https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(08)61690-6.pdf

Closing the gap in a generation: health equity through action on the social determinants of health

Erik Eriksen is a remarkable individual. He has no college degrees yet is Professor of Human Development at Harvard University. He came to psychology via art, which explains why the reader will find him painting contexts and backgrounds rather than stating dull facts and concepts. He has been a training psychoanalyst for many years as well as a perceptive observer of cultural and social settings and their effect on growing up. This is not just a book on childhood. It is a panorama of our society. Anxiety in young children, apathy in American Indians, confusion in veterans of war, and arrogance in young Nazis are scrutinized under the psychoanalytic magnifying glass. The material is well written and devoid of technical jargon. The theme of the volume is that it is human to have a long childhood which will leave a lifelong residue of emotional immaturity in man. Primitive groups and

Childhood and Society.

Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings

Poor children confront widespread environmental inequities. Compared with their economically advantaged counterparts, they are exposed to more family turmoil, violence, separation from their families, instability, and chaotic households. Poor children experience less social support, and their parents are less responsive and more authoritarian. Low-income children are read to relatively infrequently, watch more TV, and have less access to books and computers. Low-income parents are less involved in their children's school activities. The air and water poor children consume are more polluted. Their homes are more crowded, noisier, and of lower quality. Low-income neighborhoods are more dangerous, offer poorer municipal services, and suffer greater physical deterioration. Predominantly low-income schools and day care are inferior. The accumulation of multiple environmental risks rather than singular risk exposure may be an especially pathogenic aspect of childhood poverty.

Environment of childhood poverty

/pdf/the-environment-of-childhood-poverty-26w5pgnxr6.pdf

The environment of childhood poverty.

Objective Medication errors are a common cause of iatrogenic morbidity and mortality. The incidence of medication errors in pediatric emergency departments (EDs) has not been described. The objective of this study was to describe the incidence and type of drug errors in a pediatric ED and determine factors associated with risk of errors. Methods A retrospective cohort study was conducted of the charts of 1532 children who were treated in the ED of a pediatric tertiary care hospital during 12 randomly selected days from the summer of 2000. Two pediatricians, blinded to other study variables, independently decided whether a medication error occurred and ranked it according to a severity score. Disagreement was resolved by consensus. Results Prescribing errors were identified in 10.1% of the charts. The following variables were associated in univariate analysis with an increased proportion of errors: patients seen between 4 AM and 8 AM (odds ratio [OR]: 2.45; 95% confidence interval [CI]: 1.10-5.50), patients with severe disease (OR: 2.53; 95% CI: 1.18-5.41), medication ordered by a trainee (OR: 1.48; 95% CI: 1.03-2.11), and patients seen during weekends (OR: 1.48; 95% CI: 1.04-2.11). Among trainees, there was a higher rate of errors at the beginning of the academic year (OR: 1.67; 95% CI: 1.06-2.64). Logistic regression revealed increased risk for errors when a medication was ordered by a trainee (OR: 1.64; 95% CI: 1.06-2.52) and in seriously ill patients (OR: 1.55; 95% CI: 1.06-2.26). Conclusions In the pediatric ED, trainees are more likely to commit prescribing errors, and the most seriously ill patients are more likely to be subjected to prescribing errors.

Variables associated with medication errors in pediatric emergency medicine.

BACKGROUND: Evidence exists to suggest that bicycle helmets may reduce the risk of head injuries to cyclists, however helmets are not uniformly worn by all bicycle users. Legislation has been enacted in some countries to mandate helmet use by cyclists, however the issue remains controversial with opponents arguing that this may inhibit people from bicycle riding and thus from gaining the associated health benefits, or that other countermeasures may have been responsible for decline in head injuries. OBJECTIVES: To assess the effects of bicycle helmet legislation on bicycle-related head injuries and helmet use, and the occurrence of unintended adverse consequences. SEARCH STRATEGY: We searched CENTRAL, the Cochrane Injuries Group's specialised register, MEDLINE, EMBASE, TRANSPORT and other specialist electronic databases, up to February 2006. In addition we searched government websites, handsearched selected journals and examined the reference lists of selected publications. SELECTION CRITERIA: We included studies that reported changes in either the number of head injuries, helmet use or bicycle use post- versus pre-legislation. Only studies that included a concurrent control group and which reported on the effect of legislation implemented at either the country, state or province wide level were included. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed methodological quality. The data were not appropriate for meta-analysis, thus the results of the included studies have been reviewed narratively. MAIN RESULTS: Five studies, all from North America, met the inclusion criteria. For each of the studies, bicycle helmet legislation had been enacted for children only. Adults were used as controls in four of the studies, whilst jurisdictions with no helmet legislation were used as controls in the fifth. Three of the studies reported on changes in head injury rates and three reported on changes in helmet use. There were no included studies reporting change in bicycle use or other adverse consequences of legislation. In two studies, statistically significant decreases in head injuries were reported following the implementation of helmet legislation compared with controls, whilst one reported a non-statistically significant decline. Bicycle helmet use increased statistically significantly post-legislation in all three of the studies reporting on helmet use. AUTHORS' CONCLUSIONS: Bicycle helmet legislation appears to be effective in increasing helmet use and decreasing head injury rates in the populations for which it is implemented. However, there are very few high quality evaluative studies that measure these outcomes, and none that reported data on an possible declines in bicycle use. Language: en

/pdf/bicycle-helmet-legislation-for-the-uptake-of-helmet-use-and-164ei4kzod.pdf

Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries.

The primary purpose of this study was to determine the fitness variables with the highest capability for predicting hockey playing potential at the elite level as determined by entry draft selection order. We also examined the differences associated with the predictive abilities of the test components among playing positions. The secondary purpose of this study was to update the physiological profile of contemporary hockey players including positional differences. Fitness test results conducted by our laboratory at the National Hockey League Entry Draft combine were compared with draft selection order on a total of 853 players. Regression models revealed peak anaerobic power output to be important for higher draft round selection in all positions; however, the degree of importance of this measurement varied with playing position. The body index, which is a composite score of height, lean mass, and muscular development, was similarly important in all models, with differing influence by position. Removal of the goalies' data increased predictive capacity, suggesting that talent identification using physical fitness testing of this sort may be more appropriate for skating players. Standing long jump was identified as a significant predictor variable for forwards and defense and could be a useful surrogate for assessing overall hockey potential. Significant differences exist between the physiological profiles of current players based on playing position. There are also positional differences in the relative importance of anthropometric and fitness measures of off-ice hockey tests in relation to draft order. Physical fitness measures and anthropometric data are valuable in helping predict hockey playing potential. Emphasis on anthropometry should be used when comparing elite-level forwards, whereas peak anaerobic power and fatigue rate are more useful for differentiating between defense.

Relationship of physical fitness test results and hockey playing potential in elite-level ice hockey players.

Objective. Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. Methods. Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5–19 years) who were hospitalized for bicycling-related injuries from 1994–1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision , codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. Results. Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). Conclusion. This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children’s cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.

https://pediatrics.aappublications.org/content/pediatrics/110/5/e60.full.pdf

Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study.

The decline in active school transportation (AST): A systematic review of the factors related to AST and changes in school transport over time in North America.

Alison Katherine Macpherson

Papers

Variables associated with medication errors in pediatric emergency medicine.

Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries.

Relationship of physical fitness test results and hockey playing potential in elite-level ice hockey players.

Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study.

The decline in active school transportation (AST): A systematic review of the factors related to AST and changes in school transport over time in North America.