Arch Pediat Adol Med
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Arch Pediat Adol Med · Jun 1999
Comparative StudyFirearm storage practices and children in the home, United States, 1994.
To estimate the national prevalence of firearm ownership and storage practices in the home, to compare storage practices in homes with and without children, and to analyze demographic characteristics related to firearm storage practices in homes with children. ⋯ These prevalence data show that children are potentially exposed to firearms in many households. This health threat illustrates the need for education about the issue of pediatric firearm injuries and for interventions to minimize associated risks. Health care providers should take advantage of opportunities to counsel patients regarding firearm safety in the home.
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Arch Pediat Adol Med · Jun 1999
A pediatric clinical skills assessment using children as standardized patients.
To develop and implement a pediatric clinical skills assessment (PCSA) for residents, using children as standardized patients (SPs); to assess the psychometric adequacy of the PCSA and use it to evaluate the performance of residents; and to evaluate the feasibility of using child SPs and the response of the residents and the child SPs to participation in the PCSA. ⋯ Our development method gives content validity to our PCSA, and resident scores give indication of PCSA construct validity. Reliabilities are in the acceptable range. Residents found the PCSA challenging and realistic but less than enjoyable and fair. Use of child SPs is feasible. Resident performance scores were low relative to the performance criteria of the PCSA development group. The adequacy of clinical skills teaching and assessment in residency programs needs to be reviewed. Deficits in specific skills and overall performance of residents identified by a PCSA could be used to guide individual remediation and curricular change.
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Arch Pediat Adol Med · Jun 1999
Caregiver knowledge and delivery of a commonly prescribed medication (albuterol) for children.
To evaluate caregiver knowledge and delivery of a prescription medication (albuterol) for children. ⋯ Metered dosing and calibrated measuring devices aided in the accurate delivery of this prescription medication. However, considerable concern exists with the use of noncalibrated measuring devices (teaspoons), improper frequency, and duration of use. Refilling of medication was also a concern since 63% were out of albuterol. Caregiver education on use, delivery, and refilling of medications must be stressed and assessed at all emergency department and primary care visits. In addition, metered dosing and the use of calibrated measuring devices should be encouraged.
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Arch Pediat Adol Med · Jun 1999
Determinants of counseling in primary care pediatric practice: physician attitudes about time, money, and health issues.
To assess pediatrician goals and practice in preventive counseling, and to use social learning theory to examine physician attitudes about preventive health issues, time, and reimbursement to explain physician counseling behavior. ⋯ Physician goals in child health supervision were primarily biomedical, with psychosocial and safety issues of lesser importance. Concern about time for preventive counseling was associated with less reported counseling. Physician attitudes regarding the importance of a health issue and their confidence and effectiveness in counseling were more predictive of physician practice than their attitudes about time and reimbursement for preventive care.