Articles: pediatrics.
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Multicenter Study
Evaluation of a modified prediction instrument to identify significant pediatric intracranial injury after blunt head trauma.
We evaluate the effect of a modification of the University of California-Davis Pediatric Head Injury Rule on the ability of the decision instrument for pediatric head injury to predict clinically important intracranial injury in an external cohort. ⋯ In the NEXUS II cohort, a modified version of the University of California-Davis Rule misclassified a substantial proportion of pediatric patients with clinically important blunt head injury. Although we cannot evaluate the exact University of California-Davis Rule, we demonstrate that using stricter definitions of "headache" and "vomiting" and different wording than in the original study may have unintended or negative consequences. We emphasize the importance of careful attention to precise definitions of clinical predictors when a decision instrument is used.
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Multicenter Study
Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire.
To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK. ⋯ Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.
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To determine the existing patterns of sign-out processes prevalent in emergency departments (EDs) nationwide. In addition, to assess whether training programs provide specific guidance to their trainees regarding sign-outs and attitudes of emergency medicine (EM) residency and pediatric EM fellowship program directors toward the need for the development of standardized guidelines relating to sign-outs. ⋯ There is wide variation in the sign-out processes followed by different EDs. A majority of those surveyed expressed the need for standardized sign-out systems.
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Multicenter Study
The availability and accessibility of basic paediatric resuscitation equipment in primary healthcare centres: cause for concern?
Paediatric emergencies in primary healthcare centres are serious events that occur more commonly than envisaged. However, at present, these centres appear to lack the training and equipment to manage common paediatric emergencies. ⋯ Primary healthcare centres appear to lack the training and equipment to manage common paediatric emergencies. We recommend standardization of equipment and algorithms, training and assessment of key personnel, and critical incident reporting within primary healthcare centres.
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Randomized Controlled Trial Multicenter Study
Improving pediatric prevention via the internet: a randomized, controlled trial.
Innovations to improve the delivery of pediatric preventive care are needed. ⋯ A Web-based intervention can activate parents to discuss prevention topics with their child's provider. Delivery of tailored content can promote preventive practices.