Showing posts with label pediatric healthcare. Show all posts
Showing posts with label pediatric healthcare. Show all posts

Wednesday, April 20, 2011

AboutKidsHealth (AboutKidsHealth) on Twitter

AboutKidsHealth

@AboutKidsHealth Toronto, Canada
AboutKidsHealth.ca provides families and health care providers with free, evidence-based information about everyday health & complex medical conditions.

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When the temperature starts climbing, people find excuses to go outdoors. Here is the 411 on and .
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RT @: Measles outbreaks spread across Europe
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How can you help an adult that is to the ? Dr. Pat shares his thoughts and suggestions.
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A popular and to give to . Learn more about how works & its side effects

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Sunday, March 13, 2011

Colds teach the immune system how to fight future viruses

by Michael Gonzalez, MD

Viral upper respiratory illnesses, or common colds, are by far the most frequent illness I see in my office.

It is called the common cold because it is, well, common. I typically can make the diagnosis with a high degree of certainty based on the pattern and the timing of the symptoms. Deciphering cold symptoms and knowing when to worry is what a pediatrician does more often than anything else, and I believe parents can learn how to do this as well. If a parent can get a handle on what a common cold looks like, they can certainly save some co-pays and visits to the doctor. You see, there is no real treatment for the common cold. I know, I know, this is the great failure of modern medicine

Click on the "via" link for the rest of the article.

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Andrew Lopez, RN
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Saturday, February 5, 2011

Kids with allergies can die in school, responding to criticism, KevinMD.com

Like many other parents of kids with allergies, I was very dismayed to see this article, titled, Allergic boy, 7, suffers two heart attacks after teacher hands him chocolate nut in class, last week.   It seems a boy of 7 was accidentally given a chocolate candy containing a hazelnut, to which he is allergic.  After biting into the candy, he realized immediately that he shouldn’t have it and spit it out.  Despite quick treatment with an EpiPen after symptoms started, he ended up in pretty bad shape on life support after suffering a couple of cardiac arrests.

I read with interest the comments that the public left on that article.  As I’ve seen before with other peanut allergy articles (namely those that discuss banning peanuts on airplanes), this issue was very polarizing.  The teacher and child were equally blamed.  People even blamed the mother, who wasn’t even there until right afterward and did exactly what she was supposed to do.

I am almost positive that I would be one of those people saying, “What’s the big deal?  Just don’t eat peanuts” if peanut allergies didn’t affect my life in a huge way – my 4 year old son is severely allergic to peanuts.  He’s had 3 exposures, all accidental.  The last one saw us end up in the Emergency Room needing IV’s, oxygen, and several medications to treat his anaphylactic reaction.

L
Click on kevinmd.com link for the full article:

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Andrew Lopez, RN
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Wednesday, February 2, 2011

Fewer pediatricians, higher risk for kids’ appendix ruptures | Johns Hopkins University - The Gazette

Children who live in areas with fewer pediatricians are more likely to suffer life-threatening ruptures of the appendix than those in areas with more pediatricians, even when accounting for other factors such as the number of hospitals, imaging technology, insurance coverage and the number of surgeons in an area, according to a study from the Johns Hopkins Children’s Center.

The study’s findings, based on an analysis of nearly 250,000 hospital records of children with appendicitis, are published online in the December issue of JAMA–Archives of Surgery.

“Our analysis shows that the most potent predictor of outcome in children with appendicitis was the number of pediatricians available in an area, emphasizing the pivotal role they play as the point of first contact in the care of a sick child,” said lead investigator Fizan Abdullah, a pediatric surgeon at the Johns Hopkins Children’s Center and an associate professor in the Johns Hopkins School of Medicine.

The appendix is a small tube extending from the large intestine, and infections and inflammation of the organ can be dangerous. Each year, 77,000 children develop appendicitis, and an estimated one-third of them suffer a ruptured appendix, a serious complication that often results from delays in diagnosis and surgery to remove the inflamed or infected organ.

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Andrew Lopez, RN
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Tuesday, February 1, 2011

Campaign for a Commercial-Free Childhood Home

Screen-Free Week

Order Your Organizer's Kit Today!
Go Screen-Free with CCFC: April 18-24, 2011

This April, children and families around the world will turn off their TVs, video games, and computers and turn on life. Will you organize a Screen-Free Week in your school or community?  It's easy and fun and we'll walk you through the process with our brand-new Organizer Kit.  Organize your own Screen-Free Week > | Visit the Screen-Free Week store > | Become a Facebook fan >

Take Action
Shape Up, Scholastic!

Are you tired of Scholastic exploiting its unique access to schoolchildren and marketing everything from sugary beverages to television programs to cleaning products and medications in classrooms?  Are you fed-up with “book” fairs and “book” clubs that are chock-full-of toys, videogames, and other commercialized fare? We created this page to help you communicate your concerns directly with Scholastic's CEO. Take action>

 

Take Action
Tell the FCC: Sneaky New Nick Toon is Nothing but a Skechers Ad

The FCC has opened an inquiry into CCFC's petition urging the the Commission to rule that the upcoming broadcast of Zevo-3 on Nicktoons is not in the public interest.  Developed by Skechers, Zevo-3 is the first kids' program to feature characters known to children only as commercial spokescharacters and will violate longstanding policies designed to protect children from overcommercialization. But the FCC will only act if there is signification public pressure, so please submit a comment in support of our petition today. Submit a Comment to the FCC> |  Read the Petition> | Read the Press Release> | Read the AP Story>

How much television and computer time have your kids had this week?

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Andrew Lopez, RN
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Tuesday, January 18, 2011

Helping a Child Who Is Afraid of Shots

When your young child whimpers at the mention of the word "shot," you probably have mixed feelings. You want your son to be protected by his vaccinations; you just wish that the procedure was pain-free.

"Vaccines protect the health and well-being of children, but children don't understand that," says Deborah Wexler, MD, executive director of the Immunization Action Coalition, a national organization based in St. Paul, Minn. "It can be really hard for them to come in for their shots."

Fortunately, you can have an active role in changing your child's attitude. What a parent says and does before, during, and after the doctor's appointment can help to calm a child, reduce her fears, and ensure that she develops a healthy attitude toward seeing the pediatrician.

If you struggle with what to say or have trouble putting on a brave face, read on for expert advice.

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Thursday, January 13, 2011

Saving Grace (Emergency Department Nurses)- LA Times Magazine

“I heard a guttural scream,” Rich says, “and a man was handing me his lifeless son.”

“How old?” I ask.

“Nine months. We worked on him for over an hour.”

Rich moves his chair, coughs. It’s freezing in the conference room. [Note: For privacy, nurses are mentioned only by first name.] The muffled din of the emergency room is audible through closed metal doors. It’s 7 a.m., and Rich’s 12-hour shift has just ended. “I flashed to something I heard once about how a casket doesn’t weigh very much—just enough to break a father’s heart,” he says, “and I lost it. I’m standing there, between beds one and two holding that dead baby, and I’m sobbing. I am in charge, and I’m crying.”

As an 11-year volunteer in Cedars-Sinai Medical Center’s emergency room, I’ve seen close up what ER nurses deal with. It takes rare emotional courage not to burn out when you know that every time those doors open—whether you are working triage in front, where a guy may stumble in with a heart attack, or in back, where paramedics may race in with a girl who has been knifed or shot—it’s bad news. Then there’s the physical strength required to survive 12-hour shifts with two half-hour breaks and 45 minutes for lunch. ER nurses never sit. But it’s the children—every ER nurse will tell you—who take the biggest toll

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Andrew Lopez, RN
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38 Tattersall Drive, Mantua New Jersey 08051
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Monday, January 10, 2011

Preventing Heart Ailments at Their Roots - Childhood - NYTimes.com

Two studies published Monday suggest that the road to hypertension and heart disease starts in childhood and that prevention should start there, too.

Related

One analysis found that parental smoking increases the risk for high blood pressure in preschoolers, and the other that excessive sugar consumption in teenagers is associated with multiple factors known to increase the risk for cardiovascular disease. Both reports appear in the February issue of the journal Circulation.

The first study looked at 4,236 children in Germany, where 5-year-olds undergo a compulsory physical and cognitive assessment before starting school. During the period of the study, 2007-8, more than 28 percent had at least one parent who smoked. Even after correcting for body mass index and parental hypertension, having a smoker as a parent substantially increased the likelihood that a child would have blood pressure readings in the top 15 percent of the sample.

Parental smoking was not the only association, or even the strongest. Being overweight and having a parent with hypertension were also associated with high blood pressure in the children. But the lead author, Dr. Giacomo D. Simonetti, said smoking was probably the easiest risk to modify.

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Andrew Lopez, RN
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Tuesday, December 14, 2010

How adult smoking affects behavior in children, KevinMD.com

by Nancy Walsh

Both maternal and paternal cigarette smoking can contribute to adverse chronic conditions — physical and psychological — in children, two large studies found.

Writing in the July issue of Pediatrics, Marie-Jo Brion, PhD, of the University of Bristol in England, and colleagues reported that children in two cohorts whose mothers smoked were more likely to have conduct/externalizing behavior problems than were those who had no prenatal tobacco exposure:

* British cohort, OR 1.24 (95% CI 1.07 to 1.46, P=0.005)
* Brazilian cohort, OR 1.82 (95% CI 1.19 to 2.78, P=0.005)

In a second study in the same issue, Chinese researchers found that daily paternal pre- or postnatal smoking was associated with increased mean body mass index (BMI) Z-scores in offspring at seven years, with a mean difference of 0.10 (95% CI 0.02 to 0.19) and also at 11 years, when the mean difference was 0.16 (95% CI 0.07 to 0.26).

These studies “tighten the evidence around tobacco smoke exposure and chronic conditions of childhood,” observed Jonathan P. Winickoff, MD, of Massachusetts General Hospital for Children in Boston, and colleagues in an editorial accompanying the studies.

Winickoff and colleagues wrote that these studies contribute to a growing body of research findings linking tobacco smoke exposure and multiple childhood morbidities and mortality, ranging from miscarriage, stillbirth, and sudden infant death syndrome to decreased lung function and obesity.

Brion and colleagues sought to determine if maternal smoking also could be causally related to the widely reported psychological problems seen in offspring.

Their study included 6,735 children residing in southwest England born between April 1991 and December 1992, as well as 509 children from the city of Pelotas in southern Brazil who were born during 1993.

The prevalence of maternal smoking was almost twice as high in the Brazilian cohort (29.4% versus 15.9%), but consistency was observed otherwise in the two groups.

In unadjusted models, maternal smoking was associated with behaviors in children at four years of age including inattention/hyperactivity, conduct/externalizing problems, and peer/social difficulties, but not with emotional/internalizing problems.

After adjusting for multiple potential confounders, however, such as birth weight and gestational age, socioeconomic factors, and maternal-paternal smoking, only conduct/externalizing problems were seen in both cohorts.

These findings support the concept that these children’s behavioral problems may be mediated by the influence of intrauterine tobacco exposure, and particular

ly nicotine, on neurodevelopmental pathways, according to the investigators.

They acknowledged that the study had shortcomings. Information about potentially important confounders, such as maternal antisocial behavior, was not available, and different instruments were used to assess child behavior in the two cohorts.

Also, parental smoking was measured by self-report, which may represent an underestimation.

In the second study, C. Mary Schooling, PhD, and colleagues from the University of Hong Kong, examined the effects of secondhand smoke on 6,790 children born during 1997 whose mothers did not smoke, stratifying them according to degree of paternal smoking.

They found that children of daily paternal smokers were from lower socioeconomic backgrounds, had mothers not born in Hong Kong, and were less likely to be breastfed.

Unlike BMI, the children’s height was not affected by paternal smoking.

At age seven, the difference in height Z-scores was −0.01 (95% CI −0.08 to 0.06), and at age 11 the difference was 0.02 (95% CI −0.05 to 0.10).

“To date, most of the evidence for the association between parental smoking and offspring overweight comes from Western or long-term developed settings, where smoking and childhood BMI are socially patterned and usually associated with low socioeconomic position,” the investigators wrote.

They noted that in Hong Kong, few women smoke and about one-quarter of men do, and although the prevalence of overweight in childhood is comparable to that in Western countries, it may be less socially patterned.

“Therefore, currently developed Hong Kong may serve as an ideal, non-Western social laboratory in which to verify associations from Western societies that are potentially confounded by [socioeconomic position],” they wrote.

In this study, the data were collected prospectively but there still were limitations. Secondhand smoke exposure was determined by parental report, so underreporting was possible, and childhood adiposity was measured by proxy using BMI, which does not differentiate between body fat and lean mass.

Nonetheless, the study suggests that paternal smoking may contribute to excess weight in offspring. Possible explanations for this include the fact that infants in households of smokers were less likely to be breastfed, and parents may have been generally less health-conscious.

“Alternatively, our findings might reflect the physiologic effects of paternal smoking and perhaps prenatal [secondhand smoke] exposure,” they wrote.

For example, while nicotine exposure from secondhand smoke might not be sufficient to cause intrauterine growth restriction, it might lead to restricted brain development and changes in appetite and metabolism.

In the editorial, Winickoff and colleagues urged continuation of efforts to curb smoke exposure in workplaces, restaurants, homes, and cars, recommending that clinicians utilize office systems, family-centered approaches, and community outreach to further minimize exposures and improve the health of both parents and children.

“Parental tobacco dependence, itself a chronic condition, begets other chronic conditions of childhood,” they wrote.

Nancy Walsh is a MedPage Today contributing writer.

Originally published in MedPage Today. Visit MedPageToday.com for more smoking news.

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Monday, November 29, 2010

The New, Well-informed Patient - NurseZone

The New, Well-informed Patient


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Monday, November 22, 2010

Nurse-Family Partnership Celebrates 10 Years - WGHP

Nearly 500 first-time mothers can thank a Guilford County program for getting them on their feet.

The Nurse-Family Partnership program celebrated its 10th anniversary Wednesday. The program partners a low-income, first-time mother with a nurse. The nurses visit the mothers, educating them on how to improve their child's well-being, as well as how to become more economically self-sufficient.

"I was just uneasy about being a single mom. I wanted to be perfect, but there is no such thing as a perfect parent. This program has helped me work toward perfection with my son and myself," new mom Jameya Turner said.

The partnership lends support from pregnancy all the way until the child's second birthday.

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Myths Fuel Dangerous Decisions to Not Vaccinate Children | Vaccination Decline | Bacterial Meningitis & Vaccine Myths | LiveScience

Over the course of one summer vacation, Tyler Ludlum went from being a healthy 10-year-old, looking forward to the pool, to an emotionally and physically traumatized preteen who'd traded both of his feet, and half the fingers on his right hand, for his life.

It could have been prevented if he – or those around him – had been vaccinated.

Tyler had contracted meningococcal meningitis, a swelling of membranes around the brain and spinal cord that's caused by bacteria passed by nasal or oral droplets. Tyler was likely in the vicinity of a perhaps asymptomatic carrier of the disease, when this person coughed or sneezed.

But his story is more than a case of being in the wrong place at the wrong time: A vaccine that's at least 85 percent effective at preventing meningococcal meningitis is widely available and strongly recommended by health officials. Too young to have received the vaccination as part of a routine visit, Tyler was dependent on those around him to be immunized.

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Wednesday, November 17, 2010

Children's Hospital launches 'zero errors' initiative

Reeling from the deaths of two children due to medication errors, the staff of Seattle Children's Hospital devoted Saturday to special training designed to prevent a recurrence of the tragedies.

"It's so very important that we never forget that we harmed these children," said Pat Hagan, president of Children's Hospital. "We were all devastated by this when it happened. It struck us at our core."

Hagan said the patient deaths have been a "great, great tragedy for these families," and "a profound tragedy" for the hospital staff.

"We never want to forget how this feels. That feeling is going to be what drives us to continue to find ways to improve what we do here," he said.

Over 550 doctors, nurses, pharmacists and other staff members gathered at Children's for a special Patient Safety Day to address the medication errors that caused two deaths over the past 18 months.

More than 28 patient safety sessions were held, including 11 devoted to medication safety.

But first, participants gathered together in the morning to remember the two small patients who died.

"How we emerge from this situation today and over the coming months will be the real test of us as an organization," said Thomas Hansen, the hospital's CEO. "As I look around this room, I'm confident that we have the best and brightest people to rise to this challenge."

He told the staff "we must strive for zero errors, this must be our promise."

The day's sessions included topics such as decreasing verbal orders and increasing the safety of verbal orders when they are necessary, standardizing medications located on care units, ordering, dispensing and administration of high-risk medications, interruptions, provider-to-provider hand-offs and communication, ambulance transport and patient safety training using simulation.

Hospital spokesperson Louise Maxwell said Children's also is fully cooperating with state investigations of the recent medication errors and has made a number of improvements to decrease the chance of errors.

The hospital has also initiated a re-evaluation of the entire medication delivery system and launched a detailed analysis to determine why usual safety processes failed in each of the medication error cases.

Hospital officals said Saturday's special training did not affect care for patients or others needing urgent or emergency services.

--

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