Arch Pediat Adol Med
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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.
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To determine the effect of the emergency department (ED) environment and other health care system factors on test ordering for children with acute abdominal pain. ⋯ For children seen for a complaint of acute abdominal pain, we found little evidence that test ordering is affected by encounter location, resident involvement, student involvement, or faculty member experience.
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Arch Pediat Adol Med · Nov 1996
Young adolescents' comfort with discussion about sexual problems with their physician.
To identify factors associated with young adolescents' sense of comfort about discussing sexual problems with their physician. ⋯ This study emphasizes the need for physicians to discuss sexual risks with young adolescents and suggests ways physicians can help young adolescents feel more comfortable talking with them about sexual concerns.
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Arch Pediat Adol Med · Nov 1996
How rational is the crossmatching of blood in a pediatric emergency department?
To determine if typed and crossmatched blood ordered in a pediatric emergency department (ED) is actually used for transfusion and if some ordering patterns are not cost-effective. ⋯ Most typed and crossmatched units of blood ordered in our pediatric ED were never used for transfusion. The C/T and P/T ratios were high for many diagnostic categories, suggesting inefficient blood ordering and patient management. Transfusions were uncommon in children with the following problems: ventriculoperitoneal shunt malfunction, virtually all surgical diagnoses, cancer with a hemoglobin concentration greater than 105 g/L, and trauma patients with a Pediatric Trauma Score of greater than 7.
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Arch Pediat Adol Med · Nov 1996
Factors associated with the intent of firearm-related injuries in pediatric trauma patients.
To examine the characteristics of unintentional and assaultive firearm-related pediatric injuries treated in trauma centers. ⋯ Marked differences in injury circumstances exist between unintentional and assaultive firearm-related injuries among children. The late afternoon hours when many children have come home from school but their parents may still be working have the highest frequency of unintentional firearm-related injuries. The evening peak of assaultive injuries may be related to drug-related and gang-related violence. While it is important to reduce the access of firearms to children, school-based extracurricular and community-based social services should be considered in developing intervention programs.