Pediatrics
-
To describe the epidemiology of babywalker-related injuries to children treated in a pediatric emergency department despite current prevention efforts, and to investigate the beliefs of parents regarding babywalker use. ⋯ Despite the currently used prevention strategies, including adult supervision, warning labels, care giver education programs, and stairway gates, serious injuries associated with babywalkers continue to occur to young children. The US Consumer Product Safety Commission should promulgate a rule, similar to the voluntary standard adopted in Canada, regarding design requirements for babywalkers that will prevent their passage through household doorways at the head of stairs. The manufacture and sale of mobile babywalkers that do not meet this new standard should be banned in the US. A recall or trade-in campaign should be conducted nationally to decrease the number of existing babywalkers.
-
To study the association of musculoskeletal pain with emotional and behavioral problems, especially depressive symptoms in Finnish preadolescents. ⋯ Musculoskeletal pain, especially fibromyalgia, and depressive symptoms had high comorbidity. Pain and depressive symptoms should be recognized to prevent a chronic pain problem.
-
Randomized Controlled Trial Clinical Trial
Beyond dorsal penile nerve block: a more humane circumcision.
To explore techniques that can be utilized in addition to the dorsal penile nerve block (DPNB) to further reduce the neonate's stress and pain from routine circumcision, and thus make the procedure more humane. ⋯ When neonatal circumcisions are performed routinely, they should be done as humanely as possible. This study demonstrates that, when used in conjunction with DPNB, a pacifier dipped in 24% sucrose and a more comfortable, padded, and physiologic restraint can be useful in decreasing distress and pain.
-
We calculated expenditures for children with one of eight selected chronic health conditions who were enrolled in the Washington State Medicaid program and compared them with payments for all Medicaid-enrolled children. We examined variation in mean, median, and total expenditures and identified expenditure sources. ⋯ Medical care for children with selected chronic health conditions is 2.5 to 20 times more expensive than children in general, depending on the condition. A relatively few children account for the majority of expenditures. Extensive variation in mean, median, and total expenditures suggests that different conditions will need to be kept distinct for purposes of establishing payment rates. Children with certain conditions are vulnerable to restrictions in specific services, depending on what restrictions are imposed by a financing program. Further analyses are needed to identify risk-adjustment strategies to support delivery of high-quality services to this population of children as they migrate into managed-care environments.
-
Escalator-related trauma is uncommon but can cause significant injury. This study reviewed escalator-related injuries in children to determine risk factors, types of injuries, medical interventions, and long-term outcomes. ⋯ Children are at risk for sustaining severe injuries on escalators. Young age, inadequate adult supervision, improper activity while riding on the escalator, and escalator-related mechanical problems all increase the risk of injury. Public and parent education directed toward escalator safety issues may help to reduce escalator-related injuries in children.