Articles: child.
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A standardized medical examination of four to five year old children was introduced into Victorian preschools in 1977. This combined a neurodevelopmental screening with a physical examination. ⋯ The number of children referred for intervention or therapy from the disadvantaged group was 176 (34%) compared with 88 children (17.6%) from the more advantaged group. A standardized examination of the preschool child is desirable, so that consistently comparable results can be obtained and epidemiological trends can be more readily identified.
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The challenge of the limping child demands that the primary care physician identify those problems which are urgent, when neglect can harm the child, and to provide appropriate supportive care for those which are not. The approach to the limping child should consider the child's age, whether or not the limp is painful, and certain key physical findings.
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The treatment of children who require long-term hospitalization cannot remain encapsulated within the hospital. Collaborative efforts must be established within a network of community physicians, health specialists, and facilities. Each child is treated within the context of his family and community, even while hospitalized. Such treatment plans can be conceived and carried out only when there is a commitment to develop and maintain a viable collaborative treatment network.
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Historical Article
Reared in adversity: institutional care of children in the 18th century.
The earliest public pediatric care of the 18th century in this country took the form of "outdoor relief." Institutional care followed, first almshouses were built; then orphanages, hospitals, and dispensaries. Almshouses not only included workhouses but provided comprehensive medical services. Throughout the 18th century, people often referred to the almshouses as hospitals. ⋯ By the middle of this 20th century, practically all of them had been absorbed by hospitals. In these institutions, pediatric knowledge advanced and medical manpower developed even during the 18th century. By the end of that century, social movements began from which evolved the 19th-century concern for the welfare of children.