Arch Pediat Adol Med
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Arch Pediat Adol Med · Dec 1996
Randomized Controlled Trial Multicenter Study Clinical TrialEffect of emergency department immunizations on immunization rates and subsequent primary care visits.
The Standards for Pediatric Immunization Practices recommend the routine use of emergency department (ED) encounters for screening the immunization status of children and, if indicated, immunizing them. ⋯ This study provides evidence that the immunization of children in this ED was ineffective at raising their immunization rates; primary care attendance was also unaltered. Major obstacles were as follows: (1) an inability to ascertain accurately the immunization status in the ED and (2) a high rate of parental refusal to accept immunizations in the ED. The standards should be modified to de-emphasize the ED as a routine immunization site for children with access to primary care. Efforts and resources should be directed toward strengthening the primary care system and tracking immunization status.
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Arch Pediat Adol Med · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of skin-to-skin contact with standard contact in low-birth-weight infants who are breast-fed.
To evaluate the effects of maternal-infant skin-to-skin contact (SSC) vs standard contact (SC) on low-birth-weight infants' physiological profile, maternal milk production, and duration of breast-feeding. ⋯ During SSC with their mothers, low-birth-weight infants maintain a higher oxygen saturation and are less likely to have desaturation to less than 90% oxygen than are infants exposed to SC. Mothers in the SSC group are more likely to continue breast-feeding until 1 month after discharge.
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Arch Pediat Adol Med · Dec 1996
Children's bicycle helmet attitudes and use. Association with parental rules. The Pediatric Practice Research Group.
Previous studies have assessed the attitudes of parents and children toward bicycle helmet ownership and use in various settings, but they have not addressed the role of parental rules in promoting bicycle helmet use by children. ⋯ Parental rules are associated with bicycle helmet use by children. Pediatricians may increase helmet use rates by promoting strict parental helmet rules as part of their anticipatory guidance regarding bicycle safety. More research about the effectiveness of this strategy is needed.
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To determine predictors and behavioral outcomes of preoperative anxiety in children undergoing surgery. ⋯ Variables such as situational anxiety of the mother, temperament of the child, age of the child, and quality of previous medical encounters predict a child's preoperative anxiety. Although immediate negative behavioral responses develop in a relatively large number of young children following surgery, the magnitude of these changes is limited, and long-term maladaptive behavioral responses develop in only a small minority.