https://pedclerk.uchicago.edu/sites/pedclerk.uchicago.edu/files/uploads/Blood-2011-Neunert-4190-207%281%29.pdf

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia.

Generalized Linear Models (2nd ed.)

These guidelines have been replaced by British Guideline on the Management of Asthma. A national clinical guideline. Superseded By 2012 Revision Of 2008 Guideline: British Guideline on the Management of Asthma. Thorax 2008 May; 63(Suppl 4): 1–121.

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British guideline on the management of asthma: A national clinical guideline

Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs

OBJECTIVE: To revise the American Academy of Pediatrics practice parameter regarding the diagnosis and management of initial urinary tract infections (UTIs) in febrile infants and young children. METHODS: Analysis of the medical literature published since the last version of the guideline was supplemented by analysis of data provided by authors of recent publications. The strength of evidence supporting each recommendation and the strength of the recommendation were assessed and graded. RESULTS: Diagnosis is made on the basis of the presence of both pyuria and at least 50 000 colonies per mL of a single uropathogenic organism in an appropriately collected specimen of urine. After 7 to 14 days of antimicrobial treatment, close clinical follow-up monitoring should be maintained to permit prompt diagnosis and treatment of recurrent infections. Ultrasonography of the kidneys and bladder should be performed to detect anatomic abnormalities. Data from the most recent 6 studies do not support the use of antimicrobial prophylaxis to prevent febrile recurrent UTI in infants without vesicoureteral reflux (VUR) or with grade I to IV VUR. Therefore, a voiding cystourethrography (VCUG) is not recommended routinely after the first UTI; VCUG is indicated if renal and bladder ultrasonography reveals hydronephrosis, scarring, or other findings that would suggest either high-grade VUR or obstructive uropathy and in other atypical or complex clinical circumstances. VCUG should also be performed if there is a recurrence of a febrile UTI. The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care; variations may be appropriate. Recommendations about antimicrobial prophylaxis and implications for performance of VCUG are based on currently available evidence. As with all American Academy of Pediatrics clinical guidelines, the recommendations will be reviewed routinely and incorporate new evidence, such as data from the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) study. CONCLUSIONS: Changes in this revision include criteria for the diagnosis of UTI and recommendations for imaging.

Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.

Tele-HomeCare (THC) delivers health care at home using telephone technologies A THC service was developed as an adjunct to existing hospital and community care systems It connected healthcare providers to children and families at home, during the initial transition from hospital to home, using video-conferencing phones and remote vital signs monitors The goal was to support the transition from hospital to home, for children with subacute healthcare needs This paper reports the qualitative evaluation of THC and describes the experiences of families supported by THC A total of 16 mothers, four fathers and two adolescents from 16 families participated in a series of interviews conducted before, during and after THC The interviews focused on the impact of THC on the children, on the families, and on their overall healthcare experience Analysis of their accounts identified three subthemes: the stable child, a sense of security, and the healthcare-proficient parent These subthemes were consistent across all time points and participants Together they contributed to the overall effect of THC: the timely reunification of the family at home THC was consistently reported to be an important resource that supported children and families during the transition from hospital to home The benefits to children and families observed in this study may have also been a consequence of returning to their home environment, since THC allowed these children to be discharged home at a much earlier period However, our findings are consistent with previous reports of the benefits of THC Thus, THC is a successful method of healthcare service delivery that enables a safe return home with professional support provided remotely

Taking the call-bell home: a qualitative evaluation of Tele-HomeCare for children.

Strabismus examination by telemedicine.

Contexte : Cette etude a ete effectuee pour evaluer les liens entre le niveau de developpement (ND) et les facteurs biologiques, domestiques et socio-demographiques dans un echantillon representatif d'enfants canadiens. Methode : Les donnees transversales de deux cycles (1994-1995 et 1996-1997) de l'Enquete longitudinale nationale sur les enfants et les jeunes ont ete utilisees. Les enfants âges de 1-5 ans ont ete inclus. Un faible ND a ete defini comme inferieur au 15 e percentile pour les aptitudes de developpement moteur et social (1-3 ans) ou selon le Test d'echelle vocabulaire en image Peabody (4-5 ans). La regression logistique multiple a ete utilisee. Resultats : La proportion d'enfants souffrant d'un faible ND varie d'une region a l'autre du Canada selon le sexe et l'âge. Chez les enfants de 1 an du Cycle I, le fait d'avoir un faible poids a la naissance (RC=3,3; IC de 95 % = 2,1-5,2), d'etre un garcon (RC=1,6; IC de 95 % = 1,2-2,2) et d'avoir une mere immigree (RC=1,6; IC de 95 % = 1,1-2,2) augmentaient le risque de presenter un faible ND. Les memes resultats ont ete obtenus dans le Cycle II. Chez les enfants de 4-5 ans du Cycle II, le fait d'avoir une mere immigree (RC=5,3; IC de 95 % = 4,1-6,9) et une mere avec un faible niveau d'etudes (RC=2,8; IC de 95 % = 2,1-3,9) augmentaient le risque de presenter un faible ND. Un foyer a faible revenu etait un facteur de risque significatif de faible ND dans toutes les categories d'âge. Interpretation : Les liens forts et coherents entre le fait de vivre dans un foyer a faible revenu, d'avoir une mere faiblement scolarisee et d'avoir une mere immigree soulignent le besoin de cibler des controles et des services de developpement pour ces enfants.

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What factors are associated with poor developmental attainment in young Canadian children

Objective. There are not enough pediatric neurologists to meet the many needs of pediatric neurology patients. The Hospital for Sick Children has responded by expanding the nursing role in the pediatric neurology outpatient clinic. The objective of this study was to examine the use of a telephone nursing line in this hospital-based pediatric neurology clinic. Methods. A cross-sectional study was performed on all telephone call records collected during a 2-week study period. Each initial incoming call concerning a patient was counted as an index call. Associations between clinic type or diagnosis and length of telephone calls were assessed using the χ2 test. Results. A total of 208 index calls were received, generating a total of 597 incoming and outgoing calls. The most common clinic types were Epilepsy clinic (35.6%) and General Neurology clinic (32.7%), and the most common patient diagnoses were epilepsy (63.5%) and developmental delay (45.2%). Most patients were between the ages of 1 and 10 minutes) were strongly associated with a diagnosis of epilepsy. Conclusions. There is a high demand for the neurology nursing line in our clinic. Most telephone calls and most long telephone calls concerned patients with epilepsy. Nurses managed more than half of all telephone calls without physician assistance. Use of a nursing line can aid in the provision of care to complicated subspecialty patients. Additional strategies are needed to optimize delivery of care to high-need medical populations.

Use of a telephone nursing line in a pediatric neurology clinic: one approach to the shortage of subspecialists.

Video-conferencing and remote vital signs monitors were used to provide Tele-HomeCare (THC) to children with complex healthcare needs. This paper reports the effects of THC on the health-related qu...

Paul T. Dick

Papers

Taking the call-bell home: a qualitative evaluation of Tele-HomeCare for children.

Strabismus examination by telemedicine.

What factors are associated with poor developmental attainment in young Canadian children

Use of a telephone nursing line in a pediatric neurology clinic: one approach to the shortage of subspecialists.

An Examination of Quality of Life of Children and Parents During Their Tele-HomeCare Experience