Pediatrics
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Randomized Controlled Trial Clinical Trial
Do partners with children know about firearms in their home? Evidence of a gender gap and implications for practitioners.
The gender gap describing the apparent differences in male and female reports of firearm-ownership and -storage habits has never been evaluated among individuals who live in the same household. Thus, the objective of this study was to examine the level of agreement on household firearms and storage practices among cohabiting partners. ⋯ A gender gap does exist in the reporting of firearm ownership with regard to the number and type of firearms owned. There are also differences in reported firearm-storage practices, which are likely related to the finding that men were reported to be the primary owner of firearms in most households as well as the person more commonly responsible for firearm storage. Firearm-safety counseling should include male partners in the history-taking process to improve knowledge about the presence and storage patterns of household firearms.
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Safe storage of firearms has been recommended as a means of preventing gun-related pediatric injuries, yet few interventions have led to significant improvements in storage practices. This study examined a multifaceted community education campaign to promote safe handgun storage and the campaign's impact on firearm locking and loading practices in households with children. ⋯ In both the intervention and control counties, households were more likely to lock all handguns in 2001 compared with 1996. After accounting for temporal trends, this educational campaign, combined with economic incentives to purchase lock boxes, did not seem to significantly change safe storage practices in households with handguns and children. Even if the campaign did result in small improvements in firearm safe storage, simultaneous national and state-specific gun-safety activities or legislative efforts may have drawn increasing attention to gun-related issues in the control counties, thereby making it more difficult to identify effects of our specific handgun storage intervention.
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Comparative Study
Effects of child age and body size on serious injury from passenger air-bag presence in motor vehicle crashes.
Current recommendations regarding children traveling in passenger vehicles equipped with passenger air bags are based, in part, on evidence that the air-bag-related risk of injury and death is higher for children < or =12 years of age. However, the age or body size required to allow a child to be seated safely in front of a passenger air bag is unknown. ⋯ Children up to 14 years of age may be at risk for serious preventable injury when seated in front of a passenger air bag, and children 15 to 18 years of age seem to experience protective effects of air-bag presence and deployment. Age may be a better marker than height or weight for risk assessment regarding children and air bags.
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Review Clinical Trial
Bispectral index as a guide for titration of propofol during procedural sedation among children.
To determine whether the bispectral index (BIS) monitor could be used to guide physicians in titrating propofol to an effective safe level of deep sedation for children undergoing painful medical procedures. ⋯ The BIS monitor can be a useful monitoring guide for the titration of propofol by physicians who are competent in airway and hemodynamic management, to achieve deep sedation for children undergoing painful procedures.
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Comparative Study
Is bloodstream infection preventable among premature infants? A tale of two cities.
Bloodstream infection (BSI) is a significant cause of morbidity and death encountered in the NICU. The rates of BSIs vary significantly in NICUs across the nation. However, no attempt has been made to correlate this variation with specific infection-control practices and policies. We experienced a significant increase in BSIs in the NICU at the George Washington University Hospital and were seeking additional precautionary measures to reduce BSI rates. Our objective was to review policies and practices associated with lower infection rates nationally and to test their reproducibility in our unit. ⋯ Applying the closed medication system was associated with reduced BSI rates in our unit. This protocol was easily reproducible in our environment and showed immediate results. Serious attempts to share data can potentially optimize outcomes and standardize policies and practices among NICUs.