classic antipsychotics, serotonin-specific reuptake inhibitors (SSRIs) rather than tricyclic antidepressants and newer antiepileptic drugs. Another welcome trend is the use of SSRIs instead of antipsychotics in the long-term management of challenging behaviour in this population.","PeriodicalId":100075,"journal":{"name":"Ambulatory Child Health","volume":"6 1","pages":"75"},"PeriodicalIF":0.0,"publicationDate":"2009-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78344586","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: 12

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.1467-0658.2000.0062a.x

引用次数: 0

Commentary 评论

Ambulatory Child Health Pub Date : 2009-08-06 DOI: 10.1046/j.1467-0658.2000.0057b.x

引用次数: 0